'Patients First': The Next Phase in Ontario's Plan for Health Care Transformation
In early February Ontario’s new Minister of Health and Long-Term Care, Dr. Eric Hoskins, outlined the next phase of the government’s plan to transform our province’s health care system. We think there are a number of good ideas in this plan that Ontario’s nurses can support as we work together with the government to improve access to quality care and the health outcomes of our patients, residents, and clients.
The newly-released plan, ‘Patients First: Action Plan for Health Care,’ advances the priorities identified in Ontario’s Action Plan for Health Care, which has guided our province’s public health policy since its publication in January 2012. As the title of the new plan suggests, ‘Patients First’ builds on the government’s ongoing commitment to create a more patient-centred health care system that makes the desire to improve people’s lives the guiding principle of all decision-making.
‘Patients First’ focuses on four main priority areas that aim to improve the patient’s experience by making care more accessible, integrating and connecting the various services that people need, making information easier to get and more transparent, and protecting the universal public system to ensure that every person, regardless of economic status, receives the health care that she or he needs.
The plan outlines a number of good ideas for improving patient care, including expanding ways of engaging patients in care planning and improving the coordination of care for patients with complex health conditions. Like the government’s former plan, ‘Patients First’ prioritizes the coordination and integration of care in the community so that people are able to receive health services as close to the home as possible. The plan pushes forward on the creation of new memory clinics for people living with dementia and the expansion of nursing, personal support, and home-making services for seniors and other people who prefer to receive care in the home.
The strategies for improving care for older adults include expanding geriatric training for more than 2,000 clinicians and providing seniors with an additional 10,000 rehabilitation therapy visits. The government also seeks to build on the commitment it made in the 2013 Ontario budget to reduce wait times for home care services by ensuring that clients receive nursing and personal support visits within five days of being approved.
Ensuring patients receive the right care at the right time and in the right place has been one of the government’s main priorities over the past few years. ‘Patients First’ seeks to improve people’s access to care by increasing the number of same day visits to primary care providers and by removing barriers to practice of nurses and other health care professionals. We think this recommitment to finding ways of optimizing the use of all of Ontario’s health care professionals is especially encouraging, because our patients, residents, and clients deserve the best care possible.
When our Executive Director, Dianne Martin, met with Minister Hoskins in January, she spoke with him about how optimizing the use of Ontario’s RPNs offers significant opportunities for improving people’s access to quality care and enhancing patient health outcomes. There are 37,284 RPNs employed in nursing in Ontario – that’s more than one quarter of Ontario’s entire nursing work force – and almost 97 percent of these nurses work in direct practice positions, caring for people at the beside. In Ontario today six out of every ten nurses who identify caring for older adults as their primary area of expertise are RPNs.
Despite the valuable contributions that RPNs make in the lives of the people they care for, there are a number of barriers restricting these nurses from working to their full knowledge, skill and judgement. ‘It’s All About Synergies,’ our 2014 report on RPN role clarity, demonstrates that confusion about the scope of practice and the role of the practical nurse in Ontario’s health care system remains widespread. Today less than half (49 percent) of Ontario’s nursing directors, managers, clinical educators, and direct practice nurses believe that our RPNs are allowed to function to their full scope of practice in Ontario’s health care system. Only 41 percent believe that the knowledge and experience that RPNs gain in educational programs are fully-utilized in the practice environment.
Removing barriers to nursing practice and optimizing the RPN role should therefore be top priorities for provincial planners seeking to improve access, reduce health system costs, and enhance the quality of care provided to the people of Ontario. This the reason that your association has been engaging so closely with government representatives and health care decision-makers to let them know what they can do to support Ontario’s RPNs in all health care sectors.
In the coming months we will continue working with the Ministry of Health and Long-Term Care to improve the coordination and delivery of nursing care in the long-term care sector in order to enhance resident’s health and quality of life. We will also engage with government to increase the rate of full-time employment for Ontario’s RPNs, which has decreased dramatically over the past two years, creating significant challenges for infection control, patient care, and quality of life for nurses. And will work to improve access to nursing care in the community sector, where more clients – with more complex health conditions – are seeking more care than ever before.
We think ‘Patients First’ provides a clear strategy for improving access to care and enhancing patients’ health outcomes. The action items in this plan are urgently needed because Ontario’s patients, their families, and the nurses and other health professionals who care for them cannot wait any longer for the problems facing our health care system to be resolved. And for this reason, we look forward to continue working with our government as it drafts the 2015 Ontario budget and put in place the structures and resources necessary to implement these polices.
And we encourage the Ministry of Health and Long-Term Care to continue engaging with Ontario’s Registered Practical Nurses, who are leading the transformation of our health care system from the bedside.
Searle Schonewille, Director Policy and Government Relations