Download ACCREDITATION CANADA ENVIRONMENTAL SCAN SUMMARY

ENVIRONMENTAL SCAN – JUNE-JULY 2009
ANALYSE DU MILIEU – AÔUT-OCTOBRE 2009
Issue/Catégorie
AB
The Health Quality Council of Alberta released its report on the reuse of
syringes to administer drugs to different patients.
 The issue came up last October when it was found that in three facilities
patients were potentially exposed to blood-borne pathogens because syringes
had been reused. A review of patient files has already established that the risk
to public health was very low, but the Council recommended an audit be
conducted of the clinical practice use of all critical, single-use devices to
ensure compliance to Alberta Health and Wellness standards.
 It also wants a comprehensive orientation and ongoing education for all
health professionals involved in endoscopy services.
 For a copy of the report, go to
Strategic Directions/
Orientations stratégiques
This issue of “reuse” is
addressed in the sterilization
standards.
http://www.hqca.ca/assets/pdf/High%20Prairie%20Review/HP_Report_to_Ministry_J
uly_22_2009_FINAL.pdf

BC
Health Quality Council of Alberta 2009.07.24
British Columbia’s health minister wants all health regions to implement
recommendations of two reports into a persistent C. difficile outbreak at
Nanaimo General Regional Hospital.
 A report by the Chief Medical Health Officer at Vancouver Island Health
Authority (VIHA) said there should be “an even greater emphasis on
infection control” in hospitals and long-term care facilities as well as standard
protocols for regular housekeeping and cleaning during outbreaks.
The ROP on infection control
includes tracking infection
rates, indentifying clusters,
outbreaks, and trends; sharing
and reporting the information.
2
Issue/Catégorie
Strategic Directions/
Orientations stratégiques
 A total of 18 recommendations were made in his report. It was followed by
the release of another report by the B.C. Centre for Disease Control that
chronicled a number of missteps in the Nanaimo hospital’s attempts to deal
with the problem, including use of too weak a formulation of bleach to clean
the facility, rendering the process ineffective.
 VIHA has already implemented, or will be implementing, all the
recommendations in the two reports.
 Reports can be found at
www.viha.ca/about_viha/news/news_releases/nr_nrgh_cdiff_reports_jun09.htm) Victoria
Times-Colonist, 2009.06.20
BC
British Columbia's provincial health officer released his report on the health and
well-being of Aboriginal people in British Columbia.
 Improvements have been seen in overall mortality, external causes of death
such as motor vehicle accidents, accidental poisoning, and drug-induced and
alcohol-related deaths.
 But data indicates the gap still needs to be closed between the Aboriginal
population and other residents, especially in the areas of chronic disease,
HIV/AIDS, and hospitalization rates for external causes and mental and
behavioural disorders due to psychoactive substance use. B.C. Ministry of Health
2009.06.25
CDA
The majority of Canadians who suffer from chronic illnesses are getting primary
health care, but there are gaps in the quality of care they are receiving for their
Qmentum includes standards
specifically designed for First
Nation communities.
Accreditation Canada is
developing new versions of
the standards for First Nations
and Inuit Community Health
Services and First Nations and
Inuit Addiction Services for
Qmentum. They will be used
by clients being surveyed in
2010.
Qmentum includes standards
for populations with chronic
3
Issue/Catégorie
CDA
Strategic Directions/
Orientations stratégiques
conditions, a survey by the Canadian Institute for Health Information suggests.
 The survey used 2008 Statistics Canada data and measured the experiences of
11,582 Canadians with primary health care such as family doctors, walk-in
clinics and emergency rooms.
 Although the majority of people with at least one chronic illnesses (arthritis,
cancer, emphysema, diabetes, heart disease, high blood pressure and mood
disorders) reported they had access to a regular place of care, such as a family
doctor or a walk-in clinic, 40 per cent said they had not made a treatment plan
with their provider within the last 12 months.
 "This is important because people who have chronic conditions need to take
measures between visits, which is the majority of the time," said Greg
Webster, the institute's director of primary health-care information.
 The study, Experiences with Primary Health Care in Canada, can be found at
www.cihi.ca. Health Edition 2009.07.24
conditions. Standards for
primary care are being pilot
tested in the fall.
An Ottawa home telehealth monitoring program has cut hospital readmissions
of heart failure patients by 54 per cent. The program, developed by the
University of Ottawa Heart Institute, has followed more than 500 patients since
2005.
 Each day, patients measure and transmit their vital signs to the Institute
which also uses an automated calling system for patient follow-up.
 In 2007-08 researchers tracked 121 heart failure patients. Of these, over 69 per
cent were readmitted at least once in a six-month period before being signed
up for the telehealth monitoring program at which point readmissions
The telehealth supplement is
being integrated into the
Qmentum program in 2009.
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Issue/Catégorie
Strategic Directions/
Orientations stratégiques
plummeted to less than 15 per cent.
 More information can be found at www.ottawaheart.ca Health Edition 2009.07.10
CDA
A new trend to harvest transplant organs from people whose hearts have just
stopped, but may not be yet brain dead, has underlined the "pressing need" for
federal legislation to define exactly when someone has perished, a leading
medical ethicist argues.
