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Irene Jansen

CUPE to talk to health board about need to fully utilize nurses < Health care, Saskatchewan | CUPE - 0 views

cupe.ca/...lk-health-board-utilize-nurses

sk lpn utilization

shared by Irene Jansen on 12 Apr 12 - No Cached
  • CUPE’s report, Full Utilization of LPNs: A practical solution to the nursing shortage&nbsp;was sent to the health region board last month.
  • Although licensed practical nurses have the knowledge and skills to perform an array of nursing duties, CUPE 4777 President Carol McKnight says many still are not allowed to work to their full scope of training.
  • CUPE 4777 President Carol McKnight described the situation as a “terrible waste of nursing skills and talent.”&nbsp; The union’s recommendations to resolve the problem include: The development of a clear policyto enable LPNs to work to their full scope of practice across the health region.&nbsp; The policy should include a complaint/resolution process so that LPNs or supervisors can challenge an assignment of duties that violates the policy The Health Region foster a culture of respect and team work among all nursing groups The Health Region establish benchmarks in each facility to measure progress towards the goal of full utilization of LPNs
Irene Jansen

Home care nursing health human resources NHSRU Dec 2011 - 0 views

www.nhsru.com/...ng-a-quality-nursing-workforce

home care nursing utilization

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Determine how decisions, on the utilization and allocation of Registered Nurses (RNs) and Registered Practical Nurses (RPNs), are currently being made in Ontario home care provider agencies; investigate the feasibility of, and provide input into, the development of an RN/RPN utilization Toolkit for the home care sector.
  • Compile a detailed demographic profile of nurses working in the home care sector and identify areas of concern/strength related to current trends in the home care nursing workforce.
  • Evaluate the unique challenges of attracting and retaining early, mid and late career nurses to the home care sector and describe factors or policy initiatives that may be instrumental in attracting new graduates to community nursing as an employment choice.
  • Irene Jansen on 23 Jan 12
     
    Research Team Diane Doran, RN, PhD, FCAHS Dan Laporte, Research Manager, NHSRU Sang Nahm, Data Analyst, NHSRU Laureen Hayes, Research Officer, NHSRU Roshan Khan, Research Officer, NHSRU
Irene Jansen

Medecins Québécois pour un Regime Public. Two-Tier Radiology: Quebec's Creeping Public-Private System. 2012 Annual Report. - 2 views

www.mqrp.qc.ca

doctors quebec coalition ally private clinics

shared by Irene Jansen on 19 Nov 12 - No Cached
  • Irene Jansen on 19 Nov 12
     
    Our 2012 annual report is now available in English The report shows: "While it has more material and human resources, Quebec is less effective than Canada as a whole in providing accessible medical imaging services. The exclusion from public coverage of CAT scan, MRI and ultrasound tests performed outside a hospital leads to joint public-private practice that has the effect of draining resources from the public to the private sector. This damaging distortion leads to problems of access to medical imaging for most patients…"  The report documents the inequitable, inefficient, costly and potentially unsafe utilization of medical imaging technology in Quebec's unique and highly privatized system.  One aspect, the relatively effective use of technology in hospitals compared to private clinics (which would be better yet if the system were entirely public), is clearly not limited to Quebec: "According to a 2008 study by Bercovici and Bell of public hospitals and private clinics offering MRIs in several provinces, including Quebec, the rate of use of machines is about 50% higher in hospitals than in private clinics: an average of 14.7 hours of operation per day during the week and 11.8 hours per day on weekends for hospital machines, compared to 9.7 hours per day during the week and 8.2 hours per day on weekends for machines in clinics." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645224/ The recommendations are also valuable information. 
Irene Jansen

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review - 1 views

www.plosmedicine.org/...10.1371%2Fjournal.pmed.1001244

privatization quality costs excellent

shared by Irene Jansen on 31 Mar 13 - No Cached
  • Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector
  • Irene Jansen on 31 Mar 13
     
    Summary by Anna Marriott, Oxfam Access and responsiveness * Studies that measured utilization by income levels tended to find the private sector predominately serves the more affluent. In Colombo, Sri Lanka, where a universal public health service exists, the private sector provided 72% of childhood immunisations for the wealthiest, but only 3% for the poorest. * Waiting times are consistently reported to be shorter in private facilities and a number of studies found better hospitality, cleanliness and courtesy and availability of staff in the private sector. Quality * Available studies find diagnostic accuracy, adherence to medical management standards and prescription practices are worse in the private sector. * Prescribing subtherapeutic doses, failure to provide oral rehydration salts, and prescribing of unnecessary antibiotics were more likely in the private sector, although there were exceptions. * Higher rates of potentially unnecessary procedures, particularly C-sections, were reported at private facilities. In South Africa for example, 62% of women delivering in the private sector had C-sections, compared with 18% in the public sector. * Two country studies found a lack of drug availability and service provision at public facilities, while surveys of patients' perceptions on care quality in the public and private sector provided mixed results. Patient outcomes * Public sector provision was associated with higher rates of treatment success for tuberculosis and HIV as well as vaccination. In South Korea for example, TB treatment success rates were 52% in private and 80% in public clinics. Similar figures were found for HIV treatment in Botswana. Accountability, transparency and regulation * While national statistics collected from public sector clinics vary considerably in quality, private healthcare systems tended to lack published data on outcomes altogether. Public-private partnerships also lacked data. * Several reports ob
Irene Jansen

