Hospital overcrowding and hallway health care are realities facing today’s health care system in Ontario. The fact that they represent both a source and a symptom of the pressures that patients and frontline clinicians face underscores the complexity of the challenges to improve the situation.
This is one of the main messages to come from Measuring Up 2018, Health Quality Ontario’s yearly report on the performance of the province’s health system.
The report documents the cascading effects of hospital overcrowding such as longer wait times for admission to hospital from the emergency room; longer wait times to transfer out of hospital to other types of care – such as long-term care, home care; and insufficient access to mental health and addictions care. At a time when more and more patients have complex health needs, these stressors on the system are also contributing to rising levels of distress among unpaid caregivers.
Everybody wants quality health care. Why wouldn’t they?
This belief, which underpins the work of Health Quality Ontario, was recently endorsed by no less than the World Health Organization, World Bank and Organization for Economic Co-operation and Development Countries in a major report on global health care. They stated “even with essential health coverage and financial protection, health outcomes would still be poor if services were low-quality and unsafe”.
In a recent commentary in the CMAJ, we summarized data demonstrating that the quality of health care in Canada is good but not great. We also made several suggestions for improvement. In the article, we focused not on the things that individual clinicians could do differently, but rather on decisions that managers, administrators and policy makers can make. While most quality improvement initiatives are necessarily local, we feel certain key steps could be taken across the whole country.
A quality health care system seamlessly delivers care across a broad spectrum of care settings and patient populations. Unfortunately, even a good health care system can have fault lines into which patients can fall and where quality care is deficient.
Measuring Up, Health Quality Ontario’s newly released 11th annual report on the performance of the province’s health system and on the health of Ontarians, documents those fault lines as well as other areas where the provincial system can improve. It takes the pulse of the system through measurement and through narratives from people like Gordon, Lilac and Elgin who share their experiences as patients and that of Shawn Dookie, a nurse practitioner.
That the patient perspective was mentioned first in our Twitter chat about quality in health earlier this week was both gratifying and appropriate.
Ditto the fact that a number of individual members of the public and patient advocates participated in the one hour #HQOchat, which represented the first time Health Quality Ontario has hosted a discussion on Twitter.
(On June 20, I will host a discussion on Twitter about quality and health care. This blog provides the context for that Tweet chat)
Most of us can recognize quality in clothes, cars or conversation.
But defining quality in health care delivery or in a health care system is not nearly as simple.