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Doug Allan

Inside Ontario's chemotherapy scandal | Toronto Star - 0 views

www.thestar.com/...rios_chemotherapy_scandal.html

privatization drugs

shared by Doug Allan on 15 Jul 13 - No Cached
  • Claudia den Boer Grima, vice-president of cancer services for the hospital and the region, is on the other end of the line. “There is a problem with a chemo drug,” she says. “It looks like the wrong dose has been given. We don’t know how many.”
  • Peterborough Regional Health Centre, where the problem that affected all four hospitals had been discovered exactly seven days earlier.
  • It would be another seven days before she would learn that all her treatments involving this drug had been diluted by as much as 20 per cent.
  • ...31 more annotations...
  • Since the crisis, all the hospitals involved have stopped outsourcing gemcitabine and cyclophosphamide mixtures and brought it in-house, mixing their own medications.
  • Their trust would be further hit. Within two weeks, the Star reported that health-care companies are allowed to mix drugs for hospitals without federal or provincial oversight, prompting top health officials — Ontario health minister Deb Matthews and federal health minister Leona Aglukkaq — to scramble to close that regulatory grey area.
  • This week Jake Thiessen, the founding director of the University of Waterloo school of pharmacy, submitted a final report of his investigation into the issue. There has been no formal indication when it will be made public. Hospital administrators say they have been told it will be two to three weeks before they or the public see this report.
  • The Ontario College of Pharmacists has passed legislation that allows it to inspect any premises where a pharmacist works — not just licensed pharmacies.
  • All of the changes taken together would have seen Marchese Hospital Solutions still able to supply drugs as it did but subject to inspection by the college.
  • The federal government has new rules defining who can be a drug producer, adding that any facility supervised by a licensed pharmacist can do the job. The province has said that hospitals can only purchase drugs from accredited suppliers.
  • There is very little clinical evidence to indicate what might happen to a cancer patient who receives an underdose of chemotherapy.
  • At the same time, many of the more recent advances in chemotherapy have been in drugs that alleviate side effects like nausea.
  • In an oncology pharmacy, strange is not good. And on March 20, one week before Marley’s last cyclophosphamide treatment, Craig Woudsma, a 28-year-old pharmacy assistant, and a colleague at the Peterborough Regional Health Centre, had a bad feeling.
  • In this case, it was a shipment of new gemcitabine chemotherapy bags that required refrigeration, according to the label. Previous batches, from a different supplier, had not.
  • Woudsma noticed more differences. The bags from Marchese only had a total volume and concentration on the label — 4 grams of gemcitabine in 100 mL of saline — instead of the specific concentration, the amount of drug per single mL of saline, as the old bags indicated.
  • The new bag’s label did not contain enough information for him to accurately mix the patient’s dose. He needed to know the specific concentration.
  • When preparing the solution, staff at Marchese Hospital Solutions, in Mississauga, Ont., dissolved the medication into a pre-filled 100 mL bag of saline. These bags typically contain between 3 to 20 per cent more solution than 100 mL,
  • “I told the pharmacist in the area. And then it kind of went above me at that point ... They came to me saying, this is kind of a big deal; teleconferencing with the minister of health, that kind of stuff,” said recently, sitting on the front steps of his red-brick, semi-detached home in the village of Millbrook, Ont. “It’s kind of a foreign concept, to think that what we do, in our corner of the hospital, is going to get that kind of exposure.”
