REPORT OF THE CRITICAL ASSESSMENT COMMITTEE , CAPITAL REGION MEDICAL STAFF October 18, 1996 INTRODUCTION This document represents the compilation and categorization of the concerns brought forward to the Region Ten Medical Staff Council's Critical Assessment Committee by family practitioners, specialists, nurses, allied healthcare workers, support staff, patients, families, seniors, and others. These concerns have been assembled in this report along with information supplied by Regional Program Clinical Directors. The report is a categorization of diverse problem areas which are perceived to exist in the present health care system. Statistical data has been provided where possible. Selected anecdotes are used for illustrative purposes. The medical staff recognizes that the report does not provide a complete catalogue and discussion of all problems, however, it does delineate those problems which have so far been drawn to our attention. The medical staff recognizes that some concerns may have been or are being addressed and that some of the problems are not new or necessarily a result of restructuring. However, it was felt that ALL problems in the system needed to be examined and reported in order to evaluate the system properly. RATIONALE Over the past two years physicians in Region 10 have been voicing concerns regarding the deterioration of the health care system and the increasing difficulty they are experiencing in addressing patient needs. There is abundant evidence that health programs have been cut to such an extent that the system no longer works properly and that patient care is being jeopardized. Physicians, nurses, and all other members of the health care system feel that they cannot provide an appropriate level of care with the current resources, let alone cope with further reductions. Fiscal restraint has become the principle driver of change. The standard of care has become a secondary concern and has dropped to an unacceptable level. The human face of health care is disappearing. The essential elements intrinsic to care, namely, time, caring, comfort, and compassion are being seriously compromised in our system. The medical staff, in voicing their concerns, have responded to their moral obligation and their professional duty to encourage the restoration of these critical components on behalf of the patients whom we serve. Recognizing the urgency of the situation, the Region 10 medical staff have conducted this comprehensive critical assessment and review of the status of health care in the region. We have been inundated with data from those who work within the system and from those who use its services. Our information includes statistics, comments, anecdotes, and comprehensive reports. Through the analysis of what we received, we have been able to examine all areas of the system and to identify numerous serious and wide-ranging problems. Our long-term purpose is threefold:
Our goal is to participate in designing a sustainable healthcare system based on sound principles and effective processes. Our ultimate aim is to see our health care system reconstituted to provide the advanced level of care required by and deserved by the people our region serves. We forsee that this will involve additional funding and a certain degree of reorganization. Most importantly, it will require a master plan for care based on a set of guiding principle which reflects and addresses the health care needs of the citizens served by this region. GUIDING PRINCIPLES 1. Care must be patient-centred and focused on the care experience. 2. System and program development must be compatible with a principle-based master plan for care. 3. Continuity of care must be provided which minimizes fragmentation, duplication, bottlenecks, or gaps in service. 4. The patient must have timely access to the health care providers of his or her choice and to all required resources. 5. Quality care based upon best evidence must be ensured. 6. All health care providers must be given a stable work environment with adequate staffing and resources to optimize the patient care experience. 7. The essential role of education and research in the delivery of high quality care must be recognized and supported. 8. All health care providers must be given a meaningful and ongoing role in planning and assessing the health care system. 9. Changes to the health care system must be: (1) directed toward provision of the best care (at the best cost); (2) developed through a consultative process followed by appropriate action, which involves the public, health service providers, and the RHA; (3) implemented at a pace permitting careful reflection and diligent planning to avoid risk. 10. Programs must be adequately capitalized and include recapitalization plans to meet the ongoing demands of the system and to keep the system up-to-date in providing best care. 11. Changes made during program development must recognize the interdependence of all members of the health care team and all components of the health care system. 12. Comprehensive information about the health care system and its workings must be systematically collected and made publicly available in a timely manner. CATEGORIES OF PROBLEMS The information received by the Critical Assessment Committee has detailed a wide variety of problems. This data has been sorted into appropriate categories of problem areas which are linked to the set of guiding principles. 1. Continuity of Care
2. Access to Care and Resources
3. Quality of Care (the care experience) 4. Staffing
5. Equipment
6. Education 7. Off-loading of Costs
8. Morale (cost to the system) |
