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Irene Jansen

Paul Grootendorst and Aidan Hollis. February 2011. Managing Pharmaceutical Expenditure: Overview and options for Canada. CHSRF - Research Report. - 0 views

www.chsrf.ca/...9f-47d7-8817-4056e69360b7.aspx

drugs

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Paul Grootendorst Leslie Dan Faculty of Pharmacy, and School of Public Policy and Governance, University of Toronto Aidan Hollis Department of Economics, University of Calgary
  • Pharmaceuticals are becoming an increasingly important component of healthcare in Canada, both clinically and financially.
  • Despite this sector’s growing importance, drug reimbursement policy has been in a state of flux since 2006, with the provincial governments experimenting with their own approaches.
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  • Public drug plans in Canada continue to grapple with public sector pharmaceutical drug spending growth that exceeds revenue growth. Public drug spending is expected to account for 9% of public sector healthcare expenditures in 2010 (approximately 12.1 billion dollars) (CIHI, 2010).
  • This issue persists despite the introduction over the last two decades of various drug reimbursement policies to control cost, including beneficiary cost sharing, mandatory generic drug substitution as well as prior authorization and other forms of utilization review. Other approaches are needed.
  • Furthermore, some of these policies may have unintended consequences on patient health, access to drugs for those without comprehensive drug coverage, pharmaceutical innovation, the timely market entry of generic drugs, the provision of professional pharmacy services and spending on drugs.
  • Bulk purchasing and reference pricing policy have numerous advantages for all Canadians compared to the practice of best price policies by some provinces.
Irene Jansen

Communicating the Importance of Environmental Hygiene to Healthcare Workers - 0 views

www.infectioncontroltoday.com/...ene-to-healthcare-workers.aspx

cleaning hai

shared by Irene Jansen on 23 Jan 12 - No Cached
  • The Centers for Disease Control and Prevention (CDC) recommends that environmental services personnel "pay close attention to cleaning and disinfection of high‐touch surfaces in patient‐care areas," and that hospitals must "ensure compliance by housekeeping staff with cleaning and disinfecting procedures." The challenge for infection preventionists is to continue to convey this message to environmental services managers and personnel so that variations in cleaning methods can be addressed and a better system of monitoring can be implemented.
  • The key to establishing better communication and collaboration between infection preventionists and hospital environmental services professionals, according to Phillips, is "establishing better communication is incorporating environmental services into the patient care unit team – and they are a critical member of the team."
  • Kenneley reminds infection preventionists that "Adult learners learn best by 'doing' rather than being lectured to," she says. "One of the most compelling methods to convey an educational message is to present a real-life scenario and then troubleshoot the problems as a team. Also, for adult learners many times presenting the facts goes a long way. Some of the facts from environmental studies can be used to highlight the reasons for high touch surfaces to be cleaned while linking appropriate methodologies for optimal cleaning.
Irene Jansen

Healthcare Policy, 7(1) 2011: 68-79 Population Aging and the Determinants of Healthcare Expenditures: The Case of Hospital, Medical and Pharmaceutical Care in British Columbia, 1996 to 2006 Steven Morgan and Colleen Cunningham Healthcare - 0 views

www.longwoods.com/...22525

demographics spending

shared by Irene Jansen on 23 Jan 12 - No Cached
    • Irene Jansen
      Irene Jansen on 23 Jan 12
       
