May 2, 2012
“In October 2011, the Health Council of Canada hosted a national symposium on patient engagement. The plan was simple enough: we wanted to explore how good ideas have been, and could be, turned into action. As we began to develop the agenda for the day, we learned there is no shortage of Canadians—both within and outside the health system—with much to say on the matter. The over 160 people who attended collectively represented the Canadian health care system: patients; representatives from patient organizations; federal and provincial governments, regional health authorities, and local health integration networks; health system administrators; health care providers; and researchers.
We heard many perspectives. Patients told us what it is like to navigate the often intimidating and confusing Canadian health care system. Health care providers gave us an insider’s view of how they would improve this same system for their patients, and planners and administrators told us how they’re working to make patient centred care a reality. Our intention was three-fold: to raise awareness of the potential of patient engagement as an instrument of change; to spark a national dialogue that would build support for patient engagement; and to help those who are entering this burgeoning field of system-level change to gain insight into tools and experiences that are available to either start or advance their patient engagement work. To keep the momentum from that day going, we developed this commentary and proceedings report to inspire governments, health care workers, and patients to take up patient engagement in their own ways.
For the Health Council of Canada, our work didn’t end with the symposium. We will keep what we learned in October fresh in our minds, and embed it into all that we do. Patient engagement at all levels happens when we ask ourselves, “Is this the right thing to do so that patients and their caregivers have a voice?” We hope all symposium participants are doing the same.
We can learn from one another, share what others are doing well, and, more importantly, not be afraid to ask them how they did it. The ideas for change are out there. By sharing what we learn from those actively involved in health care, and putting that knowledge into practice, we can start to turn ideas and experience into a better reality for all Canadian patients.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health care reform, Patient-centered care, Quality improvement | No Comments
May 1, 2012
“Systems that provide healthcare workers with the opportunity to report hazards, hazardous situations, errors, close calls and adverse events make it possible for an organization that receives such reports to use these opportunities to learn and/or hold people accountable for their actions. When organizational learning is the primary goal, reporting should be confidential, voluntary and easy to perform and should lead to risk mitigation strategies following appropriate analysis; conversely, when the goal is accountability, reporting is more likely to be made mandatory. Reporting systems do not necessarily equate to safer patient care and have been criticized for capturing too many mundane events but only a small minority of important events. Reporting has been inappropriately equated with patient safety activity and mistakenly used for “measuring” system safety. However, if properly designed and supported, a reporting system can be an important component of an organizational strategy to foster a safety culture.
Healthcare is not as safe as it should or could be: rates of adverse events, defined as situations where patients suffer harm from the healthcare they receive (or not receiving care that would have helped), in acute care have been shown to be high. For example, the Canadian Adverse Events Study found that 7.5% of patients admitted to a Canadian hospital suffered an adverse event (Baker et al. 2004). The National Steering Committee on Patient Safety listed the comprehensive identification and the reporting of hazards as one of “nine key principles for action” that served as a foundation for the committee’s recommendations to make Canadian patients safer (National Steering Committee on Patient Safety 2002). Further, the committee recommended the adoption of non-punitive reporting policies within a quality improvement framework. Recently, the National System for Incident Reporting (Canadian Institute for Health Information 2011) was established by the Canadian Institute for Health Information, whose focus at the present time is incidents regarding hospital-based medication and intravenous fluids. The development of reporting systems to enhance patient safety has been proposed as a strategy in other countries; examples include the Australian Incident Monitoring System (Runciman 2002) and the National Reporting and Learning System in England and Wales (Williams and Osborn 2006).”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Canada, Quality improvement, Safety | No Comments
April 30, 2012
According to PwC’s consumer survey of 1,060 U.S. adults, about one-third of consumers are using the social space as a natural habitat for health discussions. Social media typically consists of four characteristics that have changed the nature of interactions among people and organizations: user generated content, community, rapid distribution, and open, two-way dialogue. This report dives into the social world of the health industry and provides insights into new and emerging relationships between consumers and the biggest health companies that serve them. It examines how individuals think about and use the social channel; how some providers, insurers, medical device, and pharmaceutical companies are responding; and discusses specific implications for organizations to take advantage of with this new view into the 21st century patient.”