 Canada has an assortment of case law and legislation defining end of life, but
the growing use of organs from cardiac-death patients may violate the law,
argues Jocelyn Downie of Dalhousie University in a recent journal paper.
 Health-care workers motivated simply by the desire to help seriously ill
patients are at risk of civil or even criminal court action because of the lack of
a clear definition, she says in the Canadian Journal of Anesthesia. The
cardiac-death protocol, meanwhile, should probably be halted until more is
known about when someone whose heart has stopped is beyond recovery,
Prof. Downie said.
 Clarity is critically important for a host of reasons. "It's only after the
declaration of death that certain things can happen: We can take your organs,
we can bury you, we can do an autopsy ... we can trigger all sorts of things
around your property," said Prof. Downie.
 Her comments are part of a debate in the medical community about the ethics
and legality of the new organ donation approach. Some experts have even
argued that current practices in organ harvesting can amount to "physicianassisted death," though are not necessarily unjustified.
Standards for organ and tissue
donation and transplant, being
released in 2010, incorporate
the donation-after-cardiacdeath (DCD) protocol.
5
Issue/Catégorie
Strategic Directions/
Orientations stratégiques
 The law in Canada is muddy, her paper indicates. Most provinces' legislation
suggests that death is to be determined by physicians according to "current
medical practice." PEI's law is a little more specific, saying death can "include
brain death," while Quebec has no legal definition at all, leaving the matter
completely to doctors.
 But the head of Ontario's Trillium Gift of Life Network, the country's largest
transplant organization, said his agency endorsed the new donation-aftercardiac-death (DCD) protocol only after extensive research and consultation
that ensured it is a moral and medically appropriate practice. National Post
2009.07.16
CDA
The Registered Nurses’ Association of Ontario (RNAO), in collaboration with
the Nurse Practitioners’ Association of Ontario (NPAO), will launch a public
awareness campaign to educate people about the role of a Nurse Practitioner
(NP).
 NPs are registered nurses with advanced education and legislative authority,
who help keep patients healthy, diagnose and treat common illnesses and
injuries, prescribe medications, and order lab tests, x-rays and other
diagnostic tests.
 In the 11 years the role has been legally recognized in Ontario, nurse
practitioners have expanded their reach and work in almost every sector of
the health care system from hospitals and community clinics to long-term
care facilities and family health teams. OHA Reports 2009.05.13
 According to the Canadian Medical Association (CMA), British Columbia
For information.
6
Issue/Catégorie
Strategic Directions/
Orientations stratégiques
has 5,250 family physicians for a population of more than four million people.
This number of family physicians cannot be expected to care for a population
that large. NPs can alleviate physician workload and increase public access to
health care services
 The Canadian Nurses Association (CNA) plays a significant role in
promoting the integration of NPs into our health care system. It believes that
NPs can improve access, delivery and coordination of services to the public.
 The CNA is not suggesting that NPs take over physicians' duties but that they
act as a complement to the healthcare system by working with other health
care providers. The Vancouver Sun 2009.06.25
NS
A state-of-the-art Emergency and Trauma Centre has opened at the QEII Health
Sciences Centre in Halifax.
 The $20.4 million facility boasts several new features including better
infectious disease control and a mental health suite.
 There is also an enhanced role for paramedics. A paramedic will do the initial
triage of patients and determine whether they need immediate attention.
Paramedics will also suture cuts and administer drugs under physician
supervision. No additional physicians or nurses are being used to staff the
2,900 square metre facility. Halifax Chronicle-Herald 2009.06.24
For information.
ON
Ontario has taken another step toward creating a 10-year strategy to transform
mental health and addiction services.
 Long-Term Care Minister David Caplan released a discussion paper created
Qmentum includes standards
for mental health, as well as
for substance abuse and
7
Issue/Catégorie
by an advisory group comprised of people with direct experience with mental
illnesses and addictions, family members, service providers and researchers.
The proposed strategy aims to integrate people with mental illnesses and/or
addictions into their communities and to integrate mental health and
addiction services with the rest of the health system.
 The government made improved community-based mental health and
addiction treatment part and parcel of its strategy to reduce emergency
department wait times in early 2008. Research has shown that patients with
mental health issues are among the most frequent users of ER services — a
sign that their needs are not being met in the community.
 Mental health, problematic substance use and problem gambling services will
be integrated into the same strategy instead of in separate silos in different
government departments. As well, the strategy will include services for
people with mild to moderate symptoms not just those with serious
conditions.
 Consultations on the discussion paper are being held in Ontario this fall, and
the advisory group is to report back to the minister in the winter. The paper,
Every Door is the Right Door, can be found at
Strategic Directions/
Orientations stratégiques
problem gambling.
The mental health standards
are being revised to better
reflect community-based
programs in mental health.
Mental health content is also
being considered for Seniors
Population and Child and
Youth Population standards.
www.health.gov.on.ca/english/public/program/mentalhealth/minister_advisgroup/p
df/discussion_paper.pdf. Health Edition 2009.07.17
ON
Ontario has started Canada’s first e-prescribing program, a new tool being
developed by eHealth Ontario.
