ACCREDITATION CANADA ENVIRONMENTAL SCAN SUMMARY

ENVIRONMENTAL SCAN FEBRUARY – APRIL 2010
ANALYSE DU MILIEU FÉVRIER - AVRIL 2010
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
AB
Ethics
 Funding cuts could result in the closure of Alberta's Provincial Health
Ethics Network, which has helped patients, health-care workers and
health regions with difficult medical ethics questions. Most of the
temporary funding from AHS runs out March 31.
 Supporters say Alberta Health Services should reinstate the funding, or
the loss will lessen the province's ability to thoughtfully deal with ethical
dilemmas likely to increase with an aging population, new technologies,
more experimental drugs and growing chronic health problems.
 The network -- the first and largest of its kind in North America -- has
trained health-care workers how to approach ethical questions such as
circumcision, the HPV vaccine, family disagreements over ending lifesupport, or disclosure of medical errors. The network has also helped
develop legislation and health policy on issues such as pandemic
planning and codes of conduct. Edmonton Journal 2010.03.11
Qmentum standards address
various ethical issues,
including developing policies
and procedures.
BC
Health Human
Resources
 BC is expanding paramedics’ scope of practice to integrate the ambulance
service more closely with the health system, empowering paramedics to
make health care decisions to improve patient care.
 Examples include dealing with people who have chronic diseases in
residential care facilities, joining home- and community-care workers in
supporting clients in their homes, and providing care in emergency
departments.
 Amendments to the Emergency and Health Services Act pave the way for
Qmentum includes standards
for Emergency Medical
Services.
The BC EMS providers were
recently integrated into
Provincial Health Services
Authority (PHSA). They will
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Topic
Matière
CDA
Health Trends
Issue
Catégorie
Strategic Directions
Orientations stratégiques
the introduction of “treat and release,” whereby a paramedic called to a
scene could assess a patient, provide appropriate treatment, and advise on
follow-up care, instead of having to transport the patient to the emergency
department.
 These legislative changes will provide the opportunity for paramedics to
play a much greater role in health care delivery, especially in rural and
remote areas. BC Ministry of Health Services 2010.04.21
be accredited through PHSA
as one of their sequential
components. Discussions with
PHSA are underway.
 According to the HealthCast series of reports on health industry trends
published by the PricewaterhouseCoopers Health Research Institute, a
growing and aging population, more people living with chronic disease,
and inconsistent service delivery (due in part to financial and workforce
shortages) are placing increased pressure on the health care system in
Canada.
For information.
 Key consumer findings include:



42% of Canadians indicated that immediate access to a doctor or
health care provider is top-of-mind in their definition of "quality"
health care, compared to only 30% globally.
When it comes to specialized care, Canadians have a much harder
time accessing specialist physicians than the rest of the world.
Almost half said it was difficult to see a specialist.
Canadians rely heavily on their physicians as a source of medical
information. In fact, 72% said they prefer to go to the doctor's office
to obtain information about their personal health.
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Topic
Matière
Issue
Catégorie

Strategic Directions
Orientations stratégiques
Consumers also want silos to be broken down in health care. Twothirds of global consumers surveyed said coordinated clinical teams
are important to them, similar to 60% of Canadian consumers. NB
Council Briefing 2010.04.20
CDA
Health Human
Resources

The Toyota method of using automobile assembly line techniques to
improve health care efficiency is “catastrophic” according to a sociologist
at the University of Quebec who did a study of the workplace at the local
area network in Ahuntsic and Montreal North. Professor Angelo Soares
found four of 10 employees posted high levels of psychological stress, and
over half felt a disconnect between their values and those of management.
Health Edition 2010.03.26
CDA
Health Care
Sustainability
 In an opinion-editorial published in the National Post (Mar. 24), Canadian
Medical Association President Dr. Anne Doig suggests a number of ways
of dealing with the question of sustaining health care spending without
crowding out other priorities like education and social programs.
 First, she says it is important to “explore and agree on the underlying
reasons why health spending exceeds economic growth. Part of this
exploration must include measuring and appreciating the value of our
health system, both realized and unrealized.” Dr. Doig points to a study
by the Public Health Agency of Canada that said the cost of premature
mortality equaled the direct cost of providing health services in 2000.
 Second and third, she says “we need to make quality king in health
care” and make governments more accountable for their oversight and
The quality of employee
worklife is an integral
component of the Qmentum
accreditation program. The
Worklife Pulse Survey is part
of the Qmentum accreditation
program.
For information.
4
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
management of the health care system. That begins with producing
comparable data and health indicators.” Then, she says Canadians need to
be encouraged to take increased personal responsibility for health and
health care.
