Tuesday, May 10, 2011

$33 million (Canadian). Any interest?

Last year, the Ontario government made a decision to allocate funds to encourage physician engagement in improving service and quality in hospitals in the province. In all, $11 million was made available in 2010, with another $22 million allocated to 2011.

According to the province, participating MRPs ("most responsible physicians") must commit to ensuring “24/7/365” coverage for unscheduled patients, developing and implementing a quality improvement plan, and reviewing their performance on key indicators, such as average length of stay, emergency department wait times, readmission rates and patient satisfaction.

This article suggested that the criteria for receiving funds were unclear:

“It’s all kind of vague. All I’m seeing is that MRPs have to engage in some kind of quality improvement program, but there are no metrics laid out for what that will look like, and no real deliverables.” Dr. Richard McLean, vice-president of medical affairs and quality at Hamilton Health Sciences in Ontario. “Beyond the money, doctors don’t know what they’re signing up for and whether or not it’s worth the hassle.”

I understand that much of the money from 2010 remains unclaimed. My sources tell me that, in addition to Dr. McLean's points, the big problem appears to be that there is little interest among the doctors in improving patient quality and safety.

After all, that's such a hassle.

In that regard, the Canadian and US health care systems seem to have some commonality.

I wonder if there will be an analysis by the province as to the reasons for non-participation. I wonder if that analysis will be made public. I wonder if the Ontario officials will compare notes with the officials at CMS in the United States, to see if they can learn from one another.


Barry Carol said...

To what extent is patient safety an issue that relates mainly to care delivered in hospitals and, perhaps, nursing homes? We don’t seem to hear much about significant avoidable harm happening in doctors’ offices, rehab centers or non-hospital owned imaging centers. I would also guess that avoidable harm in nursing homes is mostly caused by not enough staff or inexperienced staff. In hospitals, it’s more likely to be a process issue. No?

Unknown said...

Be a "splittist"! Improving quality and efficiency of care is a separate issue from participating in a governmental program which is largely "undefined".

It could be a very rational stance to participate in the first but not in the second.

Don't be a "lumper".

Anonymous said...

i agree with Barry Carol that we can avoid harm in nursing homes by increasing the facilities and by hiring the most experienced staff.

Osterreich said...

Good luck getting people behind this one. Though you make some VERY fascinating points, you’re going to have to do more than bring up a few things that may be different than what we’ve already heard.