Provincial panel to shine a spotlight on the role of the RPN | RPNAO - 1 views

www.rpnao.org/...panel-shine-spotlight-role-rpn

from heather Ontario pn scope utilization

shared by Irene Jansen on 16 Apr 13 - No Cached
  • The Registered Practical Nurses Association of Ontario (RPNAO) is pleased to announce the launch of a new provincial project titled: ‘It’s All about Synergies: Understanding the Role of the RPN in Ontario’s Health Care System’.
  • This research and consultation project, which is expected to be completed by December, 2013
  • In addition to producing a final report outlining the findings, the working panel will also lead the development of a set of resources that nurses, nurse employers and educators will be able to utilize to help enhance their understanding of the scope and appropriate engagement of the RPN role in Ontario’s health care system
Irene Jansen

Threat to Health care is a Myth - 0 views

www.straightgoods.ca/...ViewArticle.cfm

sustainability

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    http://www.troymedia.com/2011/09/21/grey-tsunami-threatening-health-care-is-a-myth/# VANCOUVER, September 21, 2011/Troy Media/ - You've heard it before: the boomers are aging and jeopardizing our health care system by the sheer number of them swanning into their golden years. Sounds right - except it isn't true. Let's check the evidence: the older you are, the more likely you are to use health care services. This is a fact, but it does not necessarily follow that the coming bulge of boomers will bankrupt the health care system. Study after study in Canada over the last 30 years shows that aging is an issue, but it exerts only a small and predictable pressure on health care spending (less than one percent annually from 2010 to 2036). More recent research shows that increases in utilization - how many and how often Canadians use health services - are twice as important as aging in increasing costs year by year. In other words, while population aging does increase costs, the kinds and amount of services provided to people in every age group are a far more important factor. How and why are these changes occurring?
Irene Jansen

Is the BCNU really serious about the "Manitoba Model?" | Hospital Employees' Union Sept 8 2011 - 0 views

www.heu.org/...y-serious-about-manitoba-model

nursing utilization bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • But it's unlikely that the BCNU's RN membership would embrace the Manitoba model. That's because top of scale hospital-based RNs earn $3.85 an hour less in Manitoba than their counterparts in B.C.
  • There's just no way that RNs in B.C. would allow their wages to stagnate or be rolled back in order to close the wage gap between RNs and LPNs. Instead, HEU has looked to Alberta as an example for moving our independent profession forward.
  • Alberta has introduced curriculum changes and a restricted activities model that provides LPNs with more independence and expanded utilization. The result? Alberta's LPNs have significantly higher wages than either Manitoba or B.C.
Irene Jansen

Resources for LPNs | Hospital Employees' Union Oct 2011 - 0 views

www.heu.org/...licensed-practical-nurses

nursing utilization bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • HEALTH CARE IS CHANGING.
  • Across North America, LPNs are taking on new roles and responsibilities as part of a modern nursing care team where every member is utilized to their full scope of practice.
  • In June, HEU brought together 60 LPN leaders for a consultation on the evolution of LPN practice in B.C.
  • ...3 more annotations...
  • In June 2011, HEU brought together 60 LPN leaders for a consultation on the evolution of LPN practice in B.C.
  • Coming out of that conference, the union issued a report entitled Making OUR profession stronger
  • During National Nursing Week in May, HEU distributed a discussion paper to LPNs entitled Taking our place in modern nursing care
  • Irene Jansen on 23 Jan 12
     
    Includes "Making Our Profession stronger" and "Taking our place in modern nursing care"
Irene Jansen

Senate Social Affairs Committee review of the health accord, Evidence, September 29, 2011 - 0 views