      Rising hospital expenses, use of specialists threaten system; Aging population accounts for one third of increase, says UBC study Vancouver Sun Tue Aug 30 2011 Page: A4 Section: Westcoast News Byline: Matthew Robinson 
  • We found that population aging contributed less than 1% per year to spending on medical, hospital and pharmaceutical care. Moreover, changes in age-specific mortality rates actually reduced hospital expenditure by –0.3% per year. Based on forecasts through 2036, we found that the future effects of population aging on healthcare spending will continue to be small. We therefore conclude that population aging has exerted, and will continue to exert, only modest pressures on medical, hospital and pharmaceutical costs in Canada. As indicated by the specific non-demographic cost drivers computed in our study, the critical determinants of expenditure on healthcare stem from non-demographic factors over which practitioners, policy makers and patients have discretion.
  • research dating back 30 years illustrates that population aging exerts modest pressure on health system costs in Canada (Denton and Spencer 1983; Barer et al. 1987, 1995; Roos et al. 1987; Marzouk 1991; Evans et al. 2001; McGrail et al. 2001; Denton et al. 2009)
  • ...6 more annotations...
  • To shed new empirical light on this old debate, we quantified the impacts of demographic and non-demographic determinants of healthcare expenditure using data for British Columbia (BC) over the period 1996 to 2006. Using linked administrative healthcare data, we quantified the trends in and the determinants of expenditures on hospital care, physician services and pharmaceuticals. To our knowledge, this is the first time that all three of these major components of healthcare costs have been analyzed in a single Canadian study.
  • our study cohort included 3,159,900 residents in 1996 and 3,662,148 residents in 2006
  • We found that population aging in British Columbia contributed less than 1% per year to total growth of expenditures on hospital, medical and pharmaceutical care from 1996 to 2006. We also found that changes in age-specific mortality rates reduced (albeit modestly) per capita healthcare costs over time, confirming what other researchers have suggested (Fries 1980; Breyer and Felder 2006). With rigorous analysis of recent healthcare data, we can therefore confirm what studies spanning earlier decades for British Columbia, elsewhere in Canada and other comparable health systems have found: the net impact of demographic factors on major components of the healthcare system is moderate (Denton and Spencer 1983; Fuchs 1984; Barer et al. 1987, 1995; Gerdtham 1993; Evans et al. 2001; McGrail et al. 2001). Moreover, when we forecasted the effects of expected demographic changes in British Columbia through 2036, we found that the future effects of population aging on healthcare spending will continue to be modest (1% or less per year).
  • Our findings also indicated that average payment per unit of hospital care increased over the period. The increase in hospital unit costs may have been an appropriate policy response to increases in age-adjusted clinical complexity per patient remaining in care following reductions in the average length of stay
  • After taking into account population aging, the average number of days of prescription drug therapy received by British Columbia residents grew more than 5% per year during the first half of our study period and plateaued in the latter half of the period (data not shown)
  • Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future.
  • Irene Jansen on 23 Jan 12
     
    Despite popular claims about population aging and the sustainability of healthcare in Canada, demographic changes exert steady, predictable and modest forces on the cost of major components of our healthcare system. This is likely to remain true for the foreseeable future. Changes in the age-specific profile of healthcare costs, by contrast, can exert and have exerted significant pressures on health system costs. Clinicians, policy makers and patients have some discretion over the non-demographic sources of healthcare cost increases - unlike population aging. Though these results are largely confirmations of studies from past decades, it is nevertheless important to update the scientific basis for policy debates. Moreover, close attention to recent trends and cost drivers - such as the price of prescription drugs that drove pharmaceutical expenditures in the past decade - also helps to illuminate the non-demographic forces that seem most amenable to policy intervention. Ultimately, then, research of this nature is a reminder that the healthcare system is as sustainable as we want it to be.
Irene Jansen

The Sources of Attitudes on the Canadian Healthcare System - 0 views

www.chsrf.ca/...02-4c9b-be8d-3ca2b329c8d3.aspx

health policy canada us medicare

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Stuart N. Soroka, Patrick Fournier 27/09/2011
  • This report relies on statistical regression analyses of individual survey data to identify the factors that explain Canadians’ attitudes toward healthcare.
  • Women are more likely than men to consider healthcare important
  • ...6 more annotations...
  • Wealthier individuals are more supportive of privatized healthcare.
  • Atlantic residents show greater levels of support for the system and spending, while residents of Western Canada show the opposite pattern. Both Quebecers and Westerners tolerate privatization to a greater extent.
  • Exposure to the mass media affects healthcare opinions. People who watch television and read newspapers more frequently have a slightly greater tendency to name health as an important issue and to support an increase in government healthcare budgets.
  • Canadians are influenced by the actual volume of media discussion about healthcare, across elections. In years when health is more prevalent in the media, issue salience is more widespread, there is more support for healthcare spending, private hospitals are less accepted and paying to jump the queue is less endorsed.
  • Assessments of healthcare vary as a function of different types of experience with the healthcare system. Hospitalization is linked to increases in positive ratings.
  • Waiting for access to emergency room services or appointments with a doctor is associated with increasingly negative attitudes. 
Irene Jansen

