Yesterday afternoon, in my capacity as Cardiac Program Medical Director at my hospital, I met with Mr. B, a 72 year old man whose wife died in hospital. I was expecting that he would want to talk about her hospital care; perhaps he wanted to explore why she died and if anything could have been …
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.
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: I have recently been diagnosed with uterine cancer and have been told it is a “high grade.” I was referred to a surgical oncologist two weeks ago. …
A urologist colleague of mine recently described the impact of long waiting times on his patient, named Linda (name has been changed). He had just completed a multi-hour surgical removal of a large, infected stone from Linda’s kidney. An operation, he pointed out, that he shouldn’t have had to do. Linda had been seen in an …
Jane’s story Jane is a 60 year old woman living in Waterloo, Ontario (a number of details of Jane’s case have been changed to protect her confidentiality). For several years she has been experiencing worsening back pain, which was recently diagnosed as spinal osteoarthritis (a degenerative condition that can cause severe back pain). The pain has grown …
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: I want to do dialysis at home but am worried. Is it safe? Is it possible? The Answer: This is the kind of question Alireza Zahirieh, head of …
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 …
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 father has been on a “wait and see” list for 36 hours, with an IV drip. Once they know surgery isn’t going to happen, why …
An Ottawa area pilot project that facilitates electronic consultations between family physicians and specialists has proved so popular among doctors and administrators that its architects are finding ways to make it permanent. These consultations occur before an actual referral to a specialist is considered by the family doctor. “Doing referrals as a family doctor is one …
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 …
A number of Canadian hospitals have started publishing live emergency department wait times online in an effort to provide patients with expectations on how long they will have to wait to be seen for non-urgent issues. These efforts are all innovative pilot projects, but there is little evidence available on whether this information makes any …
Taking a drive through some states south of the border, you might notice a peculiar phenomenon: not only are there billboards showcasing the latest fashion or promoting certain consumer goods, but obscenely large billboards advertising the ER wait times of various hospitals. “Come to our ER! The wait is only 3 minutes to see a …
Increasing access to primary care providers, such as family doctors or nurse practitioners, has been a government priority. Better access to primary care is also associated with improved population health. Although the percentage of Ontarians with a regular primary care provider has increased in recent years, fewer than half can see their primary care provider …
The frequency of obesity has skyrocketed across Canada, and its treatment is a major challenge to the health care system. Bariatric surgery is an effective treatment for obesity that appears to be good value for money. Although Ontario is expanding bariatric surgery capacity, some are concerned that capacity remains below current needs. What is bariatric …
Each year one in five Ontarians visits one of the province’s 163 emergency departments. A recent study has shown that those who present to emergency departments when waiting times are longer have worse outcomes. Since 2008, Ontario has spent a lot of money and effort to reduce waiting times and improve the quality of care …
The Ontario Health Quality council reported in 2010 that wait times for a long-term care bed in Ontario have tripled since 2005. A substantial number of people who are waiting for long-term care – and some who are currently in long-term care – could be cared for at home or in “assisted living” facilities …
About one in six beds in Ontario’s hospitals are occupied by patients who no longer need hospital care. These beds are called Alternate Level of Care (ALC) beds. Because ALC beds are not available for sick patients in the emergency department, ALC beds are an important cause of emergency department overcrowding. The term ‘gridlock’, used …