Journal articles: 'Ontario. Public Hospitals Act'

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Sumner, Jennifer, and Hayley Lapalme. "The public plate in the transnational city: Tensions among food procurement, global trade and local legislation." Canadian Food Studies / La Revue canadienne des études sur l'alimentation 6, no. 1 (January 12, 2019): 22–42. http://dx.doi.org/10.15353/cfs-rcea.v6i1.268.

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Local food systems are crucial to sustainability, and one of the most effective ways to develop them is to harness the buying power of large public institutions, such as hospitals and universities. Steering public funds toward local food systems, however, is not as easy as it might appear. Institutions must navigate a maze of regulations that can become significant barriers to effecting change. In Ontario, for example, public institutions are squeezed between two contradictory policies: the Broader Public Sector Directive, which mandates a level playing field and prohibits preferential buying based on geography, and the Local Food Act, which aims to increase the consumption of local food (with a specific focus on procurement in Ontario public institutions) and to foster successful and resilient local food economies and systems. Adding to this tension, global trade treaties are drilling down to the local level, proscribing preferential procurement of local food as “protectionist” and a barrier to trade. Public institutions are caught in the middle, wanting to purchase more local products but unwilling to risk reprisals. This paper investigates these tensions by reporting on a recent study of institutional buyers and government officials in the Toronto area to understand more thoroughly these barriers to operationalizing a local food system, while recognizing that sustainable food systems require a judicious combination of ‘local and green’ and ‘global and fair’ (Morgan 2008).

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Kruger, Arthur. "Collective Bargaining in Ontario Public Hospitals." Articles 40, no. 1 (April 12, 2005): 48–67. http://dx.doi.org/10.7202/050109ar.

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Karim, Safiya, Kelly Brennan, Yingwei Peng, William J. Mackillop, and Christopher M. Booth. "Estimating the optimal rate of adjuvant chemotherapy utilization in stage III colon cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6591. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6591.

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6591 Background: Identifying optimal chemotherapy utilization rates can drive improvements in quality of care. We report a benchmarking approach to estimate the optimal rate of adjuvant chemotherapy (ACT) for stage III colon cancer. Methods: The Ontario Cancer Registry was linked to electronic chemotherapy records to identify ACT utilization among a random 25% sample of patients with stage III colon cancer diagnosed during 2002-2008 in Ontario, Canada. We explored whether hospital factors (teaching status, regional cancer centre, medical oncologist on-site) were associated with ACT rates. The benchmark population included hospitals with the highest ACT rates that accounted for 10% of the patient population. Hospital ACT rates were adjusted for case mix in a multi-level model accounting for random variation at the hospital level. A Monte Carlo simulation was used to estimate the proportion of observed ACT rate variation that could be due to chance alone. Results: The study population included 2,801patients with stage III colon cancer; ACT was delivered to 66% (1861/2801) of patients. There was no difference in hospital ACT rate by teaching status (64% academic vs 67% non-academic, p = 0.107), comprehensive cancer centre status (65% cancer centre vs 67% non-cancer centre, p = 0.362), or having medical oncology on site (67% on site vs 66% not on site, p = 0.840). After excluding hospitals that had case volumes less than 10 (N = 150), unadjusted ACT rates varied across hospitals (range 44% to 91%, p = 0.017). The unadjusted benchmark ACT rate was 81% (95%CI 76%-86%); utilization rate in non-benchmark hospitals was 65% (95%CI 63%-66%). When using adjusted ACT rates in a multi-level model significant variation remained across hospitals (p < 0.001). The adjusted benchmark ACT rate was 74% (95%CI 63%-83%); non-benchmark hospital ACT rate was 65% (95%CI 53%-75%). The simulation analysis suggested that the non-random component of ACT rate variation across hospitals was 1.5%. Conclusions: There is significant variation in ACT rates across hospitals in routine practice. The estimated benchmark ACT rate is 74%. However, simulation analyses suggest that most of the variation in ACT utilization across hospitals may be due to chance alone.

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Goldberg, Ted, and Randolph Reid. "Methods of Payment to Hospitals in Ontario." Journal of Public Health Policy 7, no. 2 (1986): 218. http://dx.doi.org/10.2307/3342260.

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Murphy, Yoko, and Howard Sapers. "Prison Health as Public Health in Ontario Corrections." Journal of Community Safety and Well-Being 5, no. 1 (April 23, 2020): 19. http://dx.doi.org/10.35502/jcswb.122.

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The majority of incarcerated individuals in Canada, and especially in Ontario provincial correctional institutions, are released into the community after a short duration in custody. Adult correctional populations have generally poor health, including a heightened prevalence of mental health and substance use disorders. There are legal and ethical obligations to address health care needs of incarcerated individuals, and also public health benefits from ensuring adequate, appropriate, and accessible health services to individuals in custody. The Independent Review of Ontario Corrections recommended the transformation of health care in Ontario provincial corrections in 2017, including transferring health service responsibilities to the Ministry of Health and Long-Term Care. The Correctional Services and Reintegration Act, 2018, would affirm the provincial government’s obligation to provide patient-centred, equitable health care services for individuals in custody. We encourage the Government of Ontario to proclaim the Act and continue the momentum of recent reform efforts in Ontario.

