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Mike Old

Cleaners important to health care - 2 views

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    The recent revelation about out-of-control C. difficile infection rates and the breakdown of the infection prevention and control programs at Burnaby and Royal Columbian hospitals should surprise no one.
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    Op-ed published in Thursday's Vancouver Sun detailing some of the warning signs that preceded a major C. diff outbreak at Burnaby General.
Irene Jansen

Canada Health Transfer changes: the devil is in the details | iPolitics - 1 views

  • The provinces are certainly not equal in their fiscal capacity. Indeed, if one looks at per capita own-source revenues, Newfoundland and Labrador, Saskatchewan and Alberta are well above the provincial average as a result of their natural resource revenues. Meanwhile, Prince Edward Island, Nova Scotia, New Brunswick and Ontario are below the average while Manitoba and British Columbia are at about the average.
  • The provinces are also not equal in their rates of population growth, the rates at which their population is aging, the proportion of aboriginal or immigrant population, or the incidence of various diseases.
  • In 2011-12, Ottawa transferred about $58 billion in cash to the provincial and territorial governments. The three main provincial cash transfer programs are the Canada Health Transfer at $27 billion, the Canada Social Transfer (for child, post-secondary education and social programs) at about $12 billion and Equalization (funds for those provinces with a weaker fiscal capacity) at almost $15 billion.
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  • both the old and new formulas can be considered unfair in that they ignore that some provincial differences in health spending are rooted in population health differences.
  • The first component should be an equal per capita cash payment recognizing the fixed costs of operating a health system
  • The second component needs to base the payment on a formula that takes into account population growth, differences in the aged proportion of population, and perhaps even differences in the incidence of illnesses.
Irene Jansen

Johns Hopkins confirms talks with Westbank first nation - 4 views

  • Louie said the private hospital has the endorsement of more than 90 per cent of band members.A returning officer’s report of a special membership meeting and secret ballot vote that took place last summer, shows 506 band members were eligible to vote, but only 77 did. Of the ballots cast, 65 were in favour of a business partnership with a company called Ad Vitam to develop the medical facility, and 12 were opposed.
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    It would be interesting to know what their turnout is usually like for membership meetings and if the low turnout was a statement or not.... The centre sounds terrifying though. Is a chef's dinner and bottle of wine standard at private surgery centres or is this trying to establish a new niche among privates? Lou
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    In 2003, Forbes magazine named the Marburg Pavilion at Johns Hopkins one of the top 10 private luxury hospitals in the US. http://www.forbes.com/2003/07/07/cx_ns_0708healthslide_5.html?thisSpeed=20000 http://www.hopkinsmedicine.org/the_johns_hopkins_hospital/
Irene Jansen

Adami: A need for affordable care - 4 views

  • Carolyn Daniels says a revised fee system for special-care services imposed by the operator of an Ottawa retirement home will force her mother out of her room.
  • additional costs of $1,793 a month
  • At Westwood, Revera includes a long-term care component. The care is similar to what it offers in its nursing homes.
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  • owned by Revera, which operates retirement homes and nursing homes throughout Canada and the United States
  • Daniels’ relationship with the home soured about a month ago, when she found out her mother was going to be hit with new fees for services such as continence toileting or being escorted to the dining room.
  • Those services have been costing $478 a month on top of the $2,774 she pays for accommodation and food. The same care services will rise to $2,271 in September for a total monthly charge of $5,045.
  • Revera says it is introducing an “à la carte” service for all residents in its Ontario retirement homes to cover its costs.
  • Daniels says her mother is receiving all those services now for about one-fifth of the price. “It just boggles the mind,” she says.
  • The new fees don’t apply to Revera’s Ontario nursing homes because monthly rates for such facilities are determined by the provincial health ministry. But the ministry does not regulate fees for retirement homes or their long-term care components, so Provost and others living on Westwood’s two long-term floors are sitting ducks.
  • Bernard Bouchard, executive director of the Council on Aging of Ottawa, says he believes Revera is trying to make up some of its extra costs from new licensing regulations brought in by the Ontario government in April 2011. As well, he says, operators are trying to find new revenues as retirement homes are operating at about 80-per-cent capacity.
  • Daniels says her mother will have to move to a nursing home. And there lies another problem. She will have to go on a waiting list because nursing homes are full.
  • having a staff member escort her mother, who uses a walker, to the dining area and back to her room three times a day will cost $606 a month. Helping feed her when she needs assistance is another $252. Checking her room twice nightly, to see if she has fallen out of bed or needs to go to the washroom is $168. Continence toileting is $673.70. She will also be charged an additional $505 monthly for general staff assistance.
  • they said: ‘We can look after her, we have palliative care. She can stay here until she dies.’ ”
Irene Jansen