Could parenting programs lead to lower health care costs in future generations? - 0 views

www.cmaj.ca/...2083.full

determinants poverty

shared by Irene Jansen on 23 Jan 12 - No Cached
  • the Commission d’accès à l’information du Québec, the Régie de l’assurance maladie du Québec and the Ministère de la santé et des services sociaux allowed Temcheff and colleagues to undertake their important longitudinal study on the association between childhood aggression and use of health care in adulthood
  • Temcheff and colleagues have been able to assemble a cohort of nearly 4000 people representing 95% of an original cohort for whom robust childhood data on aggression and linked data on use of health services were available 30 years later
  • a proportion of health service use at age 30–40 years can be predicted from childhood behaviour independently of level of education and childhood poverty
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  • a reduction in the use of a variety of health services of about 5%–25% could be achieved by a reduction in childhood agression of one standard deviation
  • the figures presented by Temcheff and colleagues must underrepresent the total possible impact of aggressive behaviour
  • The knowledge that there is a link between aggressive behaviour in childhood and health in later life is not entirely new — it has been reported in other longitudinal studies as far back as the 1990s
  • However, the study by Temcheff and colleagues is the first to attempt to quantify the consequences of this link in terms of the use of health services.
  • The biological hypothesis here is that childhood aggression is a response to a stressful environment, and that overexposure to stress during childhood patterns the stress response5 in a way that could interfere with normal physiologic processes and predispose people to lifestyles that include such risk factors as the misuse of drugs and alcohol as a means of providing short-term relief from stress.
  • The most influential environment for the development of aggressive behaviour in children is the home, where the quality of parent–child interaction plays a key role.6
  • There is good evidence that school-based programs can improve children’s behaviour,7 but the most important interventions to prevent and treat childhood behavioural problems are parenting programs.
Irene Jansen

Holiday festivities can overwhelm those with dementia | CTV News - 0 views

www.ctv.ca/...ys-festivities-dementia-111214

dementia

shared by Irene Jansen on 23 Jan 12 - No Cached
  • trouble dealing with the sensory overload
  • too much noise, overcrowding, all of this excessive stimulation is very agitating
  • Such a reaction to the social frenzy surrounding the holidays is not uncommon, says Kathy Hickman, education manager for the Alzheimer's Society of Ontario.
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  • Even seeing the halls decked for the holidays -- multicoloured strings of lights, glittering decorations and a Christmas tree -- can be anxiety triggers for a person with dementia, especially as the disease progresses and memory loss becomes more prominent.
  • "What happens is for people who have memory loss, they don't quite understand what the decorations are for sometimes," says Rubinstein.
  • "Now all of a sudden you've got this tree in the living room. And it's a tree that wasn't there yesterday ... And because it is something new and it is out of their ordinary, it can cause anxiety: How did this get here? What's next?"
  • "Memory encompasses logic, knowledge, concentration and judgment," so its progressive diminishment can lead to some unexpected behaviours.
  • "Still continue to involve the person (with dementia). Especially in the early stages, this is so important because quite often what happens is the person with dementia is quite aware of what's happening to them and still quite able to do a lot of things.
  • "And oftentimes, people around that person will start to step back from them or not include them because of the diagnosis," Hickman says. "That can be really, really difficult for the person with dementia to feel as if they're not being included and not an important part of the family in the gathering."
  • Finkbeiner's advice to others caring for a loved one with dementia is to recognize the signs that things are not going well for the person and to be prepared to alter plans.
  • Here are some tips from the Alzheimer's Society to help make the holiday period more enjoyable for everyone involved.
  • Talk to staff in advance; they usually know best what residents can handle. Make celebrations simple; it's your presence that counts. Bring a favourite book or piece of music; read and sing together. Reminisce about past holidays or events to help trigger happy memories. Don't prolong your visit if the person seems tired or distressed.
Irene Jansen

