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Canada - Bold new approaches needed to prevent Ontarians overwhelming the hospital system by 2020

A new report released recently by the Ontario College of Family Physicians (OCFP) urgently calls for more emphasis to be put on family medicine and the primary care sector in order to provide Ontarians with what they need and want when it comes to their healthcare, and to prevent them from overwhelming Ontario's hospitals and emergency departments by 2020. The report, called "Vision 2020: Raising the Bar in Family Medicine and Ontario's Primary Care Sector" is supported by a survey conducted by Harris-Decima for the Ontario College of Family Physicians.

Canada — Ontario is consolidating the former Ontario Health Quality Council and five other health care organizations into Health Quality Ontario

Under the Excellent Care for All Act, the Ontario Health Quality Council is now Health Quality Ontario which has an expanded mandate to: recommend and help health care providers adopt evidence-based standards of care and best practices; and monitor and report on quality improvement efforts across health care sectors.

Canada - Patient experience survey

The Primary Care Patient Experience Survey is an evidence-based tool that will help providers develop an understanding of their patients’ experiences of care, identify what is working well and where there may be room for improvement. The survey is the result of a collaboration between Health Quality Ontario, the Association of Ontario Health Centres, the Ontario College of Family Physicians, the Ontario Medical Association, and the Association of Family Health Teams of Ontario. It is currently being field tested in primary care practices across the province. A draft version is available to download.

Canada – The Select Committee on Mental Health and Addictions of the Legislative Assembly of Ontario, recommends the creation of Mental Health and Addictions Ontario

The Select Committee recently released its final report, "Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians". This follows the release of an interim report (March 2010) that provided an overview of the hearings and activities of the Committee to that date. The final report includes 23 recommendations. The main recommendation is the creation of an umbrella agency, Mental Health and Addictions Ontario, to design, manage, and coordinate the mental health and addictions system, and to ensure the consistent delivery of programs and services across Ontario.

Canada - New Wait Times Data Now Available for Surgeries and Procedures Across Ontario

Ontario has launched an online tool to help people find wait times information for surgeries and procedures at the province’s hospitals. Available at, the easy-to-use tool includes the length of time between referrals and specialist appointments, as well as providing the date a procedure is due to be performed.

Canada - Ontario is launching an Action Plan to transform the health care system and deal with the demographic challenges as well as the province's deficit

The Action Plan for Health Care in Ontario will ensure families get the best health care where and when they need it, while ensuring all Ontarians get better value for their health dollars. The Plan will : make the necessary and responsible decisions regarding funding priorities and ensure funding is shifted to where we get the best value; provide new measures to prevent illness in the first place and to help Ontarians stay healthy; give Ontarians better access to family doctors and nurse practitioners — through after hours care and same-day and next-day appointments — that will save Ontarians time, keep them healthier, and help them avoid trips to hospital; support Ontario’s seniors who want to live independently at home, in their communities, by providing more home care supports.

Canada - Slowing economic growth and rising health care pressures squeeze Ontario's finances

A new report from the Conference Board of Canada sheds light on Ontario’s fiscal challenges in three ways. It estimates potential economic growth over the longer term. It models health and education spending to account for demographic and other changes, and it projects when the government is likely to rebalance its books based on revised revenue projections that account for sluggish growth. The report concludes that to achieve a balanced budget by 2022, the Ontario government needs to hold increases in health care costs well below the growth rates of the past decade.

Canada - Ontario Needs New Conversation On Health

Ontario’s Chief Medical Officer of Health, Dr. Arlene King, stated on December 1, 2011, that Ontario needs a new conversation about health, and that very little of that conversation is about health care. She calls for a comprehensive plan that is geared towards health promotion and chronic disease and injury prevention.

Canada - Ontario ranks among the best in Canada and internationally when it comes to certain measures of the coordination of care and communication between older patients and their health care providers

Ontario patients aged 55 and older often experience top-rated coordination of their health care, as well as communication with their health care providers, compared to people in other provinces and in other countries, according to Experiencing Integrated Care, the latest report from Health Quality Ontario (HQO), the provincial advisor on health care quality.

Canada - Ontario: Wait times down in emergency, but still long for some patients

A new report by Health Quality Ontario (HQO), the provincial advisor on health care quality, shows a 10% drop in the maximum amount of time patients spent waiting in Ontario’s emergency departments (EDs). Urban residents wait longest, especially ED patients requiring hospital admission.

Canada - Primary Care in Ontario, Canada: New Proposals after 15 Years of Reform

Ontario has led the way in Canada in implementing innovative primary care practice models, but funding constraints have led to increased conflict with physicians. In response, Ontario’s government is now considering more changes to primary care governance. This article discusses preliminary policy proposals suggested by a provincial primary care advisory committee.

Canada - Transformation through Value and Innovation: Revitalizing Health Care in Ontario

Produced by the Ontario Chamber of Commerce (OCC), this report calls for healthcare reform in the province that preserves the publically funded single-payer model but increasingly incorporates the private sector as a productive partner. The report includes three case studies of collaborations by Ontario’s public and private sector to improve healthcare value and innovation.

Canada - New study shows Ontario could save more than $143 million by making better use of province's pharmacists

This study from the Ontario Pharmacists’ Association (OPA) shows that Ontario could realize healthcare savings of $143 million by giving pharmacists more authority in smoking cessation, flu vaccinations, drug therapy, and prescription renewals. Increasing pharmacy-based services would help ensure the sustainability of the province’s healthcare system.

Canada - Ontario Launches $222 Million First Nations Health Action Plan

Ontario is launching a $222 Million First Nations Health Action Plan over the next three years to ensure that the province’s indigenous peoples have access to improved health outcomes and culturally appropriate care. The Action Plan includes additional funding of $104.5 million annually to address health inequities among Ontario First Nations.

Canada - It's all about synergies: Understanding the role of the RPN in Ontario's health care system

The Registered Practical Nurses Association of Ontario (RPNAO) presents, in this document, key learnings and practical strategies for enhancing registered practical nurse (RPN) role clarity and nursing team collaboration. The RPNAO invited nurses and other healthcare experts from around Ontario to share insights about critical factors that support or hinder the appropriate utilization of RPNs.

Canada - Improvements in patient and public safety highlighted in 2014 Quality Index on Ontario's Cancer System

The Cancer Quality Council of Ontario (CQCO) released its 10th annual Cancer System Quality Index on June 24, 2014. It shows that the Ontario cancer system is successful in ensuring Ontarians are receiving care based on the best available evidence. Notable improvements were made in automated drug ordering systems in hospitals. Areas for improvement include reducing unplanned hospital visits during chemotherapy and radiation.