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Reeleder, D., V. Goel, P. A. Singer, and D. K. Martin. "Accountability Agreements in Ontario Hospitals: Are They Fair?" Journal of Public Administration Research and Theory 18, no. 1 (December 26, 2006): 161–75. http://dx.doi.org/10.1093/jopart/mul024.

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Cohen, Jared C., and Kevin J. Latchford. "Sugammadex in Ontario hospitals: Access and institutional policies." Journal of Evaluation in Clinical Practice 26, no. 1 (April 22, 2019): 50–55. http://dx.doi.org/10.1111/jep.13151.

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Meehan, John F. "The Morgan Hill Earthquake of April 24, 1984—Effects on Hospitals and Public School Buildings." Earthquake Spectra 1, no. 3 (May 1985): 575–77. http://dx.doi.org/10.1193/1.1585278.

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Two hospitals constructed under the provisions of the Hospital Act and six public school buildings constructed under the provisions of the Field Act were investigated following the Morgan Hill earthquake and all were observed to have performed quite well during the Morgan Hill earthquake. Maintaining function in hospitals in an important aspect of the Hospital Act; neither of the two hospitals inspected suffered any loss of function.

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Kulis, Richard E. "The public interest and liquor licenses in Ontario." Contemporary Drug Problems 25, no. 1 (March 1998): 85–97. http://dx.doi.org/10.1177/009145099802500104.

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Residents’ groups are becoming more organized and vocal in expressing their concerns regarding the negative effects of poorly operated liquor licensed premises. Using the “public interest” measures in the Liquor Licence Act, the residents have successfully had liquor licenses revoked and new license applications denied. This paper examines some of the types of problems suffered by residents and the efforts they have made to alleviate those problems. These efforts include proactive consultation with licensed-premises operators, lobbying of politicians, adversarial license hearings, and legislative amendments.

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Mudron, Maureen, Cynthia Honssinger, Rod G. Meadows, and Lori Spencer. "Health Care and Public Health Lawyers: Reclaiming the Historical Role." Journal of Law, Medicine & Ethics 31, S4 (2003): 56–57. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00752.x.

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Traditionally, hospital emergency readiness plans primarily addressed natural disasters, but because of preparations for year 2000, the arrival of terrorism in the United States, and the potential for mass casualties, hospitals were prompted to bring together new partners and create new emergency readiness plans. These new plans, however, give rise to a number of important issues hospitals must consider. First, hospitals must consider legal liability that might arise during an emergency. For example, what liability might arise when decision are made regarding the provision of individual treatment versus mass triage? Second, hospitals must be cognizant of relevant privacy rules, such as the Health Insurance Portability and Accountability Act (HIPAA), as they apply to public health emergencies activities. Third, hospitals must be aware of the Emergency Medical Treatment and Active Labor Act (EMTALA) which requires Medicarefunded hospitals to screen patients for emergency medical conditions and prohibits their transfer until they are stabilized.

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Carter, D. D. "Legal Regulation of Collective Bargaining in the Ontario Public Sector." Relations industrielles 29, no. 4 (April 12, 2005): 776–85. http://dx.doi.org/10.7202/028554ar.

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In this paper, the author describes the major features of the legal structure for collective bargaining in the Ontario public sector. The emphasis is mostly placed upon the Crown Employees Collective Bargaining Act which applies to a sub-stantial portion of the Ontario public sector labor force. The basic issues dealt with include : disputes settlement, scope of bargaining, determination of bargaining units, representation elections and political activities.

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Lambert, Jessica, and Cliff Nordal. "10 Steps to a Successful Governance Transfer." Healthcare Management Forum 15, no. 2 (July 2002): 38–40. http://dx.doi.org/10.1016/s0840-4704(10)60580-7.

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The governance of several provincial psychiatric hospitals was transferred to the public hospitals across Ontario, with London and St. Thomas being two of them There were many learnings gained from the London/St. Thomas experience that can be taken forward to other transfers such as this. The keys to success included having a central negotiating table across all receiving hospitals, developing principles or values for a common vision across all parties, effective communication and commitment to the process. These learnings will be brought forward into Tier 2 and 3 of the transfers, when beds and programs will decentralize across Southwestern Ontario, and a reinvestment in community mental health will support the de-institutionalization of mental healthcare.

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Zoutman, Dick E., B. Douglas Ford, Matt Melinyshyn, and Brian Schwartz. "The pandemic influenza planning process in Ontario acute care hospitals." American Journal of Infection Control 38, no. 1 (February 2010): 3–8. http://dx.doi.org/10.1016/j.ajic.2009.10.002.

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George, Lindsey, Sean Kidd, Maria Wong, Rachel Harvey, and Gina Browne. "ACT Fidelity in Ontario: Measuring Adherence to the Model." Canadian Journal of Community Mental Health 29, S5 (January 1, 2010): 87–96. http://dx.doi.org/10.7870/cjcmh-2010-0036.