www.parl.gc.ca/...49055-e.htm

accord waits senate

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Christine Power, Chair, Board of Directors, Association of Canadian Academic Healthcare Organizations
  • eight policy challenges that can be grouped across the headers of community-based and primary health care, health system capacity building and research and applied health system innovation
  • Given that we are seven plus years into the 2004 health accord, we believe it is time to open a dialogue on what a 2014 health accord might look like. Noting the recent comments by the Prime Minister and Minister of Health, how can we improve accountability in overall system performance in terms of value for money?
  • ...97 more annotations...
  • While the access agenda has been the central focal point of the 2004 health accord, it is time to have the 2014 health accord focus on quality, of which access is one important dimension, with the others being effectiveness, safety, efficiency, appropriateness, provider competence and acceptability.
  • we also propose three specific funds that are strategically focused in areas that can contribute to improved access and wait time
  • Can the 2014 health accord act as a catalyst to ensure appropriate post-hospital supportive and preventive care strategies, facilitate integration of primary health care with the rest of the health care system and enable innovative approaches to health care delivery? Is there an opportunity to move forward with new models of primary health care that focus on personal accountability for health, encouraging citizens to work in partnership with their primary care providers and thereby alleviating some of the stress on emergency departments?
  • one in five hospital beds are being occupied by those who do not require hospital care — these are known as alternative level of care patients, or ALC patients
  • the creation of an issue-specific strategically targeted fund designed to move beyond pilot projects and accelerate the creation of primary health care teams — for example, team-based primary health care funds could be established — and the creation of an infrastructure fund, which we call a community-based health infrastructure fund to assist in the development of post-hospital care capacity, coupled with tax policies designed to defray expenses associated with home care
  • consider establishing a national health innovation fund, of which one of its stated objectives would be to promote the sharing of applied health system innovations across the country with the goal of improving the delivery of quality health services. This concept would be closely aligned with the work of the Canadian Institutes of Health Research in developing a strategy on patient oriented research.
  • focus the discussion on what is needed to ensure that Canada is a high performing system with an unshakable focus on quality
  • of the Wait Time Alliance
  • Dr.&nbsp;Simpson
  • the commitment of governments to improve timely access to care is far from being fulfilled. Canadians are still waiting too long to access necessary medical care.
  • Table 1 of our 2011 report card shows how provinces have performed in addressing wait times in the 10-year plan's five priority areas. Of note is the fact that we found no overall change in letter grades this year over last.
  • We believe that addressing the gap in long-term care is the single more important action that could be taken to improve timely access to specialty care for Canadians.
  • The WTA has developed benchmarks and targets for an additional seven specialties and uses them to grade progress.
  • the lack of attention given to timely access to care beyond the initial five priority areas
  • all indications are that wait times for most specialty areas beyond the five priority areas are well beyond the WTA benchmarks
  • we are somewhat encouraged by the progress towards standardized measuring and public reporting on wait times
  • how the wait times agenda could be supported by a new health accord
  • governments must improve timely access to care beyond the initial five priority areas, as a start, by adopting benchmarks for all areas of specialty care
  • look at the total wait time experience
  • The measurements we use now do not include the time it takes to see a family physician
  • a patient charter with access commitments
  • Efficiency strategies, such as the use of referral guidelines and computerized clinical support systems, can contribute significantly to improving access
  • In Ontario, for example, ALC patients occupy one in six hospital beds
  • Our biggest fear is government complacency in the mistaken belief that wait times in Canada largely have been addressed. It is time for our country to catch up to the other OECD countries with universal, publicly funded health care systems that have much timelier access to medical care than we do.
  • The progress that has been made varies by province and by region within provinces.
  • Dr. Michael Schull, Senior Scientist, Institute for Clinical Evaluative Sciences
  • Many provinces in Canada, and Ontario in particular, have made progress since the 2004 health accord following large investments in health system performance that targeted the following: linking more people with family doctors; organizational changes in primary care, such as the creation of inter-professional teams and important changes to remuneration models for physicians, for example, having a roster of patients; access to select key procedures like total hip replacement and better access to diagnostic tests like computer tomography. As well, we have seen progress in reducing waiting times in emergency departments in some jurisdictions in Canada and improving access to community-based alternatives like home care for seniors in place of long-term care. These have been achieved through new investments such as pay for performance incentives and policy change. They have had some important successes, but the work is incomplete.
  • Examples of the ongoing challenges that we face include substantial proportions of the population who do not have easy access to a family doctor when needed, even if they have a family doctor; little progress on improving rates of eligible patients receiving important preventive care measures such as pap smears and mammograms; continued high utilization of emergency departments and walk-in clinics compared to other countries; long waits, which remain a problem for many types of care. For example, in emergency departments, long waits have been shown to result in poor patient experience and increased risk of adverse outcomes, including deaths.
  • Another example is unclear accountability and antiquated mechanisms to ensure smooth transitions in care between providers and provider organizations. An example of a care transition problem is the frequent lack of adequate follow-up with a family doctor or a specialist after an emergency department visit because of exacerbation of a chronic disease.
  • A similar problem exists following discharge from hospital.
  • Poorly integrated and coordinated care leads to readmission to hospital
  • This happens despite having tools to predict which patients are at higher risk and could benefit from more intensive follow-up.
  • Perverse incentives and disincentives exist, such as no adjustment in primary care remuneration to care for the sickest patients, thereby disincenting doctors to roster patients with chronic illnesses.
  • Critical reforms needed to achieve health system integration include governance, information enablers and incentives.
  • we need an engaged federal government investing in the development and implementation of a national health system integration agenda
  • complete absence of any mention of Canada as a place where innovative health system reform was happening
  • Dr. Brian Postl, Dean of Medicine, University of Manitoba, as an individual
  • the five key areas of interest were hips and knees, radiology, cancer care, cataracts and cardiac
  • no one is quite sure where those five areas came from
  • There was no scientific base or evidence to support any of the benchmarks that were put in place.
  • I think there is much less than meets the eye when we talk about what appropriate benchmarks are.
  • The one issue that was added was hip fractures in the process, not just hip and knee replacement.
  • in some areas, when wait-lists were centralized and grasped systematically, the list was reduced by 30 per cent by the act of going through it with any rigour
  • When we started, wait-lists were used by most physicians as evidence that they were best of breed
  • That continues, not in all areas, but in many areas, to be a key issue.
  • The capacity of physicians to give up waiting lists into more of a pool was difficult because they saw it very much, understandably, as their future income.
  • There were almost no efforts in the country at the time to use basic queuing theory
  • We made a series of recommendations, including much more work on the research about benchmarks. Can we actually define a legitimate benchmark where, if missed, the evidence would be that morbidity or mortality is increasing? There remains very little work done in that area, and that becomes a major problem in moving forward into other benchmarks.
