One province, one healthcare system: A decade of healthcare transformation in Alberta

2018 ◽  
Vol 31 (5) ◽  
pp. 167-171 ◽  
Author(s):  
David Veitch
Keyword(s):  
Cost Savings ◽  
Stroke Care ◽  
Term Care ◽  
Inappropriate Use ◽  
System A ◽  
Health Authorities ◽  
Enhance Patient Safety ◽  
Integration Of Services ◽  
Regional Health Authorities

Nearly a decade has passed since Alberta folded nine regional health authorities and three government agencies into one province-wide health system: Alberta Health Services (AHS). Deemed a reckless experiment by some at the time, there is now mounting evidence province-wide integration of services across the healthcare continuum is an enabler of improved quality, safety, and financial sustainability. The article highlights specific examples of how AHS is strengthening partnerships, standardizing best practices, and driving innovation, making Alberta a national and international leader in areas such as stroke care and potentially inappropriate use of antipsychotics in long-term care. It also shows how province-wide integration is being leveraged to build workplace culture, enhance patient safety, and find operational efficiencies that result in cost savings and cost avoidance.

scholarly journals The Impact of the Long-term Care Homes Act and Public Reporting on Physical Restraint and Potentially Inappropriate Antipsychotic Use in Ontario’s Long-term Care Homes

2019 ◽  
Author(s):  
Kevin Walker ◽  
Sara Shearkhani ◽  
Yu Qing Bai ◽  
Katherine S McGilton ◽  
Whitney B Berta ◽  
...  
Keyword(s):  
Long Term Care ◽  
Physical Restraint ◽  
Public Reporting ◽  
Care Homes ◽  
Term Care ◽  
Early Adopters ◽  
Inappropriate Use ◽  
Restraint Use ◽  
The Impact

Abstract Background We report on the impact of two system-level policy interventions (the Long-Term Care Homes Act [LTCHA] and Public Reporting) on publicly reported physical restraint use and non-publicly reported potentially inappropriate use of antipsychotics in Ontario, Canada. Methods We used interrupted time series analysis to model changes in the risk-adjusted use of restraints and antipsychotics before and after implementation of the interventions. Separate analyses were completed for early ([a] volunteered 2010/2011) and late ([b] volunteered March 2012; [c] mandated September 2012) adopting groups of Public Reporting. Outcomes were measured using Resident Assessment Instrument Minimum Data Set (RAI-MDS) data from January 1, 2008 to December 31, 2014. Results For early adopters, enactment of the LTCHA in 2010 was not associated with changes in physical restraint use, while Public Reporting was associated with an increase in the rate (slope) of decline in physical restraint use. By contrast, for the late-adopters of Public Reporting, the LTCHA was associated with significant decreases in physical restraint use over time, but there was no significant increase in the rate of decline associated with Public Reporting. As the LTCHA was enacted, potentially inappropriate use of antipsychotics underwent a rapid short-term increase in the early volunteer group, but, over the longer term, their use decreased for all three groups of homes. Conclusions Public Reporting had the largest impact on voluntary early adopters while legislation and regulations had a more substantive positive effect upon homes that delayed public reporting.

scholarly journals Antipsychotic Use in Dementia

2016 ◽  
Vol 62 (3) ◽  
pp. 170-181 ◽  
Author(s):  
Julia Kirkham ◽  
Chelsea Sherman ◽  
Clive Velkers ◽  
Colleen Maxwell ◽  
Sudeep Gill ◽  
...  
Keyword(s):  
Psychiatric Symptoms ◽  
Clinical Care ◽  
Neuropsychiatric Symptoms ◽  
Mental Illnesses ◽  
Educational Outreach ◽  
Term Care ◽  
Inappropriate Use ◽  
Regulatory Changes ◽  
Current Controversy

Antipsychotics are necessary for many older adults to treat major mental illnesses or reduce distressing psychiatric symptoms. Current controversy exists over the role of antipsychotics in the management of neuropsychiatric symptoms (NPS) in persons with dementia. Although some NPS may be appropriately and safely treated with antipsychotics, a fine balance must be achieved between the benefits of these medications, which are often modest, and adverse events, which may have significant consequences. Approximately one-third of all persons with dementia are currently prescribed antipsychotic medications, and there is significant variation in the use of antipsychotics across care settings and providers. Reducing the inappropriate or unnecessary use of antipsychotics among persons with dementia has been the focus of increasing attention owing to better awareness of the potential problems associated with these medications. Several approaches can be used to curb the use of antipsychotics among persons with dementia, including policy or regulatory changes, public reporting, and educational outreach. Recently, there has been encouraging evidence of a downward trend in the use of antipsychotics in many long-term care settings, although prescribing rates are still higher than what is likely optimal. Although reducing the inappropriate use of antipsychotics is a complex task, psychiatrists can play an important role via the provision of clinical care and research evidence, contributing to improved care of persons with dementia in Canada and elsewhere.

scholarly journals The Prescription of Drug Ontology 2.0 (PDRO): More Than the Sum of Its Parts

2021 ◽  
Vol 18 (22) ◽  
pp. 12025
Author(s):  
Jean-François Ethier ◽  
François Goyer ◽  
Paul Fabry ◽  
Adrien Barton
Keyword(s):  
Information Integration ◽  
Drug Product ◽  
Medical Outcomes ◽  
Term Care ◽  
Multiple Systems ◽  
Inappropriate Use ◽  
Knowledge Models ◽  
Lack Of Information ◽  
Geographical Scale