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The province of Ontario, Canada, with a population of 13 million people, has a large Assertive Community Treatment (ACT) program. Despite the large uptake of ACT in Ontario, to date there has been no comprehensive evaluation of the degree to which the model has been successfully implemented. This project assessed the fidelity of 67 ACT teams (85%) in the province using the Dartmouth Assertive Community Treatment Scale. Scores fell in the high fidelity range in the human resources and organizational boundaries domains, and in the medium fidelity range for the nature of services domain. Areas requiring more attention include achievement of higher caseloads; recruitment and retention of staff (specifically vocational, substance abuse, and psychiatry staff); and key areas of recovery, specifically employment and substance abuse.

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Barnard-Thompson, Kathleen L., and Pierre Leichner. "Psychiatrist administrators in Ontario psychiatric hospitals: Roles and job satisfaction." Administration and Policy in Mental Health 24, no. 2 (November 1996): 167–71. http://dx.doi.org/10.1007/bf02042488.

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Bielska, Iwona A., Derek R. Manis, Connie Schumacher, Emily Moore, Kaitlin Lewis, Gina Agarwal, Shawn Mondoux, et al. "Health Sector responses to the COVID-19 pandemic in Ontario, Canada – January to May 2020." Zdrowie Publiczne i Zarządzanie 18, no. 1 (2020): 106–20. http://dx.doi.org/10.4467/20842627oz.20.010.12664.

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The first positive case of COVID-19 in Canada was reported on January 25, 2020, in the city of Toronto, Ontario. Over the following four months, the number of individuals diagnosed with COVID-19 in Ontario grew to 28,263 cases. A state of emergency was announced by the Premier of Ontario on March 17, 2020, and the provincial health care system prepared for a predicted surge of COVID-19 patients requiring hospitalization. The Chief Medical Officer of Health and the Minister of Health guided the changes in the system in response to the evolving needs and science related to COVID-19. The pandemic required a rapid, concerted, and coordinated effort from all sectors of the system to optimize and maximize the capacity of the health system. The response to the pandemic in Ontario was complex with some sectors experiencing multiple outbreaks of COVID-19 (i.e. long-term care homes and hospitals). Notably, numerous sectors shifted to virtual delivery of care. By the end of May 2020, it was announced that hospitals would gradually resume postponed or cancelled services. This paper explores the impact of the COVID-19 pandemic on multiple health system sectors (i.e., public health, primary care, long-term care, emergency medical services, and hospitals) in Ontario from January to May 2020. Given the scope of the sectors contributing to the health system in Ontario, this analysis of a regional response to COVID-19 provides insight on how to improve responses and better prepare for future health emergencies.

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O'Reilly, Richard L. "Mental Health Legislation and the Right to Appropriate Treatment." Canadian Journal of Psychiatry 43, no. 8 (October 1998): 811–15. http://dx.doi.org/10.1177/070674379804300805.

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Objective: To demonstrate how mental health legislation and its implementation can detract from a patient's “right to health.” Method: The author surveyed colleagues working at the London and St Thomas Psychiatric Hospitals about cases where the structure or implementation of the Mental Health Act in Ontario (1) impeded the provision of good psychiatric care. Results: Four clinical vignettes illustrate specific problems; possible solutions to these difficulties are suggested. Conclusion: Physicians must remain vigilant in their role as advocates for patients' right to appropriate treatment.

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Bates, Michael. "Media Frames of the Ontario Safe Streets Act: assessing the moral panic model." SURG Journal 5, no. 1 (December 23, 2011): 11–17. http://dx.doi.org/10.21083/surg.v5i1.1320.

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This paper assesses the “moral panic” framework of Stanley Cohen with reference to panhandling and squeegeeing in Ontario. There are four general tenets of the moral panic model, three of which can be said to have been documented in the case of panhandling in Ontario: a recognized threat (panhandling), a rise in public concern, and punitive control mechanisms established to eliminate the threat. This paper argues that the fourth tenet, a stereotypical presentation of the moral threat to the social order, has not been systematically analyzed, and therefore that is the task of this paper. Specifically, this paper examines the framing used by the mainstream print media in Ontario to construct the panhandling/squeegeeing problem. Articles and letters to the editor were sampled from two mainstream Ontario newspapers, the Toronto Star and the Ottawa Citizen, to examine the mainstream media’s framing of panhandling and squeegee cleaning. This sample was taken between 1995 and 2005, a timeframe which revolves around the implementation of the Ontario Safe Streets Act 2000, which is recognized as the punitive control mechanism designed to eliminate the threat of panhandling. The findings of this paper lead to the conclusion that panhandling in Ontario during the implementation of the Ontario Safe Streets Act does not constitute a classic moral panic by virtue of the role the media played. However, the evidence that punitive control mechanisms were established absent the support of the mainstream media suggests that a deeper understanding of the role of mainstream media as well as political interests is required with respect to framing moral panics.