  • This means that the bag Woudsma was holding contained 4 grams of gemcitabine in more than 100 mL of solution. The concentration of the medication wasn’t what the label would have made him think. It was weaker than advertised.
  • People have asked Woudsma why he was able to catch a problem that went undetected at other hospitals for more than a year. Simple, he says. He had something to compare it to.
  • The company’s pharmacy workers did not remove the known overfill when mixing the medication because they thought each bag was going to a single patient
  • referred to in the industry as overfill, included to account for possible evaporation.
  • The hospital had switched that very day to a new supplier — Marchese Hospital Solutions. A bag of the old supply from Baxter CIVA was still on site.
  • Medbuy, a group purchasing company for hospitals, starting in 2008, had a contract with Baxter Central Intravenous Admixtures to provide drug-mixing services. The two drugs in question, cyclophosphamide and gemcitabine, were outsourced because they come in powder form and are tricky to mix. It takes about four hours to reconstitute them in liquid, and in that time they must be shaken every 20 minutes.
  • As that contract was about to expire, Medbuy issued a request for proposals for drug-mixing services: Baxter CIVA, which wanted its contract renewed, Quebec-based Gentes & Bolduc and Marchese all stepped forward.
  • The details of the new arrangement remain known only to Medbuy. It was founded in 1989 to get better deals for hospitals buying products like scalpels, bed pans and even some medications in bulk. The company’s 28 member hospital organizations in Ontario, New Brunswick and Prince Edward Island spent a combined $626-million on contract purchases in 2012.
  • Marita Zaffiro, president of Marchese, testified at Queen’s Park that the Medbuy contract did not indicate the hospitals wanted the labels on these drugs to cite a specific concentration. The reason she included it that way in the RFP was simply to show what could be done.
  • Sobel ran the calculations in his office. For a single patient to require a 4,000 mg dose of cyclophosphamide, on a common breast cancer treatment regime, that patient would need to be about 7 feet tall and weigh 2,200 lbs.
  • “The chance of 1,200 patients getting 4,000 mg exactly — it’s just impossible.”
  • Four Marchese pharmacists who played a role in the new contract work revealed to the Queen's Park committee in June that they had either limited or no background in oncology.
  • Marchese Hospital Solutions began as Marchese Pharmacy, a Hamilton-area community drugstore that expanded beginning in 1998 when Zaffiro became president. In 1999 the company obtained a contract to supply the Hamilton Niagara Haldimand Brant Community Care Access Centres, business they did until the contract expired in 2011, shortly before it was awarded the Medbuy contract.
  • It lost the CCAC contract in 2011, shortly before the Medbuy deal, and shed employees. Fifty-seven were either laid off or left the company during this troubled time, according to internal newsletters. But then things started looking up.
  • Zaffiro attempted to get accreditation for the site, according to her Queen’s Park testimony, approaching both the Ontario College of Pharmacists and Health Canada, neither of which took steps to regulate the fledgling business because each thought the other had jurisdiction.
  • Medbuy, Marchese and Jake Thiessen have maintained that cost was not a factor in the error. Marchese’s bid on the request for proposal came in at about a quarter of the cost of previous supplier Baxter Corporation. Bags from Marchese cost from $5.60 to $6.60; Baxter charged $21 to $34.
  • CEO David Musyj thinks about what went wrong. The problems, he says, go far beyond Marchese and Medbuy. “All of us are culpable,” he says. “We could have done some things internally that could have prevented this. We could have weighed the bags when they came in.”
  • Doug Allan on 15 Jul 13
     