Nursing home inspectors say complaint investigations delayed due to lack of staff - the... - 3 views

  • Ontario nursing home inspectors are so overwhelmed with abuse and other complaints that many of the government’s rigorous new annual inspections will be delayed as long as five years, says the public service union.
  • In 2011, the ministry received 2,719 complaints from staff, families or other sources. They include critical incidents, such as sexual or physical assault, and important but less urgent issues, such as complaints about unappealing food.
  • the annual home inspection, which picks up on problems before they become serious
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  • Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, said the government promised that each home would be given an in-depth inspection each year. But now, Meadus said, the ministry says the new nursing home act only requires that a home has “an inspection” of any kind (mostly generated by an individual complaint) as long as it is done annually. “That means we are leaving it up to the homes to regulate themselves,” Meadus said. “If there are bad apples out there, they will be allowed to continue unchecked.”
Irene Jansen

Defending Public Healthcare: Long-term care industry plans reinvention during austerity - 3 views

  • "Convalescent care" beds are a form of "short-stay" beds in long-term care (LTC) facilities.  Convalescent beds receive an extra $70.94 more per day than standard long-term care beds.  That's 45.7% more funding than the $155.18 for a standard bed.   Started in 2005, the LTC "convalescent care" program is now a “Home First Program” that is designed, in part, to reduce hospital Alternate Level of Care (ALC) days.
  • The for-profit section of the long-term care industry sees convalescent care as a growth part of the LTC industry.
  • the average length of stay as the length of stay for the short-stay long term care beds varies from 25 to 65 days, while the ‘long term’ LTC beds have an average stay of 3.1 years
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  • There appears to be significant overlap between LTC 'convalescent care' beds and hospital 'assess and restore' beds.  
  • 35,000 LTC beds must be redeveloped over the “next few years” according to the OLTCA panel.  That’s about half the LTC bed stock. 
Irene Jansen

Robert Evans on doctor shortage Healthcare Policy Vol. 7 No. 2 :: Longwoods.com - 3 views

  • And second, a lid must be placed on APP program payments. Funding for benefit and incentive programs should be folded into the negotiation of fee schedules, recognizing that they are, like fees, simply part of the average prices physicians receive for their services.
    • Irene Jansen
       
      Alternative payments program (app) is the term used to describe the funding of physician services through means other than the fee-for-service method.
  • the coming increases in numbers have, once again, foreclosed for decades the possibilities for exploiting the full competence of complementary and substitute health personnel, expanding interprofessional team practice and in general, shifting the mix
  • Including rapid growth in net immigration, the annual "crop" has nearly doubled.
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  • Canadian medical schools have expanded their annual enrolment by 80% over the last 13 years
  • it is politically extremely difficult, almost impossible, to cut back on medical school places once they have been opened.2
  • In the last decade, medical expenditure per physician has also risen, by nearly 35% above general inflation.
  • Each of these waves of expansion responded to widespread perceptions of a looming "physician shortage." How accurate were those perceptions? In the case of the first wave, they rested on assumptions that were simply wrong, and by a wide margin. Medical schools were built to serve people who never arrived.
  • major increase in physician supply per capita, from 1970 to 1990, did not result in underemployed physicians. Utilization of physicians' services adapted to the increased supply. Whether the additional physicians were "needed," and what impact their activities might have had on the health of Canadians, are good and debatable questions
  • Does all this increased diagnostic activity among the very elderly actually generate health benefits?
  • As in the case of the previous major expansion, the impact on the total supply of physicians will unfold slowly, but relentlessly, over decades.
  • Table 1. Canadian health spending, percentage increase per capita, inflation-adjusted   1999–2004 2004–2009 1999–2009 Hospitals 19.1 11.7 33.0 Physicians 16.4 24.4 44.8 Rx drugs 46.1 19.0 73.7 Total health 22.2 16.5 42.3 Provincial governments 21.2 17.7 42.6  
  • Over the nine-year period, there were very large increases in the per capita volume of diagnostic services – imaging and laboratory tests. Adjusting for fee changes, per capita expenditures on these rose by 28.4% and 42.1%, respectively.
  • much greater among the older age groups – 59.4% and 64.4%, respectively, for those over 75
  • money has been poured into reimbursing diagnostic services for the elderly and very elderly, but access to primary care for the non-elderly appears to have been constrained
  • insofar as more recently trained physicians tend to be more reliant on the ever-expanding arsenal of diagnostic technology, overall expenditures per physician will continue to rise as their numbers grow
  • (Population has grown by about 14%.)
  • a lot of money is going out the door and no one has a clear picture of what it is buying
  • The question of Canadian physician supply is now moot. The new doctors are on their way, and whether or not we will need them all is no longer relevant. It may be that as cost containment efforts begin to bite we will again see renewed limits on the inflow of foreign-trained physicians, but we will not be able to turn down the domestic taps as supply increases.
  • Growth in diagnostic testing has to be brought under control, both in how ordering decisions are made and in how tests are paid for.
Irene Jansen

