Model of Care Project - press release

I received this press release in my email inbox this afternoon and thought I should share it here. The Model of Care Project referenced in the release represents an effort to promote collaborative practice and interprofessional care in the PEI health system.

For Immediate Release
June 17, 2009

The Department of Health Begins Work on a Province-wide Model of Care

CHARLOTTETOWN, PEI -- Over eighty people from across the provincial health system came together recently to form the Model of Care Design Team and to begin work on improving the ways in which health care is organized and delivered on Prince Edward Island.

“The results of the 2008 review of our health system indicate that we need to work together as an integrated health system to continue to provide quality health care for all Islanders,” said Premier Robert Ghiz. “The Model of Care Design Team is making an important contribution in achieving the Government’s vision of One Island Community, One Island Future, One Island Health System.”

Similar to other jurisdictions, Prince Edward Island’s health system faces human resource shortages, increasing demands for services and rising health care costs. The work of the Model of Care Design Team involves the creation of a “made in Prince Edward Island” solution that address these challenges.

Specifically, the Model of Care Design Team will look at clarifying the roles of Island health care providers and support staff, and improving the interactions between these roles so that all members of the health care team are empowered to work to their full potential.

“We know that our most valuable health resources are the people working within the health care system. The Model of Care Project will ensure that the effort they put forth produces optimal results across the system,” said Minister of Health, Doug Currie. “We need to find ways to operate as a team and to create opportunities to leverage the collective skills and talent of our team.”

In a display of the Government’s support for the project, Premier Ghiz, Minister Currie and Provincial Treasurer Wes Sheridan visited the team on the second day of their three-day planning session. “As a government, we recognize the importance of listening to those who work within our health care system,” said Minister Sheridan. “I was certainly impressed with the energy and enthusiasm of those involved in the Model of Care project, and have every confidence that their recommendations will enhance the way health care is delivered to all Islanders.”

Model of Care Design Team members come from across the province and represent a wide range of health care skills and perspectives, including physicians, nurses, support staff and associations.

In addition to ensuring that our health system can continue to deliver high quality care sustainably, a redesigned model of care will empower health care providers to work collaboratively to the full potential of their abilities and training. Research supports that an effective model of care can improve both the quality of care and the quality of work life for health care providers.

The Design Team will reconvene this month to continue this important work, and detailed planning will take place over the summer for the implementation of the redesigned model.

BACKGROUNDER

In November 2008, the results of the Corpus Sanchez (CSI) Health System Review were released. Hundreds of Island health care providers, public citizens and stakeholders participated in this review, contributing to the sustainability of the health system and the improved health services for all Islanders.

The Government of Prince Edward Island has endorsed the report’s general direction of One Island Health System. Extensive investigation, review and planning are now underway across the health system to determine which solutions will work best for Prince Edward Island. This is the work of the Department of Health’s Integrated Health System Project.

The Integrated Health System project will concentrate on operational improvements and service realignment. The goals are to improve health outcomes, enhance access and refocus the emphasis of the care delivery system on primary health care and services that can appropriately and safely be provided locally.

The Model of Care Project, referred to officially as the Collaborative Care Team Project, is looking into the ways in which health care providers and support staff can operate as a team. The redesigned model of care within One Island Health System will be centered on patient needs and will strive to make the best use of the system’s skills and expertise. The model will ensure that the most appropriate member of the health care team can provide the most appropriate service at the most appropriate time and place.

The Prince Edward Island Department of Health employs over 2000 health care providers, including physicians, registered nurses, licensed practical nurses, resident care workers and allied health professionals. The 2008 review of the health system reveals that the existing care delivery system is limiting the capacity of these care providers to work to the fullest extent of their abilities.

Opportunities for improvement exist in staffing models, work processes, and the use of information and supporting technology. National research and best practices show that Model of Care strategies are being used to reduce health system barriers by creating and supporting interdisciplinary, collaborative care delivery environments.

The Model of Care Project is just one of the initiatives underway in the effort to achieve One Island Health System. More information on this and the Integrated Health System Project can be obtained through the Project Management Office at healthinput@gov.pe.ca or

(902) 368-5810.

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Job Satisfaction and Retention Survey

Last week the PEI Health Sector Council announced the release of the Job Satisfaction and Retention Survey report. This report provides an analysis of job satisfaction and retention issues among the Registered Nurse (RN), Licensed Practical Nurse (LPN) and Resident Care Worker (RCW) occupational groups on Prince Edward Island. The Job Satisfaction and Retention Survey asked questions regarding place of work, years in practice, work schedule, work environment, wages, respect, scope of practice, performance review and retirement.

