May 25, 2012
“KEY MESSAGES:
- The performance of Canada’s primary healthcare (PHC) system lags behind that of other industrialized countries. Well-targeted investments in PHC can improve the health of individuals and populations, which can in turn have a positive impact on macro-economic indicators, such as employment rates, productivity and economic growth.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Economics, Primary health care, Quality improvement | No Comments
May 23, 2012
“We recommend that health care systems across Canada move actively to provide self-management
supports in a more systematic way. We see four key areas for action:
1) Create an integrated, system-wide approach to self-management support. Current efforts to promote,
deliver, and evaluate self-management support are often fragmented. This report highlights several integrated approaches that we can learn from. Continued progress on the delivery and uptake of self-management support should be monitored against specific health system performance objectives, measures, and targets. Further research in key areas, such as cost-effectiveness and how best to sustain program effects in the longer-term, is also needed.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Chronic disease, Primary health care | No Comments
May 18, 2012
Cathie Scott & Laura Lagendyk. (2012). Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships. Canadian Health Services Research Foundation. Retrieved from http://www.chsrf.ca/Libraries/Commissioned_Research_Reports/ScottLagendyk-April2012-E.sflb.ashx “Key Messages: Nationally and internationally, the need to effectively coordinate provision of care to meet the needs of patients and to make optimal use of resources have been identified […]
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health planning, Integrated care, Patient-centered care | No Comments
May 16, 2012
Following a Clinical Adoption workshop held in November 2009, Canadian change management (CM) practitioners came together to develop a common approach for addressing gaps in e-Health CM practices. Through collaborative dialogue, the group, collectively known as the Pan-Canadian CM Network, conducted a current-state analysis and environmental scan of e-Health CM activities and methodologies. As a result, a National CM Framework was developed to promote a best practice model that supports users in their adoption of e-Health solutions. This article will review the six core framework elements required in a CM process to ensure adoption and achieved return on investment, highlighted by examples of practical Canadian applications.
Posted in Journal Articles, READ Portal | Tagged with Canada, e-health, Information technology | No Comments
May 9, 2012
“Background: Finding measures to enhance the dissemination and implementation of their recommendations has become part of most health technology assessment (HTA) bodies’ preoccupations. The Quebec government HTA organization in Canada observed that some of its projects relied on innovative practices in knowledge production and dissemination. A research was commissioned in order to identify what characterized these practices and to establish whether they could be systematized.
Methods: An exploratory case study was conducted during summer and fall 2010 in the HTA agency in order to determine what made the specificity of its context, and to conceptualize an approach to knowledge production and dissemination that was adapted to the mandate and nature of this form of HTA organization. Six projects were selected. For each, the HTA report and complementary documents were analyzed, and semi-structured interviews were carried out. A narrative literature review of the most recent literature reviews of the principal knowledge into practice frameworks (2005-2010) and of articles describing such frameworks (2000-2010) was undertaken.
Results and discussion: Our observations highlighted an inherent difficulty as regards applying the dominant knowledge translation models to HTA and clinical guidance practices. For the latter, the whole process starts with an evaluation question asked in a problematic situation for which an actionable answer is expected. The objective is to produce the evidence necessary to respond to the decision-maker’s request. The practices we have analyzed revealed an approach to knowledge production and dissemination, which was multidimensional, organic, multidirectional, dynamic, and dependent on interactions with stakeholders. Thus, HTA could be considered as a knowledge mobilization process per se.
Conclusions: HTA’s purpose is to solve a problem by mobilizing the types of evidence required and the concerned actors, in order to support political, organizational or clinical decision-making. HTA relies on the mediation between contextual, colloquial and scientific evidence, as well as on interactions with stakeholders for recommendation making. Defining HTA as a knowledge mobilization process might contribute to consider the different orders of knowledge, the social, political and ethical dimensions, and the interactions with stakeholders, among the essential components required to respond to the preoccupations, needs and contexts of all actors concerned with the evaluation question’s issues.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Decision making, Health technology, Technology | No Comments
May 8, 2012
In this paper, we discuss the current capacity for governments and their health information and quality agencies to report on the performance of their health systems. We also provide international and Canadian examples of governments that are using improved performance reporting mechanisms to support their health care priorities and goals. To do this, they rely on strategic health plans to guide service implementation, complemented by reporting frameworks that use health indicators to monitor performance over a set period of time, and report their achievements regularly to the public. The strategic plans are revised regularly in light of changing political, economic, and social circumstances within each jurisdiction. In some cases, governments have begun using performance-based funding programs as a way to drive performance improvement and achievement of their health care objectives.
As a country, how can we improve the way we set goals and measure changes to health care and the health of Canadians? How do we make sure that activities are focused on achieving positive results? How do we improve accountability for achieving these results, especially in light of the significant public resources employed in the delivery of health care in Canada? These questions predate the existing health accords and remain to be answered.
This paper is intended to raise the profile of performance reporting in Canada’s health care system and to increase our collective understanding of the opportunities to improve it in the interest of better accountability.
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with Canada, Indicators, Quality assessment | No Comments
May 4, 2012
“Health data has great value: it helps make the system more accountable, guides best practices for delivering better and safer care and, ultimately, can help improve the health of Canadians. Health data is important to a variety of stakeholders ranging from policy-makers to users of health care systems—the general public. The purpose of this publication is to provide an overview of health care use and resource demands. As questions rise about the sustainability of our health care systems in Canada, it is important to identify what our uses and needs are. By analyzing current health care data, we can ensure resources are being used in the best way possible.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Statistics & numerical data | No Comments
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 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
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