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VanStone, Nancy, Adam van Dijk, Timothy Chisamore, Brian Mosley, Geoffrey Hall, Paul Belanger, and Kieran Michael Moore. "Characterizing the Effects of Extreme Cold Using Real-time Syndromic Surveillance, Ontario, Canada, 2010-2016." Public Health Reports 132, no. 1_suppl (July 2017): 48S—52S. http://dx.doi.org/10.1177/0033354917708354.

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Morbidity and mortality from exposure to extreme cold highlight the need for meaningful temperature thresholds to activate public health alerts. We analyzed emergency department (ED) records for cold temperature–related visits collected by the Acute Care Enhanced Surveillance system—a syndromic surveillance system that captures data on ED visits from hospitals in Ontario—for geographic trends related to ambient winter temperature. We used 3 Early Aberration Reporting System algorithms of increasing sensitivity—C1, C2, and C3—to determine the temperature at which anomalous counts of cold temperature–related ED visits occurred in northern and southern Ontario from 2010 to 2016. The C2 algorithm was the most sensitive detection method. Results showed lower threshold temperatures for Acute Care Enhanced Surveillance alerts in northern Ontario than in southern Ontario. Public health alerts for cold temperature warnings that are based on cold temperature–related ED visit counts and ambient temperature may improve the accuracy of public warnings about cold temperature risks.

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Paphitis, Katherine, Camille Achonu, Sandra Callery, Jonathan Gubbay, Kevin Katz, Matthew Muller, Herveen Sachdeva, et al. "Beyond flu: Trends in respiratory infection outbreaks in Ontario healthcare settings from 2007 to 2017, and implications for non-influenza outbreak management." Canada Communicable Disease Report 47, no. 56 (June 9, 2021): 269–75. http://dx.doi.org/10.14745/ccdr.v47i56a04.

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Background: Outbreaks cause significant morbidity and mortality in healthcare settings. Current testing methods can identify specific viral respiratory pathogens, yet the approach to outbreak management remains general. Objectives: Our aim was to examine pathogen-specific trends in respiratory outbreaks, including how attack rates, case fatality rates and outbreak duration differ by pathogen between hospitals and long-term care (LTC) and retirement homes (RH) in Ontario. Methods: Confirmed respiratory outbreaks in Ontario hospitals and LTC/RH reported between September 1, 2007, and August 31, 2017, were extracted from the integrated Public Health Information System (iPHIS). Median attack rates and outbreak duration and overall case fatality rates of pathogen-specific outbreaks were compared in both settings. Results: Over the 10-year surveillance period, 9,870 confirmed respiratory outbreaks were reported in Ontario hospitals and LTC/RH. Influenza was responsible for most outbreaks (32% in LTC/RH, 51% in hospitals), but these outbreaks were shorter and had lower attack rates than most non-influenza outbreaks in either setting. Human metapneumovirus, while uncommon (<4% of outbreaks) had high case fatality rates in both settings. Conclusion: Attack rates and case fatality rates varied by pathogen, as did outbreak duration. Development of specific outbreak management guidance that takes into account pathogen and healthcare setting may be useful to limit the burden of respiratory outbreaks.

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Kearon, Joanne, and Cathy Risdon. "The Role of Primary Care in a Pandemic: Reflections During the COVID-19 Pandemic in Canada." Journal of Primary Care & Community Health 11 (January 2020): 215013272096287. http://dx.doi.org/10.1177/2150132720962871.

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As COVID-19 cases began to rise in Ontario, Canada, in March 2020, increasing surge capacity in hospitals and intensive care units became a large focus of preparations. As part of these preparations, primary care physicians were ready to be redeployed to the hospitals. However, due to the effective implementation of community-wide public health measures, the hospital system was not overwhelmed. As Ontario prepares now for a potential second wave of COVID-19, primary care physicians have an opportunity to consider the full breadth and depth of scope for primary care during a pandemic. From planning to surveillance to vaccination, primary care physicians are positioned to play a unique and vital role in a pandemic. Nevertheless, there are specific barriers that will need to be overcome.

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Finlayson, Reid, and Edgardo L. Perez. "Sessional funding: Compensating psychiatrists for indirect services in Ontario general hospitals." Administration and Policy in Mental Health 20, no. 5 (May 1993): 369–77. http://dx.doi.org/10.1007/bf00706390.

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Cattapan, Alana. "Medical Necessity and the Public Funding of In Vitro Fertilization in Ontario." Canadian Journal of Political Science 53, no. 1 (October 24, 2019): 61–77. http://dx.doi.org/10.1017/s000842391900074x.

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AbstractThe recognition of a health care service as medically necessary under the Canada Health Act is contingent on a variety of practical and political factors. This article examines how in vitro fertilization (IVF) came to be understood as a medically necessary service in Ontario, focusing on the establishment of public funding for one cycle of treatment. The article argues that the legitimacy of medical necessity in the contemporary period is tied to three interrelated factors: the recognition of a service as sufficiently “medical,” as efficient and as urgent—that is, something to be funded now and not later. By applying this framework to the case of IVF in Ontario, the article demonstrates not only the ongoing malleability of medical necessity but also how the government of Ontario has mobilized the three aspects of medical necessity to make a case for the public funding of a highly contested health care service.

