Friday, March 21, 2008

Cancer Care Ontario Releases Action Plan for Improving Provincial Cancer Services

Cancer services better today, action needed to meet a 40 per cent increase in cancer patients in next 10 years

Toronto (March 20, 2008) – Cancer Care Ontario today released the 2008-2011 Ontario Cancer Plan, an action plan designed to boost cancer screening rates, improve access to diagnostic and treatment services, make cancer services better and safer, and put new cancer research into practice, faster.

"More people are surviving cancer and cancer services are better today than ever because of actions that have been taken in recent years," says Terrence Sullivan, President and CEO, Cancer Care Ontario.

"We cannot afford to be complacent because 40 per cent more people will be living with cancer in the next decade. By working with our partners to take the steps set out in the Ontario Cancer Plan, fewer people will get cancer and more will survive a diagnosis and receive better services, every step of the way."

The 2008-2011 Ontario Cancer Plan is a three-year road map for the province’s cancer system. It sets out the actions that need to be taken to control cancer and improve patient care. This is the second Ontario Cancer Plan. The first plan was released in 2004.

"We have made huge gains in the fight against cancer since the first Ontario Cancer Plan," said George Smitherman, Deputy Premier and Minister of Health and Long-Term Care. "In the last five years our government has added more quality services for patients suffering with cancer. This has reduced wait times significantly and has allowed patients to get quality cancer care closer to home. We will continue to work side by side with Cancer Care Ontario and health providers on the front lines to lessen the toll of cancer."

The 2008-2011 Ontario Cancer Plan has six goals and highlights four key actions that will have the greatest impact on cancer in the next three years:

  1. Boosting cancer screening rates through aggressive education about screening, providing tools to help primary care providers and patients participate in screening, including using IT to send invitations, reminders and prompts about screening. Cancer Care Ontario will work with our partners to reach under-screened groups including low income earners, new Canadians, people without a family physician and Aboriginals.
  2. Improving the time to diagnosis by beginning to measure and set targets for the wait time between a referral from a family physician to when the patient sees a specialist for tests.
  3. Raising the quality of regional cancer services through implementing improvements including; providing better access to chemotherapy in community hospitals, closer to home; making highly complex chemotherapy and lung surgery safer; and making intensity modulated radiation therapy (IMRT) the gold standard radiation therapy.
  4. Ensuring the high quality and safe introduction of tests that can predict people’s response to treatment and cancer risks, and enable individualized therapy – referred to as molecular medicine.

Significant progress has been made since the first Ontario Cancer Plan. Wait times for radiation and cancer surgery have been steadily going down; regional cancer services and centres have greatly expanded; there are fewer smokers because of Smoke-Free Ontario Act; and the colorectal cancer screening and HPV vaccination programs will save lives.

Growing Number of People with Cancer, Need for Services

  • Close to half of all people will develop cancer in their lifetime: 44 per cent of men and 39 per cent of women.
  • Sixty per cent of cancer patients survive 5-years or more after a cancer diagnosis, up from less than half two decades ago. Almost all prostate cancer patients and 90 per cent of breast patients live more than five years after a diagnosis.
  • In 2007 the province spent $176 million on 27,000 intravenous chemotherapy treatments. In 2011-2012, it is projected that Ontario could spend an estimated $446 million on 49,000 chemotherapy treatments. Cancer Care Ontario continually improves cancer services so that fewer people get cancer and patients receive better care.

Thursday, March 20, 2008

Minister Clement Announces Appointment of President to the Canadian Institutes of Health Research

OTTAWA - The Honourable Tony Clement, Minister of Health, today announced the appointment of Dr. Alain Beaudet as President of the Canadian Institutes of Health Research (CIHR), effective July 1, 2008.

"I am certain that Dr. Beaudet's extensive management experience and strong health science background will be of great benefit to the CIHR," said Minister Clement. "His proven track record as a leader in brokering partnerships between federal and provincial health research organizations and funding agencies makes him well-suited for his responsibilities as President, and will ensure the Institutes continued stewardship in research."

The Minister also expressed his gratitude to Dr. Pierre Chartrand for Acting as President since fall 2007 and thanked him for his contributions to the CIHR.

Dr. Beaudet holds a medical degree and a Ph.D. in neuroscience from the Université de Montréal. He did postdoctoral training at the Centre d'études nucléaires in Saclay, France, and the University of Zurich's Brain Research Institute in Switzerland. Returning to Montreal in 1980, he taught in McGill University's Neurology-Neurosurgery and Anatomy-Cell Biology departments, and went on to become assistant director of research at the Montreal Neurological Institute (MNI). He also served as president of the Canadian Association for Neuroscience from 1995 to 1997. More recently, Dr. Beaudet served as the director of scientific affairs and programs at the Fonds de la recherché en santé du Québec (FRSQ) from 2000 to 2004, and was appointed as president and chief executive officer of the FRSQ in 2004.

