Category Archives: Ontario Hospital Association

Problems at clinics should prompt rethink on competitions for hospital services

Photograph of table with thousands of cards on it while an unidentified person speaks at a nearby podium. July 8 the Ontario Health Coalition brought more than 80,000 signed cards to the Ontario legislature opposing the transfer of clinical services from hospitals to private clinics.

July 8 the Ontario Health Coalition brought more than 80,000 signed cards to the Ontario legislature opposing the transfer of clinical services from hospitals to private clinics. (Photo courtesy the Ontario Health Coalition)

The media is applauding Health Minister Dr. Eric Hoskins this week for promising greater transparency around private clinic inspections that had previously been kept secret by Toronto Public Health and The College of Physicians and Surgeons of Ontario (TCPSO).

Tom Closson, the former President and CEO of the Ontario Hospital Association, suggested in the Toronto Star last week that “bringing out-of-hospital clinics up to the same standard as hospitals regarding transparency would increase public confidence in the care they are seeking.”

Ontario’s Action Plan for health care includes systematically taking clinical services out of public hospitals and transferring them to a sector that has a history of two-tier medicine, questionable user fees, unnecessary up-selling, significant quality control issues and too little transparency. The latest revelations, particularly around infection control at several private clinics in Toronto, may have persuaded the government not to carry out spring and summer competitions for selected hospital clinical services – at least for now.

They may have learned from the Ottawa Hospital’s ill-timed decision early in 2013 to divest 5,000 endoscopies to the private sector at the same time the TCPSO was making public the list of clinics that failed inspection public – including one Ottawa endoscopy clinic that may have exposed patients to HIV, hepatitis B and hepatitis C from equipment that may not have been properly sterilized.

This spring the Ontario Health Coalition collected more than 80,000 postcards expressing opposition to the transfer of services from public hospitals to private clinics. Without any clear indication from government whether the competitions are on hold, the coalition is now working towards a November 21st mass rally in Toronto to push further on the issue.

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10 revealing moments at this year’s OHA HealthAchieve

The Ontario Hospital Association’s HealthAchieve is one of the major health care conferences on our annual calendar. Here are 10 revealing moments from this year’s three-day event:

1. Metaphors really stick. Don Berwick, former administrator of the U.S. Medicaid/Medicare program, spoke about the Choleteka Bridge in Honduras. An engineering marvel, it was considered one of the strongest bridges in the world. The year after it was built, Hurricane Mitch struck and washed out more than 150 bridges in the country – but not the Choleteka. The only problem is, the hurricane actually moved the path of the river to render the bridge obsolete. Speaker after speaker picked up on this metaphor in relation to health care delivery.

2. Performance pay is a stupid idea. OHA hospitals have been moving towards “performance” or “at risk pay” in recent years. It essentially means that a portion of an executives’ pay is contingent on the hospital reaching certain pre-established goals. Not only does this demean the executive by suggesting they would not act in the organization’s best interests otherwise, but means the goals get dumbed down – or what Berwick says “makes timidity logical.” Berwick says he prefers goals that are difficult to reach. When Berwick said he is not a fan of performance based pay, a significant portion of the packed audience broke into spontaneous applause. The OHA may want to revisit this policy.

3. “Benchmarking is the cream of the crap.” – Mark Britnell, Chairman and Partner, KPMG Global Health Practice. Say no more.

4. Several speakers emphasized the importance of “Senior Friendly Hospitals,” including the importance of early mobilization. Getting seniors mobile in hospital can shorten the length of stay, shorten duration of delirium and improve the return to independent functioning. Nobody mentioned that many Ontario hospitals are presently eliminating physiotherapy positions to balance their budgets.

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Matthews bows out of leadership race, focus instead on health care “transitions”

Health Minister Deb Matthews says she is not seeking the Ontario Liberal leadership.

Matthews made the formal announcement at the Ontario Hospital Association HealthAchieve this morning, ending weeks of speculation.

Noting how rare it was for a health minister to be addressing her fourth OHA HealthAchieve, Matthews said she wanted to remain on as Health Minister.

Many believed that the entrance of Kathleen Wynne into the leadership contest meant that Deb Matthews would stay out.

She told the half-filled hall that the next step in “Matthews hierarchy of health care needs” is to work on transitions of care so that nobody falls between the cracks.

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OHA speakers say transform health before it gets cut

KPMG's Mark Britnell at the OHA HealthAchieve

KPMG’s Mark Britnell at the OHA HealthAchieve

Speakers at this week’s Ontario Hospital Association HealthAchieve say it’s important to transform health care, not cut it.