This paper requires that you register to access it; however, it is completely free to do so.
Posted in READ Portal, Reports & Papers | Tagged with Information technology, Social media | No Comments
April 27, 2012
Key Messages:
- Fiscal sustainability generally refers to the extent to which spending growth matches growth in measures of a society’s resource base. Since 1975, real per capita government health spending in Canada has risen at an average annual rate of 2.3%, in excess of the growth in real per capita GDP, government revenues, federal transfers and total government expenditures.
- Five expenditure scenarios were constructed, using regression determinants and growth extrapolation approaches, for Canada as a whole, each of the ten provinces and the territories for the period 2010–2035.
- For Canada as a whole, real per capita public healthcare spending from 2010 to 2035 can be expected to grow anywhere from 78% to 115% and reach a level in 2035 in 2010 dollars ranging from $6,552 to $8,798 per capita.
- For the provinces, the average increase across the ten provinces from 2010 to 2035 in real per capita provincial government health spending ranges from 81% to 160%. Average estimated spending in 2035 ranges from a low of $6,711 to a high of $10,819 per capita.
- For the Yukon, real per capita public healthcare spending between 2010 and 2035 can be expected to increase from a low of 142% to a high of 652% – a range in 2035 of $14,316 to $41,089 per capita. For the Northwest Territories and Nunavut, low-end growth was 57% while the highest growth was 281%. Spending in 2035 would be estimated to range from a low of $12,423 to a high of $32,557 per capita.
- In terms of the fiscal gap, annual compound growth rates for forecast government health spending exceed those for government revenue growth for most scenarios and jurisdictions. For Canada as a whole, the public healthcare expenditure-to-GDP ratio could rise to as little as 9.5% or to as much as 13.4% by 2035 from the current 7.6%. The territories and most provinces generally also see increases in the public healthcare expenditure-to-GDP ratio by 2035.
- Under the extrapolation assumption that health expenditure trends for the 1996 to 2008 period continue but with lower economic growth, government health spending in Canada in 2035 would reach $8,798 per capita and the public healthcare expenditure-to-GDP ratio would reach 13.4%. This projected increase is equivalent to an increase in public spending today of about $2,797 per capita, possibly requiring up to a 15% increase in per capita revenues.
- Potential policy solutions to make public healthcare spending more sustainable include controlling and restructuring expenditure, raising additional tax revenues, creating a federal health tax to generate revenues for a national health endowment fund, and allowing for a greater private role in healthcare spending.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Economics, Health care costs | No Comments
April 26, 2012
“In this report, we focus on the issues and challenges related to home care for seniors and their caregivers in Canada, and the opportunities to improve and integrate the services they need to age well at home.
We begin by looking at the types of clients who are receiving home care, the services they are receiving, and the intensity of their needs. We then look at the characteristics of family caregivers, including the number of hours they spend on care and their level of distress. In particular, our analyses show that many seniors with complex and multiple health needs are receiving limited hours of home care, and as a consequence a considerable number of their family caregivers—many of whom are seniors themselves—are stretched beyond their capacity and report high levels of distress.
We also examine system issues such as the importance of integrating home care with hospitals and primary care, and the challenges facing the home care sector such as the recruitment and retention of personal support workers. We discuss the cost-effectiveness of home care compared to hospital care and long-term care facilities, noting that public spending on long-term care facilities in Canada is much higher than spending on home and community care. We look at the experiences of other countries that spend proportionally more on home care and have implemented strategies to ensure that seniors can remain at home longer with a better quality of life.
Throughout the report, we profile innovative practices that are examples of effective home care policies and programs, and that illustrate how home care can be integrated with other health services and sectors. These practices offer tools and ideas that can be adapted by governments and health systems across Canada.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health services for the aged | No Comments
April 25, 2012
“across the nation. Although they each share a common goal, historically they have operated independently of each other. However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health.
The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs. The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards.”
Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Primary health care | No Comments
April 24, 2012
“The Canadian Hospital Reporting Project (CHRP) is a national quality improvement initiative from the Canadian Institute for Health Information (CIHI). CHRP’s web-based, interactive tool gives hospital decision-makers, policy-makers and Canadians access to indicator results for more than 600 facilities from every province and territory in Canada.
CIHI selected 21 clinical and 9 financial indicators for CHRP, based on their relevance to performance measurement and quality improvement. The selected indicators measure:
- Clinical effectiveness;
- Patient safety;
- Appropriateness of care;
- Accessibility; and
- Financial performance.
These indicators were chosen after reviewing existing hospital performance indicators and collaborating with experts in the field. The goal of CHRP is to foster quality improvement, learning and action.
Posted in Multimedia, READ Portal | Tagged with Canada, Patient-centered care, Quality of care, Safety | No Comments
April 23, 2012
“Ten years ago, in September 2002, the National Steering Committee on Patient Safety delivered its report urging the development of the Canadian Patient Safety Institute and enhanced efforts to identify and reduce the risk of patient harm across the healthcare system. Two years later, the Canadian Adverse Events Study (Baker et al. 2004) provided data on patient safety in acute care – data that reported levels of harm far greater than most suspected. Today, virtually all Canadian healthcare organizations have goals around improving the safety and quality of care, and many have implemented reporting systems that identify patient safety incidents and track the implementation of recommendations to reduce hazards. In only a decade, patient safety has been transformed from the esoteric interest of a small number of champions to an essential component of healthcare performance across Canada. Today, patient safety is a fundamental prerequisite for the healthcare system: quality is impossible unless patients are protected from unintended harm.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Health care reform, Quality control, Safety | No Comments
April 20, 2012
“The safety of maternity services is of paramount importance. Maternity teams face many challenges in delivering safe care to mothers, babies and families. The King’s Fund launched an independent inquiry into the safety of maternity services in 2006. The report from that inquiry, Safe Births: Everybody’s business, made a series of recommendations about how the safety of maternity care could be improved.
Building on the recommendations from our inquiry and in partnership with the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the NHS Litigation Authority, Centre for Maternal And Child Enquiries and the National Patient Safety Agency, The King’s Fund launched the Safer Births Improvement Programme, providing customised support to 12 multidisciplinary maternity teams in England. This toolkit shares the experiences and lessons from those teams.
Improving Safety in Maternity Services: a toolkit for teams is organised around five key areas for improvement in maternity care on which the teams focused:
- teamworking
- communication
- training
- information and guidance
- staffing and leadership.
Each section begins with a brief explanation on how focusing on improvements in each area can contribute to improved safety. It then highlights some of the experiences of the maternity teams who focused on this issue and their key learning points. There are also short summaries of tools that can be used to improve safety. These provide a brief guide to how to use the tool and signpost further resources. Where available we have included examples or templates that can be used or adapted for local use. Finally, we provide more information about service improvement and the tools and techniques that can be used.”
Posted in READ Portal, Reports & Papers | Tagged with Efficiency, Health care reform, Process improvement, Safety | No Comments
April 19, 2012
“Recent research has demonstrated that an exceptional patient experience correlates with improved clinical quality, reduced readmissions and improved mortality. HCAHPS is a tool that can be used to help organizations improve the patient experience, and may have a related effect on clinical quality. With the implementation of value-based purchasing beginning with October 1, 2012 discharges, HCAHPS performance will also have an impact on financial goals.
This guide describes how HCAHPS data should be used in context with other information about organizational performance. It highlights cultural elements necessary to build a firm foundation for HCAHPS success. Once these foundational elements have been considered, the guide outlines a 5-step approach to using HCAHPS effectively to improve the patient experience, quality and safety:
- Understand HCAHPS data
- Set improvement priorities
- Identify and implement targeted interventions
- Engage the team
- Measure and monitor success
The appendix includes links to white papers and case studies that can help health care leaders better understand the HCAHPS survey and identify and successfully implement strategies for improvement.”
Posted in READ Portal, Reports & Papers | Tagged with Process improvement, Quality improvement | No Comments
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