Throughout his career, Dr. Beaudet has received numerous grants and distinctions, served on a number of health and research related committees both in Canada and internationally, and has published extensively in leading academic journals.

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to close to 11,000 health researchers and trainees across Canada.

NEW: Growing Communities Healthcare Alliance

GTA/905 Healthcare Alliance grows into alliance of communities across the province.

Toronto (ON): The GTA/905 Healthcare Alliance has long been an advocate for hospitals in the high growth regions surrounding Toronto. Continuing these efforts and given the needs of hospitals in other high growth communities in Ontario, the Alliance is expanding.

In addition to hospitals in the high growth regions of Durham, Halton, Peel, York, and Dufferin County, membership now includes hospitals in the fast growing regions of Kitchener-Waterloo, Guelph, Cambridge, West Ottawa, Fergus and Wellington North. To reflect this new reality, the GTA/905 Healthcare Alliance will be changing its name to Growing Communities Healthcare Alliance.

The six new Alliance members are:
  • Cambridge Memorial Hospital
  • Groves Memorial Community Hospital
  • Guelph General Hospital
  • North Wellington Health Care
  • Queensway Carleton Hospital
  • St. Mary’s General Hospital
They want a stronger voice to resolve long standing problems of timely local access to hospital care and hospital under funding in high growth communities.

Working in collaboration with GTA/905 and Dufferin County mayors, chairs, MPPs, and United Ways, the Alliance has helped bring to the forefront the need for improved funding and increase local access to hospital and health care services as well as other human services in high growth regions. It is hoped that these efforts can now be expanded to many more high growth communities.

The Alliance is working with the Province to begin to fix the hospital funding gaps in high growth regions and is encouraging the Ministry of Health to distribute new provincial hospital and health care funding on a population-needs-based funding formula to ensure an equitable distribution of provincial funding across Ontario.

Ann Stapleford McGuire is Chair of the Alliance. Tariq Asmi is Executive Director.

Mr. Asmi's contact information is:
Growing Communities Healthcare Alliance
Cell: (416) 948-2033 Office: (416) 205-1331

B.C. Nurses Union wins preliminary court battle over extra billing

VANCOUVER _ The B.C. Nurses Union won a significant victory in a court ruling released Tuesday, dealing a blow to the Attorney General's efforts to quash a long-running battle over how medicare is enforced in the province.

Justice Stephen Kelleher, in a 27-page ruling, dismissed an application by the Attorney General and the B.C. Medicare Commission to deny the B.C. Nurses Union standing to pursue a complaint that the commission is not enforcing all the provisions of the Medicare Protection Act.

The union said in a statement following the ruling it contends that by turning a blind eye to so-called facility fees charged by private clinics, the government is neglecting its legal responsibility to protect patients from user fees and extra billing for medicare-insured services.

The ruling dismissed most of the government's objections to the union's case _ which focused essentially on its belief that the union had no standing to be making the argument in a full court hearing.

The court found that the union has raised a serious legal issue about the Medical Service Commission's failure to enforce some portions of the B.C. Medicare Protection Act.

``I conclude that the union has the capacity to bring this petition,'' said Kelleher.

No court date has yet been set for the petition to be heard.

In his ruling, the judge made clear the two sides' positions.

There are provisions in the medicare act that prohibit the commission from paying medical practitioners ``for procedures performed under the act if the practitioners impose a user charge or extra billing in relation to the procedure.''

``The union refers to this as double-dipping. The act does not permit payment by the commission under the plan when the patient is also required to pay.''

The judge said the union's complaint, and the basis of their petition, is the ``failure of the commission to enforce these prohibitions.''

The judge noted that the nurses union started the petition in April 2005 although it first raised its concerns with the B.C. government in 2003.

The commission and the Attorney General, the judge said, say that the union ``has no legal status or capacity to bring this petition.''

The judge, however, agreed with the Attorney General's argument that the union could not advance the case on behalf of patients in the public interest.

Instead, both individual patients and the union would have to proceed arguing their direct, personal interest in the case, the judge said.

BCNU president Debra McPherson expressed happiness at the ruling.

``He has substantially broadened the rights of unions to bring actions before the courts on matters of broad public interest and turned aside the government's attempt to restrict us to narrow labour relations matters,'' she said in a prepared statement.

