Empowering vulnerability: Overcoming the fear and shame of physician errors
quality
We must protect the elderly as we move to virtual care
A call to Health Ministers: Target public reporting to areas requiring improvement
When provincial and territorial Health Ministers meet Wednesday with the new federal Health Minister Dr. Jane Philpott, it is imperative they focus not simply on the amount of money coming from Ottawa but rather on what matters most: how to get value and performance from our health care dollar. The late Jim Flaherty set the table …
Improving appropriateness of antipsychotic use in long-term care
When prescribed appropriately – to treat psychosis related to a psychiatric condition like schizophrenia – antipsychotic medications can improve a patient’s quality of life. However, too often it appears antipsychotics are being prescribed to residents of Long-Term Care Homes (LTCH) to control behavioral symptoms of dementia (such as verbal or physical aggression) without a concurrent …
Health care must learn to embrace failure
Forty is the new thirty. Orange is the new black. And failure is the new success. It seems these days that no success story is complete without a failure (or two) along the way: the bankruptcy that gave birth to a successful company; the entrepreneur who lost it all just before hitting the Fortune 500. …
More is better when it comes to hospital staff satisfaction surveys
Staff satisfaction surveys are a vital tool when trying to improve employee engagement. The connection between workplace health and quality patient outcomes is well documented. Yet, according to National Research Corporation Canada (NRCC), only two Ontario hospitals using their tool survey more frequently than once every year or two. Can an organization effectively focus on …
Safe surgery checklists: the Canadian experience
Each year there are patients who wake up from surgery to find an operation has been done on the wrong part of their body. These wrong-site surgeries are an example of “never events” – incidents that simply should not happen if all safety measures are taken. Nevertheless, these events take place each year in countries with …
Should hospital staff satisfaction survey results be public?
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 …
Decision aids: why hasn’t this proven, patient-centred practice caught on?
Health care has supposedly entered an era of patient involvement, where important medical decisions are shared between doctors and patients. But many believe that the reality in Canadian health care falls well short of this ideal. Complex medical decisions can prove difficult for patients, who are often faced with dizzying amounts of information about benefits and risks, …
Medical education must include quality improvement and patient safety
Entering medical school is like settling in a new country, you have to learn the language, adapt to the culture and figure out how to succeed. As medical students, we study the pathophysiology, clinical presentation, diagnosis and management of diseases. We learn how to effectively communicate with patients to get their stories and pair these …
Hip and knee implants need improved monitoring, assessment
Hip and knee replacement surgeries are among the most cost effective medical interventions developed, with the vast majority of patients enjoying a greatly improved quality of life as a result. They are also among the most popular surgeries. You might be surprised to learn that Canada’s yearly 75,000 joint replacements, at an estimated $15 000 …
Can Kaiser Permanente’s success be replicated in Canada?
I recently attended a briefing of Ontario health system stakeholders by representatives of the famed Kaiser Permanente Health System, often called America’s leading nonprofit integrated health plan. Kaiser Permanente representatives are regularly invited to Ontario to provide advice (and maybe hope) to the rest of us that health system reforms could produce the same sort …
Pulling back the curtain on Canada’s rising C-section rate
Caesarian sections (C-sections) are among the most common surgical procedures performed on women of child-bearing age. Canada’s C-section rate has increased dramatically in the past two decades. The national C-section rate has increased from 17% of all births in 1995 to nearly 27% in 2010. In Ontario, nearly 29% of births in 2011/12 were by C-section, with a similar rate in Alberta of …
Complacency putting Canadian health care at risk
As the United States attempts to overhaul health care and improve access for more of its citizens a US Senate committee recently met in Washington and invited several international experts to share perspectives on their own health care systems. Toronto physician Dr. Danielle Martin very nicely represented the Canadian perspective. It was an articulate presentation …
When quality trumps service, patients lose out
The Ontario government deserves applause for tackling global funding for hospitals. “Global budgets provide[d] little incentive for hospitals to focus on efficiency, innovation, improving access, coordinating care across facilities and sectors or improving quality.” In 2012, the Ontario Ministry of Health announced its commitment to patient-based funding. It promised to deliver patients: • Shorter wait …
Rethinking health outcomes in the era of multiple concurrent chronic conditions
Modern health care is very much concerned with outcomes. The language of outcomes is common in policy development, clinical work, and research. For example, Health Quality Ontario states that the overall quality aims are: Better outcomes, better experience, better value for money. In the context of clinical care, outcomes are broadly considered to be the …
A primer on Ontario’s health care system for primary health care boards of directors
Last year, Healthy Debate published a primer on Ontario health care system for the boards of directors of hospitals. We’re very happy to now release a primer on the health care system specifically designed for the boards of directors of community governed primary health care organizations. Ontario’s health care boards I have served on several …
Putting the “public” in public reporting on health system performance
As both users and funders of health care, Canadians have a stake in understanding how well their system is performing. Polls repeatedly show health to be a top priority for Canadians and their appetite is strong for performance information, provided it is easy to access and digest. The challenge is in developing reports that are …
Can quality be assured for diagnostic imaging?
News headlines from across Canada are periodically dominated by scandals and errors in diagnostic imaging. The list grows each year, with errors exposed from coast to coast. The narrative follows the same arc – an error is discovered in an area of diagnostic imaging. A radiologist – generally the physician involved in the interpretation of …
Fewer hospital staff on weekends puts some patients at risk
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 …