CUPE videos debunk the myths about privatization of health care < Privatization | CUPE - 2 views

  • The first video presents a panel of experts who take turns debunking the myths that the public system is too expensive and that privatization would cut both costs and waiting lists. This is the full-length version of the video; smaller excerpts focusing on specific issues will be available soon for easy sharing.
  • The second video features highlights from a speech by former UK health secretary Frank Dobson at CUPE’s National Health Care Sector Meeting held in Victoria in the Fall of 2010. Dobson uses his own personal experience to debunk the myths surrounding privatization. It's a must see!
Irene Jansen

Canada News: Hébert: Tories' hands-off approach to medicare unlikely to chang... - 2 views

  • The rationale behind that recommendation is not particularly compelling to start with for the committee found that the billions of federal dollars spent under those very terms as a result of the accord failed to lead to the transformation of the system
  • it will likely not divert the Harper government from its hands-off approach to medicare
Irene Jansen

CMAJ: Everything in moderation, including vision - 2 views

  • “The greatest enemy, I think, to the future of health care in Canada is government complacency at the federal level. That is the enemy of good health care for Canadians,” he adds, noting that there was no mention of health care even for those for whom the federal government has jurisdictional responsibility for providing care, such as Aboriginal peoples, prison inmates and veterans.
  • the changes in the old age security eligibility (phasing in the age of retirement to 67&nbsp;from 65&nbsp;commencing in 2023), target “an already vulnerable population. My patients have a choice between food, heating and drugs and a lot of them skip their medications because they can’t afford it and that’s going to get worse. We don’t have a pharmaceutical strategy to deal with the fact that chronic disease requires constant or prolonged medication.
  • Nor was there anything to deal with ongoing drug shortages
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  • Similarly, Canadian Healthcare Association President Pamela Fralick dubs the blueprint as “not a health budget.” “There’s shared leadership in this. We’re still looking to the federal government for some leadership on issues, which they’re not necessarily embracing at the moment,” she says.
  • the absence of any indication that the federal government plans to pursue the introduction of any manner of accountability mechanisms surrounding health outcomes as part of transfer payments to the provinces for health care
  • Among other health and research-related measures:
  • $6.5&nbsp;million over three years will be provided to researchers at McMaster University to conduct an evaluation of “ways to achieve better health outcomes for patients while also making the health care system more cost-effective, through greater implementation of medical teams.”
  • Commencing this year, physicians will be included among the “target occupations” in the Pan-Canadian Framework for the Recognition of Foreign Qualifications, under which foreign-trained professionals who seek to work in Canada will have their qualifications assessed within a one year period.
    • Irene Jansen
       
