| Report will improve health care; Johnson |
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| Local Content - Local News |
| Written by Garrett Simmons |
| Wednesday, 03 February 2010 16:13 |
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The Minister’s Advisory Committee on Health has outlined six main issues for Alberta Health Services (AHS) and the government to work through in terms of improving health care in the province. Don Johnson, a Municipal District of Taber councillor who was part of the committee that wrapped up its work last month with the completion of its report, said when breaking down the six key elements, a solid framework has been created. In terms of the report’s first recommendation, to put people and their families at the centre of their health care, Johnson added the report was clear in its intentions. “When you change the legislation to accommodate families, you have to change policy too. Then, delivery follows it through.” He cited an example of how this change would take place in terms of long-term care. Johnson said currently, there is a senior in Taber hospital with a chronic condition, who AHS wants to move to Milk River. Consultation with the family did not take place in the original decision, according to Johnson, who scoffed at the notion of taking a senior away from their family, and an area with about 15,000 people, to a community of about 800. “We want to be clear in the report — there has to be consultation with the family. You have to have the family involved in the decision.” With that same idea, Johnson added qualified health-care professionals must also be included in the consultation process, professionals that have the proper expertise to diagnose and assess where elderly patients should be sent. In terms of the second key to the report, be committed to quality and safety, Johnson added it all boils down to a simple equation. “We want to be able to provide the right kind of care at the right level, when you need it.” The third key, ensuring equitable access to timely and appropriate care, was an area of particular interest for Johnson. “That’s one I pushed hard on, because it speaks to gaps between rural and urban care.” Johnson added there has been a trend towards downgrading rural hospitals, which has led to unacceptable situations in many areas. He pointed to the problems in Milk River, which currently does not have a full-time doctor, and the City of Brooks, which lost its capability to deliver babies locally in 2009. The report suggests change has to take place in terms of access, he added. “We have to prepare legislation to facilitate a policy where you can’t close a hospital. There has to be a higher degree of accountability, so Alberta Health Services can’t make a change like that without approval of the minister and the ministry.” Included in the access equation is improvements to the way medical records are handled. Johnson added these records must become more portable, so medical information follows patients if they move anywhere in the province. Enabling decision making using the best evidence available was another hallmark of the report. An example Johnson pointed to was a doctor who questioned the need for so many MRIs in Alberta. He said the doctor was asking where the evidence exists to justify so many of the expensive procedures, and if procedures like X-rays were just as useful in some cases. “When we make decisions in policy and treatment, you have to have good, solid evidence to back up that decision,” said Johnson. Involved in that is making sure decisions are not simply based on potential cost savings. Again, Johnson raised the designated-assisted-living issue. He added it is true acute care costs Alberta about $120,000 a year for a patient, while long-term care comes in at around $56,000 and designated assisted living is about $32,000, which does not include extras like drugs, for example, or the price fluctuations for DAL care in various parts of Alberta. Johnson said AHS has been looking at the DAL model as an economic issue, not on a best-needs policy, as it should be. “When you are doing models like designated assisted living versus long-term care, is it based on the best available evidence that is going to benefit the patient?” A focus on wellness and public health was another main ingredient of the report. Johnson added the committee wants to see an increase in preventative health-care measures. “Everyone believes that and everyone talks about it, and it goes down to the patient’s responsibility. Seventy per cent who go to the emergency room don’t need emergency care.” More wellness education is needed, he added, along with an increase in the level of health literacy, to change the focus of the health system from treating the sick to preventing illness. Lastly, is the goal of fostering a culture of trust and respect. Johnson added today, many do not trust the system, but added most people do have a good experience when they use Alberta’s health system. To improve the trust factor, he added Albertans, both health-care provides and patients, need to be engaged in the system. Johnson said Alberta nurses, for instance, are upset because they feel they are not being listened to. “We need to engage those on the ground to get a better understanding of what we need.” The creation of an Alberta Health Act, in accordance with the Canada Health Act, has also been recommended, which would formally enshrine the system’s public-health component. “That’s one of the things we said — people need to have equitable access to the system, regardless of their ability to pay.” Creation of a patient charter was also included in the report, and was an issue Johnson said included many animated discussions, due to the potential lawsuits which could occur. “We felt strongly enough about putting the patient first that there should be a minimum service delivery people should expect. If the quality is not there, they have the right to ask why.” Johnson added the charter could serve a very useful function. “We needed to provide a backstop, and I think that speaks to the trust again. People have to understand what their rights are.” All in all, Johnson added it will interesting to watch where the report goes from here. He said he expects the report to be reviewed during the spring sitting of the legislature, and hopefully, be put into action sooner rather than later, to get Alberta back on the right track. “We believe, as a committee, if the province enacts this, it will decrease costs and improve the system.” The full report can be found at www.ministersadvisorycommitteeonhealth.ca. |