Quality

Can “bottom up” measurement improve the quality of Canadian health care?

| May 23, 2013
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.

Canadian medical schools struggle to recruit Aboriginal students

| May 2, 2013
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 the general population. Mental illness is also alarmingly common in …

Failed shoulder surgery and how to get it fixed

| May 1, 2013
Lisa Priest Personal Health Navigator Sunnybrook healthydebate.ca

My wife had arthroscopic surgery for a rotator cuff injury more than two years ago. Unfortunately, the surgery did not help because my wife is still experiencing severe pain intermittently. She did physiotherapy and lately she did shock wave therapy. Basically, we did everything. We want to get another opinion. Please help us on how to start.

Interpretation services in health care

| April 18, 2013
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 of new immigrants has made a “humungous difference”, says Stan …

Retail pharmacy evolution beset by implementation challenges

| April 4, 2013
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 shift in health care towards a push for greater inter-professional …

Will more finance reform improve quality in Ontario’s hospitals?

| March 28, 2013
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, so patients with the same diseases are receiving different qualtiy …

Pain control after major surgery: the patient as expert

| February 12, 2013
Lisa Priest Personal Health Navigator Sunnybrook healthydebate.ca

The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskLisa@Sunnybrook.ca The Question: After hip replacement surgery, I was placed on tramadol for pain. It worked moderately well, although in retrospect, I would have probably done better with something …

Should cautions issued to health professionals be publicly reported?

| February 7, 2013
Should Ontario's Regulatory Colleges Publicly Report Cautions?

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 change was made following reporting by the Toronto Star, which …

Hospital crowding: despite strains, Ontario hospitals aren’t lobbying for more beds

| January 24, 2013
Are Canadian Hospitals Overcrowded?

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 that hospital executives—especially in Ontario—would be pushing hard for more …

Test results: whose job is it to tell the patient?

| December 18, 2012
Lisa Priest Personal Health Navigator Sunnybrook healthydebate.ca

The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskLisa@Sunnybrook.ca The Question: Is it the family physician’s job to gather test results and explain the outcome of those tests – blood tests, ultrasounds, X-rays and CT scans – and …

Pain control: how to stay on top of it after surgery

| December 4, 2012
Lisa Priest Personal Health Navigator Sunnybrook healthydebate.ca

The Personal Health Navigator is available to all Canadian patients. Questions about your doctor, hospital or how to navigate the health care system can be sent to AskLisa@Sunnybrook.ca The Question: Before I undergo a knee replacement, I have to see an anesthesiologist. I know the visit is to go over details to put me under during the …

Improving quality and access in Ontario’s privately owned colonoscopy clinics

| November 29, 2012
Improving quality and access in Ontario’s privately owned colonoscopy clinics

Five years ago, researchers in Ontario raised concerns about access and quality in privately owned clinics that performed colonoscopy, suggesting that the quality in these clinics was significantly below the standard of care in public hospitals. Privately owned clinics can be either for-profit or not-for-profit. Medical services provided at these private clinics are paid for …

Improving the appropriateness of diagnostic tests

| November 8, 2012
Improving the appropriateness of diagnostic tests

The number of diagnostic imaging tests performed on Canadian patients has been increasing rapidly in recent years. Although the cost of each test is small, the aggregate costs add up quickly. The costs have become sufficiently large that both doctors and the government have raised questions about whether all the tests that are being performed …

Oakville clinic sets an example for quality and accountability in primary care

| October 25, 2012
Oakville clinic sets an example for quality and accountability in primary care

Primary care is the foundation of Ontario’s health care system and more than 137,000 patient care visits are made every day to primary care providers – family physicians, general practitioners and nurse practitioners – in the province. However the quality of care that patients receive in primary care is largely unknown. Even primary care providers …

The next challenges for primary care in Ontario

| October 4, 2012
The next challenges for primary care in Ontario

Over the last year, reports have suggested some of Ontario’s new primary care models, which are significantly more expensive than older practice models, have had limited success in improving access and quality. In response, the Ministry of Health and Long Term Care is conducting a review of these models, and had recently instituted a temporary …

Filling a gap: Ontario’s walk-in clinics

| August 9, 2012
Walk In Clinics Ontario

About one in four Ontarians visit a walk-in clinic each year. While the government has made access to family doctors a key priority, there is no policy framework for walk-in clinics. Although walk-in clinics have been part of Ontario’s health care landscape for decades, they remain controversial. Walk-in clinics have generally been excluded from government …

How ‘public’ are hospital performance ratings?

| August 2, 2012
Hospital Reporting

Although there is lots of talk about making measures of health system performance available to the public, the reality often falls short of the aspirations. Not only are these measures often difficult for public users to understand and access; evidence suggests that they have little impact.  In April of this year, the Canadian Institutes of Health …

Improving quality and safety in Ontario’s nursing homes

| July 26, 2012
Nursing home

Recent media reports have highlighted the problem of neglect in nursing homes. Reports from the long-term care sector, in response, have focused on how the quality of care in nursing homes could be improved. However, measuring the quality of nursing home care can be a challenge. Rob Sargeant is a general internist at St. Michael’s …

The challenges of improving hospital food

| May 31, 2012

The saying “you are what you eat” has taken on more meaning in Canadian society, with growing interest in the quality, origins and farming practices of the food we eat. For some hospitals, this phrase is “you are what you serve” with food service being increasingly scrutinized, and there are many Ontario hospitals with efforts …

Advance care planning: a difficult conversation

| May 17, 2012
advance care planning end of life palliative care rasouli ontario health care health care policy

Advance care planning is an important process by which people think about how they would like to be cared for if they are seriously ill.  While most Canadians agree that having conversations about advance care planning are important, fewer than half actually do. In some jurisdictions, advance care planning is done much better than it …