      and practical nurses
Irene Jansen

Ontario ombudsman could hold hospitals to account - thestar.com - 2 views

  • Ontario is also the only province whose ombudsman cannot investigate hospitals and long-term care facilities.
  • I am confident that they would perform better if they were subject to the scrutiny of my office
  • Many of the problems identified in the CIHI survey — less-than-adequate nursing care, mortality rates, administration costs — are issues that Ontarians have brought to my office in the past. Every year, we hear from hundreds of patients and their loved ones who say they’ve endured inadequate care, unsafe conditions, even neglect and abuse in hospitals. In the fiscal year just ended, we received some 375 complaints about Ontario hospitals that we were forced to turn away. I can only imagine how many we would receive if we were actually able to act on those complaints.
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  • cost-neutral
  • in Quebec — resources were simply reallocated from the health ministry
  • the powers of the provincial auditor general were recently expanded to cover hospitals. This is often cited as adequate oversight. But we all know the impact of hospitals on people’s lives goes far beyond financial matters.
Irene Jansen

CBC TV investigates causes of hospital-acquired infections < Healthcare associated infe... - 2 views

  • this video from the show Marketplace on CBC
  • Understaffing, contracting out, and overcrowding are shown to cause dirtier hospitals and more preventable infections.
  • CUPE drew attention to these problems in a research paper and national tour on health care associated infections, and we continue to lobby for public solutions: microbiological cleaning standards, more inhouse cleaning staff, lower hospital occupancy, and mandatory public reporting.
Irene Jansen

Saskatchewan premier to push health-care reform at national conference - Winnipeg Free ... - 2 views

  • Saskatchewan's premier is pushing for reforms to health care that he says include bold targets and new ways of delivering services.
  • isn't sustainable," Wall said
  • He'll speak to the group and take part in a panel discussion with economist Don Drummond and Globe and Mail journalist Andr� Picard.
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  • Wall wants to talk about reforms being made to improve care in Saskatchewan, including the delivery of publicly funded services by private surgical clinics.
  • lean management techniques
Irene Jansen

OCHU Epidemic of Medical Errors and Hospital Acquired Infections - 2012 Conference - 2 views

  • William Charney, a Seattle-based consultant and author of “Epidemic of Medical Errors and Hospital Acquired Infections: Systemic and Social Causes,” along with the Ontario Council of Hospital Unions, is holding a one-day conference on June 4th in Toronto
  • The conference will address some of the biggest contributors to the systemic and social causes of the epidemic of medical errors and HAIs in the US and Canada.
  • Along with William Charney, a 30-year expert as a health and safety officer in healthcare, speakers include: Joe and Terry Graedon, Kathleen Bartholomew, and Michael Hurley, the president of the Ontario Council of Hospital Unions/CUPE (OCHU)
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  • To register for the conference or for more information, please visit the OCHU website: http://www.ochu.on.ca/conferences_conventions.html.
  • speakers and contributors will be discussing possible next steps to be taken in the healthcare community
  • the conference will address issues such as for-profit care and factory medicine, staffing ratios, under reporting, shiftwork and working conditions, bullying in the workplace
  • William Charney, is a nine-time published author of healthcare safety books. He has also published more than 30 peer-reviewed articles in the field. For five years, Mr. Charney was a safety officer at the Jewish General Hospital in Montreal, Quebec. For ten years, he was the director of environmental health at the Department of Public Health in San Francisco. Then for five years, he was a safety coordinator for the Washington Hospital Association. For the last ten years, he has been a consultant in the field of occupational health.
Irene Jansen

Costs of outsourcing medical transcription skyrocket by 150 per cent in just four years... - 2 views

  • The Hospital Employees’ Union is raising the alarm about Lower Mainland health authorities’ plan to completely contract out in-house medical transcription
  • costs for limited outsourcing of this service ballooned from $2.4 million to $6 million in just four years
  • an HEU investigation of health authorities’ financial documents show that Ontario-based Accentus Inc. – a for-profit medical transcription firm – increased its billings to PHC and the three other health authorities by 151 per cent between the fiscal years 2006/2007 and 2010/2011.
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  • Outsourced medical transcription is usually performed by home-based subcontractors who must put in about double the hours to earn the same wage, and work with few benefits.
  • outsourced medical transcriptionists do not have access to secure electronic medical records or other health care team members within the hospital system
  • Our in-house medical transcriptionists already spend a lot of their time editing and correcting outsourced work.
  • British Columbians should be concerned about the privacy of their records
  • Medical transcriptionists are responsible for transcribing physicians’ dictation of surgical procedures, consultations, patient histories, test results, and various other reports.
Irene Jansen