 Finally, “we must stop looking at health spending in isolation. Once we
get a better understanding of the likely future path and size of health
spending we must determine what the subsequent implications are for
other government programs like education, social services, public security
and infrastructure.” Health Edition 2010.03.26
CDA
CDA
Health Human
Resources
Infection
Prevention and
Control
 According to a recently released report, three-quarters of Canadian family
doctors have experienced at least one incident of major abuse at the hands
of patients. Close to 40 per cent had been subjected to severe abuse
including assault.
 The findings were released in the journal Canadian Family Physician. It was
the first national examination of violence in doctors' offices.
 The study's author would like to see Canada develop a national policy on
how doctors should deal with such abuse, while ensuring the patient in
question still gets the medical treatment he or she needs. CBC 2010.03.17
Qmentum standards address
safety issues affecting both
clients and staff.
 Linguists at Xerox Corporation have teamed up with medical researchers
in France to explore how "language technology" can help curtail hospitalacquired infections (HAI).
 Researchers will use a "text mining" tool developed by Xerox to analyze
For information.
An ROP on workplace
violence prevention was
released in February. It will
apply to surveys starting in
2011.
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Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
medical records, automatically identifying patients who could be at risk of
contracting an HAI. The mining software identifies specific terms that
indicate a patient may have contracted an HAI, making the link between
patient symptoms, drugs and names of bacteria. When these links identify
potential risk of an HAI, the system automatically alerts the staff. The
project, titled “Assistant de Lutte Automatisée et de Detection des
Infections (ALADIN),” is being sponsored by the French government in
an effort to help detect HAIs more quickly and reduce infections. NB Council
Briefing 2010.03.25
CDA
Infection
Prevention and
Control
 A study by the Canadian Nosocomial Surveillance Program shows a
dramatic increase in the number of cases of Canadians becoming infected
or colonized by MRSA since 1995, both in hospitals and within the
community. Researchers found that between 1995 and 2007, the incidence
of MRSA - methicillin-resistant Staphylococcus aureus - soared 17-fold at
Canadian hospitals.
 Over the 13-year period, there was also a three-fold jump in the number of
MRSA infections associated with more virulent strains from the
community.
 According to lead author Dr. Andrew Simor, chief of microbiology and
infectious diseases at Sunnybrook Health Sciences Centre in Toronto,
Canadian hospitals have had a measure of success in dealing with MRSA,
but more still needs to be done. "There are things we can do to lower the
risk of MRSA spread in hospitals, including increased screening of highrisk patients, better compliance with hand hygiene, appropriate cleaning
of the hospital environments, and other infection prevention and control
In addition to the standards
on Infection, Prevention and
Control (IPC), there are seven
ROPs that address IPC and
apply to all clients.
Two ROPs are specific to hand
hygiene:
 Education/Training on
hand-hygiene
 Hand-hygiene audit
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Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
measures." The Canadian Press 2010.03.10
NL
Accountability

Significant progress has been made in implementing the
recommendations of the Cameron Report into faulty breast cancer
receptor testing, Newfoundland and Labrador Health Minister Jerome
Kennedy said in releasing a one-year update on the government’s work.
Of the 60 recommendations, 39 have been fully or substantially
completed. The remaining 21 are partially complete with some, such as
continuing education for staff, an ongoing activity. Some 425 patients
received the wrong results from testing conducted between 1997 and 2005.
The Accreditation Canada
laboratory standards are
included in all four NL health
authority surveys being
conducted during 2010.
Health Edition 2010.03.26
NS
OTDT
 Nova Scotia’s approach to organ donation is a "hit-and-miss" affair that
requires new rules to ensure doctors follow through on the wishes of
potential donors, the province’s health minister said. Maureen
MacDonald said she is seeking public input on proposed legislation aimed
at increasing the number of life-saving donations.
 The wishes of potential donors are often ignored by doctors who "don’t
feel comfortable" following up on the matter. As well, distraught family
members sometimes overrule the wishes of potential donors, even though
the current law says that’s not supposed to happen.
 The Organ Donation and Transplant Association of Canada says one
organ donor can save the lives of eight people and assist the lives of 50
more. NB Council Briefing 2010.04.22
OTDT standards address the
roles of the various health care
providers, and how to
communicate with family
members.
Deceased Donor Standards
and Transplant Standards
were released in February
2010. Living Donor Standards
will be released this
September.
7
ON
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
Long Term Care
 Ontario is providing $30 million in one-time funding to help long term
care facilities meet new patient care standards contained in the Long Term
Care Homes Act which comes into force July 1. The Act includes
enhanced inspection, compliance and enforcement provisions and more
stringent provisions concerning staff who provide direct resident services.
