Tag Archives: Ontario Shores Centre for Mental Health Sciences

Will advanced IT be the saviour of Ontario hospitals?

The Canadian Institute for Health Information (CIHI) has a simple vision: better data, better decisions, healthier Canadians.

It does appear at times that we are drowning in data, raising the question of how accurate and timely it is, how it is used, and whether we have the smarts to draw the right conclusions from it. Hospitals have at times complained that the breadth of data demanded by the province raises the spectre that too many priorities means there are no priorities.

The choice of what data to collect can create incentives that may not always be the best. The focus on hospital length of stay, for example, has led to charges that patients are being sent home early without adequate care.

However, health data can tell us a lot about how we use the health care system and where to put our resources. One hospital executive noted at a recent Longwood’s conference on Big Data that many of their emergency room readmissions came from patients who lived alone – information that would be useful in planning and justifying enhanced home support.

Despite the existence of CIHI, not every health provider is on equal footing when it comes to utilizing information technology.

The evidence does suggest that the information savvy providers are capable of achieving better health outcomes than the information poor. That’s been the mission of HIMSS – the Healthcare Information and Management System Society — for more than 50 years.

HIMSS certifies health care provider organizations according to their adoption and use of electronic medical records. For many, it is the Holy Grail in achieving quality service delivery.

Dr. Larry Garber, Medical Director for Informatics at the Massachusetts-based Atrius Health spoke recently at the Longwood’s Big Data conference at the Rotman School of Business.

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Royal Ottawa — prosecutions fly below the radar

The Ministry of Labour inspectors have significant powers when it comes to enforcing the Occupational Health and Safety Act.

What’s difficult to discern is where the dividing line is between issuing orders and prosecuting an employer for violations of the Act.

After months of investigation into seven complaints and 77 incidents at Ontario Shores Centre for Mental Health Sciences, in May the Ministry issued 15 orders to address issue around workplace violence.

Given how big the investigation was, how many incidents had taken place, and how many workers were interviewed, we were stunned that no charges were laid. By contrast, Ontario Shores was separately prosecuted and fined $37,500 for an incident around a worker injured cleaning and replacing a ventilation hood.

Last week we got word by a very convoluted route that the Royal Ottawa Mental Health Centre was facing prosecution on three counts stemming from a single incident of workplace violence in June 2012.

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Few anti-stigma campaigns based on evidence — Stuart

“Mental health is set aside as that other kind of health care we don’t want to talk about.” – Asante Haughton, one of three youth featured in the Ontario Shores produced film “Talk To Someone: You’re Not Alone.”

Queen’s University researcher Dr. Heather Stuart says the majority of anti-stigma campaigns are not evidence based and few are evaluated. In fact, her research suggests that we may even have to retrench and undo the damage some of these past campaigns have created.

That includes discussion of mental disorders as a brain disease. Her research shows that such descriptors actually increase social distance, not close it.

Speaking at the Ontario Hospital Association HealthAchieve on Monday, Stuart says protests over stigma can “backfire,” resulting in greater polarization of the issue. Stigma should be regarded as a “transgenerational problem.”

“You can’t sell social inclusion like you sell soap,” she told the packed conference room.

We’re all part of it, she says, including families and the mentally ill themselves who create a “self-stigma.” That includes self-blame.

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Mental health: Death should prompt MOHLTC to look upstream at root causes

It’s time for the Ministry of Health to look at the root causes behind the violence and injuries that are taking place in the province’s hospitals that provide mental health care.

Given persons who are mentally ill are no more statistically inclined to be violent than anyone else, clearly something is changing in these settings to push reports of violent incidents upwards.

While the union is privy to statistics around injuries experienced by its own members, we do not see the parallel data around patient-on-patient violence.  Why is it one can go on-line and look at the record of critical incidents at a long-term care home but not at a psychiatric hospital?

Sadly, workers being injured in such incidents barely make the news. Some believe that getting punched, spit at or slammed against a wall is part of the job (it shouldn’t be). Hospital managers and Ministry of Labour officials have shown little sympathy for workers suffering from post-traumatic stress disorder — surprising given where this is taking place.

Workers at these hospitals tell us repeatedly it’s just a matter of time before someone dies.

In fact, that time came this spring.

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Dealing with an unfair funding formula, SBGHC cuts at the top (how novel!)