Canada - Ontario Health Innovation Council Delivers Report to Ontario

The Council makes five main recommendations for creating conditions to favour the adoption of new technologies in health care. Entitled The Catalyst, the report calls for the creation of a dedicated office to lead and coordinate innovation efforts, investment in made-in-Ontario technologies, the elimination of barriers to innovation across the health system and closer relationships between industry, research and health sector stakeholders to accelerate commercialization.

Canada - Health Quality Ontario Unveils New Data on Existing Health Interventions and Highlights Areas for Change in the Province's Health Care System

Health Quality Ontario (HQO) has released the 4th edition of its Ontario Health Technology Maps Project Report. It looks at the adoption of evidence-based medical and surgical procedures and laboratory tests and provides information to healthcare professionals on variations in care across the province, and on changes needed to improve the quality of health care for Ontarians.

Canada - Building better health care: Policy opportunities for Ontario

The province of Ontario’s healthcare performance is uncompetitive among international peers, many of which spend less to achieve better outcomes. This paper urges Ontario to confront its main healthcare cost drivers (technology, drugs, increased service utilization and physician compensation), and recommends abolishing the tax subsidy for employer health insurance benefits.

Canada - Balancing more and less: Who cares about the future of health care in Ontario?

Part of a series entitled A Conversation about the Future of Care, this paper produced by Ontario’s Community Care Access Centres (CCACs) looks at the expectations of patients in an aging society and the effects of technology on the delivery of home and community care. The paper examines mechanisms to pay for Ontario health services in future.

Canada – Ontario : 2011 Quality Monitor Released

Health Quality Ontario’s sixth annual report on Ontario’s health system, and first as HQO, identifies significant achievements and challenges in areas such as access to healthcare, chronic disease management and keeping the population healthy. Overall, despite progress across a wide range of indicators, there is room for further improvement.

Canada - Health Transformation: An Action Plan for Ontario

Produced by the Ontario Chamber of Commerce, this report makes three main strategic recommendations for the province’s healthcare system and health sector. It calls for shifting Ontario towards a value-based system with a focus on patient outcomes for money spent. It also recommends a modernization of procurement chain processes and further integrating the health sciences sector within the public system.

Canada - Healthcare Reform in the NHS England: More Lessons for Ontario

Two years of hard bargaining led to legislation in 2012 to transform England’s National Health Service (NHS). This Change Foundation report comparing health reform in England and Ontario examines the journey to the UK Health and Social Care Act. The report describes how Ontario can learn from England’s experience in patient engagement, performance measurement, and service provision and quality of care.

Canada — The Response of Ontario Primary Care Physicians to Pay-for-Performance Incentives

Beginning in 1999, Ontario introduced pay-for-performance incentives for selected preventive primary care services and defined sets of other services provided by family physicians, with the goal of improving the quality of patient care. These performance incentives were considerably expanded in 2004. At the request of the Ministry and as part of the collaborative research program between the Ontario Ministry of Health and Long-Term Care (MOHLTC) and the Centre for Health Economics and Policy Analysis (CHEPA), CHEPA researchers undertook an evaluation of the effect of performance incentives on service provision in Ontario. This report presents the results of that evaluation.

Canada - Charting a Path to Sustainable Health Care in Ontario. Tenproposals to restrain cost growth without compromising quality of care

Urgent action is required to place Ontario’s health care system on more sustainable ground according to a new report by TD Economics. The report’s ten recommendations, which were submitted to Ontario’s Ministry of Health, represent significant change from the current system. Combined, they should help keep healthcare spending in line with the projected provincial growth rate of four percent.

Canada - Measuring Up 2017. A yearly report on how Ontario’s health system is performing

Using 50 indicators to assess the annual performance of Ontario’s health system, this year’s report by Health Quality Ontario (HQO) finds improvements in premature mortality, care continuity, screening, surgical wait times and long-term care. It gives black marks to access, equity, caregiver support and transitional and palliative care.

Canada – Quality Monitor. Ontario Health Quality Council. 2010 report on Ontario’s health System

The report shows that although there have been some modest improvements in quality across Ontario’s health system, there is room for more improvement. There are examples of higher performance that could be applied more broadly. The top-line findings underscore areas of concern that are of critical importance: wait times; the accuracy and completeness of medical information; chronic disease management; access to primary care; and patient safety.

Canada - 2013/14 Hospital Quality Improvement Plans: An Analysis for Improvement

This report from Health Quality Ontario analyses quality improvement plans for 2013/14 submitted by all Ontario hospitals. It assesses progress on the delivery of patient-centred, evidence-informed, continuously improving care that makes efficient use of health system resources. Findings indicate that more hospitals are soliciting the opinions of patients and involving patients in the design of care. Coordination of care remains a challenge. The report further analyses quality improvement by indicator.

Canada - Implementing Choosing Wisely Canada Recommendations in Ontario to Improve Quality of Care

Choosing Wisely Canada is clinician-led campaign to help patients and healthcare providers engage in conversations about unnecessary care. This report from Ontario highlights provincial and local initiatives across three sectors (hospital, long-term and primary care) to improve quality of care by implementing Choosing Wisely Canada recommendations. The report provides an overview of resources and support tools available in Ontario.

Canada - Health Equity in Northern Ontario

The life expectancy rates for those living in northern Ontario continue to be lower and mortality rates higher than the rates in the province overall, according to a new report by Health Quality Ontario, the provincial advisor on the quality of health care.

Canada - Introducing Physician Assistants to Ontario

This paper by researchers from McMaster University examines the introduction of physician assistants into Ontario’s healthcare system since 2006. The paper describes opposition from nurses and other groups when physician assistants applied for status as provincially regulated health professionals in 2012.

Canada - Ontario's Experiment with Primary Care Reform

This paper provides an overview of changes to Ontario’s primary care system during the past decade. The authors show how the alteration of physician compensation models is central to the province’s reforms and discuss the introduction of patient rostering — the formalized connection of patients to physician teams to create relationships that deliver better preventative care.

Canada - Fighting Cancer in Québec and in Ontario: A Patient-Centred Approach

This study published by the Institut national de la statistique du Québec, uses two surveys on the experience of patient care to provide a cross-perspective on the organization of health services for cancer patients in Ontario and Québec. It looks at the organizational context of each province in the fight against cancer, and at the methods used to assess patient experience. It highlights patient-centered care as a way to improve services for cancer patients.