While drugs and related products have profoundly changed the lives of people around the world, ongoing challenges remain, including inappropriate use of a drug product. Inappropriate uses can be explained in part by ambiguous or incomplete information, for example, missing reasons for treatments, ambiguous information on how to take a medication, or lack of information on medication-related events outside the health care system. In order to fully assess the situation, data from multiple systems (electronic medical records, pharmacy and radiology information systems, laboratory management systems, etc.) from multiple organizations (outpatient clinics, hospitals, long-term care facilities, laboratories, pharmacies, registries, governments) on a large geographical scale is needed. Formal knowledge models like ontologies can help address such an information integration challenge. Existing approaches like the Observational Medical Outcomes Partnership are discussed and contrasted with the use of ontologies and systems using them for data integration. The PRescription Drug Ontology 2.0 (PDRO 2.0) is then presented and entities that are paramount in addressing this problematic are described. Finally, the benefits of using PDRO are discussed through a series of exemplar situation.

scholarly journals COST SAVINGS FOR CAPABLE PROGRAM DRIVEN BY DECREASES IN HOSPITAL AND LONG-TERM CARE FOR PARTICIPANTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1392-1392
Author(s):  
S.L. Szanton ◽  
N.H. Alfonso ◽  
L. Roberts ◽  
D.H. Bishai
Keyword(s):  
Long Term Care ◽  
Cost Savings ◽  
Term Care

Investing in a “Rehabilitation Model” to Improve the Decision-Making Process in Long-Term Care

2013 ◽  
pp. 37-47
Author(s):  
Connie D’Astolfo
Keyword(s):  
Decision Making ◽  
Health System ◽  
Chronic Diseases ◽  
Long Term Care ◽  
Hospital Costs ◽  
Cost Savings ◽  
System Transformation ◽  
Term Care ◽  
Rehabilitation Model

An aging population is a primary factor associated with escalating healthcare costs due to increased drug spending, chronic diseases and co-morbidities, physician visits, and hospital costs (TD Report, 2010). There has already been a marked increase in the number of Long-Term Care (LTC) residents with co-morbidities, and chronic diseases will be more prevalent in future years (Conference Board of Canada, 2011). The chapter explores the use of a rehabilitation model to improve the current decision-making processes that impact the health outcomes of seniors across the Ontario LTC continuum. Improved clinical management of this population through rehabilitation could result in not only enhanced quality of care but also significant cost savings for both the Long-Term Care (LTC) industry and the health system at large. The chapter highlights the need for the LTC sector to identify strategies for harnessing innovation to improve its own activities and outcomes and become a leader in health system transformation.

Reducing Inappropriate Use of Antipsychotics in Long Term Care Residents

2014 ◽  
Vol 15 (3) ◽  
pp. B22
Author(s):  
Sahebi Saiyed ◽  
Sahebi Saiyed ◽  
Phyllis Tawiah ◽  
Manuel Eskildsen
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Inappropriate Use

scholarly journals EU level actions and instruments to support the implementation of integrated care

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Gatzoulis
Keyword(s):  
European Commission ◽  
Integrated Care ◽  
Scale Up ◽  
Healthcare Systems ◽  
Fiscal Sustainability ◽  
Term Care ◽  
Health Authorities ◽  
Care Systems ◽  
Increasing Demand

Abstract Issue/Problem The significance of integrated care as a means for improving health outcomes and the effectiveness and sustainability of health and care systems is acknowledged in several policies at national and EU level, for example: the European Commission’s Communication on effective, accessible and resilient health systems, the 2017 European Semester: Communication on Country Reports, the Joint Report on Health Care and Long-Term Care Systems and Fiscal Sustainability by the European Commission and the Economic Policy Committee, the Companion Report 2017 of the State of Health in the EU and the most recent Commission Communication on the digital transformation of health and care in the Digital Single Market. As such, there may be no doubt about whether one needs to transform the health and care model and move to integrate care, but the question is how to design and implement integrated care successfully. One pre-condition for this to happen, is for health authorities to have adequate capacity and relevant know-how. Results The European Commission aims at assisting Member State authorities at national, regional and local levels to fulfil this pre-condition and proceed with their health system reforms. There is a number of instruments, initiatives and funding support to raise the capacity of national and regional healthcare authorities to adopt and scale up integrated care. Lessons There is an increasing demand and need to provide support and assistance to Member states to drive the transformation of healthcare systems towards more coordinated, integrated and sustainable healthcare systems.

Actuarial Applications of a Statistical Model for Long-Term Care Insurance Operated with a Score-based Grading System: A Case Study of Korean Long-Term Care Insurance (K-LTCI)

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Hyuk-Sung Kwon ◽  
Bangwon Ko ◽  
Ji-Hae Kim
Keyword(s):  
Financial Risk ◽  
Long Term Care ◽  
Health Condition ◽  
Grading System ◽  
Term Care ◽  
Suggested Approach ◽  
System A ◽  
Long Term Care Insurance ◽  
The Impact

AbstractLong-term care insurance plays a very important role as providing a protection against financial risk of an individual when he/she becomes in a health condition incurring significant costs for long-term care. Construction of an appropriate actuarial model for long-term care is an integral part of maintaining and improving a long-term care insurance system. A model is suggested for analyzing the impact of change in score-based long-term care grading system and for estimating future cost of long-term care insurance. A spliced distribution was used to model assigned scores for long-term care insurance in Korea based on experience data. The suggested approach is quite flexible, as it allows us to adapt to possible changes in the grading system.

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