Walkom: Why the Harper funding diktat endangers medicare - thestar.com - 0 views

www.thestar.com/...ding-diktat-endangers-medicare

accord history diktat

shared by Irene Jansen on 23 Jan 12 - No Cached
  • the federal government’s new health financing ultimatum is a clear and deliberate step backward
  • it will gradually and inevitably destroy Ottawa’s ability to enforce the Canada Health Act
  • it will make it harder for provinces to forge long-term health-care strategies
  • ...9 more annotations...
  • it will remove money and jobs from health care precisely at those times when they are needed most
  • since its inauguration by the Liberals in 1968, medicare has been under attack from those who think the federal government has no business in health care.
  • By 2002, Ottawa was contributing only 18 per cent of the public cash going to medicare.
  • This is why Roy Romanow’s 2002 Royal Commission into health care recommended a boost in federal cash contributions. And it is why the federal-provincial health accord two years later was so important.
  • That accord eliminated any linkage between federal health transfers and economic growth. More important, it committed Ottawa to put more real cash into medicare.
  • Thanks to that accord, the federal government’s cash share of health-care funding has gone back up to about 25 per cent.
  • the Conservative arrangement would eventually return the country to where it was in 2002 — with Ottawa putting little into medicare and the federal government losing all ability to enforce national standards that Canadians accept as given.
  • Stage two has not yet been announced.
  • Prime Minister Stephen Harper can now tell the premiers that he’ll turn a blind eye if they try to make up this shortfall through creative solutions — even if such solutions (delisting of all but core services? user fees?) run directly counter to the letter and spirit of medicare.
Irene Jansen

Licensed and Registered Practical Nurses urge Premiers to agree on key principles to protect and strengthen public Medicare | National Union of Public and General Employees - 0 views

www.nupge.ca/...ree-key-principles-protect-and

shared by Irene Jansen on 02 Feb 12 - No Cached
  • Victoria, BC (16 Jan. 2012) – Licensed and Registered Practical Nurses (LPNs/RPNs), who are members of the National Union of Public and General Employees (NUPGE), met earlier this week in Victoria to discuss public policy, labour relations and professional practice issues.   They were joined by LPN representatives from the B.C Hospital Employees’ Union (HEU).   Three important issues discussed at the meeting included: Strategies to ensure LPNs/RPNs receive recognition and respect for the important independent role they play as members of a professional nursing team. The evolution of LPN/RPN practice and regulatory changes that impact entry to practice and scope of practice.  The ongoing negotiations between the federal, provincial and territorial governments for a new Health Accord in Canada.
  • In order to strengthen the delivery of health care in Canada, a new Health Accord must encourage health care employers to utilize all health care workers to full scope of practice, particularly Licensed and Registered Practical Nurses; this would help to improve the quality of care and to ensure the cost effective delivery services.
Irene Jansen

Hospital Bed Occupancy | BMJ - 0 views

www.bmj.com/...hospital-bed-occupancy

occupancy hospitals safety

shared by Irene Jansen on 21 Feb 12 - No Cached
  • Anthony P Morton, medical statistics/hospital safety Princess Alexandra Hospital Woolloongabba 4102 Australia
  • There is a great deal of evidence linking "overcrowding" and adverse events
  • "overcrowding" may be more important with new VRE isolates and this may make sense because this organism is capable of prolonged survival on environmental surfaces
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  • There has been considerable recent interest in bed occupancy in Australia4
  • 80% to 85% is widely, if anecdotally, quoted although the 85% level apparently arises from earlier work on queues.4
  • it is probable that the cost of lowering higher bed occupancy levels would be repaid substantially in reduced adverse event rates (the cost of treating potentially preventable adverse events is substantial)
  • We need to know the true cost of re-work in public hospitals that have become highly "efficient" and this should include costs to patients (who may require extended convalescence on welfare) and society as well as to the hospitals.
  • it seems unrealistic, at least in the foreseeable future, to be able to run a complex computer program in a busy public hospital at intervals to determine optimum bed occupancy
  • cutting bed numbers to promote "efficiency" may have unintended and perhaps unforeseen consequences
  • Now Complexity and Network Science tell us that sustainability and resilience are most important, that some redundancy is essential for resilience, and that as we become increasingly efficient we simultaneously become increasingly vulnerable to failures.
  • lowering average bed occupancy in busy public hospitals to an average of, say, 85% may still be feasible and very worthwhile.
Irene Jansen