Wednesday, March 19, 2008

Breakfast with the Chiefs: the video series now available

Archive: Series 2007/08 | Series 2006/07 | Series 2005/06 | Series 2004/05 | Pre 2004

These events made possible by:

Dr. Ben Chan and Michael Decter

Dr. Robert Bell, Dr. Jonathan Irish and Dr. Tak Mak

Linda O'Brien-Pallas and Tom Closson

Graham W.S. Scott and Glenda Yeates

Terrance Sullivan and Jessica Hill

Dave Garets and Ida Goodreau

Healthcare best practices: special publications list

Healthcare Quarterly

Transforming Healthcare Organizations

This article, based on the experiences of a multi-site hospital, and drawing on past research on organizational change, provides a Four-Stage model to help change leaders in healthcare.

Frequency and Type of Medication Discrepancies in One Tertiary Care Hospital

Safety of the medication use system is an issue for many healthcare organizations today. This problem was clearly identified in the Institute of Medicine's report To Err Is Human.

Enhance a Culture of Patient Safety and Assess the Risks of Medication Use Systems

One strategy for addressing adverse events involving medication use is to utilize a systems approach to patient safety rather than focusing on individual performance.


Strategic Levers for a High-Performing Health System

This special issue of Healthcare Papers brings together most of the Strategic Levers symposium proceedings.

Getting Healthy Work Environments in Health Workplaces

Unhealthy work environments result in unhealthy workers and reduced health outcomes for patients. This commentary focuses on getting real change in the workplace, changes that workers and patients will talk about.

Average hospital stay costs nearly $7,000 per patient in Canada

First CIHI report on costs of patient stays shows heart attack, stroke and injuries account for billions a year in hospital costs

OTTAWA, March 18 /CNW Telbec/ - Patient stays in acute care hospitals
account for the largest share (47%) of hospital spending in Canada, according
to a new report from the Canadian Institute for Health Information (CIHI). The
report, which examined 2.4 million recorded hospital stays (outside of
Quebec), estimates that on average each patient stay costs almost $7,000, with
a wide variation in cost by medical condition. The study focuses on the cost
of treating those patients admitted to hospital for at least one night and
does not include the cost of emergency care, day surgery, long-term care,
hospital clinics or fee-for-service payments to physicians. The Cost of Acute
Care Hospital Stays by Medical Condition in Canada, 2004-2005 is the first
report of its kind to examine what hospitals spend by patient stay and by
medical condition. Today's report includes only national figures, though costs
are expected to vary from province to province.
"Hospitals account for the greatest share of health spending in Canada,
so it is important to understand how the money is spent," says Jean-Marie
Berthelot, CIHI Vice-President of Programs. "Better knowledge of the cost of
medical conditions is useful for the planning of health services to meet the
needs of the population."

Circulatory diseases account for highest costs, followed by injury

For patients admitted to hospital, diseases of the circulatory system
(for example, heart attack, stroke) cost the most to treat in Canadian acute
care facilities, representing 19% of inpatient costs in 2004-2005. This is due
to a high cost per stay for these patients, an average of $11,260, as well as
a high volume of stays.
Injury and other consequences of external causes (such as falls,
accidents, poisoning) represent the second largest expense for acute care
hospitals, accounting for 10% of total inpatient costs. In 2004-2005, hospital
stays for injury cost, on average, an estimated $9,400 each.
"This finding is significant, because many injuries can be prevented with
targeted programs," says Francine Anne Roy, Director of Health Resources
Information. "Understanding the specific costs of these hospital stays, often
only one element of the care an injured person might eventually require, can
help hospital and system planners better prepare for these patients."

Underlying conditions or complications account for almost 30% of costs

Many people admitted to hospital with a specific diagnosis may also have
a variety of other conditions, often complicating the care they receive. The
presence of these underlying chronic diseases (or other secondary illnesses)
is costly in terms of hospital care. Almost thirty percent (27%) of the money
spent on inpatient care in Canadian acute care hospitals was associated with
conditions that were either present when the patient was admitted, or that
developed during the hospital stay. For example, a patient receiving care in
hospital for a heart attack costs an average of $7,697 over the entire
hospital stay. If the same patient has an underlying condition or experiences
complications, the average cost increases to $11,043. Some examples of
underlying conditions include diabetes, chronic obstructive pulmonary disorder
and pneumonia.

Other highlights from the report

- Along with circulatory disease and injury from external causes, the
five most expensive medical conditions to treat in hospital include
diseases of the respiratory system, cancers and diseases of the
digestive system. Together, these five conditions accounted for 58% of
the cost of inpatient hospital stays.