Canada - Supporting Research and Innovation in Health Technology Sector. Ontario Creates New Council to Study Sector Innovation

This council, established by the Ministry of Research and Innovation, will help to enhance the province's world renowned health technology sector by developing recommendations to identify opportunities for Ontario's small- and medium-sized businesses, adapt best practices of other jurisdictions, and expand the adoption of new technologies across health care settings.

Canada - Report on Ontario’s Cancer System Highlights Need for Better Integration for Patient Care

The Cancer Quality Council of Ontario finds that Ontarians receive some of the best cancer care in the world. More needs to be done, however, to integrate the individual pieces of the cancer system and the overall health system to improve the patient experience.

Canada - Ontario Proposes Investments in Home and Community Care

On April 23, 2013, the Ontario government stated it wants more people to receive timely access to home and community care. The proposed additional investment in the community care sector of $260 million in 2013-2014 would aim to reduce wait times for patients who require nursing services and permit those with complex needs to receive home care within five days of their Community Care Access Centre assessment.

Canada - Public Health Renewal in Ontario

On April 4, 2013, Ontario's public health community released Make No Little Plans, the first-ever comprehensive strategic plan for the public health sector. The plan outlines five shared strategic goals involving giving children a good start in life, immunization, getting Ontarians to adopt healthy lifestyles, municipal planning and public health sector capacity.

Canada - Ontario primary care reform and quality improvement activities: an environmental scan

The intent of this research was to complete an environmental scan and capacity map of quality improvement activities being built in and by the primary healthcare sector in Ontario. This is intended as a first step to developing a coordinated and sustainable framework of primary healthcare that will enable an evaluation of these initiatives.

Canada - Putting Innovation to Work: Improving chronic disease management and health system sustainability in Ontario

Produced by the Better Care Faster Coalition, a group of health service providers, professionals, charities, and patient groups, this report issues recommendations for improvements to chronic disease management in Ontario, and identifies barriers to innovation in this area. The report calls for standardized evaluation formats, simplified tracking and reporting of performance indicators, and greater flexibility for innovation at the local level.

Canada - Measuring Up. A yearly report on how Ontario’s health system is performing

This report marks the first time Health Quality Ontario (HQO) has used the Common Quality Agenda – a set of about 40 indicators created by HQO in consultation with health partners and system leaders — to monitor the quality of health care. Comparisons with other provinces and countries are included for some indicators.

Canada - Family-centred care delivery. Comparing models of primary care service delivery in Ontario

Ontario has four main models of primary care service delivery: community health centres, fee-for-service practices, health service organizations and family health networks. This study examines whether the four models differ in providing family-centred care, and concludes that multidisciplinary practices and community health centres offer the best setting for family-centred care.

Canada - Non-Profit Community-Based Specialty Clinics in Ontario

Ontario is establishing new community-based specialty clinics offering select OHIP-insured, low-risk routine procedures. These clinics will focus on providing high volume services, such as cataract and colonoscopy procedures that do not require an overnight hospital stay. Moving low-risk routine procedures from hospitals to community specialty clinics will help improve the overall patient experience while resulting in better value for taxpayers. Specialty clinics will work closely with Local Health Integration Networks (LHINs) and hospitals and operate under existing legislation and quality assurance frameworks to ensure oversight and accountability.

Canada - Ontario Making Historic Investment in Mental Health Care

Ontario has announced the biggest provincial investment in Canadian history in mental health and addiction services: a four-year investment of $2.1 billion that will reframe the system to deliver better and more accessible integrated care. The investment will make it easier to access services through a local school, family doctor's office, or community-based organization.

Canada - Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario

This discussion paper, published on December 17, 2015, by the Ontario Ministry of Health and Long-term Care, presents recommendations for addressing structural issues that create inequities and for truly integrating the healthcare system so that it provides the care patients need no matter where they live. The Ministry is inviting input on the proposal from patients and providers across the province. Feedback should be provided by February 29, 2016.

Canada - Ontario Establishing Patient and Family Advisory Council

Ontario is creating a Patient and Family Advisory Council to advise the province on health policy priorities impacting patient care. The council will involve patients, families and caregivers throughout the policy development process. Council members will be chosen by a public process to nominate suitable candidates taking place in 2017.

Canada - Expanding the Scope of Practice for Pharmacists in Ontario

In 2009, legislation enlarged Ontario pharmacists’ scope of practice to allow them to administer vaccinations, alter and renew prescriptions, and prescribe a small number of drugs. This paper argues that the reforms have increased vaccinations but failed to shift physicians’ burden of care for minor illnesses. It finds no evidence of improved health system efficiency.

Canada - Comparison of Family Health Teams to Other Primary Care Models, 2004/05 to 2011/12

Produced by the Institute for Clinical Evaluative Sciences (ICES), this longitudinal analysis fills a longstanding knowledge gap by comparing outcomes of Family Health Team patients in relation to other Ontario primary care models over time. The report has been released in tandem with a paper addressing population variability in Ontario Community Health Centre (CHC) data.

Canada - Quality in Primary Care Setting a Foundation for Monitoring and Reporting in Ontario

Ontarians are less likely to receive optimal primary care if they are immigrants, live in a low-income neighbourhood, or live in a rural, remote or northern area of the province, according to this new report published by Health Quality Ontario.

Canada - Measuring Up. A yearly report on how Ontario’s health system is performing

Measuring Up uses the Common Quality Agenda, a set of indicators developed with experts across the province, to see how the quality of care is changing in Ontario — how each local health integration network (LHIN) region is performing, and how the province compares with the rest of Canada and other countries. The report shows that over the past four to 10 years, 13 key performance indicators demonstrate improvement, 20 indicators show no change and two have deteriorated.

Canada - Province Increasing Access to Primary Care for Ontario Families

Ontario is improving access to primary care by providing $22 million in additional funding for 445 primary care organizations, including community health centres, nurse practitioner-led clinics, family health teams and nursing stations that together serve nearly six million Ontarians. The funding will allow the organizations to better attract and retain healthcare professionals.

Canada - Health Quality Ontario Publishes New Report on Cross-Sectoral Quality Improvement

A Quality Improvement Plan (QIP) is a formal commitment to quality improvement, aligned with system and provincial priorities. This most recent analysis of the QIPs submitted by Ontario’s healthcare organizations explores how organizations across the province are partnering with their peers in other sectors in order to deliver more collaborative care for their patients and ensure appropriate transitions between care providers.

