Category Archives: Local Health Integration Networks

Unintended Consequences – Northumberland Hills CEO says replacing ALC patients comes at a cost

Posted on November 29, 2012 | Leave a comment

Reducing the number of “alternative level of care” (ALC) patients in a hospital may have unintended consequences.

Robert Biron, CEO of the Cobourg’s Northumberland Hills Hospital, told the Central East LHIN yesterday that his current operating deficit may be partially linked to the hospital’s success in reducing the number of ALC patients from a high of 36.8 per cent in December 2010 to a low of 2 per cent in June of this year.

Alternate level of care patients are those who have completed their acute care treatment at the hospital but are not well enough to return home. Wait lists for long-term care beds and home care services have left many hospitals without an ability to responsibly discharge these patients.

Biron says filling the former ALC beds with high acuity patients requires more resources, not less, including advanced nursing care. These are additional costs to the hospital in a year when base budgets are frozen.

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Much left on health care agenda by prorogued parliament

Posted on October 16, 2012 | Leave a comment

The decision by Premier Dalton McGuinty to step down and shut down the provincial parliament leaves many questions about the future of Ontario’s health care.

With no parliament, there will be no review of the Local Health Integration Networks, a commitment that the McGuinty government wrote into the original Act that created the Crown agencies.

When the government wrote the Local Health System Integration Act in 2006, somebody forgot to calculate that a five year mandated review would take place just prior to a fixed date election. Whoops! McGuinty did suggest that such a review might not be necessary at all until someone reminded him that it was written into the legislation.

There was no way the government was going to undertake a review of the unpopular LHINs just prior to going to the polls. In recent months we had heard that such a review was finally going to go to committee. Now that won’t happen. That means it could be seven years before the five-year review happens.

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CCACs could play expanded role as direct home care providers

Posted on October 9, 2012 | 2 comments

Doris Grinspun, the executive director of the Registered Nurses Association of Ontario (RNAO) has been a tireless defender of public not-for-profit health care. We’ve seen her speak truth to power at numerous conferences and public events. When she advocates on behalf of the RNAO, she speaks plainly and passionately.

Last month the RNAO released its submission to the government on Ontario’s seniors care strategy.

The document is full of good recommendations, from strong staffing standards in long-term care homes to a broadening of the policy lens to include government’s impact on the social determinants of health.

The biggest surprise, coming out during the same month as the Hudak health care platform, is the RNAO’s recommendation that the Community Care Access Centres be scrapped and the work be redistributed to the Local Health Integration Networks and to primary care providers, such as family health teams, community health centres and nurse practitioner-led clinics.

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Vector Poll: Most Ontarians think McGuinty government is doing a poor job on major health priorities

Posted on September 24, 2012 | 1 comment

Deb Matthews may want to get out more.

We’ve previously noted that Ontario’s Health Minister has made far fewer public speeches than her predecessors. The Ministry’s on-line speech archive lists two speeches for Matthews this year, one for last year. There have been a total of five press releases issued during the summer months (June to August), most dealing with basic alerts, such as reminding Ontarians to protect themselves from West Nile virus.

For a government intent on radically remaking the health system, there appears to be very little coming out of the Minister’s office. The effects are telling in a recent poll around the province’s long waited health action plan.

When the Local Health Integration Networks were formed, the province was charged with developing an overall health strategy. This was supposed to be the basis for the LHINs own integrated health service plans.

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Good writing, good health: CDC publishes social media guide

Posted on May 2, 2012 | Leave a comment

Here at Diablogue we slog through a lot of health care reports that are loaded with jargon and sentences you need an advanced degree to unravel.

After a day of reading this stuff, it is easy to fall into the trap of writing like that.

While it’s easy to dismiss such concerns as shop talk, the reality is how we communicate in health care matters.

The U.S. Center for Disease Control (CDC) is trying to do something about it. They have recently published their own guide to writing for social media.

The CDC notes that nearly nine in ten adults have difficulty using the every day health information that is routinely available in health care facilities, retail outlets, media and communities.

