Articles
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May 2013
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Can “bottom up” measurement improve the quality of Canadian health care?
Progress has been made in measuring the quality of Canadian health care. Yet there are still large gaps in what is measured in our health care system, and much of what is measured is only useful to top-level system managers, not to the front-line clinicians whose day-to-day work is so important to the overall quality of the system. This leads experts to question whether measurement is being used effectively to improve the quality of Canadian health care.
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Maternity services disappearing in rural Canada
The plan to eliminate obstetrical care at Banff’s Mountain Springs Hospital, and to replace it with enhanced vascular and plastic surgery services, was labelled a potential “quick win” in a 2012 community and rural health planning document. Babies would no longer be delivered in Banff…
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Canadian diabetes strategies under fire as diabetes rates continue to rise
In the past six months, the Auditor Generals of both Canada and Ontario have turned their attention to problems with strategies designed to tackle one of Canada’s biggest health threats—the epidemic of diabetes. The government watchdogs have scrutinized the value that Canadians have received from…
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Canadian medical schools struggle to recruit Aboriginal students
The featured image for this story is reproduced with permission from the Health Council of Canada. Illustrator: Leah Fontaine Canada’s First Nations, Inuit and Métis peoples have, on average, much poorer health than other Canadians. Chronic diseases like diabetes are significantly more common among Aboriginal peoples, and they have a substantially shorter life expectancy than…
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April 2013
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Big changes coming to Healthy Debate
Dear Healthy Debate community, We have been working quietly on some big changes to the site over the last few months, and we’re finally read to unveil them! Over the coming weeks we are re-launching the website with a new look, lots of interactive features…
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Groundbreaking Canadian cohort studies aim to shed light on risk factors for cancer, chronic diseases
The British Whitehall studies helped establish the importance of the social determinants of health, while a Danish study of children provided strong evidence to disprove the damaging MMR-vaccine-causes-autism hypothesis. Those are just two of many international cohort studies—studies that follow large groups of people over…
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Interpretation services in health care
“We have a large immigrant population, and people sometimes have no English. This program has been a godsend.” –- Winnipeg pediatrician Stan Lipnowski Obtaining a good history is the most important thing in practising medicine, so being able to get that history about the children…
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Ontario Citizens Council: a failed experiment or a success in the making?
Decisions about health policy often involve difficult trade-offs. This is especially true when assessing new health technologies and medications, where funding one item can mean not being able to fund another. These decisions often force policy makers to go beyond scientific considerations of a drug’s…
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Retail pharmacy evolution beset by implementation challenges
Reforms to the way that Ontario community pharmacies are compensated for professional services, combined with an expanded scope of practice for pharmacists, are presenting major adjustment and implementation challenges for the profession. The changes are part of a culture change ushered in by a general…
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March 2013
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Will more finance reform improve quality in Ontario’s hospitals?
After a decade of focusing on access to health care services, the Ontario government appears to be turning its attention to improving the quality and costs of these services. At the moment, there is considerable variation in how health care is delivered in Ontario’s hospitals,…
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Toronto casino would mean more problem gamblers, more “individual disasters”
With so much money to be made if a Toronto casino is built, it’s no surprise that the health effects of increased gambling receive short shrift in the media compared to news of intense lobbying activities. Private investors, construction trades and companies, as well as…
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Increasing access to surgery without considering appropriateness leaves patients in the dark
Over the last decade, most Canadian provinces have shortened wait times for many surgical procedures, including hip and knee replacement. However, while provinces have poured resources into improving access, they have paid relatively little attention to measuring outcomes of these surgeries. The result, experts believe, is that…
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Canadian alcohol pricing research makes waves abroad, not so much at home
Canadian research that shows how alcohol price policies can reduce alcohol-related harm is making waves in the United Kingdom, Australia and the United States—but not yet at home. International attention has far outstripped domestic attention for a surge of public health-related alcohol research coming out…
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February 2013
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Health Links: Ontario’s bid to provide more efficient and effective care for its sickest citizens
Ontario’s Health Links initiative is a “big manoeuvre” in a complex provincial system, acknowledges Helen Angus, associate deputy minister with the transformation secretariat of the Ministry of Health and Long Term Care (MOHLTC). The initiative aims to facilitate coordination of care at a local level…
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There are hidden costs of moving care out of hospitals
Connie’s story Connie is a Personal Support Worker (PSW) who cares for seniors and people with dementia in their homes. She is a graduate of George Brown College’s PSW program and has been working in home care for the last 10 years. She makes $16…
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Hospitals begin to recognize social media’s potential to improve patient experience
“In Canada in health care we’re at a point where most hospitals accept the role of social media for branding and communication, but only the lead adopters are using it for patient engagement and for clinical use.” – Ann Fuller, public relations director, Children’s…
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Should cautions issued to health professionals be publicly reported?
Last week, the governing council of the College of Physicians and Surgeons of Ontario (CPSO) voted unanimously in favor of changing its bylaws to allow for public reporting of the results of inspections of Out-of-Hospital Premises, such as private colonoscopy and plastic surgery clinics. This…
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January 2013
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Strengthening primary care for child and youth mental health
Chris’ story Chris is a family doctor at a Family Health Team in a Southern Ontario farming community (some details including his name have been changed to protect his and his patients’ identities). He sees many children and youth who have mental illnesses such as…
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Hospital crowding: despite strains, Ontario hospitals aren’t lobbying for more beds
Patients languishing on stretchers in hospital hallways, hospitals issuing capacity alerts when they can’t take more patients, tension in emergency departments as patients wait hours and even days to be admitted. That’s too often the reality in our hospitals. And, given the statistics, you’d think…
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“Chronic blindness” to health impact of alcohol policies
It’s a political football. Whenever the prospect of privatizing the Liquor Control Board of Ontario (LCBO) is placed on the agenda, the result is a heated and polarized debate. Tax revenues, employment, competition and consumer convenience—these are the concerns that dominate discussion. But when…
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