Op-Ed: Health care needs to work smarter, not harder

A new op-ed by Strata Health’s President & CEO, Peter Smith, was published on Healthy Debate today on the need for a ‘work smarter, not harder’ approach to solving Canada’s health care crisis. We are pleased to share the article below.

The health-care crisis across Canada comes on the back of a burnt-out workforce and poor patient flow.

Emergency departments are overrun. Hospital beds are occupied by patients awaiting discharge to appropriate post-acute care. People with non-urgent conditions crowd emergency rooms because they don’t know what to do or where to go.

The result? A bottlenecked point of entry into the health-care system, dangerously long wait times for patients with urgent needs and frustrated, exhausted staff.

Throwing more people at the issue won’t fix the problem and, quite frankly, isn’t an option any longer.

For nearly a decade, I have worked closely with health system leaders. To deal with the influx of patients and help ease the burden on hospitals, we must address the capacity issues and operational challenges front-line staff face today. With a better ability to see and manage the entire patient journey, staff can begin to reduce the waste and frustration caused by poor patient handoffs, transfers, referrals and (ultimately) outcomes.

Recent data from Statistics Canada finds that one in four nurses plan to leave the profession in the next three years, citing extended hours, added stress and changes in the method of delivering care as driving factors. Staffing shortages have reached a critical point, putting an unprecedented strain on hospitals and in some regions causing emergency departments to close their doors.

And it isn’t just emergency care that’s failing.

Canada’s health system is disjointed – composed of disconnected parts that make up the crumbling whole. Despite having some of the highest quality care in the world, Canadians can’t access it. We need only look at the gridlock around supportive housing for people with developmental disabilities, brain injury, and severe mental illness to realize how broken the system really is.

Despite having some of the highest quality care in the world, Canadians can’t access it.

Some die while they wait. `

In 2020, at least 2,367 patients died while on a waiting list. It’s becoming imperative that the many lists of patients waiting for care are managed and optimized to ensure the sickest patients are being seen first.

Some argue that more privatization is needed – others who stand for the founding principle of our universal health-care model push back. I’m not sure either side is right. We need to shift the focus of the debate because our health-care system is already a complex ecosystem of private and public players, and the challenge is accessing the system. I hope we can all agree that in this regard, our current model isn’t working.

By looking at alternative health care funding and service delivery models, we can begin to address the gaps in our publicly funded health system. In a first for Ontario, the Government recently began piloting publicly funded psychologists to support front-line workers’ wellness in partnership with five mental health hospitals. These essential workers can now access services that were previously not covered by the public health system.

However, in these instances where private clinics and providers are paid using public dollars, transparency is no longer an option, it’s a must. The public deserves complete visibility into who these providers are, their services, who accredits them, and the quality of care being delivered. This is where the system has failed thus far in Canada. When possible, patients should be allowed to make an informed decision concerning the best treatment and health care provider for their needs. This is not happening enough.

The bottom line is we need more system capacity, which means either building more capacity or using the available capacity more efficiently, or both. For example, the backlog of hospital patients awaiting discharge into long-term care is overwhelming the system. It costs us four times more to care for these patients in hospital beds than in long-term care beds. We need to quickly fill vacant long-term care beds with the next most appropriate patient, and we need to add more long-term beds.

Our healthcare system is far too complex for clinicians and patients to navigate on their own with limited resources. We need to manage patient journeys with efficiency, consistency and scalability – but also with individualized care. Healthcare needs to move beyond the fax machine and embrace modern technology.

While the road ahead may not be simple or straightforward, drastic changes are needed. Canada’s health system is on life support, and those in positions of authority need to act now to bring it back to life with intelligence and compassion. `

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