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Wilkinson, Margaret Ann. "Extending freedom of information and privacy legislation to municipalities in ontario." CISM journal 45, no. 3 (October 1991): 383–91. http://dx.doi.org/10.1139/geomat-1991-0028.

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In 1991, a new statute, the Municipal Freedom of Information and Protection of Privacy Act, 1989, came into effect in Ontario. It is modeled on the earlier Freedom of Information and Protection of Privacy Act, 1987 which continues to apply to public sector organizations at the provincial level. Rather than provide an overview of this area of legislation, this article concentrates on certain aspects of the legislation which may prove to be troublesome to members of the public using these statutes in the future. These potential difficulties in some cases lie in differences between this new statute which governs the conduct of municipal bodies and the original statute which applies to provincial organizations. Other problematic areas are common to both statutes.

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Green, A., A. Dong, and A. McGeer. "Survey of occupational health policies for varicella susceptible employees in ontario hospitals." American Journal of Infection Control 21, no. 2 (April 1993): 92. http://dx.doi.org/10.1016/0196-6553(93)90284-b.

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George, Lindsey, Janet Durbin, and Christopher J. Koegl. "System-Wide Implementation of ACT in Ontario: An Ongoing Improvement Effort." Journal of Behavioral Health Services & Research 36, no. 3 (August 13, 2008): 309–19. http://dx.doi.org/10.1007/s11414-008-9131-5.

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Stringer, Bernadette, and Ted Haines. "Ongoing Use of Conventional Devices and Safety Device Activation Rates in Hospitals in Ontario, Canada." Journal of Occupational and Environmental Hygiene 8, no. 3 (January 22, 2011): 154–60. http://dx.doi.org/10.1080/15459624.2011.555258.

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Lo, Jennifer, Bradley J. Langford, Valerie Leung, Rita Ha, Julie Hui-Chih Wu, Samir N. Patel, Sameer Elsayed, Nick Daneman, Kevin L. Schwartz, and Gary Garber. "Development of a provincial interactive antibiogram tool for Ontario." Official Journal of the Association of Medical Microbiology and Infectious Disease Canada 6, no. 2 (July 2021): 129–36. http://dx.doi.org/10.3138/jammi-2020-0010.

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Background: Antimicrobial resistance (AMR) is a public health issue with significant impact on health care. Antibiogram development and deployment is a key strategy for managing and preventing AMR. Our objective was to develop an Ontario antibiogram as part of a larger provincial initiative aimed at advancing antimicrobial stewardship in the province. Methods: As part of a voluntary provincial online survey, antibiogram data from 100 of 201 (49.8%) Ontario hospitals were collected and included. All hospitals in Ontario were eligible to participate except those providing only mental health or ambulatory services. Weighted provincial and regional antibiotic susceptibilities (percentages) were conducted using descriptive statistical analyses, and an interactive antibiogram spreadsheet was developed. Respondent-identified barriers to collecting and interpreting antibiogram data are presented descriptively. Results: There was wide regional variability in antimicrobial-resistant organisms across Ontario. Provincial methicillin-resistant Staphylococcus aureus prevalence was 24.6%, ranging from 5.9% to 43.7% regionally. Provincial Escherichia coli resistance to ceftriaxone and ciprofloxacin was 13.8% (regional range 6.0%–25.1%) and 22.5% (regional range 9.8–37.8%), respectively. Klebsiella spp resistance to ceftriaxone and ciprofloxacin was similar across all health regions, with overall provincial rates of 7.5% and 5.6%, respectively. Conclusions: We have demonstrated that integrating hospital AMR tracking and reporting as part of a larger voluntary provincial antimicrobial stewardship program initiative is a feasible approach to capturing AMR data. The provincial antibiogram serves as a benchmark for the current state of AMR provincially and across health regions.

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Franz, Berkeley, Cory E. Cronin, Alexandra Wainwright, and José A. Pagán. "Measuring Efforts of Nonprofit Hospitals to Address Opioid Abuse After the Affordable Care Act." Journal of Primary Care & Community Health 10 (January 2019): 215013271986361. http://dx.doi.org/10.1177/2150132719863611.

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Objectives: To assess the strategies that nonprofit hospitals are adopting to address opioid abuse after requirements for community engagement expanded in the Affordable Care Act. Methods: We constructed a dataset of implementation activities for a 20% random sample of nonprofit hospitals in the United States. Using logistic regression, we assessed the extent to which strategies adopted are new, existing, or primarily partnerships. Using negative binomial regression, we assessed the total number of strategies adopted. We controlled for hospital and community characteristics as well as state policies related to opioid abuse. Results: Most strategies adopted by hospitals were new and clinical in nature and the most common number of strategies adopted was one. Hospitals in the Northeast were more likely to adopt a higher number of strategies and to partner with community-based organizations. Hospitals that partner with community-based organizations were more likely to adopt strategies that engage in harm reduction, targeted risk education, or focus on addressing social determinants of health. Conclusions: Community, institutional, and state policy characteristics predict hospital involvement in addressing opioid abuse. These findings underscore several opportunities to support hospital-led interventions to address opioid abuse.

