Thesis: Current Issues Affecting Health Care in Canada

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¶ … Health Care in Canada: An Examination of the Healthcare Work Environment

The focus of this work is to choose one current issues in health care or nursing of particular interest and to examine the topic from every angle possible. This work will first identify the issue and examine why it is indeed an issue. This work will also identify those affected and answer the question of what is being currently done to solve the issue. Finally this work will examine what might be further done to solve the issue. For the purpose of this work the current issues that affect health care in Canada will be examined.

Shortage of Healthcare Workers

A recent poll conduced by Innovative Research Group for the Canadian Defense and Foreign Affairs Institute reports that Canadian adults "remain concerned about their medical services" and that in fact, twenty-four percent of respondents to the poll believe that the most important issue that is presently faced by Canada is that of health care. (AngusReid Global Monitor, 2006) The work entitled "Current and Emerging Trends: Occupational Health and Safety in the BC Healthcare Sector" which was prepared for OHSAH Stakeholder Meeting of September 19th of last year states that just as in the United States the population of British Columbia and Canada "is aging. Added to this is the fact that there is a severe shortage of healthcare workers in Canada and Canada is stated to be the first country in the world "to officially implement multiculturalism as a national policy." (Back, 2008)

There is a shortage of registered nursing professionals and the future outlook is bleak because the largest part of the registered nursing professional population is also aging and this results in a decrease in their "...physical abilities and increase[s]...age-related illnesses." (Back, 2008) Of the present registered nursing population fifty percent are estimated to be reaching retirement age in the next fifteen years. The demand for an increase in healthcare workers results in a "short-staffed and stressful work environment." (Back, 2008)

II. Predicted Results of Present Issues

Predictions states that resulting will be "an increasing risk of injury and illness, increased absenteeism, lower commitment to the workplace and intent to leave and ultimately increased turnover and reduction in patient quality of care." (Back, 2008) The literature reviewed conducted by Back (2008) additionally reports that the high turnover rate has resulted in "significant costs to the healthcare system in Canada." Costs resulting directly from those associated with RN turnover are stated to be "between $62,000 and $67,000" per RN. (Back, 2008)

III. Interviews with Healthcare Workers

Recruitment strategies include those that "increase the retention of RNs" and this is stated to include the development of a "positive and challenging work environment, increasing roles and responsibilities, ensuring respect and recognition, and allowing for flexible scheduling..." (Back, 2008) In a recent national study on the work environment it is stated that the lowest ratings were those given by healthcare professional. Incidentally healthcare workers also were those to give the lowest ratings "on questions related to a healthy and supportive work environment." (Back, 2008)

IV. Challenges

Today's healthcare workers "much like all emergency responders...face risk of exposures to unknown hazardous agents, such as emerging infectious diseases similar to SARS and avian influenza." (Back, 2008) Healthcare workers are stated as well to be very likely to face such as "increased exposure to a variety of antibiotic-resistant pathogens." (Back, 2008) Back additionally notes that high hazard chemical use combined with other "...potentially hazardous new technologies continues to grow in healthcare settings." (2008)

V. Current Workplace Occupational Health and Safety Issues Identified in Interviews

The health and safety issues identified in the interviews include those as follows with the responses ranked from highest to lowest: (1) Workload (e.g., shortage of healthcare workers, aging workforce, span of control); (2) Violence (e.g., patient to worker, worker to worker); (3) Working alone; (4) Musculoskeletal injuries (primarily patient handling related; some emphasis on acute care); (5) Infection control and biological diseases (e.g., increase in superbugs, unable to keep up with worker immunizations); (6) Lack of OHS education and training for workers, managers, supervisors, and joint occupational health and safety committees (JOHSC) (e.g., lack of resources, weak infrastructure, disparity in educational programs from colleges); (7) Mental health; (8) Accountability for OHS (e.g., lack of internal responsibility system, decline in OHS standards for privatized support service workers, lack of enforcement of OHS regulations); (9) Increasing sick time and long-term disability; and (10) Increasing presenteeism. (Back, 2008)