CHSRF - Public Perceptions and Media Coverage of the Canadian healthcare System: A Synt... - 2 views

  • This report reviews the state of Canadian public opinion on healthcare, focusing on trends over the past five years. It combines a discussion of public opinion with an analysis of media content on healthcare issues.
  • reviewing results from all recent and readily available commercial polling on healthcare
  • content analysis of more than 100,000 articles on healthcare in major Canadian English- and French-language dailies from the past 15 years
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  • focusing in particular on public attitudes about quality, sustainability and public versus private provision of services
  • there is majority support for private sector delivery of tax-supported healthcare services, and Canadians are nearly evenly divided on the issue of allowing people to pay for quicker access to healthcare services when the public system cannot provide timely access
  • The general trend over the past few years, in line with public opinion, has been away from discussion of wait times and doctor shortages; more recent coverage focuses somewhat more on disease outbreaks (e.g., H1N1 flu) and also fitness and nutrition.
Irene Jansen

Andre Picard. Dragging medicare into the 21st century Page 1 - The Globe and Mail - 2 views

  • Nothing matters more, individually or collectively, than our health. Regardless of political allegiance, there is near unanimity that a universal health system is a good thing – for reasons of economics and social justice.
  • every other developed country has universal health care that is better, fairer and cheaper than ours
  • Canadian health care is a $200-billion-a-year enterprise with no clear goals and a dearth of leadership.
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  • Our medicare model is a relic, frozen in time.
  • Today, the average age of Canadians is 47.
  • The vast majority of our care needs are now for treatment of chronic illnesses.
  • Neither the model for delivering care nor the insurance payment model has adapted to the new reality.
  • We need to essentially take our hospital-based care system and turn it on its head to make community-based primary care the focus.
  • We need to extend universal health coverage to prescription drugs.
  • We need to treat people where they live, in the community, not in expensive, soulless, germ-ridden institutions.
  • We need to invest in prevention efforts, particularly for socially disadvantaged and marginalized groups such as aboriginal people.
  • ration based on results – which ensures everyone gets basic, effective care. Quality care is cheaper in the long run.
Irene Jansen

Hospitals look to Toyota automaker for efficient operating rooms - thestar.com - 2 views

  • Six Canadian hospitals are part of ThedaCare, a group of North American health care facilities using the Toyota principals as their business strategy.
  • The Saskatoon Health Region recently announced it had identified $800,000 in lost time associated with scheduling problems thanks to lean.
  • For the Michigan study, operating room employers mapped out their normal work flow, identifying root causes of “muda,” the Japanese term for valueless work. Researchers then measured operating room turnover time (the time between the departure of one patient and arrival of the next) and turnaround time (the time between the final dressing on one patient and the first incision on the next). When lean changes were enforced, turnover time dropped 30 per cent to 29 minutes and turnaround time dropped 20 per cent to 69 minutes. Automated alerts to janitorial staff cut room cleaning times.
Irene Jansen

Act hidden in budget bill begins sell-off of Ontario, means more back-room deals | CUPE - 2 views

  • An act buried in the Ontario Liberal government’s mammoth budget bill makes sweeping changes that open the door to privatizing almost any crown corporation or government service, and will lead to more back-room deals, CUPE Ontario President Fred Hahn and lawyer Steven Shrybman exposed at a Queen’s Park press conference
  • released a new legal opinion written by Shrybman
  • “This act opens the door to privatizing every public service in the province, even contracting OHIP services out to an American HMO, all without the approval of the Legislature, and all without any scrutiny
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  • Schedule 28 gives cabinet authority over “contracting out or privatization of any and all Ontario Government Services,” to any person or corporate entity, whether Canadian or foreign-owned
  • The act overrides requirements for quality standards contained in other, pre-existing laws. It also allows private service providers of public services new powers to collect and retain fees, even though that is prohibited by the Financial Administration Act, and transfers decision-making authority from the Legislature to individuals and private corporations.
  • It opens the door to back-room deals to sell off the LCBO or Hydro One, and allows government services including water quality monitoring or school curriculum development to be privatized or contracted out.
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    Incroyable! Deserves far more publicity.
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