Social Interactions, Identity and Well-Being Research Progress | CIFAR - 0 views

www.cifar.ca/d-well-being-research-progress

empowerment ltc quality culture change social cure

shared by Irene Jansen on 09 Feb 12 - No Cached
  • program members identify that a major contributor to happiness, which traditional economics ignores, is the sense of identity that comes from belonging to groups and from having control over one’s outcomes and surroundings
  • employees become more productive and satisfied when they have greater input into the design of their workspace; senior citizens adapt more effectively to moves to long-term care facilities if they maintain memberships in formal clubs or informal groups of friends
  • In long-term care facilities, changes such as aging and declining health are a threat to residents’ sense of self and well-being. A range of studies known collectively as “The Social Cure” use theory, experimentation and field trials to show how well-being can be improved simply by helping people engage with each other more. Studies of identity loss among seniors when they move from their homes to long-term care facilities found that those who remain engaged in social groups and clubs fare better. This study and others demonstrate that health care interventions that get people involved with social networks can foster new social identities that can buffer adverse effects of aging, promote recovery from heart surgery and stroke, and delay the onset of degenerative diseases.
  • ...1 more annotation...
  • A range of studies known collectively as “The Social Cure” use theory, experimentation and field trials to show how well-being can be improved simply by helping people engage with each other more.
  • Irene Jansen on 09 Feb 12
     
    Haslam, Jetten, Haslam, Knight, The Importance of Remembering and Deciding Together: Enhancing the Health and Well-Being of Older Adults in Care. in The Social Cure: Identity, Health and Well-Being. Edited by Jolanda Jetten, Catherine Haslam and S. Alexander Haslam.
Irene Jansen

Canada's Best Kept Secret Revealed. Council of Canadians. 2008 - 0 views

www.canadians.org/...health.html

medicare privatization important allies coc economic advantage

shared by Irene Jansen on 06 Mar 12 - No Cached
  • Canada’s Best Kept Secret Revealed: Public health care gives Canada an economic advantage – despite the high dollar
  • This analysis neglects an important point: As the recent United Auto Workers-General Motors collective agreement reminds us, Canadian companies don’t have to deal with the health care headaches of our neighbours – or with the costs. Indeed, the fact that Canadian companies, large and small, don’t have to offer health benefits to compete for the most talented and productive workers explains in large part why we are still largely competitive in the NAFTA era – despite our skyrocketing dollar.
Govind Rao

UNISON | Keogh Review into high hospital mortality rates | Home - 0 views

www.unison.org.uk/...4014

unison hospital mortality rates staffing

shared by Govind Rao on 17 Jul 13 - No Cached
  • Both the Francis report into the failures of care at Mid Staffs, and The Keogh Review into high hospital mortality rates, released today, highlight how important the right skills mix and sufficient numbers of staff are to providing top quality care. Having the right staff cover is increasingly important out of hours – at evenings and weekends, said the union.
  • “We are pleased that the Keogh Review, as the Francis Report before it, has recognised the relationship between quality care and safe staffing levels. UNISON has been campaigning for safe staffing levels and the right skills mix on wards for many years. This includes in the evenings and at weekends - there is clear evidence that out of hours cover isn’t safe. It is time for the government to start listening and take action by committing to minimum staffing levels. They must also listen to staff and patients who are the best barometer of an organisation.
Govind Rao

Abolishing purchaser-provider split helped New Zealand scheme to cut costs, says King's Fund | BMJ - 0 views

www.bmj.com/bmj.f5503

from heather international privatization funding

shared by Govind Rao on 13 Sep 13 - No Cached
  • Abolishing purchaser-provider split helped New Zealand scheme to cut costs, says King’s Fund
  • A pioneering integrated healthcare scheme in New Zealand has improved the care of patients while reducing demand on hospital services, a new report has concluded.
  • The King’s Fund report said that the scheme had lessened strain on the main hospital involved and increased efficiency within it—prompting fewer cancelled admissions. The proportion of elective work rose from less than 23% of activity in 2006-7 to 27% in 2011-12.
  • ...4 more annotations...
  • The report concluded, “What the Canterbury experience demonstrates is that it is possible to provide better care for patients, reduce demand on the hospital, and flatten or reduce elements of the demand curve across health and social care by improved integration—particularly around the interface between the hospital, primary care and community services.”
  • On the contracting side, the report said that the abolition of the purchaser-provider split in the health system was important as it gave boards the autonomy to decide how to fund their hospitals.
  • BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5503 (Published 12 September 2013) Cite this as: BMJ 2013;347:f5503
  • Gareth Iacobucci
  • Doug Allan on 13 Sep 13
     