Factors that are stated to lead to high workload by respondents in the interview reported in the work of Back (2008) are stated to include those as follows: (1) Shortage of healthcare workers and an aging workforce (decreases number of HCWs available); (2) Aging patients (increases amount of work needed); (3) Heavier patients/residents/clients (increase physical demand required during care); (4) Increase in Mental health issues associated with stress, anxiety, depression, and an unhappy and unhealthy workforce (decreases number of available workers through early retirement and difficulty in recruitment); (5) Span of control (high number of direct reports to managers and supervisors) and (6) Increase in the number of patients being cared for in the home, increasing the demand placed on community health workers. (Back, 2008)

Health and safety issues that are stated to be emergent in nature include those stated as follows: (1) Increased cancer rates and other chronic illnesses; (2) An increase in facilities requiring renovation or rebuild; this may also cause an increase in asbestos concern; (3) An increase in bariatric patients; (4) OHS issues that have not been properly evaluated in the past; (5) An increase in surgical procedures that will increase potential for exposure to biological hazards, infectious diseases, and higher physical demands placed on workers; and (6) An increase in the sensitization and sensitivities of workers to various occupational hazards, such as enzymatics. (Back, 2008)

Issues noted by respondents as having effects on the occupational health and safety of healthcare workers which are yet effects that are unknown include the following issues: (1) Rising costs of healthcare that may lead to restructuring in the industry; and (2) The effects of new technologies, such as nanotechnologies and biologics. (Back, 2008)

Stated to be emergent occupational health and safety trends in the interviews of healthcare workers are those as follows: (1) The current focus on a green environment and green workplaces; (2) Lack of coordinated data records and data integration; (3) A possible change in government and the impact this may have on funding and structure; (4) Generational differences of healthcare workers; (5) Continued lack of funding for OHS; and (6) New product purchases. (Back, 2008)

VI. Stakeholder Interview Question Responses Examined

When stakeholders were quizzed concerning their views of the healthcare industry in Canada and British Columbia and its ability to deal with OHS issues in the near future, Back (2008) reports as follows:

"Few respondents felt that the healthcare industry was well prepared. Those who answered "yes" felt that the human resources and support mechanisms are in place, collaborative relationships have been established, and the OHS issues have been recognized and are considered a priority by senior management. However, all respondents, including those who answered "yes," provided reasons why the healthcare industry is not optimally prepared to deal with OHS issues over the next three years." (Back, 2008)

Reasons stated for this include the following: (1) A poor infrastructure for OHS; (2) Lack of long-term planning to deal with OHS; (3) Lack of integration and communication between stakeholders to share the efforts in OHS; (4) Lack of leadership (institutional and provincial) and commitment to OHS; (6) Lack of funding dedicated to OHS at the department, institutional, and provincial level; (7) Lack of human resources dedicated to OHS at the department, institutional, and provincial level; (8) Lack of education and training for workers, supervisors, managers, and JOHSC and lack of positive reinforcement for OHS; (9) Inadequate resources to deal with OHS, including OHS professionals in BC as well as frontline resources; high workload of those currently addressing OHS in healthcare; (10) Healthcare is too political to allow OHS to be dealt with effectively and efficiently; (11) Lack of accountability at the departmental, institutional and provincial level; (12) Lack of enforcement of OHS regulations; (13) The organizational culture in healthcare is not ready for OHS (which may be associated with a lack of education and training); and (14) The OHS system in healthcare is too reactive. (Back, 2008)

VII. Possible Solutions

Survey respondents identified needs for leadership and commitment from management toward occupational health and safety. This will necessarily involve high standards in education and training initiatives that are ongoing in nature and serve to keep healthcare workers informed and knowledgeable about occupational health and safety issues and accident prevention which leads to recognition of a need for higher levels of funding in order that these improvements in the healthcare system are effectuated successfully.

Summary and Conclusion

This work has identified the inherent risks and the factors that serve… [END OF PREVIEW]

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