- Mental or behavioural disorders are among the top 10 most expensive
conditions to treat in hospital, representing 6.6% of the cost of acute
care hospital stays.

- Though pregnancy and childbirth accounted for the highest volume of
stays, they represented only 5% of total inpatient costs.

- When childbirth is excluded, it costs more, on average, to treat male
patients ($7,964 per stay) in a hospital than it does to treat female
patients ($6,236 per stay).

- At almost $14,000 per stay, the most expensive conditions to treat are
those involving congenital malformations or other chromosomal
abnormalities present at birth.

About this report

The Cost of Acute Care Hospital Stays by Medical Condition in Canada,
2004-2005 is the first report to break down total acute care inpatient costs
into cost per stay and number of stays, and to estimate the share of costs
that can be allocated to the treatment or presence of complexity. This report
uses Canadian administrative data and the CIHI's Discharge Abstract Database
(DAD) to answer key questions related to total hospital costs for acute care

Bird Flu Speculation: Inaccurate Media Reporting

From Toronto's East General Hospital

Toronto, OntarioMarch 19, 2008 Toronto East General Hospital (TEGH) is concerned about inaccurate media speculation and reporting regarding human cases of avian flu. TEGH has no reason to speculate that any patients in the hospital have avian flu.

Toronto is experiencing steadily increasing cases of seasonal flu in the community. For example, during the week of March 2 to 8, 2008, there were 47 new cases of seasonal flu (not avian flu) in Toronto. Although TEGH has effectively responded to an increased number of patients with seasonal flu-like symptoms, including those from other facilities experiencing seasonal flu outbreaks, the hospital has no reason to believe that any patients at TEGH have H5N1 avian flu.

Furthermore, media reports are indicating that the individuals suspected to have avian flu had recently traveled to Bangladesh. It is important to clarify that, according to the World Health Organization, there have been no reported human cases of H5N1 avian flu in Bangladesh.

TEGH has a comprehensive screening program to identify patients who present with potential respiratory illness. The hospital is proud of our record in identifying such individuals. Effective identification enables TEGH to provide appropriate treatment, to utilize respiratory precautions and to protect staff and others. We are confident that no staff, patients or visitors have been inadvertently exposed to seasonal influenza at TEGH.

We wish to reassure the public that the hospital is safe and that there is no reason for anybody who has visited the hospital to be concerned. All services, including scheduled procedures, continue to be fully available. We do not anticipate a need for any reduction in service or visitation restrictions.

Matthew Anderson appointed Chief Executive Officer

Toronto Central Local Health Integration Network gets new boss.

Mr. Anderson has served as Executive Lead for the Toronto-based, 13 organization Shared Information Management Services (SIMS) Partnership which has been identifying, planning and implementing joint information, safety and process improvement initiatives that are contributing to a coordinated and integrated health care delivery system. Good beginnings. Click here.

NEW. the Centre for the Advancement of Health Innovations

OTTAWA, March 17 /CNW Telbec/ - The Conference Board of Canada and the Canadian Health Industries Partnership (CHIP) have reached an agreement to jointly create the Centre for the Advancement of Health Innovations (CAHI).

The new centre will build on the resources, talent, and commitment of the Conference Board and CHIP to make Canada a world leader in the development and commercialization of health innovations.CAHI will adopt a global perspective in identifying and exploring the applicability of best practices to Canada and Canadian industries. To this end, the centre will have an International Advisory Panel chaired by Henry Friesen, founding president of the Canadian Institute of Health Research and founder of CHIP. This panel will be made up of world leaders in health innovation who bring with them a vast wealth of experience and knowledge. The inaugural meeting of this policy centre will take place on March 31-April 1, 2008 in Toronto.

The co-chairs are Dr. Calvin Stiller, Chair of Genome Canada and Mark Lievonen, President of Sanofi Pasteur Limited and Chair of CHIP.

The Conference Board of Canada (CBoC) is widely recognized as Canada's foremost independent, not-for-profit research organization specializing in economic trends, public policy, and organizational performance.

The Canadian Health Industries Partnership (CHIP) is a legally constituted not-for-profit organization that provides a forum to enable governments, academia, and leaders of Canada's industrial health innovation sector to collaborate in exchanging perspectives, discussing and developing recommended strategy directions and policy options on health innovation.

Tuesday, March 18, 2008

First-ever national guidelines to assist and support healthcare providers in the disclosure of adverse events to patients and their families

March 18, 2008: TORONTO -- The Canadian Patient Safety Institute (CPSI) and the Disclosure Working Group today released the first-ever national guidelines to assist and support healthcare providers in the disclosure of adverse events to patients and their families. Experts from organizations representing physicians, nurses, pharmacists, healthcare providers, patients and others created the Canadian Disclosure Guidelines through nearly two years of collaborative effort.