    This report say that the abolition of the purchaser-provider split in the health system was important as it gave boards the autonomy to decide how to fund their hospitals
Govind Rao

Retirement Health Costs Loom As Big Concern for Boomers - EIN News - 0 views

www.einnews.com/...oom-as-big-concern-for-boomers

from heather costs ltc

shared by Govind Rao on 13 Dec 13 - No Cached
  • A national study of Canadians with more than $100,000.00 in investable assets shows that worries over health-care needs have emerged as the second most-important driver, behind retirement itself, of their investment planning. Among investors under 50, 34% identify health care as a priority compared to the average of 46% of all respondents, but even among this younger group, health care needs emerge as a significant rationale for investments. Even among respondents with $1 million+ in investable assets, 41% identify "health-care needs" as an important investment objective.
  • Dec. 11, 2013
Govind Rao

How far along are we in making hospitals more 'senior friendly'? - Healthy Debate - 0 views

healthydebate.ca/...senior-friendly-hospitals

from heather hospital seniors ontario Alberta

shared by Govind Rao on 10 Apr 14 - No Cached
  • by Karen Born, Verna Yiu & Mike Tierney
  • April 10, 2014
  • Being hospitalized can have dramatic impacts on seniors’ wellness, and time spent in hospital contributes to loss of important functions such as strength and mobility – critical to their independence and wellbeing. Camilla Wong, a geriatrician at St. Michael’s Hospital in Toronto says “hospitalization robs us of the things that are really important for older people.”
  • ...1 more annotation...
  • There are efforts underway across Ontario and Alberta to make hospitals more ‘senior friendly’ and to better tailor care to the needs of patients like Margaret and Jim. This article will highlight that there is still considerable variation in the extent of these programs in both provinces. Many of these programs remain pilot or trial interventions, and questions remain about how they will be translated into province-wide efforts to improve hospital care for seniors.
Govind Rao

Friends of Medicare - Promoting and protection public health care in Alberta - 0 views

www.friendsofmedicare.org/default.asp

from heather coalition Alberta

shared by Govind Rao on 10 Jun 14 - No Cached
  • Friday, June 06, 2014 NOW YOU SEE HIM, NOW YOU DON''T: PRENTICE DISAPPEARS FROM BOARD OF HOLDINGS COMPANY THAT OWNS $4,495-a-YEAR CONCIERGE CLINIC @import url(../CSS/Default_RTE_Styles.css); @import url(../CSS/Default_RTE_Styles.css); Premier-to-be must level with Albertans about his personal financial interest in elitist private health care  
Govind Rao

Harper Government Highlights the Importance Between Strong Financial Management and Good Health - 0 views

www.fin.gc.ca/14-071-eng.asp

from heather federal government determinants

shared by Govind Rao on 16 May 14 - No Cached
  • May 16, 2014
  • This year, students are learning about the important link between financial health and physical health.
Govind Rao

Treating patients in the comfort of their homes; Community-care nurses help people heal faster at less cost and with a sense of control - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|tost|20150509|220134672