Here’s a story we don’t see every day: South Bruce Grey Health Centre is cutting two of its four senior management positions as part of its efforts to deal with a budget deficit.

Contrast that with hospitals such as Ontario Shores Centre for Mental Health Sciences, which carved out a new advisory position for its departing CEO at a time when front line staff are bracing for tough times ahead.

The decision may have been slightly easier to make at SBGHC given two senior managers are retiring. However, as most front line workers already know, when you cut vacant positions, it still has an impact on the workload of those left behind.

SBGHC is one of the few hospitals to have weathered the last decade without consistently running into deficit. The fact that they are now forced to trim their sails owes a lot to a punitive new funding formula emerging from Queen’s Park. Small rural hospitals weren’t supposed to be part of that formula, but because SBGHC combines resources from four small hospitals together, they do.

The irony is that by consolidating their resources these four small hospitals are being penalized. For the Hanover hospital, which has somehow managed to stay out of SBGHC despite being located within the same geographic area, they must be breathing a sigh of relief.

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Psychiatric Hospitals: The food is terrible… and such small portions

Yum. Actual meal at one of Ontario's psychiatric hospitals.

Yum. Actual meal at one of Ontario’s psychiatric hospitals.

The nurse thought it was a mistake. A large patient at Ontario Shores Centre for Mental Health Sciences was given a plate with six pieces of ravioli on it as that day’s lunch. The nurse on the unit thought it was not going to be nearly enough. When she contacted the dietary department they said there was no mistake, these are proper portions.

Staff at Ontario Shores tell us that such portions mean the same patients are down at the canteen later on filling up on less healthy foods.

Recently we asked representatives from our mental health sector if they had similar experiences to their colleagues at Ontario Shores. The answer was yes.

By being strict about calorie counts, you would think that patients would be losing weight. However, when the evening meal leaves you hungry, there are other options, unhealthy options that result in patients actually gaining weight.

In another psychiatric hospital we were told of patients ordering in fast food to fill that hunger. While delivering a pizza or Chinese food to a public hospital may appear odd, it is not uncommon.

We were told these hospitals are taking it right to the line with regard to portion size and calorie count.

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The best of Diablogue in 2012

It’s time for us to take our seasonal break and wish the best of the season to all our readers and posters. Next year will be challenging for health care activists as hospitals continue to shed services to balance their budgets, home care faces unrealistic and high expectations over relatively modest funding increases, bed shortages compound wait times in long-term care and all health providers try to find ways to better work together.

If you are new to our BLOG, or are an occasional viewer, you may have missed some of our postings throughout this year.

Here is a sampling of some of our more popular stories from 2012:

1. In recent days we have been unpacking the contents of the Auditor General’s chapter on long-term care in his 2012 annual report. Much of Ontario’s bed shortage problem is based on the Health Minister’s insistence on holding the line on opening new beds, noting Denmark’s success in diversifying long-term care options. But Denmark still has more nursing home beds per capita than Ontario and has made massive investments in home care. To read more, click here.

2.  When the province introduced its new Long Term Care Act, it was to include stepped up inspection. Problem is, they never hired enough long-term care inspectors to get the job done. Most Ontario nursing homes have not had a thorough inspection since 2009, and some may never see a detailed inspection. To read more, click here.

3. Norma Gunn won a disability rights award this year from the Ontario Federation of Labour for telling her own story about being assaulted at the Ontario Shores Centre for Mental Health Sciences and coping with the subsequent post traumatic stress disorder. A psychiatric nurse at the Whitby-based hospital, Gunn has been at the center of a struggle to reduce incidents of violence at the hospital. In recent days we’ve learned that CEO Glenna Raymond is stepping down in April. Will it be an opportunity for the hospital to press its own reset button on this issue and repair its relations with the staff who work there? To read more, click here.

4. This spring we were in Thunder Bay for a rally around the closure of the Canadian Blood Services plasma donor clinic.  Canadian Blood Services was created following the tainted blood scandal of the late 1980s and the subsequent inquiry by Justice Horace Krever. As we probed the decision by CBS to close down the Thunder Bay donation centre, we began to wonder if all the lessons from the inquiry were truly learned. To read more, click here.

