|
|
The last couple months have been an incredibly busy time for me as Toronto has played host to dozens of conferences, and I have endeavoured to reacquaint myself with the myriad facets of healthcare—from detailed examinations of medical specialties to high-level overviews of healthcare delivery.
It is no great leap to suggest that Canadian healthcare—all healthcare, in fact—is in a period of great flux, but what struck me particularly was that despite the many flavours of this flux—wait times issues, e-health initiatives, expanding treatment options—there was one theme that ran through and guided all of these issues: the changing roles of healthcare professionals. From the highest status physician to the newest recruit in maintenance, the mechanisms for healthcare delivery at each level are changing; evolving into something quite different. And perhaps frightening to some, the greatest changes are yet to come.
For example, at the recent National Healthcare Leadership Conference, professionals from Sunnybrook’s Holland Orthopaedic & Arthritic Centre described how they were changing their model of care for patients in the hip and knee replacement program. Central to this change was the introduction of advanced practice physiotherapists to replace physicians in the assessment/triage and post-op follow-up phases, and nurse practitioners and anesthetists for operative and post-op pain management. The goal: reduced time for specialist physicians in routine care.
Similarly, at Insight Information’s recent Emergency Care conference, Dr. Grant Innes of Vancouver’s St. Paul’s Hospital suggested that a big part of the problem of emergency department overcrowding was human resource functional capacity, with hospitals closing stretchers because of nursing shortages and sick calls. Not only must hospitals recruit and train ED nurses, he said, but they should also look at other healthcare providers, such as care aides, to take over many of the less vital responsibilities that bog down nurses, such as dressing patients. We need to better match care needs to provider skills, he said.
In some respect, changing the roles and expectations of healthcare providers would go a long way to reducing wait times—e.g., orthopedic surgeons would have fewer duties per patient and could therefore see new patients more quickly—and physician and nursing shortages—e.g., if duties are being fulfilled by other professionals, demand for physicians and nurses will decline.
The new processes will take time, however, to implement, and a concerted effort on the part of schools and professional associations to both accept the new realities and prepare the next generation of professionals for their new roles is vital.
|