from heather home care

shared by Govind Rao on 11 May 15 - No Cached
  • Toronto Star Sat May 9 2015
  • Roushad Omar-Ali is relaxing on his comfy sectional watching a cooking show as the doorbell rings and Lesley Rodway lets herself in. "How are you feeling today?" the registered nurse asks cheerily as she studies the chart with his health data. "She's pretty good at what she does," Omar-Ali offers when Rodway disappears to set up his dialysis machine in the bedroom. The Ajax resident has had his share of hospital stays for a stroke, a bad fall and a pacemaker implant. And there's no doubt where he'd rather be for his daily dialysis treatment.
  • The good thing about this is you get to hook yourself up whenever you want," he says. "At the hospital, you sit there and wait and wait whereas at home, as soon as it's done, I disconnect myself." It's thanks to nurses like Rodway that Omar-Ali can be treated in the comfort and convenience of his own home. Arranged through Community Care Access Centres (CCAC), government-funded visits by registered nurses and registered practical nurses provide a range of services including post-surgical, wound and palliative care, IV antibiotics, dressing changes and cancer treatment. (University-educated RNs care for patients with more complex needs while RPNs, who have attended community college, take on less complex cases.) "Patients don't really want to be in hospital," says Dianne Martin, executive director of the Registered Practical Nurses' Association of Ontario (RPNAO). "At home it feels good, they feel in control and more like they're in the driver's seat." They tend to heal faster and are safer from infections, Martin adds. It is also far cheaper to treat someone at home: an average of $42 per visit compared to $842 per day for a hospital bed.
  • ...3 more annotations...
  • And the cooking's good here," jokes Donna Fox as Rodway stops in at the well-kept bungalow she shares with Bob, her husband of 62 years. Rodway, who's worked for ParaMed Home Health Care for 17 years, manages his symptoms and keeps him comfortable during his terminal illness. "It's very important because I couldn't exist without someone looking after me," Bob, a former marathon runner, says from the raised bed where he watches sports on TV or the awakening of spring outside his window. Suzanne, a Whitby breast cancer patient, credits a home-care nurse for possibly saving her life by sending her to hospital for a swollen hand caused by a blood clot. Now she gets shots of blood thinner at home.
  • "You're near the end, that's awesome," Rodway tells her after administering the day's needle, the 90th in a series of 100 prescribed injections. "You've been a trooper," she adds as Suzanne says, through tears, that her last chemo treatment is just days away. "There are many times I've cried with a client," Rodway says later. "People are appreciative because you're helping them feel better." Rodway, a mother of two young children, sees five or six patients a day in Whitby and Ajax. She says working 25 or 30 hours a week gives her a good balance of career, volunteer work and home life. "I get a lot of satisfaction." For RPN Max Hamlyn, it's all about the personal touch. "You've got the ability to spend time with the person and develop a closer bond," unlike hospitals where staff are too rushed, he says. "It's more than just running in and changing a dressing. I'll ask, 'How are you doing, are you eating OK?' And I say, 'What's the most important thing I can do for you today?' "
  • Hamlyn, who works in Ottawa for the government branch of Bayshore Home Health, covers up to 100 kilometres a day, seeing eight to 10 patients in private homes, retirement residences, detention centres and halfway houses. After 38 years in the profession - doing community care for the last 13 - he maintains "people do much better in their home" than in hospital. "I love it. I think home care is an amazing place for RPNs to work," says Hamlyn, whose youngest client is 23 and oldest, 102. He recalls the year he spent caring for a woman with colon cancer, meeting all her children and grandchildren and always staying for coffee and cake. "You become part of the family," Hamlyn says of many of his clients. "I get along really well with my people. I have a lot of fun with them - we laugh, we joke. They're such lovely people."
Govind Rao

Ontario hospitals unprepared for aging population - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150423|219020120