Among other things, the Act also institutes a policy of zero tolerance on
resident abuse and neglect, and minimal use of restraints. Health Edition
Qmentum includes standards
for long term care.
2010.04.30
PEI
Health System
Restructuring
 Prince Edward Island’s 2010-11 budget provides new funding for its “One
Island Health System” program — an initiative for improving the
integration of health services as recommended by a major consulting
report for the government in 2008.
 Focusing on health care renewal, the government is moving forward with
creating five Primary Care Networks throughout the island. “This model
will ensure that no Islander is more than a 30-kilometre radius from a
family physician and a wide variety of primary health services and
programs,” says Finance Minister Wesley Sheridan. The government is
putting $500,000 into the development of these Networks this year.
 Home care was another issue identified in the consulting report - PEI was
spending far less of its health budget on home care than other provinces.
The government increased home care spending by $2.2 million last year
A presentation on the Ministry
of Health and Long Term
Care’s new compliance
program will be given to
Accreditation Canada on May
13. Following this meeting,
mapping of the two programs
will be conducted.
Update on the restructuring in
PEI.
As requested, feedback was
provided to senior
government officials
regarding their governance
model at the time of their
previous survey.
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Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
and is increasing the amount again this year to a total of $13 million.
 Another recommendation of the report was to improve the governance
model for health care. A new agency — Health PEI — came into existence
April 1 to take over the running of health-care services. Health Edition
2010.04.30

Leo Steven, former CEO of Sunnybrook Health Sciences Centre, has been
appointed chair of Health PEI; he will head an 11-member board. Health
Edition 2010.04.23
QC
New Standards
 The Montreal Gazette (Feb. 15) comments on the case of a 25-year-old
woman who died two years ago in the recovery room of a private clinic
after having cosmetic surgery. Her family has recently announced that it
will sue the clinic after the coroner concluded it did not have proper
treatment standards. The Gazette notes that the government will be
implementing new accreditation standards on April 1 for private clinics to
perform some 50 designated procedures. The start date had been put off,
as the Gazette observes, “on the regrettable grounds that too few of the
province's 60 private clinics were ready to put the rules into effect.” It says
no further delay should be permitted. “Medical clinics, whether they're
publicly funded or run privately, should all adhere to the same high
standards of professionalism. Those standards must be spelled out – and
enforced – by government.” Health Edition 2010.02.19
 Quebec abortion clinics will be exempt from licensing standards being
applied to private clinics as of March 31. These standards, some of which
Accreditation Canada is
developing Independent
Medical or Surgical Facilities
Standards.
9
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
are comparable to what exists in a public hospital operating room, have to
be met in order for clinics to perform any of some 50 procedures. Last fall,
abortion clinics said it was unrealistic and inappropriate for them to be
subject to the same criteria. Some threatened to close, and they received
the backing of the medical community in their stand. The government
made it official this week that abortion clinics will be exempt from the
new rules. Health Edition 2010.03.26
QC
Nouvelles
normes
 Le quotidien The Gazette (15 février) a commenté le décès d'une femme de
25 ans survenu il y a deux ans dans la salle de réveil d’une clinique privée
après qu’elle ait subi une chirurgie esthétique. La famille de la défunte a
récemment annoncé qu’elle engagera une poursuite contre la clinique, le
coroner ayant conclu que cette dernière n’avait pas respecté les normes
appropriées liées au traitement. The Gazette fait remarquer que le
gouvernement instaurera de nouvelles normes d’agrément le 1er avril de
manière à ce que les cliniques privées puissent effectuer quelque
50 interventions désignées. Comme le souligne The Gazette, la date
d’entrée en vigueur a été reportée « en raison du fait déplorable qu’un
trop petit nombre des 60 cliniques privées de la province est prêt à
satisfaire aux normes ». Le quotidien soutient qu’aucun délai
supplémentaire ne devrait être permis. « Les cliniques médicales, qu’elles
soient subventionnées par l’État ou privées, devraient toutes adhérer aux
mêmes normes élevées en matière de professionnalisme. Ces normes
doivent être clairement énoncées et appliquées par le gouvernement. »
Health Edition, 19 février 2010.
 Au Québec, les cliniques d’avortement seront exemptées des conditions
Agrément Canada élabore
actuellement des normes pour
les établissements médicaux
ou chirurgicaux indépendants.
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Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
requises pour la délivrance d’un permis imposées aux autres cliniques
privées à compter du 31 mars. Les cliniques doivent respecter ces
conditions, comparables à celles pour les salles de chirurgie en milieu
hospitalier, afin de pouvoir pratiquer l’une de quelque 50 interventions.
