Authors:Amy Zarzeczny; Luiza Radu Abstract: On September 3, 2020, Saskatchewan launched an organ donor registry that allows participants 16 years and older to register their intent be an organ donor either online or using a paper form. Saskatchewan has historically performed poorly at a national level with low rates of organ donations, which is concerning given the high need for organs. Saskatchewan’s new registry is intended to increase the numbers of organ donors in the province, while also helping to modernize its organ donation system and ease donation conversations with families. Saskatchewan’s introduction of this registry brought the province in line with other provinces and territories across Canada that use similar systems, and provided a response to the surge in public interest around organ donation that followed the Humboldt Bronco bus crash tragedy and related “Logan Boulet Effect”. The 2019-2020 and 2020-2021 provincial budgets included dedicated funding for the development and launch of the registry, which was accompanied by a media campaign to increase public awareness. Though it is too early to evaluate the success of the registry, the province is hoping to increase organ donations to 23 donations per million people by March 31, 2021 which suggests that donation rates will be a key evaluation metric. Registries are commonly thought to help increase public awareness of, and support for, organ donation, but improving Saskatchewan’s organ donation rates will likely also require companion measures to strengthen the culture and practice of donation in the province.
Authors:Winnie Guan Abstract: Extensive pressure on acute care services and changing population health trends created a sense of urgency for primary health care reform in British Columbia. A lack of direction to addressing primary health care needs and delivery required a method of reform that would provide guidance and offer effective solutions. The collaboration between the Ministry of Health, on behalf of the provincial government, and medical associations to identify health targets was a determining step in advancing primary health care reform. The Primary Health Care Charter is a landmark published in 2007 as a blueprint for primary health care reform by ensuring collateral effort from key stakeholders towards mutually identified objectives. Accessibility is a fundamental objective to primary health care reform; seven priorities were identified in the Charter based on the needs of vulnerable population groups in British Columbia including Indigenous peoples, people with mental health challenges or substance use, people with chronic conditions, people with terminal illnesses, pregnant women, and seniors. While multiple efforts attempted to increase the number of primary care physicians, it did not fulfil the need for general practitioners; however, attention towards other priorities from the Charter marked the beginning of success towards PHC reform. Fostering partnerships between various stakeholders remain indispensable to policymaking towards improving health outcomes for all.
Authors:Denise Webb Abstract: Presumed consent policy for organ donation sets the foundation to an opt-out system, meaning all individuals are considered organ donors for deceased donation, unless they explicitly express otherwise. In 2019, Nova Scotia (NS) and Alberta became the first and only two jurisdictions in North America to introduce presumed consent policy into their provincial legislatures, beginning the policy adoption process. Through comparative health systems analysis, this study aims to compare the factors that led to the consideration of presumed consent policy in NS and Alberta, and to identify what other provinces can learn from their experience. The analysis was guided by Kingdon’s Framework and the Stakeholder Matrix, to understand the influential factors and key actors instrumental to the process. Primarily grey and academic sources informed the analysis, drawing on provincial assemblies and the Library of Parliament. The findings suggest that the policy entrepreneurs presented the problem on similar grounds, employing an emotional narrative and emphasizing the need to support those willing to donate. The policy and politics streams differed, as NS’s policy window opened as a result of strong political interests in the issue, whereas in Alberta, the national mood shifted towards organ donation in light of a tragic focusing event. Nevertheless, each case offers a lesson on the value of stakeholder support in implementing an opt-out system, as well as the importance of education and human resources in supporting the policy. Future research is suggested to further explore the practicalities of presumed consent in the North American context.