5. One of our most popular stories this year was a posting about corporations stashing away record amounts of “dead” cash and the rich squirreling away billions in tax havens while insisting on further tax cuts. The impact is juxtaposed against a backdrop of hospital cuts across Ontario as the province claims it is broke. To read more, click here.

 6. This was the year that P3s (Public Private Partnerships) came back into the news. This summer we were reminded of how bad the situation is in Britain, the birthplace of these schemes. These so-called PFIs — Private Finance Initiatives — are saddling generations of Britons with a mountain of debt. Worse still, the actual value of these projects is about half the size of the accumulated debt, raising questions about value. Ontario represents more than half of such P3 projects taking place in Canada. To read more about the British experience, click here.

7. Ontario is the only province where the ombudsman does not have jurisdiction over the health sector. In BC the ombudsman has made significant contributions to staffing issues in that province’s long-term care homes. Why not here in Ontario? Click here.

8. What would Diablogue be without its bad hospital food stories? Truly if there is one issue that galvanises everyone — including hospital administrators concerned about patient satisfaction scores — it’s bad hospital food. Now the evidence would suggest it’s about more than just tasteless taters and mountains of wobbly Jello. Click here for more.

9. It’s a catch-22. We criticize much that takes place within our public health system. Then we defend the hell out of it when someone suggests we should replace it. This post reminds us of what it is we are fighting for. Click here.

10. Another of our more popular posts this year was the analysis of how former bank executive Don Drummond has skewed his economic projections to make it look like Ontario was in an even worse crisis than actually existed. To what end? Click here.

See you all back in January!

Ontario Shores’ activists win awards

The Workers Health and Safety Centre, the Durham Labour Council and the Ontario Federation of Labour has honoured OPSEU’s campaign for workplace safety at Ontario Shores Centre for Mental Health Sciences with two awards.

Local 331 President Yvonne Lewis has won her regional health and safety award for her tireless advocacy on behalf of staff at the Centre.

Norma Gunn has won the OFL’s disability rights award after sharing the story of her struggle with post-traumatic stress disorder. Norma was the subject of a recent video by Operation Maple.

Ontario Shores was fined $37,500 in September after a worker suffered a serious injury while cleaning ventilation hoods in the kitchen.

The hospital is also under major investigation by the Ministry of Labour following numerous complaints about workplace violence.

Lost time injuries are almost double the rate of the Centre for Addiction and Mental Health, and total paid sick time hours are higher than the other three major stand-alone psychiatric hospitals in Ontario.

The hospital is beginning to respond to concerns raised by Lewis, Gunn and others. A number of recently announced initiatives are welcome. Some appear to have been prompted by Ministry of Labour orders and suggestions.

The awards will be presented at a ceremony in Port Hope on November 15.

Ontario Shores fined $37,500 after worker suffers concussion

Ontario Shores Centre for Mental Health Sciences has pleaded guilty and fined $37,500 under the Occupational Health and Safety Act after a worker was injured cleaning and replacing ventilation hoods in the hospital’s kitchen area.

The September plea bargain by the hospital included the dropping of seven other counts under the Occupational Health and Safety Act.

The Ministry of Labour inspector had determined that the worker had not received any training or instruction for the work, nor did Ontario Shores have any procedures in place to safely carry out this cleaning.

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More managers to front line staff has an impact well beyond cost of salaries

Asking how the ratio of management to front line staff has changed at a public hospital seemed like a straight-forward question.

In this era of obsession with hyper-efficiency, you’d think the Ministry of Health, the Local Health Integration Networks and the hospital boards would be asking this question, and asking it regularly.

Doesn’t everyone want more live bodies actually delivering diagnostics, acute care and rehab?

To be fair the Ministry breaks down data by what they describe as “unit producing personnel” (UPP) and those whose “primary function is the management and or support of the operation of the functional centre” (MOS). Oddly the terms themselves suggest that managers don’t actually produce anything, which is much further than we would certainly go. (Note to managers reading this – are you really okay with these terms?)

If all this confuses you, apparently it does for hospitals too. There have been past complaints about the consistency and subsequent validity of such data. In our recent survey of the changing ratios of managers to front line staff, several hospitals opted (with our permission) to give us the UPP/MOS data instead of interpreting themselves who was in fact a manager.

Conducting what we thought was a basic freedom of information request, we received data in various formats and continually got the question: what is management?

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