    Since the crisis, all the hospitals involved have stopped outsourcing gemcitabine and cyclophosphamide mixtures and brought it in-house, mixing their own medications. This week Jake Thiessen, the founding director of the University of Waterloo school of pharmacy, submitted a final report of his investigation into the issue. There has been no formal indication when it will be made public. Four Marchese pharmacists who played a role in the new contract work revealed to the Queen's Park committee in June that they had either limited or no background in oncology."The chance of 1,200 patients getting 4,000 mg exactly - it's just impossible." Marchese lost the CCAC contract in 2011, shortly before the Medbuy deal, and shed employees. Fifty-seven were either laid off or left the company during this troubled time, according to internal newsletters. But then things started looking up. Medbuy, Marchese and Jake Thiessen have maintained that cost was not a factor in the error.
Doug Allan

It's time for BC to reconsider private drug plans for public employees | Troy Media - 0 views

www.troymedia.com/...rug-plans-for-public-employees

drugs bargaining

shared by Doug Allan on 15 Jul 13 - No Cached
  • Doug Allan on 15 Jul 13
     
    Suggests moving public sector drug plans from private insurance providers to public insurance.
Doug Allan

Shortage of personal support workers in Ontario home care feared | Ontario | News | Tor... - 1 views

www.torontosun.com/...rs-in-ontario-home-care-feared

PSW homecare

shared by Doug Allan on 02 Jul 13 - No Cached
  • She and a whole generation of PSWs like her, who look at the work as a vocation, will be retiring in droves over the next two decades. The Canadian Research Network for Care in the Community estimates that 45% of PSWs are over the age of 50 and may retire in the next 15 years.
  • “I’ve trained many, many girls over the years,” she said. “At the end of the day, they’ll look at me and say ‘I think you’re absolutely stupid. Why are you doing this when you can go into a facility and earn twice the money and you’re not running your ass off.’”
  • But already, the need for home care services is increasing. According to the Canadian Home Care Association demand for home-care services has increased across the country by 55% over the past five years. Seniors represent 70% of that demand.
  • ...4 more annotations...
  • Stewart’s concerns are echoed by one of the country’s largest not-for-profit home care providers, the Canadian Red Cross. National director of health programs Lori Holloway says any plan to make Canada’s health care system sustainable has to include a human resources plan the focuses on retention, and that includes PSWs specifically, she said.
  • Stewart says being a personal support worker is far from a path to financial security. Workers who deliver home care make between $12 and $14 an hour on average. That compared to $17 to $20 an hour working in a nursing home or $20 to $25 an hour working in a hospital. Stewart says increasingly young workers train in home care and then leave. According to a study done by Personal Support Network of Ontario, 7,000 PSWs are trained every year in Ontario, 9,000 leave the profession annually.
  • The workers depended upon to deliver that front-line care in most cases are personal support workers. But according to Service Employees International Union Healthcare president Sharleen Stewart, who represents approximately 8,000 PSWs, their work is under-appreciated and under-funded.
  • Ontario Home Care Association executive director Sue VanderBent says the disparity between PSW wages has been created by a traditional view of the sector, which have always seen it diminished or funded after other areas like nursing homes and hospitals.
  • Doug Allan on 02 Jul 13
     
    Shortage of home care PSWs claimed in this story.  
Doug Allan

SBGHC gets funding reprieve - Infomart - 0 views

www.fpinfomart.ca/...171950347

funding

shared by Doug Allan on 28 Jun 13 - No Cached
  • Doug Allan on 28 Jun 13
     
    Fight over whether South Bruce Grey Hospital is one large or several small hospitals.  This will affect funding.   More sign that funding information is leaking out to the hospitals from MOHLTC and LHINs.
Doug Allan

Wait times worrisome - Infomart - 0 views

www.fpinfomart.ca/...171949765

cuts

shared by Doug Allan on 28 Jun 13 - No Cached
  • Government funding that is falling short of the increasing demand for certain surgeries sought locally has been blamed for the mounting wait times for several procedures including knee operations, hip replacement and cataract surgeries.
  • Trenton Memorial Hospital has the dubious honour of having the longest wait times for cataract surgeries in South East Ontario. Part of the problem involved Trenton losing funding that equated to costs for roughly 150 cases, creating a dilemma for ophthalmologists who book surgeries months in advance.
  • This week, QHC board member Doug McGregor confirmed the network is struggling to "try and live within the allocated volumes."
  • ...3 more annotations...
  • "It's difficult to absorb the (cost) volumes," McGregor said about QHC offsetting the additional cost. He said ongoing funding cuts could "quite possible be a greater problem in coming years."
  • Last year, slightly more than 20,000 cataract procedures were completed in Trenton. The current wait time is 136 days, which falls below the provincial average of 142 days. The LHIN target is between 91 and 100 days. The network was funded for 219 hip (reduction of one from previous year) and 481 knee (10 less than previous year) procedures over the past year. Average wait times here, for both those procedures (hips 141 days and knees 138 days) fall below the provincial average.
  • "We are anticipating we will receive funding for about the same number of hips and knees as we had in 2012/13, but exact numbers have not been confirmed," QHC spokesperson Susan Rowe.
  • Doug Allan on 28 Jun 13
     