Exemplary Care: Registered Nurses and Licensed Practical Nurses Working Together

The Association of Registered Nurses of PEI, the Licensed Practical Nurses Association of PEI, and the PEI Health Sector Council today announced the release of Exemplary Care: Registered Nurses and Licensed Practical Nurses Working Together. This publication highlights the guiding principles shared among RNs and LPNs and clarifies some of the key differences between RNs and LPNs in clinical practice. The discussion and examples presented in the report reflect the practice of typical nurses and is intended to promote an understanding of:

• the scope of practice of each group,
• the practice expectations when both groups work together, and
• the contributions that both groups bring to the care setting.

Having a full understanding of the different health care contributions of RNs and LPNs will enhance and improve the process of collaboration and effective decision-making in the clinical setting.

RNs and LPNs are two health professions that work very closely together. This document represents an important milestone in fostering mutual knowledge-sharing and increased collaboration between the two professions to relieve some of the tremendous human resource pressures on the health system and create an exemplary health care workplace. A more efficient, collaborative nursing practice benefits all of us – nurses, other allied health professionals, and clients of the health system. An efficient, collaborative nursing practice enhances our ability to recruit and retain nurses and leads to better utilization of human resources and, consequently, savings in financial resources.

I hope you get a chance to read and comment on this document.

Cheers,
Mark

Teams in Action: Primary Health Care Teams for Canadians

Last week the Health Council of Canada released a report on health teams in Canada called Teams in Action: Primary Health Care Teams for Canadians. The report was released exclusively as an e-document to limit paper use and save some trees in the process. The HCC asked if I would post a link to the report here and I am happy to oblige, especially considering its focus on Collaborative Practice, one of our favourite topics at the Health Sector Council.

The Teams in Action report profiles many of the public health benefits of collaborative practice in health care, what makes a collaborative health team and efforts to encourage the formation of health teams, and the extent of access to health teams across Canada. Although the report is not health human resource specific, it does make note of the human resource benefits of collaborative practice, including increased job satisfaction and greater knowledge and skill-sharing among health professionals in a collaborative practice setting. In addition to the main report, the HCC has also released backgrounders and supplementary reports specific to each Canadian jurisdiction, including Prince Edward Island. Check out the other site-specific documents here.

Have a look at the report, spread it around, and post your thoughts here. And I promise, the PEI Health Sector Council is not a branch of the Health Council of Canada, despite appearances from the last number of posts!

Cheers,

Mark

Prince Edward Island's Intergrated Palliative Care Program

This post originally featured a video profile of PEI's Integrated Palliative Care Program that was produced by the Health Council of Canada. I've since removed that video as it is somewhat out-of-date and doesn't reflect the current reality of palliative care in PEI. The video can still be viewed on the Health Council of Canada's website if you're curious, but I feel it is important to stay current with these posts. I will have more to say about palliative care and collaborative practice on PEI in the future.

Cheers,
Mark

Canada's Health Care System: Dissed in America

I touched on some of the differences between Canadian and American health care in my last post. Here is a recent press release from the Health Council of Canada also addressing the issue. It highlights some interesting facts on per capita spending on health care in the two countries. There are also some links in the release to the Health Council of Canada's discussion boards that are worth checking out.

FOR IMMEDIATE RELEASE

Canada’s Health Care System:
Dissed in America

TORONTO (April 6, 2009) – When U.S. President Barack Obama recently announced his intention to create a public health care system that would be accessible and affordable for all Americans, he touched off a firestorm of criticism with some south of the border saying Canadian-style health care is not the way to go.

The critics say that Canada has long wait times, inadequate access to diagnostic equipment, and a shortage of specialists, making our health care system a poor example to emulate.

Some of the criticisms about the Canadian system heard in the U.S. include:

Canadians [have] to wait more than a year to get hip replacements, with some patients ending up addicted to pain killers due to the long wait. We Americans will never put up with a system like that.
Health Care Reform Analysed at United Way Meeting. Bill Corley, Indianapolis Star

Routine care in Canada is pretty good — just hope you aren't really sick or have a chronic condition.
Canada isn’t Utopia. Howard Wilkin, Desert News

Are these criticisms accurate?