from heather Ontario hospital ageing seniors

shared by Govind Rao on 23 Apr 15 - No Cached
  • Toronto Star Thu Apr 23 2015
  • With the provincial government set to table its budget today, much of the public discussion to date has focused on the future of alcohol sales and power generation in the province. While these issues are important, we must not lose sight of other priorities - particularly how best to care for our aging population. While Ontario hospitals have not received an inflationary funding increase over the last three years, the province's 149 public hospitals have been working very hard to adapt to meet the needs of patients. Hospitals have worked hard to help the government meet its financial objectives by improving operating efficiencies and reducing costs while also enhancing patient care. Over the past decade, Ontario hospitals have become the most efficient in Canada. Despite serving a record number of patients, wait times have gone down and more people are getting the care they need faster in areas such as cancer surgery, cardiac procedures, cataract surgery, and hip and knee replacement. And they're doing so with the fewest hospital beds, per citizen, of any Canadian province.
  • However, hospital leaders are now facing some very challenging budget decisions to contain costs and meet the ever-increasing service needs of Ontarians.
  • ...6 more annotations...
  • When we established our universal health care system more than 50 years ago, the average Ontarian was 27 years of age and less likely to be living with chronic and complex health issues. In contrast, 60 per cent of our total hospital days last year were amongst older Ontarians, particularly those living with multiple health issues, and with minimal social supports.
  • When these patients end up in hospitals, it becomes a particular challenge to get them back in their own homes. In fact, more than 14 per cent of Ontario's hospital beds are currently occupied by patients like these who cannot be discharged because we don't have the right types of services available in the community. By having to stay in hospital, these patients aren't getting the kind of care that they should. And by remaining in hospital, the cost of their care and cost to their overall health is much higher than it actually needs to be. The majority of these patients are waiting for less costly at-home care services through home and community care agencies, or care in more supervised or assisted living environments, such as nursing homes. We also know that too many older Ontarians are still sent to nursing homes when there isn't enough home care, which is less expensive, available. With these growing pressures coming to a head, now is the time to act and make sure that our province can continue to provide the high-quality care that Ontarians want, need and deserve.
  • It is time to invest aggressively in home and community care, nursing home and assisted living services, and other vital areas so that patients can stay healthy and independent in their communities for as long as possible and when hospitalized, be discharged quickly and safely to get quality care in their community.
  • We need to identify the right mix of services to ensure all Ontarians can get the right kinds of care where and when they need it. That means knowing the right number of beds needed in hospitals or long-term care homes, as well as the number of assisted living spaces, home care hours, and primary care and mental health services required to meet the needs of our aging population. Given the exploding need for different kinds of services, it also means we need to be innovative by creating new models of care.
  • While the government has recently acknowledged the importance of robust health-service capacity planning, neither we nor any other Canadian jurisdiction currently has such a plan. This is worrisome because what we do know with absolute certainty is that the number of older Ontarians will double over the next two decades. With service demands growing rapidly at the same time that the system moves to further contain cost growth, we owe it to patients and clients to meet their changing health care needs not only for today but for the decades still to come.
  • Ontario needs clear-eyed and effective long-term planning to ensure its health care system has the ability meet the evolving health care needs of Ontarians. Until we know exactly what services the people of Ontario need, our system won't have the long-term plan required to meet them. Dr. Samir Sinha is director of geriatrics at Mount Sinai and the University Health Network Hospitals and provincial lead of Ontario's Seniors Strategy. Anthony Dale is president and CEO of the Ontario Hospital Association.
Govind Rao

Time to speak up on health services - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|brrt|20150520|220833984

from heather Ontario coalition campaign cuts

shared by Govind Rao on 20 May 15 - No Cached
  • Brockville Recorder and Times Wed May 20 2015
  • Since fears for the future of Brockville General Hospital's maternity ward became public in February, there has been a consistent chorus of voices calling on the public to "speak up" for local health care. Now, with three consecutive meetings dedicated to the future of local or regional health services, local residents cannot argue they did not have a chance to be heard. There has been plenty of speaking up already, in the form of social media advocacy and a rally in front of BGH by the Canadian Union of Public Employees (CUPE) in April.
  • If it's more advocacy-driven events one seeks, there is always the Ontario Health Coalition's "Public Meeting to Save Our Hospital Services," scheduled for Thursday, May 28, at 7 p.m. at the Brockville Convention Centre. However, it would be wrong to underestimate the importance of the public meetings organized by local health care institutions. On Tuesday, the South East Local Health Integration Network (LHIN) held a public open house seeking input on the future of regional health services. The event drew many people already involved with BGH and its operations, in particular hospital board members, as well as members of the broader general public. Not counting those already in the sector, organizers say, the four-hour event drew 38 people. Their input will contribute toward the development of a health care plan for the broader region of Southeastern Ontario.
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  • It would have been more productive, however, had more members of the general public attended. People who did not attend can still answer a survey online, through May 29, at www.surveymonkey.com/s/healthcaretomorrow. BGH officials at the event were eager to remind people that another open house, this one specific to the future of the local hospital, is scheduled for Tuesday, June 2, from 5 p.m. to 8 p.m. at the 1000 Islands Mall. The June 2 meeting will give the public a chance to hear directly from BGH officials about the challenges the hospital faces as it tries to address a $1.9-million shortfall. BGH officials have pledged to listen to the public on how it will deal with that shortfall. They have also promised that, while service delivery may be changed as efficiencies are sought, the services themselves will not be reduced. This is an important opportunity -one of many, we hope -to show them the public is watching. This is not a meeting to skip. @RipNTearRon on Twitter
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