    Quinte Cuts -- fights over allocations of surgeries
Doug Allan

'A positive step' - Infomart - 0 views

www.fpinfomart.ca/...171951372

restructuring

shared by Doug Allan on 28 Jun 13 - No Cached
  • Unveiling a sign touting land in Niagara Falls for the site of a new south Niagara Hospital is meant to send a clear message to the Province, Mayor Jim Diodati says.
  • "This is a very clear message to the Minister of Health, to the Premier - we're ready," Diodati said just prior to joining with John and Anita Grassl to reveal the billboard-sized message board. "It's a positive step that says we're ready to move forward."
  • The unveiling has rubbed some in Niagara the wrong way. Members of Welland's Health Care Committee criticized Niagara Falls and its mayor, calling the unveiling nothing more than a political stunt. "The minister hasn't even said they are building a new hospital," said Campion, who has forwarded his concerns to Minister of Health Deb Matthews. Campion said Niagara Falls is trying to essentially force the issue, naming itself the future site.
  • Doug Allan on 28 Jun 13
     
    fights in Niagara get sharper as communities fights over hospital restructuring and where a proposed new hospital will be located
Doug Allan

South West Local Health Integration Network | Innovative Non-Emergency Transportation A... - 1 views

www.newswire.ca/...ansportation-approach-launched

EMS privatization

shared by Doug Allan on 28 Jun 13 - No Cached
  • This LHIN-wide approach, a first in the province, was developed with the collaboration and support of all hospital organizations in the South West LHIN.
  • Standards have now been developed for non-emergency transportation vehicles, including their on-board equipment and qualifications of drivers.
  • Prior to the implementation of this LHIN-wide approach to non-emergency transportation service delivery, there were no established standards to follow, and various transportation providers, including ambulances (EMS), were called upon to transport patients.
  • ...5 more annotations...
  • "This non-emergency transportation approach is precisely the type of collaborative effort that will help transform the health care system in Ontario. Standardized equipment and qualifications will lead to enhanced quality of care and safety for all the people hospitalized in the South West LHIN." - The Honourable Deb Matthews, Minister of Health and Long-Term Care
  • Their goals for this initiative were to: Develop transportation standards for vehicles and transportation staff; Create a standardized decision making guide to assist hospital staff to determine the most appropriate services based on the needs of the patient; and Educate users on the appropriate way to use Non Emergency and EMS transport services Select a common supplier to provide the service across the South West LHIN geography.
  • These service standards will also help meet infection control requirements.
  • EMS services fully support this development.
  • Neal Roberts, EMS Executive Chief, Middlesex-London Emergency Medical Services Authority and Ontario Association of Paramedic Chiefs Vice President.
  • Doug Allan on 28 Jun 13
     
    Standardized qualifications for drivers.  Response to the scandal of privatized patient transfers uncovered by CBC.  But still no legislation as promised by government. 
Doug Allan

'Innovative' change to non-urgent patient transfers - Infomart - 0 views

www.fpinfomart.ca/...171950955

EMS privatization

shared by Doug Allan on 28 Jun 13 - No Cached
  • Hospitals in southwestern Ontario have agreed to use one company for all non-urgent patient transfers.
  • Using one contractor with one set of standards will free up EMS vehicles for emergency calls while providing patients with a safe and reliable means of transportation between hospitals, according to the South West Local Health Integration Network (LHIN).
  • Voyageur Patient Transfer Service won the contract through an open RFP.
  • ...3 more annotations...
  • Minister of Health and Long-Term Care Deb Matthews called the new approach, a first in the province, an example of how health care in Ontario is transforming.
  • "Standardized equipment and qualifications will lead to enhanced quality of care and safety for all the people hospitalized in the South West LHIN," she said in a news release.
  • Non-emergency transportation is used for medically stable patients who need to be moved from one hospital to another. Examples of medically stable patients include people who are no longer critically ill and require transfer from one hospital to another for additional inpatient care or patients who need specific services such as kidney dialysis or cancer treatment associated with their current admission when other transportation options such as ambulances are not suitable.
  • Doug Allan on 28 Jun 13
     
    One, private, non-emergency transported for SW Ontario: Voyageur Patient Transfer Services.  This deal was explicitly endorsed by the Health Minister
Doug Allan

It's all booming great! ; Minister denies we're not ready for seniors population explos... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|109723|tosn|20130623|171533700

accord funding

shared by Doug Allan on 23 Jun 13 - No Cached
  • Matthews said Ottawa should play a larger role in both planning and funding health care. She was "taken aback" when Finance Minister Jim Flaherty announced they would not discuss an extension of the federal health accord with the provinces.
  • Doug Allan on 23 Jun 13
     