  • the whole process needed to be much more multidisciplinary in its focus and nature, much more team-based
  • the issue of appropriateness
  • Some research suggests the number of cataracts being performed in some jurisdictions is way beyond what would be expected to be needed
  • the accord did a very good job with what we do, but a much poorer job around how we do it
  • Most importantly, the use of single lists is needed. This is still not in place in most jurisdictions.
  • the accord has bought a large amount of volume and a little bit of change. I think any future accords need to lever any purchase of volume or anything else with some capacity to purchase change.
  • We have seen volumes increase substantially across all provinces, without major detriment to other surgical or health care areas. I think it is a mediocre performance. Volume has increased, but we have not changed how we do business very much. I think that has to be the focus of any future change.
  • with the last accord. Monies have gone into provinces and there has not really been accountability. Has it made a difference? We have not always been able to tell that.
  • There is no doubt that the 2004-14 health accord has had a positive influence on health care delivery across the country. It has not been an unqualified success, but nonetheless a positive force.
  • It is at these transition points, between the emergency room and being admitted to hospital or back to the family physician, where the efficiencies are lost and where the expectations are not met. That is where medical errors are generated. The target for improvement is at these transitions of care.
  • I am not saying to turn off the tap.
  • the government has announced, for example, a 6 per cent increase over the next two or three years. Is that a sufficient financial framework to deal with?
  • Canada currently spends about the same amount as OECD countries
  • All of those countries are increasing their spending annually above inflation, and Canada will have to continue to do that.
  • Many of our physicians are saying these five are not the most important anymore.
  • they are not our top five priority areas anymore and frankly never were
  • this group of surgeons became wealthy in a short period of time because of the $5.5&nbsp;billion being spent, and the envy that caused in every other surgical group escalated the costs of paying physicians because they all went back to the market saying, "You have left us out," and that became the focus of negotiation and the next fee settlements across the country. It was an unintended consequence but a very real one.
  • if the focus were to shift more towards system integration and accountability, I believe we are not going to lose the focus on wait times. We have seen in some jurisdictions, like Ontario, that the attention to wait times has gone beyond those top five.
  • people in hospital beds who do not need to be there, because a hospital bed is so expensive compared to the alternatives
  • There has been a huge infusion of funds and nursing home beds in Ontario, Nova Scotia and many places.
  • Ontario is leading the way here with their home first program
  • There is a need for some nursing home beds, but I think our attention needs to switch to the community resources
  • they wind up coming to the emergency room for lack of anywhere else to go. We then admit them to hospital to get the test faster. The weekend goes by, and they are in bed. No one is getting them up because the physiotherapists are not working on the weekend. Before you know it, this person who is just functioning on the edge is now institutionalized. We have done this to them. Then they get C. difficile and, before you know, it is a one-way trip and they become ALC.
  • I was on the Kirby committee when we studied the health care system, and Canadians were not nearly as open to changes at that time as I think they are in 2011.
  • there is no accountability in terms of the long-term care home to take those patients in with any sort of performance metric
  • We are not all working on the same team
  • One thing I heard on the Aging Committee was that we should really have in place something like the Veterans Independence Program
  • some people just need someone to make a meal or, as someone mentioned earlier, shovel the driveway or mow the lawn, housekeeping types of things
  • I think the risks of trying to tie every change into innovation, if we know the change needs to happen — and there is lots of evidence to support it — it stops being an innovation at that point and it really is a change. The more we pretend everything is an innovation, the more we start pilot projects we test in one or two places and they stay as pilot projects.
  • the PATH program. It is meant to be palliative and therapeutic harmonization
  • has been wildly successful and has cut down incredibly on lengths of stay and inappropriate care
  • Where you see patient safety issues come to bear is often in transition points
  • When you are not patient focused, you are moving patients as entities, not as patients, between units, between activities or between functions. If we focus on the patient in that movement, in that journey they have through the health system, patient safety starts improving very dramatically.
  • If you require a lot of home care that is where the gap is
  • in terms of emergency room wait times, Quebec is certainly among the worst
  • Ontario has been quite successful over the past few years in terms of emergency wait times. Ontario’s target is that, on average, 90 per cent of patients with serious problems spend a maximum of eight hours in the emergency room.
  • One of the real opportunities, building up to the accord, are for governments to define the six or ten or twelve questions they want answered, and then ensure that research is done so that when we head into an accord, there is evidence to support potential change, that we actually have some ideas of what will work in moving forward future changes.
  • We are all trained in silos and then expected to work together after we are done training. We are now starting to train them together too.
  • The physician does not work for you. The physician does not work for the health system. The physician is a private practitioner who bills directly to the health care system. He does not work for the CEO of the hospital or for the local health region. Therefore, your control and the levers you have with that individual are limited.
  • the customer is always right, the person who is getting the health care
  • It is refreshing to hear something other than the usual "we need more money, we absolutely need more money for that". Without denying the fact that, since the population and the demographics are going to require it, we have to continue making significant investments in health, I think we have to be realistic and come up with new ways of doing things.
  • The cuts in the 1990s certainly had something to do with the decision to cut support staff because they were not a priority and cuts had to be made. I think we now know it was a mistake and we are starting to reinvest in those basic services.
  • How do you help patients navigate a system that is so complex? How do you coordinate appointments, ensure the appointments are necessary and make sure that the consultants are communicating with each other so one is not taking care of the renal problem and the other the cardiac problem, but they are not communicating about the patient? That is frankly a frequent issue in the health system.
  • There may be a patient who requires Test Y, X, and Z, and most patients require that package. It is possible to create a one-stop shop kind of model for patient convenience and to shorten overall wait times for a lot of patients that we do not see. There are some who are very complicated and who have to be navigated through the system. This is where patient navigators can perhaps assist.
  • There have been some good studies that have looked at CT and MRI utilization in Ontario and have found there are substantial portions where at least the decision to initiate the test was questionable, if not inappropriate, by virtue of the fact that the results are normal, it was a repeat of prior tests that have already been done or the clinical indication was not there.
  • Designing a system to implement gates, so to speak, so that you only perform tests when appropriate, is a challenge. We know that in some instances those sorts of systems, where you are dealing with limited access to, say, CT, and so someone has to review the requisition and decide on its appropriateness, actually acts as a further obstacle and can delay what are important tests.
  • The simple answer is that we do not have a good approach to determining the appropriateness of the tests that are done. This is a critical issue with respect to not just diagnostic tests but even operative procedures.
  • the federal government has very little information about how the provinces spend money, other than what the provinces report
  • should the money be conditional? I would say absolutely yes.
Irene Jansen

