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  #1  
Old Posted Apr 2, 2015, 4:33 PM
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Calgary Health Care

Since the construction thread is getting a bit derailed on this

Also to add:

A relative had a minor stroke in the last week and I have a few observations of the system:

1. While recognizing that having specialists traveling across the city on any regular basis is not desirable, having a patient across the city from friend and family who live in proximity is a challenge.

Case: Primary stroke treatment is based out of Foothills, but my relative lives 10 min from the South Health Campus. Having her treated at the south hospital allowed for her friends and husband to have relatively easy access to visit her in the hospital, where as if she had been transferred to Foothills (as she would have with a more severe stroke) they would have to drive across the city. Further complicating this is the fact that her husband can no longer drive (as a result of the stroke she can't for the immediate future either).

2. Lack of staff resulted in her staying in the hospital at least a day longer than required. She required a EKG and since the staff wasn't available (not sure why) she ended up having to stay overnight. This resulted in a bed being used when it shouldn't have been.

3. She was placed in what was designed as single room, that has two people in it. Cuts to the system will only make this more prevalent.

4. Urban design of our cities has created what will only become a bigger problem as Baby Boomers age, when they are no longer able to drive themselves. We are either going to have a significant number of SDH's coming on to the market or are going to have to find transportation alternatives for these people to get to their day to day needs. The last number of decades of planning is going to come back to bite us in a big way in the next 10-20 years. Including that many of our communities were not designed for transit and now have inefficient routes resulting in underutilization of them. Our primary measure of independence in our city is driving, if one can drive they are independent, losing that ability is the first step to losing the rest of your independence as you become more isolated due to the inability to interact outside of walking distance. Whereas if one is able to get out through other means (transit, etc.) it dramatically increases their mobility.

5. In a separate interaction with the system, test results for a number of blood tests monitoring medications levels were not reviewed by the clinic at ACH. Why this occurred I'm not sure, but then end result was that we had to inquire with them to identify that they hadn't been reviewed and they then identified that the medication level could be lowered.

Ideas:

Virtual presence may allow for some specialists to be centralized while still supporting teams in remote locations.

Overall proper staffing of our healthcare system is required.

Our cities need to be designed in a way that ensures people are able to fulfill their basic needs without the requirement for vehicle transportation.

Retrofitting our suburbs with transit roadways (cut throughs, etc.) that allow efficient routing will increase options for those who can't or choose not to drive.
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  #2  
Old Posted Apr 2, 2015, 5:56 PM
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Items 2 and 3 are very common. I saw item 2 happen more times than I can count for so many different reasons. Starving a patient for 3 days(no food allowed before scan) for an MRI that kept getting pushed back due to lack of equipment or techs was probably the worst.

Any time we were stuck in emergency for days becuase there were no available beds made me think, gee, I wonder what patient is waiting to go home and free up a bed, but can't for any number of reasons, most of which are due to lack of funding ending up costing more money.

Being stuffed in a makeshift room at the end of a hallway with partition walls was almost as pleasant as the time we were in mental ward, but better than being in the secure ED area(not becuase we needed it, it was the only space). Hi crazy lady, it's 3am, could ya knock it off for a couple hours please?
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Old Posted Apr 2, 2015, 6:10 PM
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Items 2 and 3 are very common. I saw item 2 happen more times than I can count for so many different reasons. Starving a patient for 3 days(no food allowed before scan) for an MRI that kept getting pushed back due to lack of equipment or techs was probably the worst.

Any time we were stuck in emergency for days becuase there were no available beds made me think, gee, I wonder what patient is waiting to go home and free up a bed, but can't for any number of reasons, most of which are due to lack of funding ending up costing more money.

Being stuffed in a makeshift room at the end of a hallway with partition walls was almost as pleasant as the time we were in mental ward, but better than being in the secure ED area(not becuase we needed it, it was the only space). Hi crazy lady, it's 3am, could ya knock it off for a couple hours please?
Part of the issue is overbuilt infrastructure for which operations cannot be afforded.

Unions are also a challenge - and the amount of overtime is atrocious, especially when seeing how many are not 1.0 FTE.
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Old Posted Apr 2, 2015, 6:35 PM
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Overbuilt infrastructure, or just the right amount with no staff for it?

If overtime is the issue, maybe we should ask why is it that we require it? Not enough staff so the ones there need to work longer hours? From what I have seen when nurses are working OT it is becuase they are caring for patients, not becuase they want to be there longer.
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Old Posted Apr 2, 2015, 7:39 PM
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Overbuilt infrastructure, or just the right amount with no staff for it?

If overtime is the issue, maybe we should ask why is it that we require it? Not enough staff so the ones there need to work longer hours? From what I have seen when nurses are working OT it is becuase they are caring for patients, not becuase they want to be there longer.
Being a regular frequenter of Timberline, you'll be able to tell us how many <1.0 FTE nurses AHS has.

For others who don't know the flip side of FUZZ' grinding axe, the union has a pretty sweet deal. Massive amounts of nurses take on 0.5 or 0.8 FTE (full time equivalent) roles, and then pick up extra hours at over time rates, so they end up making massive bucks for in effect just doing a 1.0 FTE. If you count number of staff and number of hours, the balance is good, but nurses keep insisting on less than 1.0 FTE roles so they can milk the system. In a 2012 report, it showed only 28% of AHS nurses work full time. Two or three part time nurses totaling 1.0 FTE is wayyyy more expensive than a single full time nurse, because of how benefits and other overhead works, let alone the overtime scam that is implemented. Some will ask, why not just make most jobs 1.0 FTE and the nurses take or not. Reason is, many of those getting the sweet 0.5 FTE plus megabucks overtime are more senior, and the union (which is led by a bunch of part time nurses) steps in there. You see the fix?