 Electronic prescribing is a key component of the Medication Management
For information.
8
Issue/Catégorie
Strategic Directions/
Orientations stratégiques
part of the province’s e-health strategy, and is expected to dramatically
improve patient safety and quality of care by reducing prescription errors
from illegible handwriting.
 Two sites are involved in a three-month demonstration project which started
last month: the Group Health Centre in Sault Ste. Marie and Georgian Bay
Family Health Team in Collingwood. Both are well advanced in the use of
electronic medical records. eHealth Ontario 2009.05.15
ON
All 148 Ontario hospitals are filmless with facilities now using picture archiving
and communications technology to produce digital images.
 “Doctors will be able to review, diagnose and report on diagnostic imaging
tests from anywhere within the diagnostic imaging repository system,” said
Ron Sapsford, acting CEO of eHealth Ontario. Health Edition 2009.07.10
Qmentum includes standards
for diagnostic imaging; as
well, Accreditation Canada
has surveyors who specialize
in this area.
ON
Ontario has introduced legislation expanding the scope of practice of a number
of health professions to improve access to care.
 Examples: nurse practitioners will be allowed to conduct ultrasounds and set
a fracture; physiotherapists will be allowed to treat a wound; midwives will
be able to place tubes in the nose or mouth of a newborn; medical radiation
technologists will be able to give needles; and, dietitians will be able to prick
the skin to check a patient’s blood readings. Health Edition 2009.05.15
For information
PEI
A Model of Care Design Team is at work in Prince Edward Island to clarify the
roles of Island health care providers and support staff, and ensure everyone is
As our clients restructure their
services, Accreditation Canada
9
Issue/Catégorie
working to their full potential. It is part of the government’s efforts to create an
integrated health system for the Island.
 Health human shortages are an issue on the Island, and optimizing the
resources the province does have is a key activity.
 A PEI health system review by consulting firm Corpus Sanchez last
November counseled a shift in focus from hospital care to integrated, well
coordinated primary care. The firm made similar recommendations in a
review it did of Nova Scotia’s health system in January 2008. Considerable
work has since been done on the Model of Care Initiative in Nova Scotia
(MOCINS) which is also predicated on team members working
collaboratively to their full scope of practice.
 Mr. Currie said his department is leading a detailed examination of all
recommendations in the Corpus Sanchez report to determine which ones
work best for the province.
 In April, a Health Governance Advisory Council began consultations on a
province-wide governance model to oversee the delivery of health care on
PEI. The lack of such an entity was a criticism in the Corpus Sanchez report.
Strategic Directions/
Orientations stratégiques
will ensure the program
continues to meet their needs.
Accreditation Canada has a
positive and transparent
relationship with PEI.
Health Edition 2009.06.19
QC
McGill University Health Centre is partnering with Quebec-based Medical.MD
to launch a personal electronic health record called MedForYou.
 It will allow people to post and track their medical information online.
Medical.MD is also in discussions to include its new offering in Telus Health
Space, powered by Microsoft HealthVault.
 Medical.MD is looking for 300 subscribers to test its system which it hopes to
The importance of good
communication between
clients and health providers is
emphasized in the standards.
10
Issue/Catégorie
Strategic Directions/
Orientations stratégiques
make available to the Quebec market in October, and eventually to the rest of
Canada. More information is available at www.medforyou.com Health Edition
2009.07.10
QC
Le Centre universitaire de santé McGill travaille en partenariat avec
Medical.MD qui est situé au Québec, pour lancer un dossier médical
électronique appelé MedForYou.
 Ce dossier permettra aux patients d’afficher en ligne leur information
médicale et d’effectuer un suivi de celle-ci. Medical.MD est en pourparlers et
compte offrir son nouveau produit au moyen de la plateforme Telus Espace
Santé, qui est optimisée par HealthVault de Microsoft.
 Medical.MD est à la recherche de 300 abonnés qui mettront à l’essai son
produit; il espère ainsi pouvoir l’offrir en octobre au marché du Québec et par
la suite, au reste du Canada. Pour de plus amples renseignements, rendezvous au www.medforyou.com Health Edition 10/07/2009
Les normes mettent l’accent
sur l’importance d’une bonne
communication entre les
clients et les prestateurs de
soins.
SK
The Saskatoon Health Region is formalizing its plan for "hallway nursing."
 A document is circulating to staff at Saskatoon's three hospitals detailing
procedures for treating patients in hallways. Patients are to be placed in a bed
when possible, the document says, but once beds are full, "the next patient is
cared for in a hallway" somewhere in the hospital until other arrangements
can be made. Saskatoon Health Region 2009.07.03
For information.
Items have been compiled from Health Edition, Canada’s Health Newsweekly; Health Quality Council of Alberta; Victoria Times-Colonist; B.C. Ministry of Health; National Post;
The Vancouver Sun; Halifax Chronicle-Herald; eHealth Ontario; and the Saskatoon Health Region.