Don Berwick, former Administrator for U.S. Medicare and Medicaid Services, told the OHA conference the U.S. presently spends 17.6 per cent of its economy (GDP) on health care and is headed for 24 per cent, or almost one dollar out of every four spent south of the border.

In a later session in the afternoon, the UK’s Mark Britnell, Chairman and Partner of KPMG’s Global Practice, spoke about advanced economies being “increasingly burdened” by rising health care costs, a situation “exacerbated by the fiscal crisis.”

Britnell called economist and banker Don Drummond’s report on how to get Ontario’s house in order one of the best he’s read, even though many of Drummond’s projections have already proven to be wrong.

Neither Berwick or Britnell ever mentioned that for three consecutive years now Canada’s health care spending has dropped not only as a share of GDP, but also as a percentage of provincial spending. Britnell still shows charts claiming that Canada’s health care costs are going to rise by a staggering 2 per cent of GDP.

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Employee engagement has substantial impact on reducing workplace stress – OHA study

Ontario hospitals could be paying a big price for not engaging their employees.

A new study from the Ontario Hospital Association suggests that “the quality of the work environment for staff and physicians is a key determinant of a high-performing health care organization.”

Written by workplace consultant Dr. Graham Lowe, The Relationship Between Employee Engagement and Human Capital Performance notes that “engaged employees are committed to their employer, satisfied with their work, and willing to give extra effort to achieve the organization’s goals.”

The study looks at data from small, teaching and community hospitals. The data links information from two tools — NRC Picker employee surveys and PwC Saratoga HR benchmarking project.

The evidence would suggest engaged employees are less inclined to experience workplace stress, suffer from fewer patient-handling injuries, and be less inclined to seek employment elsewhere.

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Hospitals to compete on cost as province introduces new funding mechanisms

In March Deb Matthews told the media that 36 hospitals will have their budgets cut by as much as three per cent when this year’s new hospital funding formula rolls out.

This week the Ministry held a technical briefing and remarkably told its labour stakeholders that in year one about 10 per cent of hospitals will see increases in funding no greater than 1.8 per cent and decreases no greater than 1.5 per cent.

They also state that 90 per cent of hospitals will see less than a one per cent difference in their budget allocation, plus or minus.

Back in March 91 hospitals were expected to “benefit” from the new formula. Now the Ministry says only 90 hospitals will participate – small rural and northern hospitals being excluded from the Health Based Activity Model (HBAM).

That’s a big difference.

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Campbell named OHA CEO and President

Pat Campbell has been named the new president and CEO of the Ontario Hospital Association.

Campbell most recently served as CEO of Echo, an agency whose goal is to collaborate with health partners and conduct research to improve women’s health.

She may be more familiar to OPSEU members as the past President and CEO of Grey Bruce Health Services.

Campbell will take up her role June 4 and replace interim OHA President Mark Rochon.

OHA proposes voluntary extension of CEO wage freeze

On the day Ontario’s 2011 “sunshine” list is being released the Ontario Hospital Association has called for a voluntary three-year extension of the two-year legislated wage freeze for executives.

The OHA says such a freeze would save $47 million over five years, averaging slightly less than $10 million a year on a health budget approaching $50 billion.

However, this may not necessarily mean all those CEOs and VPs will see their compensation packages unchanged.

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New interim OHA CEO responsible for hospital amalgamations

Mark Rochon is replacing Tom Closson as CEO of the Ontario Hospital Association (OHA) – at least for now.

Rochon will fill the post until a permanent replacement his hired by the OHA Board of Directors.

Rochon comes from Toronto Rehab, where he served as CEO from 1998-2011. He also served as OHA Board Chair 2007-2008.

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Much hype but little scandal in hospital contract disclosure

The media have been on a feeding frenzy today around Tuesday’s disclosure of hospital executive compensation packages. Like the sunshine list, it is a chance for the private sector to paint a picture about how the public sector has been wining and dining on the taxes of the downtrodden, even if it is less than true.

The real story is there are really no big revelations here.

The most shocking example we found appears to be the work of sloppy reporting rather than executive excess.

The Toronto Star reported that Dr. Robert Howard, CEO of St. Michael’s Hospital, was receiving “a $75,000 allowance for a car.” This would lead most people to believe Howard was getting $75,000 each year to apply to a lease or purchase of a vehicle. In fact, had the reporters been a bit more careful, they might have figured out that it was for a lease or equivalent for a car whose retail value was up to $75,000. Nice, but at this level, ho-hum.

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