A report issued earlier this year showed that about 10,000 AHS front-line staff (IE nurses, not doctors) made over $100,000 per year:
http://www.edmontonjournal.com/Nearl...769/story.html

Quote:
The document shows that as of 2013, a total of 9,786 AHS workers crossed the $100,000 threshold. <...> massive escalation of salaries and benefits since 2009, when 4,688 employees earned that rate.
Quote:
AHS said most of its employees making over $100,000 are front-line workers who often earn overtime.
Quote:
non-unionized staff receiving $100,000 or more has declined by 13 per cent in recent years.
Put those excerpts together, read between the lines, and then you do the math.

Thank you FUZZ for raising this topic. It is interesting indeed.
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Old Posted Apr 2, 2015, 10:58 PM
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LOL What?

You raised it.
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Old Posted Apr 2, 2015, 11:30 PM
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LOL What?

You raised it.
Great response.

I gotta compliment you on your trolling!
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  #8  
Old Posted Apr 3, 2015, 12:34 AM
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Unions are also a challenge - and the amount of overtime is atrocious, especially when seeing how many are not 1.0 FTE.
Sigh. I can't believe I even have to do this. No wonder so many have blocked you. Sometimes you can be a decent participate in interesting discussions, other times I wonder what planet you are on.
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Old Posted Apr 3, 2015, 1:12 AM
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Massive amounts of nurses take on 0.5 or 0.8 FTE (full time equivalent) roles, and then pick up extra hours at over time rates, so they end up making massive bucks for in effect just doing a 1.0 FTE. If you count number of staff and number of hours, the balance is good, but nurses keep insisting on less than 1.0 FTE roles so they can milk the system. In a 2012 report, it showed only 28% of AHS nurses work full time. Two or three part time nurses totaling 1.0 FTE is wayyyy more expensive than a single full time nurse, because of how benefits and other overhead works, let alone the overtime scam that is implemented. Some will ask, why not just make most jobs 1.0 FTE and the nurses take or not. Reason is, many of those getting the sweet 0.5 FTE plus megabucks overtime are more senior, and the union (which is led by a bunch of part time nurses) steps in there. You see the fix?
I don't know where you get your information from but I am a member of HSAA and also happen to be a 1.0 FTE.

Getting OT, especially in the last 3 years, is damn near impossible.

I'd say in my profession there is maybe 1.5 shifts of OT available per month.

That's less than 12 hours of OT available per month.

Now as for your assertion that nurses take a 0.5 or 0.7 and then pick OT shifts - that's not possible - you can't get OT at all unless you are already over 1.0 FTE hours in a rotation - AND if you are a 0.5 or 0.7 or whatever, you are not allowed to pick up OT shifts unless every single 1.0 FTE passes on it first, in order of senority.

If you are a 0.5 (or anything other than a 1.0) and you pick up shifts you are picking them up for straight time, not OT.

And frankly we will simply run short these days rather than give out OT - which leads to a whole host of other problems, but that's another discussion.
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Old Posted Apr 3, 2015, 4:23 AM
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Getting OT, especially in the last 3 years, is damn near impossible.
Happy the abuse has slowed down over the last three years.

What are your thoughts on the number of front-line staff in Alberta making $100,000/yr going from <5000 a few years back to 10,000 now, while at the same time the percentage of out of scope in that bracket has gone down 13%?

Last edited by suburbia; Apr 3, 2015 at 4:13 PM.
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  #11  
Old Posted Apr 4, 2015, 3:42 AM
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Originally Posted by Fuzz View Post
Items 2 and 3 are very common. I saw item 2 happen more times than I can count for so many different reasons. Starving a patient for 3 days(no food allowed before scan) for an MRI that kept getting pushed back due to lack of equipment or techs was probably the worst.

Any time we were stuck in emergency for days becuase there were no available beds made me think, gee, I wonder what patient is waiting to go home and free up a bed, but can't for any number of reasons, most of which are due to lack of funding ending up costing more money.

Being stuffed in a makeshift room at the end of a hallway with partition walls was almost as pleasant as the time we were in mental ward, but better than being in the secure ED area(not becuase we needed it, it was the only space). Hi crazy lady, it's 3am, could ya knock it off for a couple hours please?
We're now on day 3, another day taking up a bed when she could be at home, looks like they may do it as an outpatient procedure now, at least that way she'll get to hopefully go home tomorrow.
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  #12  
Old Posted Apr 4, 2015, 4:19 AM
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Sorry to hear. Weekends are bad for anything happening, long weekends are the absolute worst as emergency situations tend to take priority and you get bumped down the list. Good luck!
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  #13  
Old Posted Apr 7, 2015, 12:19 AM
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this study caught my attention

CIHI releases top 10 reasons for hospitalization and surgery

http://www.cihi.ca/cihi-ext-portal/i...elease_05mar15

and the winners are:

1. Giving birth
2. Chronic obstructive pulmonary disease (COPD)
3. Heart attack
4. Congestive heart failure
5. Osteoarthritis of the knee
6. Pneumonia
7. Other medical causes (e.g., palliative care, chemotherapy)
8. Mood disorders
9. Schizophrenia and other delusional disorders
10. Fracture of the femur
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