Canada - Greater efficiencies realized in Ontario's cancer system

The Cancer Quality Council of Ontario has released findings from the 2016 Cancer System Quality Index (CSQI) that measures the performance of the province’s cancer system. The findings indicate that efficiencies, such as new cancer treatment centres, have begun improving patient outcomes and safety by enabling greater capacity in the system.

Canada - McGuinty Government Helps Recruit More Doctors

Ontario is improving access to health care with two new programs that will help communities that have traditionally had the hardest time recruiting doctors. The province is introducing: 1. The Northern and Rural Recruitment and Retention Initiative, which will provide grants to doctors and new doctor graduates who agree to practise in a northern or highly rural community. 2. The Postgraduate Return of Service Program, in which international medical graduates agree to practise for five years in any Ontario community, except the Toronto area and Ottawa, in exchange for postgraduate training opportunities. Previously, these doctors were restricted to practising in rural and northern communities for five years, following graduation.

Canada - Ontario Launches Updated Plan for Health Care

On February 2, 2015, the Ontario Ministry of Health and Long-Term Care launched "Patients First: Action Plan for Health Care to Improve the Health Care Experience." It represents the next phase of transformation to the province's healthcare system to improve results for patients and meet the needs of an aging population. The plan focuses on access, connecting people with services they need close to home, information and education, and protecting the universal public health care system for generations to come.

Canada - CHT Conundrum. Ontario Case Study

Ontario has yet to agree to decreases in the Canada Health Transfer (CHT) proposed by the federal government. As Ontario’s healthcare costs are expected to rise at a pace well above the previously agreed CHT, the health transfer will fall as a share of provincial expenditures even if it is not cut as anticipated. This paper urges a quick return to the negotiating table to resolve the issue.

Canada - Ontario’s Health System: Key Insights for Engaged Citizens, Professionals and Policymakers

Edited by the McMaster Health Forum’s director, John Lavis, this book aims to help make the Ontario healthcare system more understandable to the citizens who pay for it and are served by it, the professionals who work in it, and the policymakers who govern it. The book begins by providing historical context and ends by examining current goals and improvement strategies. Each of the 11 chapters begins with key messages for each of these groups.

Canada - Ontario Investing $28 Million in Mental Health and Addictions Services

On February 26, 2015, the Ontario Ministry of Health and Long-Term Care announced investments in local mental health and addictions organizations to provide care closer to home for people who are experiencing mental health and addictions challenges. Funding will go to improve access to supportive housing, support groups and treatment programs, a registry of inpatient mental health beds, and improved transitions between care teams.

Canada - Ontario Investing $44 Million in Home and Community Care

The Minister of Health and Long-Term Care in Ontario is increasing funding to programs that can help seniors who have experienced a loss of strength or mobility, often associated with a hospitalization, recover from illness or injury so they can continue to live more independently. Among the programs that will receive additional funding are short-stay rehabilitation programs, community supports and comprehensive risk assessment programs in the community.

Canada - Ontario Introduces Legislation on Medical Assistance in Dying

Ontario has introduced legislation to support medical assistance in dying by providing more protection and greater clarity for patients, their families, and healthcare providers. The proposed Medical Assistance in Dying Statute Law Amendment Act aligns with new federal laws concerning medical assistance in dying.

Canada - Evidence highlights danger of cutting RNs in Ontario

The Registered Nurses' Association of Ontario (RNAO) has launched an online database collecting 70 years of research into nurse effectiveness. Over 95% of the 626 studies in the new database show that registered nurses (RNs) have a positive impact on health outcomes.

Canada - Major $1.3 Billion Investment for Quicker Access to Specialized Care and Services in Ontario

Ontario is improving access to health care by investing $1.3 billion over three years to reduce wait times, with more than $285 million designated for the year 2017-2018. Patients will see improved local access through the introduction of innovative interprofessional models of care, including new ways to assess patients with lower back, hip, and knee pain.

Canada - Moving To Patient-Based Funding Will Improve Care in Ontario

On March 19, 2012, the Ontario government announced a new funding model that will see hospitals funded based on how many patients they see, the services they deliver and the quality of those services. Anticipated results include shorter wait times and better access, more services and better quality care with less variation between hospitals.

Canada - Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10

This study by the Institute for Clinical Evaluative Sciences (ICES) compares primary care models and concludes that Ontario’s Community Health Centres (CHCs) are the most effective way to keep Ontarians out of hospital ERs. The study finds that CHC clients visited ERs 21% less often than patients in other primary care models, and that CHCs connect services to poorer populations who face barriers to accessing primary care.

Canada - Safer cancer care for Ontarians

The 2017 Cancer System Quality Index (CSQI), released May 17, 2017 by the Cancer Quality Council of Ontario, identifies several improvements to safety this year within the cancer system. There were fewer perforations during colonoscopies, better drug ordering for chemotherapy, and increasing use of peer review among radiation oncologists across Ontario, increasing quality assurance and safety within the system.

Canada - Ontario Passes Legislation on Medical Assistance in Dying

The province of Ontario passed legislation on May 9, 2017 that will support the implementation of medical assistance in dying in the province. The law provides more protection and clarity for patients, families, healthcare providers and institutions. The new act aligns with federal legislation and will address areas that fall under provincial jurisdiction.

Canada – The Ontario Government Reports First Year Progress on Patients First Action Plan

On March 23, 2016, the Ontario Minister of Health and Long-Term Care released a report detailing results of efforts to give patients better and faster access to high-quality health services. Measures to improve access have included making hospital parking more affordable, supporting in vitro fertilization, funding nurse practitioners and selecting Ontario's first ever Patient Ombudsman.

Canada - Public Services For Ontarians: A Path To Sustainability And Excellence

This publication from the Ontario Minister of Finance provides a detailed proposal for reducing Ontario’s budget deficit. The authors assessed the 2011 Budget Scenario for the next seven years. It then developed a Status Quo Scenario on how the province’s finances would unfold if no changes were made now and projected that the deficit would more than double in 2017–18. The authors then drew up a Preferred Scenario to see the budget balanced by 2017-18, relying on spending cuts as no new taxes were permitted in the exercise. Health care reforms figure prominently in the cuts needed for the Preferred Scenario.

Canada - Registered Nurses’ Association of Ontario issues recommendations to ensure patients come first

The Registered Nurses' Association of Ontario (RNAO) has released a report saying upcoming reforms to health services delivery in Ontario won’t succeed unless they include a health human resources (HHR) strategy. The report identifies provincial nursing employment trends that contradict the government’s stated priorities.