    Ontario Health Minister Matthews raises some concern about the Health Accord.  She said Ottawa should play a larger role in both planning and funding health care. She was "taken aback" when Finance Minister Jim Flaherty announced they would not discuss an extension of the federal health accord with the provinces
Doug Allan

Ontario hospitals: Time to move into the 21st century - The Globe and Mail - 1 views

m.theglobeandmail.com/...article12707248

funding

shared by Doug Allan on 21 Jun 13 - No Cached
  • Ontario pays for most of its hospital care using the same global budget “lump sum” approach it has used since the late 1960s. Meanwhile, the rest of the industrialized world has spent the last thirty years moving to funding models that pay hospitals based on the types and quantities of patients they treat. Forward-thinking countries are already shifting to the next generation in health care funding: paying for care that stretches beyond the walls of the hospital.
  • These sorts of issues have pushed countries like Sweden and England to move from global budgets to a per-patient funding approach that pays hospitals through fixed prices for each type of patient based on the complexity of treatment required. Per-patient funding motivates hospitals to treat each case more efficiently and to increase the number of cases they treat in order to increase their revenue.Under this approach, hospitals begin to admit more patients and discharge them more quickly. More patients are treated for the same number of beds.
  • Elsewhere, countries that have used per-patient funding for years, like the United States and England, are now wondering if it’s time to move on. Traditional hospital-focused patient funding does a good job of buying more surgeries, but it doesn't do much to address the challenge of co-ordinating care across health care providers.
  • ...2 more annotations...
  • Ontario faces a tough challenge ahead: do they expand traditional hospital-focused per-patient funding to try and reduce stubborn wait lists?
  • By introducing per-patient funding approaches that also integrate payments across hospitals, physicians and community care providers, Ontario can begin to tackle the triple challenge of access, cost and quality rather than passing the buck from one health care sector to the other.
Doug Allan

Scarborough's two hospital systems to study merger - Infomart - 0 views

www.fpinfomart.ca/...171390451

restructuring scarborough

shared by Doug Allan on 21 Jun 13 - No Cached
  • Scarborough's two hospitals have agreed to start studying a full merger.
  • The Central East Local Health Integration Network, a regional overseer expected to approve the study on Monday, ordered the hospitals in March to create an "integration plan" between TSH General and Birchmount campuses and RVHS Centenary.
  • "Right away it was like silos fell down between the two hospitals," said Lyn McDonell, a TSH board member on the committee.
  • ...9 more annotations...
  • "Everything's on the table," said TSH CEO Robert Biron, who argued Scarborough's hospitals have suffered a lack of operating and capital funds because they are split, an arrangement he called "to some degree dysfunctional."
  • The TSH board expected to hear the report of an expert panel on two proposals the LHIN said required more study, the elimination of the birthing centre at the General and a division of programs turning the Birchmount into a centre for day surgery and the General into the facility for operations requiring overnight stays.
  • "We felt strongly that merger seemed to be the (option) that had the most potential."
  • As the province forces hospitals into "a more competitive model," those in Scarborough need a way to "obtain our fair share," he said.
  • We're much better positioned if we do that together."
  • "The days of hospitals doing everything for everybody" are changing, said Dr. Robert Ting, the group's president. "We have to decide what our community needs and focus on certain areas."
  • So much enthusiasm for a merger was expressed, Warren Law, a TSH board member who is not on the ILC, cautioned colleagues the appropriate time to make the case was "down the road."
  • Biron insisted the ILC is "starting from a blank slate" and no decision to merge had been made.
  • In 2011, Dr. John Wright, the former TSH CEO, initiated study of a merger between TSH and Toronto East General Hospital in East York, but the work was shelved last year after objections from medical staffs of both hospitals, residents and the LHIN, which noted the East General was outside its jurisdiction.
  • Doug Allan on 21 Jun 13
     
    As the province forces hospitals into "a more competitive model," those in Scarborough need a way to "obtain our fair share," he said. "We're much better positioned if we do that together."
Doug Allan

