
Shut out of clinical trials, community hospitals miss out on ‘cutting-edge therapy’

Welcome back Rounds Table listeners! This week we interview Dr. Robbie Goldstein to find out how Mass General Hospital (MGH) in Boston has prepared, and adapted, to a massive influx of patients with COVID-19. Dr. Goldstein is an Instructor in Medicine at Harvard Medical School and an Infectious Disease physician at MGH. He is also…
In an emergency department in Calgary, a woman says she slipped on the ice, but her injuries don’t match a fall. In a private setting, the nurse begins to talk to her about domestic violence. Initially, the patient insists that she slipped, but after a long conversation, the nurse and the patient call the police together.…
When Frank Gavin’s son was a child, he frequently had to be rushed to the emergency department at Sick Kids Hospital in Toronto. One of the first things that struck him was, despite all the young children and parents in the department, finding the washroom was like navigating a maze. Gavin’s experience as a parent…
Two years ago, Colin’s first son was born at a hospital in a mid-size city in southern Ontario. After a long, difficult labour, his wife and baby were moved to a semi-private room at 5:30am. But Colin was not allowed to join them. “The nurses said I’d have to leave, and come back later in…
In 2010, after a regional needs assessment for medical imaging, the Pembroke Regional Hospital was approved by its Local Health Integration Network (LHIN) to purchase a new MRI scanner. This new machine will allow the city and neighbouring region’s residents to be scanned locally, instead of having to drive as much as 3 hours each way…
Patients and their families were treated with “callous indifference.” Water was left out of reach. Soiled bed sheets weren’t changed, sometimes, for months. The abuses that took place between 2005 and 2008 in an England hospital shocked the country. A 139-day public inquiry revealed that there were many signs leading up to the abuse. If acted…
Ontario’s health care system can feel like a maze. The system has become so complex that even people who work in it every day often struggle to navigate it. So for members of the public – who often encounter the system at a time of crisis – it can be hopelessly confusing and frustrating. In…
Starting next year, doctors’ malpractice insurance in most parts of the country will cost a lot more – more than doubling in many places. Fortunately for physicians, however, that will affect provincial health budgets more than their own practices. Most doctors are covered by the Canadian Medical Protective Association (CMPA), a non-profit mutual defence organization…
Hymns, protests, and arrests – that’s what happened when the Fort Erie, Ont. community rallied against a planned conversion of their local hospital’s emergency room to an urgent-care centre. It didn’t work, and in 2009, it seemed their fears were realized when a teenager died after she was in a car crash and had to be…
In 2007, a group of Canadian cardiologists found themselves in a unique position. New – and expensive – implantable cardiac defibrillators were being used by fewer than a dozen doctors. And the Institute for Clinical Evaluative Sciences was offering to help them create a registry that would track outcomes for five years. Soon, they had the largest registry…
Can health care learn from assembly lines? Manitoba’s St. Boniface General Hospital thinks so. It’s been using Lean, a system inspired by Toyota, on processes around the institution. Last year, one of its projects was to reduce wait times for CT scans. Staff ran a Rapid Improvement Event, where a team mapped out patient flow and…
Shalimar Novak is sick of paying for parking. The social worker has been to Toronto’s Mount Sinai once or twice a week recently for appointments related to her pregnancy, and paid about $15 every time. “It definitely adds up,” she says. “And when you have a kid coming, you’re thinking in diaper dollars. It would be nice…
Rahel Yetbarek sits with her feet up, looking out onto the city and the large swath of treed land that surrounds the freeway below her. The nurse is taking in the view over her lunch break, from the 10th floor rooftop garden at Bridgepoint, a Toronto hospital. Nearby, a few patients do the same. The…
Being hospitalized can have dramatic impacts on seniors’ wellness, and time spent in hospital contributes to loss of important functions such as strength and mobility – critical to their independence and wellbeing. Camilla Wong, a geriatrician at St. Michael’s Hospital in Toronto says “hospitalization robs us of the things that are really important for older…
Michael’s Story Michael was a 75 year-old living in Canada’s Prairies. His wife recently spent five days in hospital for a scheduled hip replacement. At the time she was admitted to hospital, Michael was on a one-week course of Amoxicillin, an antibiotic medication to treat a sinus infection. Michael spent a great deal of time…
Lately I have found myself on a few health care boards in both Alberta and Ontario. I have been impressed by the dedication of the board members, and the depth and breadth of expertise they provide. I am also convinced that having many board members who are not health care insiders provides an exceptionally important…
In the modern economy, many industries, such as aviation, retail and manufacturing, no longer slow down over weekends. Yet hospitals have mostly resisted this trend, even though demand for many forms of health care is no less on weekends than on weekdays. While most hospitals are open every day of the week, many operate with…
Katie’s story Three years ago, Katie (name and some details changed to protect her identity) was in a car accident on a rural road two hours outside of an urban centre. Her ankle was crushed in the accident, and after a delay of several hours due to weather, she was air-lifted to the nearest trauma…
After finishing medical school, new doctors go through several years of post-graduate, on-the-job training – known as residency – in order to become licensed to practice independently. Historically, residency has involved very long hours spent in hospital, so that residents see a high volume of diverse cases as well as provide patient care. As part…
“They made me feel genuinely cared for. They listened, made eye contact with me, conveyed warmth and understanding in their voice and repeated back to me what I was saying.” — Sophia, about her visit to a chronic pain clinic, from a “care moment” prepared by the Patient Experience department of Alberta Health Services. Mounting…
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 (population about 8,200) and instead obstetrical care would be “consolidated”…
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…
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 per hour, but rarely gets paid for more than four…
“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 Hospital of Eastern Ontario (CHEO) Call up the website home…
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…
Ontario Ombudsman André Marin’s bid for jurisdiction to investigate complaints about patients’ experiences at the province’s hospitals and long-term care facilities has support from a wide range of patient advocacy groups. Marin stresses that his counterparts in all the other provinces have jurisdiction to investigate these types of complaints, although the scope of their powers…
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: My mother is in hospital. We feel she is not well enough to go home as she cannot get up to go to the bathroom or…
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…
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…
The Ontario Ministry of Health and Long-Term Care is changing the way it funds hospitals for the upcoming fiscal year, which starts on April 1. The new funding formula is intended to improve efficiency. However, many hospitals are unprepared for the change. We spoke with hospital executives and other experts to better understand what is…
A recent report by the Canadian Institute for Health Information provides information about the major drivers of health care costs in the past decade, which include growing salaries for health care workers and greater intensity of treatment. The report suggests that the aging population is not a major contributor to rising health care costs. These findings clash…
Hospital accreditation is a process that assesses a hospital’s performance against a set of standards. This process is done differently across provinces and countries. In Canada, most hospitals go through an accreditation process conducted by Accreditation Canada. The accreditation process could be more transparent and provide more information to the public about the quality of…
In August 2011, a supervisor was appointed at the Niagara Health System to “restore public confidence” in the hospital. The Ontario Public Hospitals Act allows the government to appoint a supervisor to take over the administration of a hospital if it is considered in the public interest to do so. While appointing a supervisor happens…
The Centre for Innovation in Complex Care hosted a debate on April 8, 2011 focused on the resolution that “the single most important step in improving hospital quality is having physicians paid and employed by hospitals.” Healthydebate.ca covered this issue on April 6, with a story on How Hospital Doctors Be Paid? At the debate,…