Canada - Costs of health care across primary care models in Ontario

This study examines the relationship between new primary care models in Ontario and the costs of primary care and total health care. It focuses on payment mechanisms for primary care physicians (fee-for-service [FFS] and blended capitation), and finds that new primary care models are associated with lower total healthcare costs compared to the traditional FFS model, despite higher primary care costs in some models.

Canada - Enhancing Community Care for Ontarians (ECCO) – A Three Year Plan

In October 2012, the Registered Nurses Association of Ontario (RNAO) published a plan to reorganize home care and support services. The new RNAO model, Enhancing Community Care for Ontarians (ECCO), would see primary care organizations provide complete care coordination, eliminating the need for Ontario’s 14 Community Care Access Centres (CCAC).

Canada - Variations in Quality Indicators across Ontario Physician Networks

This chartbook from the Institute for Clinical Evaluative Sciences (ICES) in Ontario reports performance levels for a set of quality indicators that reflect health care delivery across settings of primary and specialty care, acute hospital care and long-term care, as well as shared care and transitions from one setting to another. The quality indicators include screening and prevention, evidence-based medications, drug safety, hospital to community transitions, adverse outcomes, imaging and cancer end-of-life care.

Canada - Bringing Care Home

This report from the Expert Group on Home and Community Care, commissioned by the Ministry of Health and Long-Term Care in Ontario, aims to improve services available to the province's population. Its recommendations will help advance the transformation from a home and community care system based on the needs and preferences of providers to one based on the needs and preferences of the client and family—bringing care home rather than providing homecare.

Canada - Accepting new patients: What does the public think about Ontario’s policy?

The aim of this study is to gauge the public’s opinion of the College of Physicians and Surgeons of Ontario’s (CPSO’s) policy on how primary care physicians should accept new patients.

Canada - Primary Care Reform: Can Quebec’s Family Medicine Group Model Benefit from the Experience of Ontario’s Family Health Teams?

This paper published in Healthcare Policy analyzes the family medicine group (FMG) model's potential as a lever for improving health care system performance and discusses how it could be improved. It reviews the history of primary care in Quebec, presents the FMG model and discusses ways of advancing primary care services in Quebec using the family health team (FHT) model developed in Ontario.

Canada - Enhancing the Continuum of Care - Report of the Avoidable Hospitalization Advisory Panel

In September 2010, the Ontario Ministry of Health and Long-term Care convened an Avoidable Hospitalization (AH) Advisory Panel, with Dr. Ross Baker as the chair. Its mandate was to identify system-wide AH best practice guidance, inventory AH improvement practices and measures and produce an evaluation framework for AH initiatives. The full report is now available.

Canada - Association between quality domains and health care spending across physician networks

This Ontario study investigates relationships between healthcare quality and spending, measuring 65 quality indicators in six care domains across physician networks. The study evaluated associations between domains and spending, and measured indicators using administrative databases. Large variations were seen in timely hospital-to-community transitions and potentially avoidable hospitalizations. Investment in effective primary care services may reduce the burden on the acute care sector and associated expenditures.

Canada - Improving Rural And Northern Health Care. The Ontario Government Seeking Input To Address Unique Health Care Challenges

Ontarians are being asked for their feedback on how to provide the best access to quality health care services in rural and northern areas of the province. Specifically, Ontarians are invited to respond to recommendations made by the Rural and Northern Health Care Panel. There are a number of ways that the public can make its views known - including online, by phone and in-person at roundtable discussions in rural communities across the province.

Canada - Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform

Like healthcare jurisdictions elsewhere, Canada’s provinces have begun shifting away from global hospital budgets. This evaluation focuses on Ontario’s implementation of quality-based procedures (QBPs), a funding approach involving a pre-set price per episode of care coupled with best practice clinical pathways. The evaluation concludes that implementation of QBPs has suffered from policy drift, and says the funding mechanism remains misunderstood in Ontario’s healthcare system.

Canada - Ontario Funds Bundled Care Teams to Improve Patient Experience

Patients in six communities across the province will now benefit from an approach called bundled care, which is helping people transition more smoothly out of hospital and into their homes. The bundled care model provides a single payment to a team of health care providers to cover care for patients both in the hospital and at home. As a patient moves throughout the system and back to their home, the majority of their health care team remains the same. Services are coordinated around the patient's needs, resulting in fewer emergency department visits and less risk of being readmitted to hospital.

Canada - Adding it all up: A value-based allocation process for child and youth mental health services

Focused on Ontario, this report examines ways to efficiently allocate provincial resources for child and youth mental health services. It recommends a process whereby the Ontario Ministry of Children and Youth Services (MCYS) and its agencies clarify the value and cost of services when determining allocations. The process would involve data collection, determination of service value, and collaborative planning.

Canada - New report reveals inequities in people’s health risks, care and outcomes based on their income

Health Quality Ontario has issued a health equity report showing that the province’s poorest people are more likely to have shorter lifespans and suffer from chronic conditions. Ontarians below the poverty line are twice as likely to have multiple chronic conditions and die up to five years earlier than richer residents.

Canada – New report outlines actions needed to reduce chronic disease in Aboriginal communities

On June 15, 2016, Cancer Care Ontario released the report Path to Prevention - Recommendations for Reducing Chronic Disease in First Nations, Inuit and Métis. Rates of cancer, diabetes, heart disease and respiratory diseases are increasing, and the report provides the Government of Ontario with evidence-based policy recommendations to reduce exposure to four key risk factors: commercial tobacco use, alcohol consumption, physical inactivity and unhealthy eating.

Canada - Ontario Launches Home Care Plan to Improve Access and Expand Service

The new plan outlines how the government will transform how care is delivered at home and in the community. In addition to increasing nursing hours, key initiatives will include: Expanding supports for family caregivers; Giving clients and caregivers greater say in choosing a provider, and how and when that provider delivers services; Clear and consistent levels of home and community care services no matter where in the province a patient lives; Enhancing support for personal support workers; Providing greater choice for palliative and end-of-life care.

Did changing primary care delivery models change performance? A population based study using health administrative data

Brief analytical summaries or syntheses #24 Did changing primary care delivery models change performance? A population based study using health administrative data Summary Primary care reform in Ontario started with the introduction of new enrolment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups. Background It has been increasingly recognized that health care systems with a strong primary care component are more efficient and better able to handle current and future health care pressures. This has led to several primary care reform strategies in the U.K., Australia, the U.S. and Canada. Common to all of these reform strategies is a movement away from providing service based on…

Canada - A $4.9 Billion Decrease in Health Care Expenditure: The Ten-Year Impact of Improving Smoking, Alcohol, Diet and Physical Activity in Ontario

This report describes the proportion of Ontario adults at risk for four health behaviours: smoking, unhealthy alcohol consumption, poor diet and physical inactivity. It then estimates the impact of these behaviours and socioeconomic position on total healthcare costs, and, separately, costs for hospital care, community care and prescription drugs.