Improving quality in Canada's nursing homes requires "more staff, more training" - Heal... - 3 views

healthydebate.ca/...uires-more-staff-more-training

LTC staffing

shared by Doug Allan on 20 Jun 13 - No Cached
  • According to data from Statistics Canada, staffing levels in Ontario’s nursing homes have historically been below the national average (behind only British Columbia for the lowest staffing levels in the country).
  • While Ontario legislation requires there to be a nurse on duty at all times in nursing homes, Ontario has not legislated a minimum staffing ratio – the ratio between the number of nursing home staff (nurses and non-nurses) compared to the number of patients they care for.
  • Statistics Canada data shows the average staffing ratio in Ontario nursing homes was 4 hours per resident day in 2010 (the last year for which data is available). This was 25% less than in Alberta, where nursing homes averaged 5.3 hours per resident day. (This is only a measure of the hours paid to all staff in nursing homes, not of the actual time care staff spend providing care ‘at the bedside.’)
  • ...9 more annotations...
  • Staffing levels in nursing homes are a concern not only because they are low, but they may not be increasing fast enough to meet the rising medical complexity of patients in nursing homes.
  • Data from the Canadian Institute for Health Information shows that between 2008 and 2012, the proportion of residents in Canadian nursing homes with disease diagnoses increased for every category of disease.
  • Dementia is also increasingly common among Canadian nursing home residents, with over three quarters of residents having some level of cognitive impairment. More than one in four residents suffers from severe dementia.
  • As a result, the care needs of nursing home residents have grown. In Ontario, care needs are assessed using the Method for Assigning Priority Levels (MAPLe) scoring system. The system ranges from a score of 1 (low needs) to 5 (very high needs). In 2012, 85% of new admissions from the community and 78% of admissions from hospital were in the High or Very High (MAPLe 4 and 5) clinical needs categories. Less than 1% of admissions were in the low and mild (MAPLe 1 and 2) clinical needs categories. Projections from the Ontario Long Term Care Association suggest that soon virtually all patients admitted to nursing homes will be from the two highest need categories.
  • The increasing needs of nursing home residents in Ontario has been driven in large part by the shift from letting individual nursing homes choose their residents, to having Community Care Access Centres determine who is in greatest need of long term care, says Dr Samir Sinha, lead for Ontario’s Senior Strategy
  • Ontario has begun to increase both the number and skill sets of nursing home staff, while also trying to find efficiencies to free up more staff time for direct patient care.
  • “One of the most promising initiatives to date has been Behavioral Supports Ontario (BSO),” says Sinha. The BSO initiative is province-wide, and has funded the hiring of 604 new staff (194 nurses, 272 PSWs, and 138 other health care professionals, such as social workers) with specialized skills in caring for and supporting residents with complex and challenging behaviors, such as violence.
  • Researchers and policy strategists in Alberta believe another key to improving quality in nursing homes is to engage Health Care Aides (HCA in Alberta is the rough equivalent of a PSW) as full members of the care team.
  • Carole Estabrooks, a Professor of Nursing at the University of Alberta has been researching the engagement of HCAs in quality improvement for the last several years. She believes that too often, HCAs are not treated as members of the care team. “Care Aides typically have the least amount of formal training, and as a result doctors, nurses and others too often assume they have nothing to offer,” she says. Frequently, this means they have little input into the care plans they are expected to carry out.
Doug Allan

TMH will forge ahead to separate - Infomart - 0 views

www.fpinfomart.ca/...171299019

cuts

shared by Doug Allan on 20 Jun 13 - No Cached
  • Mayor John Williams said Wednesday the city will forge ahead with an attempt to get Trenton Memorial removed from Quinte Health Care.
  • Fed up with the latest rounds of service cuts at TMH, Quinte West queued up behind a group in Prince Edward County calling themselves Patriots of our County Hospital, or POOCH, demanding local hospitals be yanked out of QHC.
  • Williams said the city will take a different tact. That means preparing a business case and presenting it to the southeast Local Health Integration Networks.
  • ...6 more annotations...
  • But officials with POOCH received bad news Tuesday when provincial Health Minister Deb Matthews let it be known the hospital in Picton would not be de-amalgamated any time soon.
  • "We were told to state our case to the LHIN," said Williams.
  • "If we can't de-amalgamate, then we want to have more control over the decision making when it comes to TMH," he said. "And were not talking about forming another advisory committee. Those clearly haven't worked in the past. The thing is we want something with some real teeth."
  • City officials and medical staff who work at the hospital say TMH is on the verge of becoming nothing more than a first aid post.
  • Since the formation of the QHC, dozens of beds have closed and staff laid off.
  • As for services the hospital has lost its ICU, obstetrics, special care beds and its laboratory.
Doug Allan