Nursing Policy Secretariat - 0 views

www.npsec.ca

nursing care aide hhr

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Irene Jansen on 23 Jan 12
     
    BC Ministry of Health documents regarding the utilization of lpns and care aides
Govind Rao

Austerity is what this spending plan is all about - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246471|tost|20150424|219097096

from heather Ontario budget

shared by Govind Rao on 24 Apr 15 - No Cached
  • Toronto Star Fri Apr 24 2015
  • In the end, Ontario's provincial budget is based on austerity, modest hope and much confusion. Austerity is the hidden theme. Finance Minister Charles Sousa doesn't use the word in his budget speech. But it is what Premier Kathleen Wynne's Liberal government has effectively promised. Over the next three years, spending on health care will take a real cut once inflation is taken into account. Education, training and justice will take even bigger real hits.
  • The government does promise to spend a bit more on what it calls children's and social services. But over the next three years, average spending on everything else, from prisons to agriculture, is slated to be cut. It's all in aid of reaching balanced-budget nirvana. Sousa calls it "making every dollar count." A more accurate description might be that the government is accelerating its squeeze on services. The modest hopes are found in the revenue side.
  • ...3 more annotations...
  • Sousa reckons that Ontario is coming out of the economic slump. Progress is slow and uneven. But the government estimates, with some justification, that matters are beginning to look up, that more people are being employed and that government tax receipts will therefore rise. The reasons are well-known. The oil price slump may be bad news for Alberta. But it's good news for the consumers and manufacturers of this province. More important, the U.S. economy is on the rebound - which helps Ontario exporters. And finally the dollar has slipped. That's tough for those buying, say, Florida oranges. But again it's good news for Ontario manufacturers, who now have a built-in price advantage in the U.S. market. Interestingly, Sousa's budget shows that the growth-driven gains in tax revenues will contribute far more to the elimination of the province's deficit than either spending cuts or asset sales. Which suggests two things: First, budgets do often balance themselves - when the business cycle picks up. Sousa calculates that Ontario will reap
  • $10 billion in new revenue over the next two years, more than enough to eliminate the current $8.5-billion deficit. Second, many of the other things the Wynne government has done to balance the books may not have been necessary. Which is the confusing part of this budget. Why is Wynne's government going out of its way to cause itself to political grief? Exhibit A: the proposal to sell to private investors 60 per cent of Hydro One, the publicly owned electricity transmission utility. After paying off Hydro One's debts, the province expects to net $4 billion from the sale. The government says it wants to use the proceeds to build transit infrastructure over the next 10 years. But by selling a chunk of the electricity monopoly, Queen's Park is also giving up close to $5 billion in guaranteed revenue over the next 10 years. It would be cheaper to hold onto
  • 100 per cent of Hydro One and use the utility's profits to fund infrastructure. In a press conference Thursday, a jovial Sousa was asked about Hydro One. In effect, he answered that selling most the utility was a good deal for the government. He didn't really explain why. Other matters mentioned in, but not seriously addressed by, the budget include Wynne's decision to fight climate change through a so-called cap-and-trade system, her proposed Ontario Retirement Pension Plan and the Liberal promise to cut auto insurance premiums by 15 per cent. On cap-and-trade, the budget confirmed that crucial details have not yet been decided. On pensions, it revealed that the government has talked to a lot of people and heard a lot of different things. Auto insurance? Two years ago, the insurers grudgingly agreed to cut rates, but only if they were allowed to provide accident victims with fewer benefits. The government was fine with this. According to the budget, it still is.
Govind Rao

Confusion about RPN role a blind spot in Ontario's health care system: Report - Infomart - 1 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|240525|wcnw|20140603|197472618

from heather pn utilization ontario

shared by Govind Rao on 03 Jun 14 - No Cached
  • Canada Newswire Tue Jun 3 2014,
  • New report provides recommendations for nurses, nursing employers and educators MISSISSAUGA, ON, June 3, 2014 /CNW/ - Despite the fact that Registered Practical Nurses (RPNs) make up more than a quarter of Ontario's nursing workforce, a newly released report reveals that there is a significant lack of understanding among nurses, nursing leaders and educators in terms of the role of the RPN or how they can be best utilized.
  • Registered Practical Nurses Association of Ontario
Govind Rao

Let Blood Services lead the way - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|242663|ntnp|20150414|218428860