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Driscoll, Elizabeth, Klaus Seeger, Patrick Doyle, Ken Gorman, and Christina Milani. "Mandatory Continuing Professional Competencies: Making the Case for Modification of Ontario Regulation 566." Environmental Health Review 58, no. 1 (March 1, 2015): 9–14. http://dx.doi.org/10.5864/d2015-005.

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The Canadian Institute of Public Health Inspectors (CIPHI) has acknowledged the importance of having a competent membership. As a result, it developed the Continuing Professional Competencies Program in 2010 to assist its members in maintaining their skills, knowledge, and expertise, and to formally recognize these activities. Participation in this program is mandatory for CIPHI members; however, membership is not compulsory in order to practice as a public health inspector (PHI). As a result, PHIs in Ontario do not have to participate in an organized system to maintain and document their continuing professional competency. To this end, the CIPHI Ontario Branch is seeking to have Ontario Regulation 566 Qualifications of the Board of Health Staff, under the Health Protection and Promotion Act R.R.O. 1990, revised to include the requirement for continuing professional development for PHIs.

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Bartlett, Peter. "English Mental Health Reform: Lessons from Ontario?" International Journal of Mental Health and Capacity Law 1, no. 5 (September 8, 2014): 27. http://dx.doi.org/10.19164/ijmhcl.v1i5.359.

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<p>Reforms in areas related to mental disability are under debate in England to an extent unprecedented for almost half a century. The Law Commission’s proposals on incapacity, following further consultation from the Lord Chancellor’s Department, have now largely been accepted in principle by the government for legislative enactment at some time in the undetermined future. A joint green paper from the Home Office and the Department of Health has established a policy agenda concerning the governance of people with serious personality disorders. Proposals by an expert committee chaired by Professor Genevra Richardson on mental health reform have likewise been followed up by a government green paper, and the two green papers have in turn resulted in a joint white paper on reform of the Mental Health Act 1983. All this takes place as the Human Rights Act 1998 takes effect, with its guarantees relating to liberty and security of the person, standards for hearings, respect for private and family life, and protection from inhuman or degrading treatment. Throughout the development of the reforms, a number of similar themes have recurred, involving civil rights, the provision of appropriate legal processes, anti-discrimination, the respect for people with capacity, the extension of controls into the community, and the safety both of people with mental disabilities and of the public as a whole.</p><p>At least in the public arena, most of the debate has focussed on the English situation. The premise of this paper is that the situation in the rest of the world may have something to teach us. The paper examines the law of Ontario. While it focuses primarily on those issues related to the Richardson Report and its subsequent government response, Ontario legislation divides issues somewhat differently to English law, and thus overlap with the other reform proposals is inevitable.</p>

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Adrian, Manuella, Minh Van Truong, and Tim Osazuwa. "Measuring Levels of Comorbidity in Drug User* Emergency Patients Treated in Ontario Hospitals." Substance Use & Misuse 42, no. 2-3 (January 2007): 199–224. http://dx.doi.org/10.1080/10826080601141909.

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Shin, Peter, and Marsha Regenstein. "After the Affordable Care Act: Health Reform and the Safety Net." Journal of Law, Medicine & Ethics 44, no. 4 (2016): 585–88. http://dx.doi.org/10.1177/1073110516684801.

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Two major safety net providers – community health centers and public hospitals – continue to play a key role in the health care system even in the wake of coverage reform. This article examines the gains and threats they face under the Affordable Care Act.

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Hwong, Alison R., Noor Qaragholi, Daniel Carpenter, Steven Joffe, Eric G. Campbell, and Lisa Soleymani Lehmann. "A Systematic Review of State and Manufacturer Physician Payment Disclosure Websites: Implications for Implementation of the Sunshine Act." Journal of Law, Medicine & Ethics 42, no. 2 (2014): 208–19. http://dx.doi.org/10.1111/jlme.12136.

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Public disclosure of industry payments to physicians is one way to address financial conflicts of interest in medicine. As part of the Patient Protection and Affordable Care Act, the Physician Payment Sunshine Act (PPSA) requires pharmaceutical, medical device, and biologics manufacturers who have at least one product reimbursed by Medicare or Medicaid to disclose payments to physicians and teaching hospitals on a public website starting in 2014. The physician payment data will contain individual physician names, monetary values, and specific products connected to payments.According to the Final Regulations issued by the Centers for Medicare and Medicaid Services (CMS) in February 2013, the law will make transparent the extent and nature of relationships between physicians, teaching hospitals, and manufacturers.

