Monthly Archives: December 2014

Healthcare reform to address needs of Canadians not service providers

TORONTO – Canadian Association of Retired People (CARP) is calling for a full system re-design of the healthcare system to provide a comprehensive 360 degrees of care and that treats Canadians as “healthcare citizens” – with the right to expect timely and appropriate care and equal treatment regardless of age, income and postal code.

CARP’s submission to the Advisory Panel on Health Innovation calls on the government to prioritize the needs of the healthcare citizen rather than the needs of the service provider.

Currently, the system is designed around the priorities of the service providers rather than the people it is supposed to serve, creating a fragmented and inefficient agglomeration of silos within silos. While many will welcome the mandate of the Advisory Panel on Healthcare Innovation to seek improvements in the quality and accessibility of care, Canadians do not want more pilot projects that add more elements, complexity and costs to the current $215 billion healthcare spending with limited sustained impact. As taxpaying healthcare citizens, Canadians want a system that wraps fully around their needs, enabling them to maintain their health and well-being.

A comprehensive health and wellness system would comprise and provide for:

  • social determinants of health,
  • prevention of illness,
  • medical treatment and care,
  • caregiver support, and
  • end of life care.

The healthcare system has failed to meet our post-acute and chronic care needs, leaving many people stuck between institutions or running from pillar to post to seek care for themselves or their loved ones. We need to break down the silos in the system built around the service providers so that people get the care they need, when and where they need it, not where it is convenient for the system to provide it.

“Why can’t hospitals ensure they restore people before releasing them home instead of placing them in ALC beds where they languish and deteriorate? Hospitals saying it’s not in their mandate is not an acceptable answer.

“Why can’t long-term care be delivered in homes and in the community rather than have us wait for more nursing homes to be built? Why can’t Canadians be guaranteed palliative care regardless of postal code? The healthcare system needs to start prioritizing its citizens”   – Susan Eng, VP Advocacy, CARP

I see first-hand how important it is to for us to treat the whole person. I hear it from my patients and I heard it from the thousands of Ontarians I have consulted with throughout the province.  Ensuring that people get the right care at the right time – is not just about how we deliver health care, but also about addressing poverty, housing, healthy living, advanced care planning and end of life choices – all elements within CARP’s call for 360 degrees of care and a necessary system re-design to deliver it. It’s time for policy makers and political leaders to make this a reality”, said Dr. Samir K. Sinha, Director of Geriatrics, Mount Sinai and the University Health Network Hospitals, Provincial Lead Ontario’s Seniors Strategy

CARP’s submission reminds government that healthcare is a social contract with its citizens which must uphold the values described in the Canada Health Act: to protect, promote, and restore the physical and mental well-being of residents of Canada and facilitate reasonable access to health services without financial or other barriers. This means that Canadians should be able to expect

  • national standards of quality care and timely access,
  • care responsive to need,
  • sustained funding,
  • value for money, and
  • system overhaul to reallocate resources.

Healthcare remains the highest priority for Canadians, and especially as they age, Canadians are calling for immediate change.

CARP is a national, non-partisan, non-profit organization committed to advocating for a New Vision of Aging for Canada, social change that will bring financial security, equitable access to health care and freedom from discrimination. CARP seeks to ensure that the marketplace serves the needs and expectations of our generation and provides value-added benefits, products and services to our members. Through our network of chapters across Canada, CARP is dedicated to building a sense of community and shared values among our members in support of CARP’s mission.

For further information, please contact:

Sarah Park   416.607.2471 Director, Communications

How safe are your hospitalized patients?

Adverse event rates in Canadian hospitals have not significantly improved. According to “The Canadian Adverse Events Study” published in the Canadian Medical Association Journal, approximately 7.5 per cent of hospitalizations are associated with at least one adverse event, of which 37 per cent are preventable. In 2013, a Commonwealth Fund Study revealed that Canada is not doing as well as could be expected, according to its national health care scorecard. So what are we doing wrong? How can we change the culture of patient safety in Canadian hospitals and teaching institutions?

Those are some of the important questions that were addressed during the five-day ASPIRE (Advancing Safety for Patients in Residency Education) program held in Ottawa, Ont., from November 16-20, 2014.

Building on the success of the first ASPIRE in 2013, the Royal College and the Canadian Patient Safety Institute, its partner in this initiative, offered this second edition to align patient safety and quality improvement concepts with the CanMEDS 2015 Framework, taking a very focused and hands-on approach.

“As a profession, we have an obligation to step up to the plate and contribute to solving quality and safety problems. The Royal College has recognized these issues and has proactively embedded patient safety and quality improvement throughout the newly-revised CanMEDS 2015 Physician Competency Framework,” remarked Brian Wong, MD, FRCPC, ASPIRE chair and physician at the Sunnybrook Health Sciences Centre in Toronto, Ont.

“We need to firstly recognize the gaps in quality of care, and then incorporate evidence to improve practices in our health care system that will help us close those gaps.”