Canada’s publicly-funded system is founded on the principle of universality, meaning that everyone is entitled to the same services regardless of their ability to pay. Last year, we spent $172 billion on our system. On a per capita basis, we spend 48% less than in the United States, where health care is not universal and some 47 million people do not have health care coverage.

Canadians live longer than Americans and appear to have similar or better health outcomes in most aspects of healthcare. Despite the significant amount of money Americans are spending, are they getting value for their money?

Are Canadians and Americans getting value for the money we spend on our health care systems? What do you think?

“We want to hear what Canadians are saying about these issues,” notes John Abbott, Chief Executive Officer of the Health Council of Canada. The Council recently launched www.CanadaValuesHealth.ca for exactly this kind of discussion.

It’s time for Canadians to speak up on such questions as:

• What do we value about our publicly-funded system? Are there ways to improve and build upon what we have? What constructive new ideas and suggestions can we come up with?
• Can we make our dollars go further? Can we get a bigger bang for our buck? Where can we improve our system to get better value?
• Can we sustain the system without having to spend billions more?
• What can the United States learn from our experiences with universal coverage?

Visitors to www.CanadaValuesHealth.ca can join in this important discussion, watch videos, listen to podcasts, read what other people are saying, and more.

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Pierre Lachaine
Health Council of Canada
Phone : 416-480-7085
plachaine@healthcouncilcanada.ca

Jaclyn Clare or Rachel Sa
PR POST
Phone: 416-777-0368
jaclyn@prpost.ca

About the Health Council of Canada

Created by the 2003 First Ministers’ Accord on Health Care Renewal, The Health Council of Canada is mandated to monitor and report on the progress of health care renewal in Canada. Councillors were appointed by the participating provinces, territories and the Government of Canada.

And now for something completely different...

This post isn’t specifically related to health human resources but I just had to bring it to attention, mostly for its comedic value. I was surfing some of the health blogs this morning and came across this post on Dr. Wes’ blog. Hilarious. A colonoscopy contest? Is this for real? Apparently so. Here is a link to the contest, sponsored by CBS and supported by the National Cancer Institute.

A lot of ink has been spilled about the differences between Canadian and American health care. Debating the merits and faults of either isn’t something I’m going to get into here. But nothing strikes me as more indicative of that difference than a sweepstakes contest offering free health care. Then again, a certain Halifax radio station had a contest a few years ago offering free plastic surgery (let’s just say, to ‘enhance’ certain assets) to the lucky winner. So, I guess crass reality show-style promotional events aren’t restricted to American-style health care. It’s funny, it’s weird. What do you think?

To give this post a bit of context and draw attention to the real issue here, I’d like to highlight a few facts (from the PEI Ministry of Health Annual Report 2006-2007 and the Health Canada website):

• Colorectal cancer (which the colonoscopy screens for) is one of the most common forms of cancer (including lung, prostate and breast cancers) affecting Canadians, with an incidence rate of 62 men and 41.1 women per 100,000 population in 2006.
• Incidence rates for colorectal cancer were higher for PEI than the rest of Canada (64.9 men and 52 women per 100,000 population). They were also higher for lung, prostate and breast cancer.
• Mortality rates for colorectal cancer were higher in PEI (31 men and 22 women per 100,000 population in PEI versus 27 men and 17 women in Canada). They were also higher for lung, prostate and breast cancer.
• Risk factors for colorectal cancer include age (over 70 most at risk), heredity, diet (high in red meat and low in vegetables may increase risk), weight, alcohol consumption and smoking.
• Colonoscopy is one of a number of screening techniques and is considered to be the most thorough screening technique.

It is somewhat disconcerting that the PEI incidence rates for colorectal and other cancers are higher than the Canadian average. There are likely many reasons for this – could human resources be one of them? Availability of human resources must certainly have an effect on mortality rates from these cancers. A 2006 article in the Montreal Gazette suggests that a lack of specialists and equipment in Québec is to blame for year-long wait lists for colonoscopies in that province, prompting many to pay for the procedure in one of Montreal’s many private clinics. Still, I don’t think we’ll see anything as bizarre and ‘un-Canadian’ as the CBS/National Cancer Institute colonoscopy contest on this side of the border anytime soon.

I believe it is also important for all of us to stay on top of managing our own health by living a healthy lifestyle and communicating with our physicians, pharmacists and other health care providers. It is always best to identify issues early.

Cheers,
Mark