Canada - Strong Action to Improve Health Care. McGuinty Government Launches 2012 Progress Report

This report released on October 26 details Ontario's accomplishments in putting patients first, while ensuring the future sustainability of the health care system. It highlights initiatives such as improved access to immunizations, nurse-practitioner-led clinics, an increase in home care and the expansion of Family Health Teams.

Canada - The scale of hospital production in different settings: One size does not fit all

This paper from Denmark’s University of Copenhagen compares the productive efficiency of 117 Ontario hospitals with 24 hospitals in New Brunswick. Using data from 1998-2004, the paper finds that efficient hospitals in urbanized Ontario are larger than non-efficient hospitals, whereas the reverse is true in mostly rural New Brunswick.

Canada - McGuinty Government Proposes New Rules, Higher Standards for Broader Public Sector

Ontario is proposing strict new rules that would prevent organizations funded with taxpayer dollars from using public funds to hire external lobbyists to ask for more funding. The proposed Broader Public Sector Accountability Act would, if passed, bring in new rules and higher accountability standards for hospitals, Local Health Integration Networks (LHINs) and the broader public sector around the use of external lobbyists, consultants and expenses. Hospital and LHIN executives could see reductions in pay, should they fail to comply with the requirements under the proposed Act. In addition to ending the use of taxpayer dollars to hire lobbyists, the new rules would: 1. Expand Freedom of Information legislation to cover hospitals, 2. Require hospitals and LHINs to post expenses of senior executives online, 3. Require hospitals and LHINs to report annually on their use of consultants.

Canada – Ontario: Pharmacists Can Now Give Flu Shots, Renew Prescriptions

Expanding the role of highly trained pharmacists is part of the government's Action Plan for Health Care. On October 9, 2012, Premier Dalton McGuinty announced that, in addition to giving the flu shot, pharmacists can now also renew or adapt existing prescriptions, prescribe medication to help people quit smoking, demonstrate how to use an asthma inhaler or inject insulin, and support patients who have a chronic disease, such as diabetes, monitor their condition.

Canada - Accountability and Access to Medical Care: Lessons from the Use of Capitation Payments in Ontario

In the province of Ontario, healthcare reforms have improved access to primary care by implementing a capitation model where doctors are paid for a roster of patients rather than by fee-for-service. According to this paper from the C.D. Howe Institute, however, too many Ontarians are still using doctors other than the one with whom they are rostered. The paper suggests encouraging patients to stick to their regular physician.

Canada - Toward Performance and Quality

This special edition of Healthcare Quarterly highlights the transformation that is under way in Ontario’s healthcare system. Many topics are discussed such as patient-centred care, successful Quality Councils, leadership, links between evidence and quality of care, and The Excellent Care for All Act.

Canada - Improving Care for High-Needs Patients. McGuinty Government Linking Health Providers, Offering Patients More Co-ordinated Care

On December 6, 2012, the Ontario government announced that it is improving co-ordination of care for high-needs patients such as seniors and people with complex conditions through the creation of 19 Health Links across the province. Health Links will encourage greater collaboration and co-ordination between a patient's different health care providers as well as the development of personalized care plans.

Canada - Paying For Primary Care: The Relationship between Payment for Primary Care Physicians and Selection of Patients Based on Case-Mix

Using administrative data to compare primary care physicians across payment models in Ontario, this study analyzes whether physicians respond to financial incentives by selecting patients based on their risk profile. After controlling for physician self-selection, the study found no evidence of risk-selection behaviour.

Canada - Quality Matters: Realizing Excellent Care for All

The Quality Matters initiative is part of Health Quality Ontario’s ongoing effort to unite everyone in the health system through a common language of quality and to reach a shared commitment to take action on common goals. This report articulates the vision guiding the initiative. It offers six domains of quality, a set of principles to guide us, and key factors we need to consider in order to instill quality at the core of our health system. A one-page visual and a patient video accompany the report.

Canada – Exploring Accountable Care in Canada: Integrating Financial and Quality Incentives for Physicians and Hospitals

This report, commissioned by the Canadian Foundation for Healthcare Improvement and the Ontario Ministry of Health and Long-Term Care explores the relevance and feasibility of establishing Accountable Care Organizations (ACOs) in Canada using Ontario as a case study. In ACOs, physicians, hospitals and other provider organizations assume accountability for the cost and quality of care for a defined population.

Canada - Ontario is lowering emergency room waiting time by expanding the Pay for Results program that has already helped hospitals across the province make significant wait time improvements

Since 2008, the province's Pay for Results program has helped participating hospitals lower overall waiting time by 4.7 hours (28%) for patients who require complex medical care or admission to hospital, and by 1.4 hours (22%) for patients with minor conditions. The program helps hospitals implement initiatives like patient flow tracking systems, which improve discharge and admission processes, or hiring nurse practitioners to treat patients with less complex conditions. This year, through a $100 million investment, the government is expanding the Pay for Results program to an additional 25 hospitals across the province, bringing the total number of participating hospitals to 71.

Canada –Nurses launch vision for the health system that meets current and future care needs without resorting to medical tourism and other forms of privatization

A paper just released by the Registered Nurses' Association of Ontario (RNAO) sets out the association's vision for the province’s healthcare system and makes recommendations concerning the future of primary, hospital, and long-term care. The paper argues that person-centred care, better outcomes and same-day access must all become integral parts of Ontario’s system.

Canada - Mental Health and Addictions System Performance in Ontario: A Baseline Scorecard

This scorecard assesses mental health and addictions care in outpatient physician and acute care settings in Ontario from 2006 to 2014. The scorecard comprises 10 performance indicators that describe how well the health system responded to patient needs, along with eight contextual indicators reflecting the services provided and patient outcomes. Performance on each indicator is evaluated by age, sex, geography, neighbourhood income, and immigration status.

Canada - Learning from Kaiser Permanente: Integrated systems and healthcare improvement in Canada

Written by a UK academic for the Canadian Foundation for Healthcare Improvement, this paper compares two distinctive approaches to health service provision: a US non-profit insurance and managed care system, and two provincial tax-funded, single insurer systems in Ontario and Saskatchewan. The report finds that the US system, Kaiser Permanente, invested heavily in an integrated clinical system that holds many lessons for Canadian systems.

International - eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US

Advances in eHealth offer better care and support for people with complex care needs. This article presents case studies from Ontario, Scotland, and the state of Colorado to identify how these jurisdictions are using eHealth to address multi-morbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case, and thoughts on eHealth's future in complex care are presented.

Canada - Healthcare Organizations Across Canada Launch Improvement Projects

In April 2017, the Canadian Foundation for Healthcare Improvement (CFHI) announced nine healthcare improvement projects it will support through its flagship fellowship program. Selected healthcare organizations in Quebec, Ontario, British Columbia and Nova Scotia will implement and evaluate projects focusing on innovative ways of providing patient care in the home and communities.

Canada - Toward Quality Mental Health Services in Canada: A Comparison of Performance Indicators across 5 Provinces

In 2015, the Centre for Applied Research in Mental Health & Addiction (CARMHA) at Simon Fraser University led an initiative to develop mental health and addictions performance indicators that could be used comparatively across five provinces: British Columbia, Alberta, Manitoba, Ontario and Québec. These two reports present the project: one provides an overall summary and the other details technical information on indicators and results.

Canada - Mental Health Commission of Canada Launches Mental Health First Aid Program for Seniors and Their Caregivers and Service Providers

On September 6, 2017, the Mental Health Commission of Canada (MHCC) launched Mental Health First Aid (MHFA) Seniors, an Ontario training program to support the mental health needs of older people. MHFA Seniors trains senior citizens, caregivers, and service providers to respond to an emerging mental health problem until appropriate treatment is delivered.

Canada - Change in health care use after coordinated care planning: a quasi-experimental study

Conducted in southern Ontario’s Hamilton-Niagara region, this study investigated whether 600 patients with a coordinated care plan differed in their use of health care (number of ER visits, inpatient admissions, and length of hospital stays) compared with a control group of patients with no care plans. Results showed care plan beneficiaries had fewer ER visits but found no significant difference in admissions to, or length of stay in hospital.

Canada - Primary Care Access and Emergency Department Utilization: Theory and Evidence from Canada

Studying how after-hours physician incentives affect emergency department (ED) use, this paper developed a model suggesting reduced ED use is related to expanded primary care access. However, incentivizing primary care physicians to provide after-hours services can also reduce service during regular hours and increase ED utilization: an ambiguous result. Testing with Ontario healthcare administrative data from 2004-2013 produced findings consistent with these predictions.

Canada - Adopting eHealth Solutions: Implementation Strategies

Published by the Registered Nurses’ Association of Ontario, this guideline provides evidence-based recommendations to enhance the capacity of all individuals involved in the implementation of an eHealth solution. Organizations are encouraged to establish suitable infrastructures to support eHealth education needs and facilitate technology-enabled health system transformation.

Canada - More than 60,000 Canadians left the country for medical treatment in 2016

A Fraser Institute study has found that 63,459 Canadians travelled abroad for medical care in 2016, departing for general surgeries (9,454 patients), urology treatment (6,426), internal medicine procedures (5,095) and ophthalmology treatment (3,990). British Columbia reported the highest proportion (2.4%), while Ontario had the greater number (26,513) of patients leaving Canada for care.

Canada - Understanding and Implementing Best Practices in Accountability

Relying on document analysis and informant interviews, this study assesses whether findings on best practices in accountability from a previous Ontario-based study (Approaches to Accountability, 2014) apply across Canada. Results reinforce earlier findings, showing that goals, resources, stable leadership and a focus on transitions points within the system are essential to good practice, as is the availability of good measurement.

Canada - Leaving Canada for Medical Care, 2016

Published by the Fraser Institute, this briefing estimates that 45,619 Canadians left the country to receive medical treatment in 2015. The largest number was from Ontario (22,352 patients). Almost 4,980 Canadians travelled abroad for urology procedures alone. One explanation for travelling abroad is long wait times in Canada’s healthcare system.

Canada - Return on Investment: Mental Health Promotion and Mental Illness Prevention

The Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) commissioned the Canadian Policy Network at the University of Western Ontario to complete a scoping study that examines the return on investment and cost effectiveness of mental health promotion. It found that there is research showing a return on investment for some mental health promotion/illness prevention interventions, especially those targeting children and youth.

Canada - Performance-Based Healthcare: How Hospitals Can Leverage Business Intelligence and Information Management to Meet Ontario's Healthcare Reforms

This paper by three consultants with IBM Global Business Services in Volume 10, Number 2 of Electronic Healthcare recognizes that hospitals are at different stages of readiness in information management to align their practice with Excellent Care for All Act quality legislation. It identifies eight key business intelligence dimensions that can help hospitals advance their information management and quality improvement agendas.

Canada - The Value of Electronic Health Records Extends Far Beyond Patient Care

A paper released March 2, 2012, by the Toronto Board of Trade describes the benefits of incorporating the principles of Privacy by Design into the electronic health record (EHR) environment. The paper, entitled Embedding Privacy Into the Design of Electronic Health Records to Enable Multiple Functionalities – Win/Win is co-authored by Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario, and Richard C. Alvarez, President & CEO, Canada Health Infoway, argues that privacy considerations are essential to using health information for a broad range of purposes.

Canada - Health Care Transformation Benefiting All Ontarians

This news release from the Ontario government describes achievements in the first year of the Action Plan for Health Care. Among them: expanding non-profit community clinics for select procedures like vision care; new physician service agreements that include support for e-consults; improved services for older Ontarians, including more home care; expanded services from pharmacists and 30,000 more house calls by primary care providers.

Canada - McGuinty Government Releases e-Health Progress Report

The 2011 eHealth Progress Report, released August 19, showed that more than 7,000 doctors, who care for 6.5 million Ontarians, now manage their patients' health information with an electronic medical record — more than any other province. The report points to significant cost and wait-time savings as well as better safety resulting from the use of electronic health records.

China — Roadblocks to health reform in China

Two years after China launched a sweeping US$130-billion health care reform plan, the country faces huge obstacles to progress in what’s been described as the world’s largest health care experiment. The plan centres on quickly reforming hospital management while delivering universal access to primary health care through national insurance schemes. But roadblocks have arisen, according to new research presented at the annual world congress of the International Health Economics Association in Toronto, Ontario (July 10–13).