ASPIRE participants create enhanced educational plans

During the ASPIRE program, faculty-participants covered a wide range of topics such as the culture of patient safety, recognizing and responding to adverse events, analyzing and designing systems, patient-centred communication skills, patient engagement, teamwork, handovers, human and system factors, and quality improvement (QI).

Attendees also worked in teams and learned about how to integrate essential patient safety and QI concepts into concrete educational plans, which they now intend to implement in their local institutions.

Touching patient story reinforces the need for patient-centred care

During one of the program sessions, a video by Ms. Donna Davis, an acclaimed patient safety advocate from Saskatoon, Sask., was played. Ms. Davis also shared her poignant story with the ASPIRE group during a live Skype session, encouraging them to include patients in patient safety training efforts and reinforcing the need for patient-centred care.

One participant, fifth-year resident in Anesthesiology Ashleigh Farrell, MD, admitted that the domain of patient safety has only recently been taught in her program. She has seen firsthand clinical crises and a few debriefs, leading her to suggest that “check-backs” and self-reflection should be better incorporated into daily practice to address and prevent safety gaps.

Julien Poitras, MD, FRCPC, vice dean, School Directions and Strategies Projects at l’Université Laval in Québec, Que., believes that future residents will have a key role to play in making these changes, as their learning will bring new patient safety standards to the forefront.

Upcoming programs

The next ASPIRE program will be offered in French in June 2015, and another English course will be offered in conjunction with the 2015 International Conference on Residency Education (ICRE) in Vancouver, B.C., next October. Preliminary planning for an international ASPIRE program is also underway.

For more information on ASPIRE, and to access some of the tools explored during the program, please visit our website.

National Physician Survey reveals huge growth in Canadian Specialists use of IT

More Royal College Fellows, and more Canadian doctors overall, are using information technology in their practice.

Seventy-five percent of Canadian physicians now report using electronic records to enter or retrieve clinical patient notes on a laptop or desktop, according to the recently released 2014 National Physician Survey (NPS) findings. This number has tripled from the 26 per cent reported in 2007.

“A huge growth in the use of information technology is taking place across Canada,” said Royal College President Cecil Rorabeck, MD, OC, FRCSC. “Doctors are not only using information technology more, but finding it enhances their ability to provide high-quality care.”

Adoption occurring across specialties and regions

Overall, the three disciplines most likely to have gone completely electronic were Diagnostic Radiology (51%), Anatomical Pathology (45%) and Family Medicine (42%).

Notably, cancer specialists reported very high rates of using electronic records to enter or retrieve clinical patient notes — 96 per cent of radiation oncologists and 97 per cent of medical oncologists surveyed.

Physicians in Alberta, British Columbia and Ontario were most likely to report using electronic records, at close to 81 per cent of respondents from each province according to the NPS findings.

Nearly two-thirds report better quality of care

Sixty-five percent of physicians reported seeing better or much better quality of care since the implementation of electronic records, a rise of nine percentage points from last year. The most frequent benefits that were quoted include

  • identifying lab results,
  • ability to access a patient’s chart remotely, and
  • being alerted to critical test results or to potential medication warnings.

Diagnostic radiologists were the most likely group to cite improved productivity, with 75 per cent reporting improved quality of care.

Electronic tools used by physicians, other than electronic medical records, are also on the rise.  The most frequent use of electronic tools is the access to lab/diagnostic test results — 80 per cent compared to 38 per cent in 2010.

Significant challenges remain

Information technology is not a uniform success. Canada’s physicians reported several challenges in accessing information, with

  • 52% reporting technical glitches,
  • 46% experiencing compatibility issues with other systems, and
  • 26% complaining about firewall or security issues.

The 2014 national physician survey builds on the previous surveys with a focus on use of information technology by physicians of Canada. This year, more than 10,000 licensed physicians from across the country completed the online electronic survey.

Year-end Statement from the President of the Canadian Medical Association

By the standards of any organization, 2014 has been momentous for the Canadian Medical Association (CMA) – more to come in 2015

In addition to developing a new strategic plan to guide us through the next three years and radically restructuring the organization to allow us to better serve our members and meet future challenges, the CMA has also adopted a new mission and vision.

The mission: Helping physicians care for patients

The vision: CMA will be the leader in engaging and serving physicians, and the national voice for the highest standards for health and health care.

Both the mission and vision speak clearly about why the association exists, and why I feel it will continue to be a vital force in supporting members and helping sustain a vibrant health care system in Canada.

These are statements that will serve the CMA well as the organization continues to support Canadian physicians and patients in meeting whatever challenges 2015 might bring.

As we end this remarkable year, I would like to extend to all CMA members and their families best wishes for the holiday season and the year to come.

Dr. Chris Simpson President, Canadian Medical Association

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Check out the ‘ambulance drone’ that could one day save your life

A student in the Netherlands has come up with the idea of fitting out a quadcopter with a defibrillator to create what is believed to be the world’s first ‘drone ambulance.’

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