from heather pharmacare cbs drugs

shared by Govind Rao on 14 Apr 15 - No Cached
  • National Post Tue Apr 14 2015
  • I magine having to choose between putting food on the table or buying necessary medication. Research suggests this is the case for one in 10 Canadians who can't afford to fill their prescriptions. Canada is the only country with universal health care that does not also have universal drug coverage. Even for those who do have private or public drug coverage, there are discrepancies in what and who is covered from province to province. Canadians also pay more for drugs than citizens in almost any other Western nation. These are just a few of the arguments that have reignited calls for a national pharmacare program. It is not a new concept, but one that is gaining traction as leaders are turning over every stone to "bend the cost curve" in health care downward. In a recently published study in the Canadian Medical Association Journal (CMAJ), health economists and researchers concluded a universal drug program could actually save Canadians billions of dollars. Great savings are achieved by pooling provincial and territorial needs and resources to increase buying power, eliminate duplication and establish a platform for collaboration and cost-sharing. If health-care leaders are looking for proof that provinces and territories can do more together than they can on their own when it comes to the provision of life-saving and enhancing drug therapies, they need look no further than the blood system they created close to 20 years ago.
  • Many are aware that since its creation in 1998, Canadian Blood Services has been in the business of collecting, processing and distributing blood components in all provinces and territories outside Quebec. But few realize we have also been running a national formulary of biological drugs, providing universal and equitable access to plasma-derived medicine at no cost to patients for nearly two decades. Our organization has sole responsibility for managing a national portfolio of plasma-derived products and their synthetic alternatives worth about $500 million a year. These life-saving pharmaceuticals are used to treat people with hemophilia and other bleeding disorders, patients with inherited and acquired immune disorders, burn and trauma victims, and many others. A national, scalable, cost-shared infrastructure and logistics network ensures the right product gets to the right patient, at the right time.
  • ...3 more annotations...
  • Our approach to managing this drug portfolio is based on best practices in public tendering. This means we provide a competitive, transparent mechanism to achieve best pricing. In fact, governments are benefiting from Canadian Blood Services' success in negotiating an estimated $600 million in savings over five years through 2018 - a testament to the value of pan-Canadian buying power and proof of concept of one of the arguments in the CMAJ study. Some detractors of tendering suggest it can put supply at risk by placing all the purchaser's eggs in that one proverbial basket. However, in our process, we avoid single-sourcing whenever possible, not only to encourage competitive pricing, but to ensure security of supply. Carrying multiple brands of a product, purchasing them in smaller, diverse lots, and negotiating a dedicated and guaranteed "safety stock" are all measures we take to mitigate risks to supply disruption.
  • We have also focused on product choice by incorporating stakeholder (physician and patient) input where appropriate in our tendering processes. Through our medical directors, we provide expert advice when a physician has a patient-based issue that could benefit from an additional specialist perspective - added value for patients and health systems. We also independently qualify new suppliers and audit them periodically, adding another layer of vigilance and product safety for patients. We are often aware early on of supplier issues in bringing products to market or maintaining adequate Canadian supplies, which helps to mitigate the risk of shortages. Because of our governance structure, once a plasma-derived drug is accepted in our portfolio, it becomes available in all jurisdictions. This practice effectively reduces geographic or financial barriers to care, and is consistent with the principles of universal access informing the Canada Health Act and medicare. Equitable access also encourages consistency of practice, and fosters pan-Canadian dialogue on best practices for optimal product utilization. Canadian Blood Services collaborates with health-system leaders, including governments, transfusion medicine physicians and others, to help ensure appropriate utilization and to further control costs.
  • By offering our experience, we are not proposing Canadian Blood Services should bulk-purchase other drugs or that our model is a "cookie cutter" solution to apply to national pharmacare, in part or in whole. Rather, we are suggesting there are important lessons from our 17 years' experience that can be leveraged, and that a national drug program is not only possible - it is already being done, with significant benefits to patients and health system funders. A system that ensures no Canadian patient is left unable to afford life-saving medication, while at the same time driving down system costs, is not only good politics, it's good policy. National Post Dr. Graham Sher is CEO of Canadian Blood Services.
Doug Allan

Hospital pharmacies also operating without regular Ontario College of Pharmacists inspections, MPP says | Toronto Star - 0 views

www.thestar.com/...ists_inspections_mpp_says.html

pharmacies college private clinics

shared by Doug Allan on 05 Jun 13 - No Cached
  • But hospital pharmacies, which also mix and supply cancer drugs to patients every day, are not subject to regular inspections by the college.
  • College Registrar Marshall Moleschi said outdated legislation in Ontario’s Drug and Pharmacies Regulation Act exempts hospitals and other health institutions from having to follow the same rules and regulations as community retail pharmacies.
  • “I was very surprised when I started working in hospitals that the college does not have any role in the pharmacy side in hospitals, especially given the types of products that are made and handled and utilized within hospitals,” Froude told the committee.
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  • Moleschi said the process to begin legally inspecting hospital pharmacies is a lengthy one that can take a year or two as it moves through Ontario’s legislative assembly.
  • Health ministry spokeswoman Zita Astravas told the Star that hospital pharmacies are “subject to oversight on a number of levels” and that “it’s incorrect to suggest otherwise.”
  • She pointed to subsections of the Public Hospitals Act: one that allow an investigator to be appointed to report on the quality of care and treatment of patients in a hospital; another that allows for a hospital supervisor to be appointed “where it is in the public interest to do so.”
  • Those measures aren’t enough, Yurek said. College oversight “should go across the board, that way there is one overseer of anything that is a pharmacy,” he said.
Irene Jansen

HEU submission on LPN regulation Jan 8 2013 - 0 views

www.heu.org/...akes-submission-lpn-regulation

from heather bc cupe pn regulation scope

shared by Irene Jansen on 22 Jan 13 - No Cached
  • In response to proposed changes to the regulation that governs the LPN profession that were announced this fall, HEU made a submission on December 21 to the B.C. Ministry of Health.&nbsp;
  • government’s proposed changes to the regulation currently governing LPN practice –&nbsp;while containing some advancements –&nbsp;also has the potential to set back LPN practice
  • the regulation moves away from LPNs being under the direct supervision of an RN, to a “restricted activities” model
  • ...1 more annotation...
  • the proposed new regulation does not reflect the full scope of current LPN practice and competencies, and could negatively impact LPN utilization
Govind Rao

Association between household food insecurity and annual health care costs - 0 views

www.cmaj.ca/...E429.full

from heather determinants food costs research cma

shared by Govind Rao on 14 Oct 15 - No Cached
  • CMAJ October 6, 2015 vol. 187 no. 14 First published August 10, 2015, doi: 10.1503/cmaj.150234
  • Our study showed that household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food insecurity could offset considerable public expenditures in health care and improve overall health.
healthcare88

