Innovations
As the Canadian Medical Association prepares to sweep across our country, this is our opportunity to have our voices heard loud and clear, reinforcing the overwhelming support Canadians have for Medicare.
But advocating for the status quo is not enough.
We all know that the system faces real challenges: long wait times for some services, a lack of electronic records, and significant disparities in access and outcomes for some populations.
My Better Medicare seeks to illustrate how the Canadian, publicly-funded health care system is providing quality health care services and to demonstrate improvements to the health care system.
Health experts from across Canada share some of these innovative projects that are improving access, quality and cost-effectiveness in health service delivery.
Featured Innovations |
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In 1999, the Vancouver/Richmond Regional Health Board took a big risk. They sent 14 nurses out onto the streets of Vancouver’s downtown east side (DTES) to deliver influenza and pneumococcal vaccinations in what they called a “vaccine blitz” approach.
The nurses worked in teams with volunteers from the community in single-room occupancy hotels, soup kitchens, food banks, needle exchange sites, drop-in-centres, pubs, medical clinics, the city jail, pre-trial and even right on the streets. They delivered over 15,000 shots that month in hundreds of different make-shift clinics – nearly as efficient as an office-based clinic would have been. They reached a population that is notoriously difficult to reach. And they were universally welcomed.
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Alberta Bone and Joint Institute |
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The Alberta Bone and Joint Institute has introduced an improved model for providing care for hip and knee replacement patients in Alberta at a time when the need for efficient, high quality care is rising due to an aging population and population growth. The approach is based on the best evidence and care is delivered by multidisciplinary teams; services are fully standardized and integrated so that patients receive the same type and level of treatment regardless of where they are located in Alberta. The model has been extensively evaluated and has proven itself to be successful.
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Long and Brier Islands Model of Care |
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The Long and Brier Islands are geographically remote areas of Nova Scotia where the only health care provider available to the population of 1240 residents for many years was a registered nurse providing foot care services. Concerned community leaders successfully lobbied for improved access to primary care, and today receive primary health care and emergency services from an on-site team comprised of a Nurse Practitioner and paramedics supported by an off-site physician. This innovative model of rural primary health care has shown to have increased access to health services with high levels of resident acceptance and satisfaction.
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Primary Care Practice Support in British Columbia |
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In Canada, debate about reforming health care is driven by delayed access to specialists and procedures. Enhancing specialist intervention is not, however, the key to health care improvement. Countries with better primary care have better population health outcomes and lower health care costs, and the World Health Organization released a report in 2008 urging that primary health care be prioritized.(1,2)
Access to family physicians is inadequate in BC, as it is in all provinces. The perceived demands and complexity of full-service practice may promote family physician sub-specialization and employment in walk-in clinics. Alarmed by the trend away from full-service family practice, leaders in BC established the General Practice Services Committee (GPSC) with representatives from the Ministry of Health Services and the BC Medical Association.
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Provincial Primary Care and Cancer Engagement Strategy |
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The Provincial Primary Care and Cancer Network (PPCCN) was officially launched on October 30, 2008 and represents a powerful initiative and strategy of Cancer Care Ontario to engage primary care providers (Family Physicians, Nurse Practioners and Pharmacists (PCPs)) to become more involved in their patients’ cancer journey. The network consists of a Provincial Lead (Dr. Cheryl Levitt) and 13 Regional Leads representing the different Local Health Integration networks across Ontario. Strong clinical evidence supports the critical role of PCPs in improving clinical outcomes, patient experiences and quality of care from health promotion, prevention, screening and early diagnosis through to survivorship, recovery or palliative care.
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Several recent experiences with patients in my family practice have given me cause to think deeply about the nature and challenges currently existing in Canadian medicine. I have been privileged to work for 16 years in rural practice followed by 20 years as a practicing academic physician with health education and systems experience on three continents. For many years I have worked with American colleagues and have had experience of working in America. Thus I have some 40 years of practice on which to reflect when helping patients navigate a complex health care environment. One advantage of my widespread geographical, social and temporal experience is the perspective it gives to my current work.
By and large, that perspective has been one of gratitude. Gratitude that I have been able to see some of my current patients for over 35 years.
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Canadian Health Care Matters: Safer Health Care for “Sicker” Canadians |
Released November, 2009
The first bulletin, Safer Health Care for “Sicker Canadians: International Comparisons of Health Care Quality and Safety, was based on an analysis of the 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults.
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Canadian Health Care Matters: Helping Patients Help Themselves |
Released January 27, 2010
The second Canadian Health Care Matters bulletin showed that many Canadians with chronic health conditions don’t regularly receive some of the expected types of support that could help them better manage their own care.
Helping Patients Help Themselves: Are Canadians with chronic conditions getting the support they need to manage their health? - was based on the 2008 Canadian Survey of Experiences with Primary Health Care, which measured the quality of health care as reported by Canadian patients, including those living with at least one chronic condition.
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Canadian Health Care Matters: Beyond the Basics |
Released April 28, 2010
Our last bulletin, Beyond the Basics: the Importance of Patient-Provider Interactions in Chronic Illness Care, was also based on the Commonwealth Fund Data.
The findings helped validate the importance of good primary care and reinforced the Health Council of Canada’s strong support of primary health care teams and electronic health records as vital to chronic disease management.
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