LHC 4053 - Unit 2 F2024 PDF

AHCT – LHC 4053 Health Care Reform: Managing Effectively in a Changing Environment  Unit 2 The demands on the health care professions, what types of services will be in demand and how this will impact the workforce 2  Object...

AHCT – LHC 4053 Health Care Reform: Managing Effectively in a Changing Environment  Unit 2 The demands on the health care professions, what types of services will be in demand and how this will impact the workforce 2  Objectives 1. Explore and explain the challenges the Canadian health care system has faced in recent years 2. Discuss the ways in which the federal, provincial and territorial governments are working with health care professionals, organizations and institutions to better understand and mitigate the risks involved in the delivery of health care 3. Describe the impact of change management initiatives on health care delivery in terms of policies, workforce and costs associated with health services  Geographical and Health Gaps – Access to health care is a challenge for rural Canadians. – Canada is the second largest country in the world, and it has very large, inhabited areas. – This geographical disparity also translates into health gaps. The situation of the First Nations, the Métis, and the Inuit has improved in the last few years, but they are still behind compared to urban populations. Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 4  Geographical and Health Gaps: Access to Doctors – Generalized access to a regular medical doctor is not equal as it depends on where people live. – For many citizens, the first contact for health care is their doctor, and being without a regular medical doctor correlates to fewer visits to general practitioners or specialists, who can prescribe early screenings or treatment of medical conditions. – Canadians in urban areas have access to a regular doctor, and if they do not, they have other options to look for health care. Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 5  Watch this Video and discuss the following Questions – Canada’s Struggle to Provide Health Care – to Northern Communities CBC News: The National https://www.youtube.com/watch?v=0stGbq22cL0 – What challenges did the doctor have when providing service to the remote community? – What are your thoughts on health care challenges in remote communities? – What can Canada/Ontario do to improve healthcare services in remote areas of Canada? 6  Limitations to Public Coverage: Private Coverage Can Be Expensive – Medicare does not cover all medical services. – Health care depends on where the patient is being treated—in a hospital or not— and what province he/she lives in. – For provinces to receive federal funds for health care programs, they must comply with the requirements stipulated in the Canadian Health Care Act. – Public coverage is not defined; it is left to provincial interpretation. – Some services not covered by the public health care system should be considered necessary and therefore covered (for example, dental, home care, and psychological services). Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 7  Oral Health – An Example – Many Canadians cannot afford this service and if their condition worsens, and they must resort to dental emergencies in hospitals, they only receive antibiotics and painkillers that do not treat the underlying issue. – If the situation becomes more serious, the risk is that the patient must be admitted in a hospital, and the costs are absorbed by the public service. Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 8  The Aging Population – Health care expenses will continue to increase for the next few decades. – Due to the Canadian population aging, changes in public policies will be needed. – This aging trend is due to decreasing fertility rates and increasing life expectancy. This Photo by Unknown Author is licensed under CC BY-ND Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 9  Re-Thinking Care for Canada’s Aging Population EvidenceNetwork.ca https://www.youtube.com/watch?v=TWd3WQ4xW2U 6:12 10  Dissatisfaction Over Wait Times – In April 2007, Prime Minister Stephen Harper announced that the provinces and territories would have their wait times guaranteed by 2010 for the following areas, which would be prioritized by the provinces: cancer, hip and knee replacement, heart problems, diagnosis and imaging, cataract surgery, and primary care (Nation Talk, 2007). Valle, Valeria Marina. “An Assessment of Canada’s Health Care System Weighing Achievements and Challenges.” Norteamérica, vol. 11, no. 2, 2016, pp. 193–220., doi:10.20999/nam.2016.b008. https://www.sciencedirect.com/science/article/pii/S1870355018300168 11  Patient Flow – Efficient patient movement in health care facilities improves patient care and organization’s financial status. – A patient receiving timely diagnosis and treatment has a higher likelihood of obtaining a desired clinical outcome than a patient whose diagnosis and treatment are delayed. COURSE TEXTBOOK: McLaughlin, Daniel B., and John R. Olson. Health Care Operations Management. Health Administration Press, 2017, pp. 283. 12  Ways to Improve Patient Flow – Emergency Department Create two streams, one for acute patients and one for non-acute patients. Results: reduced time spent in the emergency room and improved patient satisfaction. COURSE TEXTBOOK: McLaughlin, Daniel B., and John R. Olson. Health Care Operations Management. Health Administration Press, 2017, pp. 283. 13  Ways to Improve Patient Flow – Discharge plans- Post MI Create a uniform discharge time. Write discharge orders the night before release. Communicate discharge plans early in the patient’s care. Plan for testing procedures critical to a patients' discharge. Improve discharge coordination with social services. COURSE TEXTBOOK: McLaughlin, Daniel B., and John R. Olson. Health Care Operations Management. Health Administration Press, 2017, pp. 283. 