Authors:Andrea Baumann; Crea-Arsenio Mary, Jennifer Blythe Abstract: There is consensus that a professional full-time nursing workforce leads to better patient outcomes and a safer healthcare environment. In 2004, the Ontario Ministry of Health and Long-Term Care introduced an official Nursing Strategy to build healthcare system capacity and increase full-time employment opportunities for nurses via two key funded policy mechanisms: the 70% Full-Time Commitment and the Nursing Graduate Guarantee (NGG). The goal of the first was to ensure 70% of nurses were employed full time and 30% were employed in casual and part-time positions, the goal of the second was to promote retention of new nurse graduates and increase the total supply of nurses in Ontario. Several factors have affected the supply and employment status of nurses in the province over the past two decades, including the introduction of unregulated healthcare workers and crises such as SARS and COVID-19. A secondary analysis of the College of Nurses of Ontario registration database was conducted to identify and evaluate trends in the supply and employment of nurses in Ontario prior to and following introduction of the NGG. The results demonstrate that full-time employment of new registered nurses and new registered practical nurses initially increased but has since fallen to below pre-policy levels. Investments in health human resources have a stabilizing effect on the nursing workforce and ensuring an adequate number of nurses is imperative for crisis preparation, management and recovery, particularly in sectors with low surge capacity; however, sustained financial, political, public and professional support is required. Il est unanimement admis que la présence de professionnels en soins infirmiers à temps plein améliore le sort des patients et la sécurité dans le milieu de la santé. En 2004, le ministère de la Santé et des Soins de longue durée de l'Ontario a élaboré une stratégie officielle pour les soins infirmiers visant à accroître la capacité du système de santé et à augmenter les perspectives d'emplois en soins infirmiers à temps plein. Pour ce faire, il a adopté deux principales politiques subventionnées: un engagement à assurer 70 pour cent d'emplois à temps plein et l'initiative Garantie d'emploi des diplômés en soins infirmiers (GEDSI). L'objectif de la première était de s'assurer que 70% des infirmiers et infirmières occupaient un poste à temps plein, alors que les autres 30% travaillaient à temps partiel ou de façon occasionnelle. La seconde politique visait pour sa part à promouvoir le maintien en poste des récents diplômés et à accroître l'effectif total du personnel infirmier en Ontario. Plusieurs facteurs ont eu des répercussions sur la quantité des effectifs et leur statut professionnel dans la province au cours des deux dernières décennies, dont l'arrivée de professionnels de la santé non réglementés et l'éclosion de crises comme celles attribuables au SARS et à la COVID-19. Une analyse secondaire de la base de données des membres de l'Ordre des infirmières et infirmiers de l'Ontario a été menée afin d'identifier et d'évaluer les tendances dans la quantité d'effectifs et le statut d'emploi des infirmiers et infirmières en Ontario, avant et après la mise en place de l'initiative de GEDSI. Les résultats ont démontré que l'emploi de nouveaux infirmiers et infirmières autorisés et de nouveaux infirmiers et infirmières auxiliaires autorisés dans des postes à temps plein avait d'abord augmenté, mais qu'il avait ensuite diminué en-deçà des niveaux préalables à l'instauration des politiques. Les investissements en ressources humaines dans le domaine de la santé ont un effet stabilisant sur la main d'œuvre en soins infirmiers. Il est impératif d'assurer une quantité suffisante de ressources en vue de la préparation et de l'application de plans de gestion de crise et de relance, particulièrement dans les secteurs où la capacité d'intensification est faible; un soutien financier, politique, public et professionnel est toutefois nécessaire.
Authors:Winnie Guan Abstract: Extensive pressure on acute care services and changing population health trends created a sense of urgency for primary health care reform in British Columbia. A lack of direction to addressing primary health care needs and delivery required a method of reform that would provide guidance and offer effective solutions. The collaboration between the Ministry of Health, on behalf of the provincial government, and medical associations to identify health targets was a determining step in advancing primary health care reform. The Primary Health Care Charter was passed in 2007 to outline goals and targets to support healthy populations while maintaining a sustainable health care system. Accessibility is a fundamental objective to primary health care reform; seven priorities were identified in the Charter based on the needs of vulnerable population groups in British Columbia including Indigenous peoples, people with mental health challenges or substance use, people with chronic conditions, people with terminal illnesses, pregnant women, and seniors. While multiple efforts attempted to increase the number of primary care physicians, it did not fulfil the need for general practitioners; however, attention towards other priorities from the Charter marked the beginning of success towards PHC reform. Fostering partnerships between various stakeholders remain indispensable to policymaking towards improving health outcomes for all.
Open Access journal
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