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Falls Prevention: Will the LHINs overcome the impact of delisting and fiscal restraint?

Posted on April 30, 2012 | 3 comments

Taken by themselves, the numbers are startling.

About 50 per cent of injury-related hospitalizations for seniors are from falls.

We spend an estimated $962 million a year dealing with the health outcomes from falls.

Falls are responsible for 95.1 per cent of all hip fractures.

One in three seniors is likely to fall at least once per year.

Six Local Health Integration Networks (LHINs) had identified falls as a priority and have already implemented comprehensive prevention programs.

Last July the LHIN Collaborative (LHINC) put out its own framework and toolkit, aiming to establish a province-wide strategy on falls.

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Hospitals: I am a dinosaur. Hear me roar.

Posted on April 7, 2012 | 1 comment

This is what we’re all expected to believe: if you cut the funding from hospitals and give it to community-based care, our health system will become more effective and sustainable.

The people who say hospitals should be nothing but acute care centers appear to be winning the debate on health care reform despite a lack of evidence to support their views. Those of us who suggest otherwise are quickly labelled dinosaurs.

Even the warm and friendly Canadian Centre of Policy Alternatives appears to be getting in on the act, suggesting in their federal alternative budget that as long as the community services remain not-for-profit, all will be well. They recommend an increasing share of federal transfers should be used to enhance primary and community-based care, not to support hospitals.

When we think about expensive hospitals, we think about beds.

And yet, the CCPA acknowledges that Canada already has the highest rate of day surgery in the world – an average of 87 per cent of all surgeries.

They point out that hospitals have only increased slightly as a percentage of spending relative to the size of the economy, from 3 per cent in the 1970s to 3.4 per cent in 2009. That’s more than 30 years.

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Drummond report mostly ignores mental health despite the high cost of doing nothing

Posted on March 26, 2012 | Leave a comment

The McGuinty government says they are committed to implementing about half of the recommendations from the Drummond Commission on the Reform of Public Services.

The other half will be subject to study (read: likely to drift away into the ether).

In health care most of that should be relatively easy given a significant number of Drummond’s 105 recommendations are already in the McGuinty government’s plan, from the implementation of a new funding formula for hospitals (Health-Based Allocation Model) to his endorsement of the government’s sketchy mental health strategy.

Given the recommendations are intended to be implemented over the next four years, it may take some time to ultimately figure out what is really in and out.

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National security advisor, former Mulroney cabinet minister among LHIN appointees

Posted on March 13, 2012 | Leave a comment

Who is running our Local Health Integration Networks (LHINs)? With Commissioner Don Drummond’s calls to beef up the power of the regional health organizations, the make-up of the LHIN boards may become increasingly important.

For six years the McGuinty government has been making appointments to these boards. Most appointments are for three-year terms, meaning many LHINs are just now filling the third generation of their boards.

Who they are is very much a reflection of the government in power, many coming from the education and business sectors. Forty-eight claim some connection to the public and post-secondary education system, including teachers, professors, lecturers, principals, school board trustees and those who have served on the boards of colleges and universities. On the business side there almost the same number again of chartered accountants, consultants, IT professionals, human resources managers and bankers. About one in four business people on the LHIN boards are from the financial services industry.

Twenty-three LHIN board members state they are retired from their active careers, although many more fail to list a current position, suggesting they too may also be retired.

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Wealth, age and geography should be significant factors in “ranking” LHIN performance

Posted on March 12, 2012 | Leave a comment

According to the Hamilton Spectator, the three wealthiest regions of the province have the best health results despite the lowest per capita health funding, a blatant reminder of the link between income and health.

These three LHINs also happen to be adjacent to Toronto, where many patients cross LHIN boundaries to seek care.

It also tells us that tackling poverty could have a substantial impact on public health care costs.

Does that make these three regions the best run LHINs? Not necessarily.

Unfortunately, the newspaper’s ranking of the 14 Local Health Integration Networks may not be entirely fair given the emphasis on population health in those standings.

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