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Hebdon, Robert, and Maurice Mazerolle. "Regulating Conflict in Public Sector Labour Relations." Articles 58, no. 4 (March 23, 2004): 667–86. http://dx.doi.org/10.7202/007821ar.

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Abstract Using a comprehensive collective bargaining data set, we examine dispute resolution patterns of all bargaining units in the province of Ontario over a 10-year period. A central finding is that bargaining units covered by legislation requiring compulsory interest arbitration arrive at impasse 8.7 percent to 21.7 percent more often than bargaining units in the right to strike sectors. Even after controlling for legislative jurisdiction, union, bargaining unit size, occupation, agreement length, time trend, and part-time status, strong evidence was found that compulsory arbitration has both chilling and dependence effects on the bargaining process. The problem of failure to reach negotiated settlements is particularly acute in the health care sector, especially among hospitals. Our results also call into question the use of interest arbitration in a central bargaining context. The centralized structure appears to exacerbate the negative effects of interest arbitration.

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Oberlander, Jonathan. "Between Liberal Aspirations and Market Forces: Obamacare's Precarious Balancing Act." Journal of Law, Medicine & Ethics 42, no. 4 (2014): 431–41. http://dx.doi.org/10.1111/jlme.12166.

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The American health care system long has been distinctive in its embrace of market forces. For-profit private insurers play a major role in providing coverage, though they operate alongside public insurance programs that cover over one-third of the population. Historically, federal and state governments’ regulation of insurance markets was limited, leaving insurers to set premiums and coverage rules largely as they saw fit. Government’s role in controlling health care spending has been even more circumscribed. Purchasing power is fragmented, with each insurer negotiating its own rates with physicians and hospitals. A formidable medical-industrial complex of for-profit providers, from hospitals to home-health care agencies, dialysis facilities, pharmaceutical companies and much more, has arisen to sell services.

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Chatham, Robert. "Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital." Journal of Law, Medicine & Ethics 27, no. 2 (June 1999): 202–3. http://dx.doi.org/10.1017/s1073110500012961.

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The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

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Slavik, Catherine E., Sheila Kalenge, and Paul A. Demers. "Recent trends in the industrial use and emission of known and suspected carcinogens in Ontario, Canada." Reviews on Environmental Health 33, no. 1 (March 28, 2018): 99–107. http://dx.doi.org/10.1515/reveh-2017-0021.

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AbstractBackground:In 2010, Ontario, Canada’s most populous province, implemented its Toxics Reduction Act, Ontario Regulation 455/09 (TRA), which requires four major manufacturing and mineral processing industry groups that already report releases of pollutants federally to the National Pollutant Release Inventory to additionally track, account and report their use and creation. The TRA was modeled after the Massachusetts Toxics Use Reduction Act of 1989, which has been very successful and reported significant reduction in toxic use and carcinogen release.Methods:Data from the TRA were retrieved, and the trends in the use and release of 17 known and suspected carcinogens associated with the seven most prevalent cancers diagnosed in Ontario and reported by industrial facilities in Ontario from 2011 to 2015 were examined using methodology adapted from (Jacobs MM, Massey RI, Tenney H, Harriman E. Reducing the use of carcinogens: the Massachusetts experience. Rev Environ Health 2014;29(4):319–40).Results:Carcinogens associated with lung cancers, leukemia and lymphomas were observed as the most used and released carcinogens in Ontario by amount. Overall, for 2011–2015, there was an observed reduction in the industrial use of carcinogens, except among breast carcinogens, which increased by 20%. An increase in the industrial releases of carcinogens was observed across all cancer sites, except among lung carcinogens, which decreased by 28%.Conclusion:The results of this study highlight the potential for reducing the cancer burden by reducing the use and release of select carcinogens associated with particularly prevalent cancers. Toxics use reduction programs can support cancer prevention initiatives by promoting targeted reductions in exposures to industrial carcinogens.

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van Dijk, Adam, Emily Dawson, Kieran Michael Moore, and Paul Belanger. "Risk Assessment During the Pan American and Parapan American Games, Toronto, 2015." Public Health Reports 132, no. 1_suppl (July 2017): 106S—110S. http://dx.doi.org/10.1177/0033354917708356.

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During the summer of 2015, the Pan American and Parapan American Games took place in the Greater Toronto area of Ontario, Canada, bringing together thousands of athletes and spectators from around the world. The Acute Care Enhanced Surveillance (ACES) system—a syndromic surveillance system that captures comprehensive hospital visit triage information from acute care hospitals across Ontario—monitored distinct syndromes throughout the games. We describe the creation and use of a risk assessment tool to evaluate alerts produced by ACES during this period. During the games, ACES generated 1420 alerts, 4 of which were considered a moderate risk and were communicated to surveillance partners for further action. The risk assessment tool was useful for public health professionals responsible for surveillance activities during the games. Next steps include integrating the tool within the ACES system.

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Kagan, Ilya, Ronit Kigli-Shemesh, Nili Tabak, Moshe Z. Abramowitz, and Jacob Margolin. "Patient Rights and Law: tobacco smoking in psychiatric wards and the Israeli Prevention of Smoking Act." Nursing Ethics 11, no. 5 (September 2004): 472–78. http://dx.doi.org/10.1191/096973304ne725oa.