Time to revisit Canada Health Act - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246243|kwrc|20161101|259599453

privatization medicare

shared by healthcare88 on 01 Nov 16 - No Cached
  • Waterloo Region Record Tue Nov 1 2016
  • We're paying some of the highest costs in the world for health care and we've got a middle-of-the-road health-care system." - Jane Philpott
  • On Oct. 18, the provincial health ministers met in Toronto and pushed for restoration of the previous six per cent annual increase in federal transfers in a renewed Health Accord. Federal Health Minister Jane Philpott refused, but promised extra funding targeted to home care, mental health and system innovation. But many provinces balked. As Quebec Health Minister Gaetan Barrette stated, "We are being asked to do more with less. All provinces and territories will have to make difficult choices."
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  • Ontario Health Minister Eric Hoskins predicted that the reduction in the annual "escalator" to three per cent would result in a "declining partnership." Yet considering Ottawa contributes only 23 per cent of the average provincial health budget, the three per cent difference in the annual "escalator" translates into a reduced rate of increase of only 0.69 per cent! Much of this is mere political bluster! Is it not finally time to revisit the Canada Health Act and fine-tune it?
  • As Konrad Yakabuski has stated (Globe and Mail, Oct. 19), "As long as the provinces remain bound by the Canada Health Act, which constrains their ability to dramatically alter the way health care is paid for and delivered, any new conditions on the use of federal transfers are only likely to further weigh down an already overly bureaucratic system."
  • When it was passed in 1984, it was understood that the federal government would pay half of health costs. Now it covers less than a quarter. Thanks to Ottawa's admission of refugees and migrants, overall growth of an aging, sicker population, new diseases, and new technologies, the provinces must shoulder an increasing burden.
  • Yet as Bacchus Barua (Ottawa Sun, Oct. 21) has stressed, more efficient health care systems in Europe allow a greater role for the private sector, use co-payments and user fees (with exemptions for the poor and elderly) and fund hospitals according to activity, not by global budgets, which have been frozen in many provinces.
  • MDs could be required to work - perhaps 25 to 30 hours per week - in the public system in order to receive government reimbursement for malpractice insurance. Most MDs would confine their practice to the public system. They deserve fair treatment. Thus Philpott should amend the CHA to mandate binding arbitration when provincial negotiations fail.
  • For those not a member of a "special group," the main option for timely care may be to go to the United States. This provides employment to American doctors and nurses and profits to U.S. hospitals. Would it not make more sense to allow all Canadians to spend their after-tax discretionary income on their own health in their own province?
  • Frozen hospital global budgets have caused excessive wait times for knee and hip replacements as operating rooms are often not functioning at full capacity. According to a 2013 survey, 15 per cent of Canadian surgeons considered themselves underemployed and 64 per cent cited poor access to ORs. Hence if orthopedic surgeons had access to additional "private" OR time, wait times could be shortened. If hospitals were permitted to operate electively on Americans and other foreign patients, this would bring in extra revenue for hospitals and relieve the strain on provincial health ministries.
  • Philpott has vowed to do more than just "open the federal wallet." She admits that "innovation" is required. Yet governments are being constrained by blindly adhering to certain parts of the CHA. Despite denials by politicians, a "two-tier" system has always existed. Federal prisoners, WSIB patients, members of the military and RCMP, politicians and professional athletes usually obtain more timely care - often at private facilities.
  • When the premiers meet with Prime Minister Justin Trudeau in December, besides discussing funding of the new Health Accord, they need to revisit the CHA and begin putting forth proposals as to how best to amend and modernize it. Where wait times are excessive, certain diagnostic services and surgical procedures should allow for private access for all Canadians - not just a select few.
  • This would utilize expensive equipment and provide new employment for nurses, technicians and surgeons. It would provide extra revenue - from both inside and outside the country - that would help to keep universal public health care sustainable and accessible for all Canadians. Ottawa should then enforce all sections of the CHA on all provinces and territories.
  • Ottawa physician Dr. Charles Shaver was born in Montreal. He graduated from Princeton University and Johns Hopkins School of Medicine. He is currently chair of the section on general internal medicine of the Ontario Medical Association.
Heather Farrow

Are disposable hospital supplies trashing the environment? - Healthy Debate - 0 views

healthydebate.ca/...hospital-medical-waste

environment hospital

shared by Heather Farrow on 18 Aug 16 - No Cached
  • Date: August 18, 2016 Author: Wendy Glauser, Jeremy Petch &amp; Sachin Pendharkar
  • It’s something that a patient who is worried about a surgery or recovering from a trauma is unlikely to think about. But behind the scenes, plastic syringes, single-use gowns, sterile packaging, surgical instruments and much more are piling into dumpsters. While the amount of waste is difficult to quantify, a report from the Ontario Hospital Association estimates hospitals are responsible for at least 1% of non-residential landfill waste.
  • Hospital waste comes from areas like food, electronic and paper waste, but the biggest source is clinical care. It’s estimated that North American operating rooms alone are responsible for 20%-33% of total hospital waste. And a US study found that a single hysterectomy produced 20 pounds of waste in plastic, packaging, drapes, and so on (bio-waste was not included). The problem may be getting worse – due to patient safety, cost and convenience, more and more clinical instruments and supplies are being marked as “single use” and thrown out.
  • ...5 more annotations...
  • The rise of throw-away medical supplies
  • Efforts to improve hospitals’ waste production
  • But isolated hospitals are making changes. The Children’s Hospital of Eastern Ontario is in the process of moving toward a green purchasing strategy, which it’s developing in partnership with Canadian Coalition for Green Healthcare. (The draft plan is currently available online for other hospitals to utilize.)
  • Ways to minimize the impact of disposables
  • She also thinks hospitals should be encouraged to buy more socially responsibly, given that many health supplies are produced around the globe by people working in dangerous conditions for poverty-level wages. “The health, environmental and social costs of the production of these consumables is something that doesn’t get costed,” she says.
Govind Rao