14  5 CHALLENGES In Operations Management FACED TODAY By: Simplicity Consultancy https://www.youtube.com/watch?v=JPbGViQPpRw 15  Roles of the federal, provincial and territorial governments Federal Provincial and territorial Municipal (Canada, 2018)  Government consultation with professional groups to understand and mitigate risks involved in the delivery of health care Consultation with professional groups to gain perspective of various groups e.g. Registered Nurses Association of Ontario, Physiotherapy Professional association, Ontario Medical Association Important to work with professional groups to understand the perspective of health care professionals in order to provide excellent quality care Health care costs are increasing and there is an increased accountability for leaders to justify spending and to utilize health care dollars efficiently (Ackerman-Anderson & Anderson, 2010)  Government Consultation (cont’d) Consultation with professional groups will result in gaining perspective from the providers as to how to manage the change process to achieve successful transformation of the health care system (Ackerman-Anderson & Anderson, 2010)  Consultation with Patient Groups – Health care delivery has evolved to a place where the patient perspective is important when planning the delivery of health care – This results in the need to listen to what health care consumers need and want in the health care system – Government consultation is taking place with patient groups to determine strategies for managing their health care needs (Ackerman-Anderson & Anderson, 2010)  Consultation With Patient Groups.. Both provincial and federal governments have recognized that health care consumers are interested in how health care dollars are invested Since the management of chronic disease is becoming an increasing priority in the health care system, it is essential to involve patients in the decisions as to how services will be provided (Ackerman-Anderson & Anderson, 2010)  The Government and organizations – The organization of Canada's health care system is determined by the Canadian Constitution, in which roles and responsibilities are divided between the federal, and provincial and territorial governments. – The provincial and territorial governments have most of the responsibility for delivering health and social services. – The federal government is also responsible for delivery of services for certain groups of people. – Publicly funded health care is financed with revenue raised through federal, provincial and territorial taxation, such as personal and corporate taxes, sales taxes, payroll levies and other revenue. Health Canada. “Canada's Health Care System.” Canada.ca, Government of Canada, 17 Sept. 2019, www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care- system/canada.html. 21  – Setting and administering national – these group include: principles for the system under the First Nations people living on reserves Canada Health Act Inuit – Financial support to the provinces serving members of the Canadian and territories Armed Forces eligible veterans – Several other functions, including inmates in federal funding and/or delivery of primary penitentiaries(prisoners) and supplementary services to some groups of refugee claimants certain groups of people Health Canada. “Canada's Health Care System.” Canada.ca, Government of Canada, 17 Sept. 2019, www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care- system/canada.html. 22  Governments and delivery – Deliver most of Canada's health care services. – Provincial and territorial health insurance plans need to meet requirements set out under the Canada Health Act. – Health insurance plans cover medically necessary hospital and doctors' services that are provided on a pre-paid basis, without direct charges at the point of service. – Services are funded federal cash and tax transfers. Health Canada. “Canada's Health Care System.” Canada.ca, Government of Canada, 17 Sept. 2019, www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care- system/canada.html. 23  What is “medically necessary”? – Definition is up to the provincial and territorial health insurance plans, in consultation with their respective physician colleges or groups, to determine which services are medically necessary for health insurance purposes. – If it is determined that a service is medically necessary, the full cost of the service must be covered by the public health insurance plan to be in compliance with the Act. – If a service is not considered to be medically required, the province or territory will not cover it through its health insurance plan. Example: For instance “Free Testosterone level and Prostate Specific Antigen testing do not consider as a necessary lab tests to be ordered by primary care physicians. Health Canada. “Canada's Health Care System.” Canada.ca, Government of Canada, 17 Sept. 2019, www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care- system/canada.html. 24  Impact of change initiatives on health care delivery Changes in the methods of delivery of health care services have an impact on the organizations which provide these services Organizations are required to develop new policies and procedures which will change the current state of the organization in terms of how they deliver care Development of policies and procedures requires an investment on the part of the organization to ensure the changes are successfully implemented (Ackerman-Anderson & Anderson, 2010)  Impact of Changes (cont’d) Organizations need to ensure that their leadership has the ability to manage these changes within their organization Organizations need to assess the need to provide training for their leadership team in terms of managing multiple change initiatives to ensure success This may require allocation* of resources to provide the training (Ackerman-Anderson & Anderson, 2010)  In class activity # 2 Has your current status based on your insurance coverage impacted your accessibility to the healthcare services? How? And how can you mitigate the vulnerability of the situation? What can Government do in order to facilitate this process as a smooth transition?  Accessibility Act Accessibility for Ontarians with Disabilities Act, 2005 – ensures that public organizations will comply with rules to ensure their facility is accessible Legislation ensures that access will be provided to all Ontarians with disabilities with respect to goods, services, facilities, accommodation, employment, buildings and structures Ontario Premier appointed Accessibility Minister (Ackerman-Anderson & Anderson, 2010)  Accessibility Act cont’d Each organization is responsible for whatever changes are necessary to make necessary changes Organizations must be in compliance with the legislation by January 1, 2025 (Ackerman-Anderson & Anderson, 2010)  References Ackerman-Anderson, L. S., & Anderson, D. (2010). The change leader’s roadmap on how to Navigate your organization's transformation. Wiley. Canada, H. (2022, June 15). Government of Canada. Canada.ca. Retrieved July 23, 2022, from https://www.canada.ca/en/health-canada.html Richardson, E., & Al, E. (2013). Health systems in transition: Belarus : health system review. European Observatory On Health Systems And Policies. Thank you 