"A focus on patient safety is now emerging in Canada in an effort to learn from and take coordinated action to reduce preventable harm and death," said CPSI Chief Executive Officer Philip Hassen. "CPSI has been pleased to provide coordination, leadership and funding support to the Disclosure Working Group, whose tireless efforts to develop the guidelines have resulted in an important tool for supporting open and transparent communication between providers and patients."

"The Canadian Disclosure Guidelines are intended to assist and support the development and implementation of disclosure policies, practices and training methods. They represent a commitment to the patient's right to be informed if they are involved in an adverse event, by promoting a clear and consistent approach to disclosure, emphasizing inter-professional teamwork, and supporting learning from adverse events."

"The guidelines build on various patient safety initiatives currently underway across Canada," said Working Group chair Brent Windwick. "Through them, we hope to encourage healthcare providers to develop or enhance their disclosure policies and practices by incorporating the core elements, but in ways that are adapted to their respective needs."

For patients and their families, the guidelines stress the importance of providing an apology, timely information and access to further health care, designating a knowledgeable and familiar staff member to provide practical and emotional support, and assisting patients in accessing additional provider and personal supports.

"Things can happen with any type of treatment or care, but when they do, disclosure is very important," said Working Group member and Patients for Patient Safety Canada member, Katharina Kovacs Burns. "As stressful as this may be for healthcare providers, who are the ones disclosing, as well as the patients and families who get the news, apologies are always appreciated. Apologies are a sign of caring, compassion and empathy, not guilt or blame."

For healthcare providers, the guidelines present clear expectations on what should be done to disclose information and assist patients and their families when harm occurs. The guidelines also promote the adoption of a variety of strategies to make organizational and professional supports available to providers, as well as discourage speculation or attribution of blame.

"Adverse events affect thousands of patients every year in Canada," said Working Group member and registered nurse Carolyn Hoffman. "These guidelines support frontline staff and senior healthcare leaders as they enter into timely disclosure conversations with their patients. Open and honest communication following an adverse event helps everyone to learn what happened and what may prevent the same thing from ever happening again."

"Patients are treated and healed through a relationship with their healthcare providers that is based on trust and respect," said Working Group member Dr. Ward Flemons. "When adverse events occur, that relationship is at risk. Timely, truthful and transparent disclosure can re-establish patient/provider trust and is always the right thing to do."

Sunday, March 16, 2008

Government of Canada announces 11 new Centres of Excellence for Commercialization and Research

World-class centres will share $163 million to move discoveries out of the lab and onto the marketplace

OTTAWA, Feb. 14 /CNW Telbec/ - The Honourable Jim Prentice, Minister of Industry, today announced $163 million to establish 11 new Centres of Excellence for Commercialization and Research (CECRs). These centres will share $163 million to pursue major discoveries and bring them to the marketplace over the next five years.

"Today's announcement marks a milestone in Canadian research history," said Minister Prentice. "The technologies, therapies, services and products generated by these new centres will help improve the well-being of all Canadians while positioning Canada at the forefront of priority research areas. As we stated in our Science and Technology Strategy, this Government is committed to encouraging these exciting, multidisciplinary partnerships between the private, academic and public sectors."

The 11 CECRs and their funding amounts are:

- Advanced Applied Physics Solutions, Inc. (AAPS), Vancouver, BC--$14.95 million

- Bioindustrial Innovation Centre (BIC), Sarnia, ON--$14.95 million

- Centre for the Commercialization of Research (CCR), Ottawa, ON--$14.95 million

- Centre for Drug Research and Development (CDRD), Vancouver, BC--$14.95 million

- Centre of Excellence in Personalized Medicine (CEPM), Montreal, QC--$13.8 million

- Centre for Probe Development and Commercialization (CPDC),Hamilton, ON--$14.95 million

- Institute for Research in Immunology and Cancer/CECR in Therapeutics Discovery (IRICoR), Montreal, QC--$14.95 million

- MaRS Innovation, Toronto, ON--$14.95 million

- The Prostate Centre's Translational Research Initiative for Accelerated Discovery and Development (PC-TRIADD), Vancouver, BC--$14.95 million

- Pan-Provincial Vaccine Enterprise (PREVENT), Saskatoon, SK--$14.95 million

- CECR in the Prevention of Epidemic Organ Failure (PROOF), Vancouver, BC--$14.95 million

More information on each Centre is provided here:
Networks of Centres of Excellence