Canada - Health Care Funding: Needs and Reality

There is no shortage of flashing red lights on health care funding by Ottawa and the provinces, as Antonia Maioni notes in this overview of the health issue. First, the 0-year, $41-billion federal transfer to the provinces is up for renewal in 2014, with no indication of where the money will come from. Then, an aging population will make increasing demands on a system that already consumes more than 10 percent of GDP. In the provinces, British Columbia and Ontario have introduced health care premiums, while Quebec, in its 2010 budget, brings on a health care head tax that will rise to $200 per taxpayer in 2012, as well as a $25 user fee for doctors’ visits, which, she writes: “is contrary to the spirit of the Canada Health Act.”

Canada - Population Health and Health System Reform: Needs-Based Funding for Health Services in Five Provinces

This essay explores the introduction of population-needs-based funding (PNBF) formulae for the provision of health care services in five provinces (Newfoundland and Labrador, Quebec, Ontario, Saskatchewan and Alberta) as part of a larger project examining a range of health reform decisions in those provinces.

Canada - Canada Health Consumer Index 2010

The annual Canada Health Consumer Index evaluates healthcare-system performance in the ten provinces from the perspective of the consumer. For the third straight year, Ontario and British Columbia finish with the top scores in the CHCI’s overall rankings.

Canada — Did changing primary care delivery models change performance? A population based study using health administrative data

Primary care reform in Ontario, Canada started with the introduction of new enrolment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups.

International - Framework for assessing, improving and enhancing health service planning

This report aims to contribute to policy learning across countries from the diversity of healthcare planning approaches in Europe and elsewhere through developing and validating a framework for assessing, improving and enhancing healthcare planning. It identifies a set of criteria within three broad themes: "Vision", "Governance" and "Intelligence", which were then tested empirically through an in-depth analysis of four countries, using a case study approach: Germany, Austria, Canada (Ontario) and New Zealand.

Canada - Never Events for Hospital Care in Canada

This report published by Health Quality Ontario presents the collective work of the National Patient Safety Consortium to identify, for the first time, a list of 15 never events for hospital care in Canada. Never events are patient safety incidents that result in serious patient harm or death and that are preventable using organizational checks and balances.

Canada - Policy Innovation is Needed to Match Health Care Delivery Reform: The Story of the Champlain BASE eConsult Service

This commentary says Canada needs to reform health services delivery and finds that the current lack of policy responsiveness hinders the expansion of innovations to improve patient care. To illustrate these challenges and how they might be overcome, the authors explore an innovative electronic specialist consultation start-up that is growing into an Ontario-wide service.

Canada - A 3-year study of high-cost users of health care

This study presents a 2009-2011 retrospective analysis of Ontario residents. It identifies the clinical diagnoses, demographic characteristics and costs of high-cost users of healthcare (users with the highest 5% of costs). Diagnoses included chronic diseases, infections, and palliative care. Most spending among high-cost users was for institutional care; costs were far more concentrated among children than older adults.

Canada - Integrating Long-Term Care into a Community-Based Continuum. Shifting from “Beds” to “Places”

The authors of this IRPP study argue that if more community support were available, the tipping point at which patients with greater care needs require residential long-term care would be higher, and people would be able to stay at home longer. Drawing on research in Ontario and overseas, the authors examine some promising community--based rural and urban initiatives. Through the lens of neo-institutional political theory, they analyze the hurdles encountered in attempting to scale up or replicate such initiatives.

Canada - Mental health. Special Issue. Healthcare Quarterly

This special issue of Longwood’s Health Quarterly focuses on mental health in Canada. Topics of the 10 article include: psychiatrist health human resource planning, early intervention programs for psychoses and mood disorders, community recovery services, peer support, the social determinants of health (housing and income) and Ontario mental healthcare delivery.

Canada - New study suggests that a family physician's decision to investigate symptoms suggestive of cancer could help explain international differences in cancer survival

This study by the International Cancer Benchmarking Partnership examined beliefs, behaviours and systems in primary care across six countries with similar healthcare systems, analysing responses from family physicians (FPs) on how they would manage patients presenting with symptoms suggestive of lung, colorectal or ovarian cancer. These responses were then correlated to one-year mortality rates from these cancers. Cancer Care Ontario researchers who participated in the study report that early investigation by FPs is reflected in mortality and that access to diagnostic tests by FPs may play a role in their decision to investigate symptoms.

Canada - Release of 2014 Report Card on Wait Times in Canada - Time to Close the Gap

The Wait Time Alliance (WTA) released its 2014 Report Card on June 3. It finds that medical wait times have improved since the signing of the 2004 Health Accord, but progress has been uneven. While Newfoundland and Labrador, Ontario and Saskatchewan have made or are beginning to make substantive and sustained progress, other provinces continue to struggle and there remain significant variations within provinces and communities.

Canada - Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study

In this study, conducted in hospitals and primary care practices in Ontario and Quebec, authors interviewed 57 managers to identify barriers and facilitators to evidence-informed decision-making (EIDM). Limited resources were the most frequently identified barriers, while advocacy by decision-makers was the main facilitator. Most interviewees said documentation and reporting tools were needed to support EIDM.

Canada - Quebec Ranks In The Middle Of The Pack On Population Health

Quebecers give themselves top grades for their health. Yet, when Quebecers' health is compared to that of other Canadian provinces and advanced countries, Quebec ranks in the middle of the pack, according to The Conference Board of Canada's How Canada Performs: Health report card. Quebec gets an overall "B" grade and finishes 11th among 29 jurisdictions in the first-ever report card that includes the provinces, territories and 16 peer countries. Quebec places third among the provinces behind British Columbia and Ontario, and just below Canada as a whole.

Canada - Mental Health Commission of Canada Releases Summary of Report on Support to Emerging Adults

On February 23, 2015, the Mental Health Commission of Canada released the executive summary of its forthcoming report on how to promote a more seamless continuum of services for emerging adults. Developed in partnership with a research team from the Children’s Hospital of Eastern Ontario (CHEO), the report will detail the current state of policies and practices in the area of youth transitioning from child and youth to adult mental health and addiction services. It will also present best practices and policies from the Canadian and international experience.

Canada - More regulated nurses entering the profession than leaving it

New data shows that more regulated nurses in Canada are entering the profession than leaving it. In 2015, there was an inflow of 30,897 regulated nurses and an outflow of 22,534, culminating a 10-year period in which Canadian nursing supply grew by 18%. Regulated nurses are Registered nurses (RNs), including nurse practitioners (NPs); Licensed practical nurses (LPNs), also called registered practical nurses in Ontario; and Registered psychiatric nurses (RPNs).