Hospital lab's future in doubt - Infomart - 1 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbng|20150923|229875334

from heather cuts cupe Ontario hospital

shared by Govind Rao on 23 Sep 15 - No Cached
  • The North Bay Nugget Wed Sep 23 2015
  • The outpatient lab at the North Bay Regional Health Centre is under the microscope as the facility tries to staunch a flood of red ink. We are reviewing a number of different parts of the hospital operation," Dave Smits, vice-president of corporate, said Tuesday. Smits said the health centre is looking at about 40" different initiatives, including the outpatient lab. The health centre announced last week it is cutting 158 full-time equivalent jobs with another 50 possibly to be cut if the province doesn't help with one-time funding for early retirement packages. The hospital also will close 30 beds between the medical and mental health sides of the facility. The hospital has laid off 196 staff over the past three years.
  • Smits said the outpatient clinic in North Bay operates different from most communities in the province, because there is no private laboratory in the city to handle some of the tests. We are looking at it," Smits said. We've been looking at it off and on over the years. We've talked about it and we continue to go back to it. The question is, if it is different here, is it different good or different bad? Are there options in the community? Will others be able to provide the services in the community?" Smits said the lab at the hospital is heavily utilized and provides a high degree of service." He said any physician in the community can order any type of laboratory test at the hospital's outpatient lab, while other communities across the province have private labs that can pick up the majority of tests.
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  • We historically are different because there is no testing laboratory in the community," Smits said. That means the tests or samples have to be sent out of the city, which can result in sometimes substantial delays." There isn't a patient who visits the hospital, he said, who does not have at least some contact with the lab, including testing at various clinics offered at the hospital. Smits said the review of the laboratory has been underway over the summer. He expects it should be completed in the next month or so, and we will have a decision on what exactly might change in the next four to six weeks." The announced cuts at the hospital will affect positions across the facility, including allied health workers such as social workers, dietitians and occupational therapists, as well as nurses and cleaning staff.
  • The province has frozen hospital funding over the past four years, which has cut budgets in real terms by more than 20 per cent, according to the Canadian Union of Public Employees. In a release, CUPE said the facility received $14 million less in provincial funding this year than it needed just to maintain existing services. Last year the provincial funding deficit was $18 million, while 40 nursing positions were eliminated in 2013 to counter a $14-million deficit."
Heather Farrow

Socialist Action will stand up for the people - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|sjet|20160524|247747304

nl cuts campaign

shared by Heather Farrow on 25 May 16 - No Cached
  • The Telegram (St. John's) Tue May 24 2016
  • Socialist Action is gaining a foothold in Newfoundland Labrador and it is needed now more than ever. The provincial government has tabled an austerity budget that will have drastically regressive effects on public services, seniors, women, youth, those most vulnerable, and the provincial economy as a whole. The provincial government's budget is a stark contrast to Alberta's budget, where low commodity prices have also taken a big bite and the NDP government has taken a different course than that of the Liberal government in N.L. There is nothing in our b
  • udget about creating jobs, eradicating poverty, improving literacy, providing opportunities for young Newfoundlanders and Labradorians, enhancing life in rural communities and for seniors, eliminating the gender wage gap, and improving mental health programs.
  • ...6 more annotations...
  • Socialist Action participated in the NL Rising! rally on May 5 at the Confederation Building. The event was organized by the Newfoundland and Labrador Federation of Labour and was attended by public and private sector unions, social justice groups, women and youth rights groups, and all those affected by the cuts to services, axed jobs and unfair tax measures. There were about 2,500 in attendance and a Socialist Action member held an SA banner on the main stage with the help of a member of Anonymous.
  • Socialist Action also has participated in town halls to rally support against the austerity budget. "This is the most miserable budget I've ever seen, except for Greece, and Greece's was forced on them" is how one CUPE economist put it.
  • Socialist Action is also involved in starting a local NDP socialist caucus within the ranks of the provincial NDP modelled after the socialist caucus in the federal NDP. The finance minister has made some of her money thanks to temporary foreign workers working at her fast-food restaurants. She was previously the biggest cheerleader for the Muskrat Falls project when sitting on the board of directors for Nalcor, the provincial utility and energy company. Now she says she has to implement this budget because of the cost overruns on the dam project. It is a project lacking transparency and accountability, and making a lot of people from outside Newfoundland and Labrador wealthier, including foreign construction companies that have never done jobs like this in Canada, a Canadian engineering company that was involved in a bribery scandal with Libya when Moammar Gadhafi was still in power, and foreign banks, bond holders and credit rating agencies. Her goal seems to be to obey the credit rating agencies and please them.
  • Newfoundland and Labrador is in a more precarious position now than in 1933, when Newfoundland was bankrupt and Canada and Britain were worried about their own credit ratings. The British and Canadian governments appointed a Commission of Government which was controlled by two private bankers. This was the start of a 15-year political breach which eventually led to the Crown selling off Newfoundland and Labrador to the Canadian bourgeois wolves to pay off their war debt in 1949.
  • Socialist Action NL has unanswered questions about Don Dunphy, an injured worker who was seemingly killed for a tweet when an RNC officer on the then premier's security detail showed up at his home on an Easter Sunday. What is happening to the pensions of iron ore miners from Labrador who have provided raw material to Hamilton Steel Mills for years? We still have foreign multinational corporations willing to exploit our fishery resources. Those corporations and the provincial government are stomping on indigenous peoples' rights in Labrador.
  • Socialist Action is on the ground in Newfoundland and Labrador, active in the labour movement, social justice, international solidarity, feminist and environmental campaigns. We will continue to make the socialist caucus visible in the NDP provincial party, to be at the table at the N.L. independence debate, to actively support indigenous peoples' struggles, as well as in anti-war, anti-poverty and the human rights movements. Socialist Action NL is in solidarity with the Fourth International worldwide. Chris Gosse St. John's
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