Lessons Learned From Health Professionals
As the MHST:601: Foundations of Health Systems in Canada class is made up of various health professionals and users of the health care system I questioned how I might connect with professionals that work on opposite ends of the spectrum then myself. I went on to learn that despite one’s professional domain or region there appears to be many common themes of focus among us all. In comparing Ontario’s legislation and system to other provinces such as British Columbia, Nova Scotia and Alberta I believe that as a province we will have to reflect on other provincial models of funding and legislation to properly face the recently implemented restructuring. With BC operating with 5 regional health authorities and Nova Scotia utilizing 4 management zones we as a province will have to review these systems for some insight during our restructuring and ‘downsizing’ of the provinces 14 LHINs. This will likely prove to be particularly challenging as Ontario is almost double in population size of BC and Alberta put together.
Moving forward, with Ontario’s anticipated restructuring our health care system will depend even more on collaborative work and interdisciplinary approaches in health care decision making. I feel that Ontario’s new ‘Health Teams’ will empower inter-professional work and allow health professionals and providers to make more unified decisions. The ultimate foundation to our health system in Canada is approaching health care with an interdisciplinary approach. Despite what we know about team collaboration, Ontario has a long way to go in improving their hospital and home and community care communication and collaboration. The Ontario Hospital Association (2019) has determined that in order to make these improvements the province may need to remove certain existing legislative, regulatory and/ or policy barriers. This process includes the integration of various professionals, users of the system, and community to develop and create the best possible strategies for an optimized health care system (Canadian Inter-professional Health Collaborative, 2010).
In reviewing my classmates' week two forum posts I identified six common themes that connected most of our roles as professionals working in the health care system: Health Promotion, Quality Improvement, Wait times & Wait-lists, and vulnerable populations. Though not all our roles necessarily overlap many of us had similar visions and ideas on inter-contentedness and modernizing the Canada Health Act.
Health Promotion
With major funding limitations in health care across most provinces in Canada, Health Promotion is an essential tool to enabling Canadian’s to live healthy lifestyles, remain active and independent and in return relieve the health care system in the long-term. Whether it be nursing, dental, nutritional, social work, home care, pharmacy or other, we all want clients, patients and families to successfully manage their own care and improve their health to increase their well-being. In terms of my role in home and community care, health promotion can play a significant role in an a person’s ability to live in their home longer. Those requiring home care services can be provided with tools based on their needs to help them stay safe and comfortable in their own home for as long as possible. In reading my classmates responses on how their role interacts with others in the system I learned that dental and nutritional professionals integrate health promotion into their everyday as they promote preventative teeth cleaning and education on proper eating to aide people to remain healthy. As professionals working in health care we are all responsible for health promotion in our area or domain which includes and is not limited to; physical, social, psychological and spiritual well-being.
Quality Improvement
The main census of the group was that in each of our roles we all have the obligation of Quality Improvement (QI) within our profession. Most professional bodies set out goals annually or semi-annually in order to decrease or increase certain targets to improve quality care and services. I believe as a health professional it is your duty to create action plans to help improve service care and delivery. By creating Quality Improvement Initiatives in different areas of the health care system i.e., hospitals, home and community care, and long-term care facilities . It is imperative however, that QI teams are made up of interdisciplinary and collaborative it can help modernize and innovate our health care system. Creating collaborative teams can allow for more unified and fully scoped action plans to help streamline services.
A QI initiative I see fit for all provinces is to mandate gerontological and mental awareness education into registered and licensed professional programs. As we know much of Canada’s population is made up of individuals 65+ who are more commonly living with more than one chronic condition, mental health issues and other health challenges. Therefore, some level of gerontology courses and/or training should be mandated in health professional programs, as well as workplace environments to improve quality of services. In my opinion this could lead to higher quality services, reduce ageist related stigmas and create more sensitivity and compassion toward the older population.
Wait Times & Wait Lists
Wait Times & Wait Lists effect everyone in and outside of Ontario whether you’re a user of the system or a provider. Wait times refer to time spent awaiting immediate medical or scheduled medical services such as emergency department, surgery and walk in clinics. Wait lists come into place when places like hospitals, long-term care facilities and home and community care have reached capacity and or limitation of resources. Typically, those put on wait-lists are prioritized based on their needs, however, in home and community care most clients on the wait list are high need clients (The Globe & Mail, 2015). In connecting with a fellow nurse in the class we shared a mutual frustration regarding hospital overcrowding. Home and community care receives an immense amount of pressure when hospitals are in crisis due to overcrowding as they often discharge a large amount of clients that tend to be older adults with no where else to go as they are either waiting LTC or home care services. In addition, Canada struggles inter-provincially with geographical location effecting the accessibility of services for those in need. In my role working with wait-lists many of our clients have been placed on the wait-list due to their geographical area while others don’t have to be placed on a list at all for services.
Vulnerable Populations
Two major vulnerable populations in all Canada include the older population and those living with mental health issues and addictions. In the week 2 forum many of us touched on provincial short comings of mental health services and the need for coverage to expand to these services as it is essential for the well-being of all individuals. Provincial legislation and policy do not currently enforce mental health services as high enough importance and isn't considered as ‘medically necessary’ and therefore is not eligible for coverage anywhere in Canada.
Furthermore, in discussion with classmate Rosi, a social worker, I learned that although social workers are paired with older hospitalized patients, while in hospital the worker is not always informed of the patients release and have yet to complete their social work process. Another issue with this was that social workers are not permitted to continue seeing said patients once discharged unless the patient is immobile and unable to go into the community for resources. This policy is extremely outdated to say the least and uses a poor predictor to determine the need of social services and thus, in my opinion does not optimize a person's ability to live independently. Legislation and policy must change in order to properly serve vulnerable populations inter-provincially and enable all parts of the collaborative team to be play and equal role in the care plan.
In conclusion, I learned that although evidence proves that a collaborative team approach is the foundation to a successful health care system most provincial health systems must make more of an effort toward inclusiveness of various health professionals, workers, and families. There is also a lack of outpatient support especially in regard to the older population. I believe by modernizing the Canada Health Act via updated provincial legislation and policies to better suit the needs of each region will guide us toward a better functioning and more efficient system.
References
Canadian Interprofessional Health Collaborative:A National Interprofessional Competency Framework. (2010, February). Retrieved May 26, 2019, from https://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Church, E., & Grant, K. (2015, July 10). No place like home? Investigating Ontario’s home-care shortcomings. The Globe and Mail. Retrieved May 27, 2019, from https://www.theglobeandmail.com/news/national/no-place-like-home-investigating-ontarios-home-care-shortcomings/article25409974/
Ontario Hospital Association. (2019). A Balanced Approach: The Path to Ending Hallway Medicine for Ontario Patients and Families Pre-Budget Submission 2019 Ontario Budget [PDF]. Toronto, Ontario.
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