Chill wind from Ottawa blows over Queen's Park - Infomart - 0 views

www.fpinfomart.ca/...171288306

Health accord

shared by Doug Allan on 20 Jun 13 - No Cached
  • A federal firewall has just gone up between Ottawa and Queen's Park: emails ignored, letters snubbed, meetings refused.
  • The premier professes to be unfazed by the federal government's habit of rounding on - and then tuning out - Canada's biggest province. How to describe the chill wind blowing in from the nation's capital? "I wouldn't say it's actively rancorous," Wynne told me, defaulting to diplomacy mode. "It's just - there are issues we've got to work out, and there are disagreements." Federal Finance Minister Jim Flaherty is leading the charge of the smite brigade.
  • Despite getting the cold shoulder from Ottawa, Ontario is far from isolated. Next month, Wynne will chair a meeting of her fellow premiers as the province hosts the Council of the Federation in Niagara-on-the-Lake, Ont. She organized a conference call among her counterparts, last week, to forge a co-ordinated provincial stance on job training programs (whence the federal Tories are unilaterally shifting money around.)
  • ...1 more annotation...
  • Oh, and here's another issue the provinces have added to the agenda: pension reform. While Flaherty is taking a pass on pensions, the premiers may be rising to the challenge of CPP improvements.
Doug Allan

AHS to reverse controversial home care decisions - Infomart - 0 views

www.fpinfomart.ca/...171192617

homecare privatization

shared by Doug Allan on 19 Jun 13 - No Cached
  • Care providers at Abby Road Housing Co-operative, Artspace Housing Co-operative and Creekside Support Services, who had been slated to be laid off July 31, will keep their jobs.
  • Management and staffing at all three facilities had been set to pass to private, for-profit contractors as part of the province-wide reduction in homecare companies
  • "We have reversed a decision that effectively cancelled homecare contracts with three Edmonton-based supportive living cooperatives, recognizing the unique and specialized care they provide," he added.
  • ...3 more annotations...
  • Alberta Union of Provincial Employees president Guy Smith spoke in support of the reversal.
  • The Wildrose Party also spoke out in favour of the decision.
  • ?Ultimately, the decision to centralize home-care providers means less choice and less quality of care for patients who have a very personal relationship with their caregivers.
  • Doug Allan on 19 Jun 13
     
    Alberta reverses decision to turn home care work over to three (Ontario based) for-profit home care providers
Doug Allan

Doctors warn they are losing battle against superbugs | CTV News - 0 views

www.ctvnews.ca/...le-against-superbugs-1.1328388

hai

shared by Doug Allan on 18 Jun 13 - No Cached
  • Hospitals across Canada are struggling to deal with new strains of killer bacteria that have already claimed the life of one Canadian and seem to be almost impossible to treat.
  • Some reports suggest the bacteria are becoming resistant to even these strongest drugs.
  • Doctors at Brampton Civic Hospital, who are seeing a growing number of multi-drug resistant infections, have turned to “last resort” treatments that have long been avoided due to their side effects.
  • ...4 more annotations...
  • These aren’t your ordinary superbugs like C. difficile, VRE and MRSA. New strains like Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii often come from other countries.
  • there aren’t any new antibiotics in the pipeline.
  • “I don’t think we are going to be seeing anything new to treat these infections within five to 10 years,” Mulvey said.
  • More than 2,890 hospital patients in Canada are infected with superbugs at any one time, according to new research published in the journal Infection Control and Hospital Epidemiology.
  • Doug Allan on 18 Jun 13
     
    More than 2,890 hospital patients in Canada are infected with superbugs at any one time, according to new research published in the journal Infection Control and Hospital Epidemiology. In total, one in 12 adults in hospital either carried or was infected by one of the big three superbugs: C. difficile, VRE and MRSA.
Doug Allan