L’automne dernier, les cliniques d’avortement ont soutenu qu’il n’était
pas réaliste ni approprié qu'elles soient assujetties aux mêmes critères que
les cliniques privées. Certaines ont menacé de fermer et ont reçu l’appui
de la communauté médicale. Le gouvernement a annoncé cette semaine
que les cliniques d'avortement seront exemptées des nouvelles règles.
Health Edition, 26 mars 2010
QC
Communication
 The McGill University Health Centre (MUHC) has launched a free
personal electronic health record (PEHR) service at www.unani.ca that
allows people to aggregate, track and share health and lifestyle
information.
 Anyone with an Internet access can subscribe to Unani.ca. Co-developed
with Quebec-owned Medical.MD, Unani.ca is the first consumer-minded
personal electronic health record (PEHR) in the Canadian marketplace.
PEHR service is the outgrowth of a successful test conducted last July
with the Montreal company Medical.MD, and is now poised to be part of
the “health space” offering from Telus so subscribers can update their
health records electronically including via their mobile phones.
 Information can also flow in the other direction, so a person’s cell phone
may ring when it is time to take medication. Within a year or so the PEHR
system should be connected with physicians, hospitals and clinics. The
Canadian Press 2010.03.15
For information.
MUHC is a client
organization.
11
QC
Topic
Matière
Issue
Catégorie
Communication
 Le Centre universitaire de santé McGill (CUSM) a lancé un service gratuit
de dossier de santé électronique au www.unani.ca qui permet aux
utilisateurs de se regrouper, de faire le suivi et d’échanger de
l’information sur la santé et le style de vie.
 Quiconque disposant d’un accès Internet peut s’inscrire au Unani.ca. Mis
au point conjointement avec Medical.MD, une entreprise québécoise,
Unani.ca est le premier service de dossier médical personnel à l’intention
des consommateurs sur le marché canadien. Mis à l’essai en juillet dernier
en collaboration avec Medical.MD, ce service est maintenant prêt à être
intégré à la plateforme TELUS espace santé. Les abonnés pourront donc
mettre à jour leur dossier de santé électronique, notamment à l'aide de
leur téléphone mobile.
 L’information peut aussi circuler dans l’autre sens : par exemple, une
sonnerie de téléphone mobile pourrait aviser son propriétaire qu’il est
temps de prendre son médicament. D’ici environ un an, la connexion au
système de dossier de santé électronique devrait être établie pour les
médecins, les hôpitaux et les cliniques. La Presse canadienne, 15 mars 2010.
QC
OTDT
 Quebec posted an average of more than 3.6 transplanted organs per
deceased donor in 2009 despite a slight decrease in the number of donors,
Québec-Transplant announced this week.
 The sharing of best clinical practices has been a determining factor in
increasing the supply of organs available for transplantation in the last
five years, and this has resulted in an almost 15 per cent increase in the
number of organs transplanted. Health Edition 2010.02.12
Strategic Directions
Orientations stratégiques
À titre indicatif.
Le CUSM est un organisme
client.
Québec-Transplant was
participated in the focus
group discussion of panCanadian stakeholders during
the development of the Organ
and Tissue Donation and
Transplant Standards.
12
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
Deceased Donor Standards
and Transplant Standards
were released in February
2010. Living Donor Standards
will be released this
September.
DOTT
 Québec-Transplant a annoncé cette semaine que la province a affiché une
moyenne de plus de 3,6 organes transplantés par donneur décédé en 2009
et ce, malgré une légère diminution du nombre de donneurs.
 La communication des meilleures pratiques cliniques s’est avérée un
facteur déterminant dans la réserve d’organes disponibles aux fins de
transplantation au cours des cinq dernières années, ce qui a entraîné une
augmentation de près de 15 pour cent du nombre d'organes transplantés.
Health Edition, 12 février 2010.
Québec-Transplant a pris part
au groupe de discussion
réunissant des intervenants de
partout au Canada dans le
cadre de l’élaboration des
normes en matière de dons
d’organes et de tissus, et de
transplantation.
Les normes en matière de
dons d’organes et de tissus
(donneurs décédés) et les
normes en matière de
transplantation d’organes et
de tissus ont été publiées en
février 2010. Quant aux
normes en matière de dons
13
Topic
Matière
Issue
Catégorie
Strategic Directions
Orientations stratégiques
d’organes et de tissus
(donneurs vivants), elles
seront publiées en septembre
prochain.
Items have been compiled from Health Edition, Canada’s Health Newsweekly; The Canadian Press; Edmonton Journal; NB Council Briefing; CBC; and BC
Ministry of Health Services.
Les éléments proviennent du Health Edition, Canada’s Health Newsweekly, de la Presse canadienne, du Edmonton Journal, du NB Council Briefing, de la CBC
et du ministère des Services de santé de la Colombie-Britannique.