SOMEONE HIT DUH-LETE ; If we let Grits get away with this, playing dumb will become sta... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|152793|tosn|20130616|170981332

P3 gas plant

shared by Doug Allan on 16 Jun 13 - No Cached
  • Except the real worst-case scenario was public revelation that shortly before McGuinty quit as premier in February, his chief of staff, David Livingston, asked the secretary of cabinet (head of the civil service) how to "wipe clean the hard drives in the premier's office." Though he was apparently told to check his legal obligations to preserve documents, his e-mail was deleted, plus that of Craig MacLennan, chief of staff to two prior energy ministers.
  • And last summer someone deleted the accounts of Livingston's predecessor, Chris Morley, McGuinty's principal secretary Jamison Steeve and deputy director of policy Sean Mullin.
  • Doug Allan on 16 Jun 13
     
    Former head of Infrastructure Ontario and cabinet secretary implicated in deletion of emails, possibly including some related to gas plant P3 disaster?
Doug Allan

ALC numbers down | Local | News | Sudbury Star - 0 views

www.thesudburystar.com/...alc-numbers-down

Sudbury ALC

shared by Doug Allan on 12 Jun 13 - No Cached
  • In the year ending March 31, 2013, the percentage of ALC patients has fallen from 32.11% to 22% throughout the region.
  • That is good news, said Paquette, and reflects that services in the community have been boosted so frail elderly people are moved out of hospital more quickly.
  • The North East LHIN measured its performance on 15 indicators that show how it's doing in areas such as length of time in hospital emergency departments and wait times for joint replacement surgery.
  • ...1 more annotation...
  • More work needs to be done on the transitions of care, said Paquette, between the hospital and community care services.
Doug Allan

BBC News - Peterborough City Hospital PFI cost threat to Trust - 0 views

www.bbc.co.uk/...ngland-cambridgeshire-22811007

P3 Britain

shared by Doug Allan on 07 Jun 13 - No Cached
  • A new hospital built under a private finance initiative (PFI) is set to lose so much money it threatens the future of a health trust, it has been claimed.
  • Health watchdog Monitor has concluded Peterborough and Stamford Hospitals NHS Trust is "not financially sustainable".
  • Inspectors said the trust worked well "clinically" but would lose £38m a year under present arrangements.
  • ...2 more annotations...
  • The trust's forecasts for the next five years show a continuing deficit of £38m or more each year and a cash shortfall of at least £40m a year.
  • The Peterborough City Hospital PFI is costing £40m a year and has 31 years left to run but ending the arrangement would trigger a very substantial one-off payment, the CPT report concluded.
  • Doug Allan on 07 Jun 13
     
    Another British P3 fiasco.  The Dept. of Health has already bailed out this hospital, I believe.  
Doug Allan

McMeekin visits trendsetting Assess and Restore Unit - Infomart - 0 views

www.fpinfomart.ca/...170190736

LTC

shared by Doug Allan on 06 Jun 13 - No Cached
  • The Villa's Assess and Restore Unit started in 2007 under a different name, and, in 2009, the Hamilton-Niagara Local Health Integration Network took over funding. But the Villa project has taken the lead in returning people home healthy - instead of clogging up long term care or hospital beds at higher costs.
  • The Villa is able to offer the services of a large long term care facility to recovering patients - services they would not get if they were still in hospital.
  • "Hospitals are great for acute care," Gadsby said. "We're good for cost effectiveness - hospitals aren't."
  • ...2 more annotations...
  • The nurses also pointed out getting patients out of hospital as soon as possible means they aren't exposed to a variety of other illnesses and infections.
  • It's a model the Hamilton-Niagara Local Health Integration Network started supporting in 2009, after it had been running at the Villa for two years, and even re-created in other locations. The Villa started a "transitional" bed program in January 2007 in partnership with Hamilton hospitals - with the goal of returning more people to their own homes instead of putting them in long term care and keeping them out of the hospital. The LHIN took over funding in 2009.
  • Doug Allan on 06 Jun 13
     
    Assess and restore beds in LTC.
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