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In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers’ dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients’ rights and welfare.

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De Salvia, Domenico, and Angelo Barbato. "Recent Trends in Mental Health Services in Italy: An Analysis of National and Local Data." Canadian Journal of Psychiatry 38, no. 3 (April 1993): 195–202. http://dx.doi.org/10.1177/070674379303800308.

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This paper reviews trends in Italian mental health services after the implementation of the 1978 Mental Health Act. Data available at the national level on public and private inpatient services, community mental health centres, residential and day care facilities are presented and discussed. Findings from two case-register areas, where comprehensive community services according to the Mental Health Act have been implemented, are discussed. Public mental hospitals are no longer used for psychiatric treatment, except for a small number of long stay patients. General hospital psychiatric units are the only setting in the public sector where psychiatric patients can be admitted. In private mental hospitals, the number of residents has decreased, while admissions have remained stable. However, community services are unevenly distributed and residential facilities are generally lacking. Little is known about quality of care provided, although data from some pilot studies are encouraging. Stable admission rates to forensic mental hospitals suggest that the criminalization of mentally ill has not increased. The effect of changing patterns of mental health care on suicide rates are discussed.

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Swinburne, Mathew, Katie Garfield, and Aliza R. Wasserman. "Reducing Hospital Readmissions: Addressing the Impact of Food Security and Nutrition." Journal of Law, Medicine & Ethics 45, S1 (2017): 86–89. http://dx.doi.org/10.1177/1073110517703333.

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Food insecurity in the United States is a profound public health challenge that hospitals are uniquely situated to address. Through the enactment of the Hospital Readmission Reduction Program, the Affordable Care Act provides a strong economic incentive for hospitals to actively confront food insecurity within the communities they serve. While there is a spectrum of nutrition interventions that hospitals can look to when engaging in these efforts, healthy food prescriptions and medically tailored meals are two particularly innovative and promising approaches that could help hospitals reduce readmissions by addressing the nutritional needs of vulnerable patients.

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Singhal, S., C. Quiñonez, and H. Manson. "Visits for Nontraumatic Dental Conditions in Ontario’s Health Care System." JDR Clinical & Translational Research 4, no. 1 (September 20, 2018): 86–95. http://dx.doi.org/10.1177/2380084418801273.

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Background: Physicians’ offices and emergency departments (EDs) are not suited for addressing nontraumatic dental conditions (NTDCs); however, significant numbers of people in Canada, including Ontario, visit such settings for their dental complaints. Also, people sometimes visit hospitals for day surgery to get their complicated dental conditions treated. This reflects the inefficient usage of the health care system and gaps in accessing timely dental care. Methods: We assessed trends in the burden of NTDCs in Ontario by estimating the visits made for such conditions to physicians, EDs, and hospitals for day surgery. Aggregate data for years 2001 to 2015 were retrieved from Intellihealth Ontario. Descriptive analysis was conducted to calculate rates of visits as stratified by sex, age groups (0 to 6, 7 to 18, 19 to 64, and ≥65 y), and jurisdictions (public health unit level). Results: On average, 70,274 visits to physicians, 51,861 to EDs, and 13,889 to hospital day surgery are made each year in Ontario for NTDCs, which costs approximately CAN$29 million. Children aged 0 to 6 y visit more than their counterparts. Statistically significant increasing trends for physician and ED visits were observed over the years. Analyses show large variations in rates of visits across public health units, with higher rates in rural communities. Conclusion: A large number of visits for NTDCs, with jurisdictional variations, were consistently made to nondental health care settings in Ontario over the last 15 y. Central- and local-level policy options for optimizing resources and health care system use are required. Knowledge Transfer Statement: The findings of this study will provide oral and general health professionals a comprehensive understanding about the ineffective usage of a health care system for nontraumatic dental conditions. Quantifying the burden and associated dollars spent will promote crucial policy discussions to explore the possible options for providing emergency and essential dental services for all Canadians and possible equitable options to enhance access to dental care for vulnerable populations in Canadian society.

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Rose, Joseph B. "The Assault on School Teacher Bargaining in Ontario." Articles 57, no. 1 (July 24, 2003): 100–128. http://dx.doi.org/10.7202/006712ar.

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Summary Between 1975 and 1997, school teacher bargaining was conducted under the School Boards and Teachers Collective Negotiations Act (Bill 100). By most accounts, the teacher bargaining law was successful in promoting bilateral settlements with minimal strike activity. Following its election in 1995, the Harris government reduced public expenditures and introduced educational reforms. In doing so, it repealed Bill 100 and passed laws restricting teacher bargaining. These measures ranged from imposing restrictions on the scope of negotiable issues to attempts to make “voluntary” extracurricular activities mandatory. This study finds that the government’s blunt and heavy-handed efforts to control collective bargaining processes and outcomes, not only proved futile, but led to an increase in work stoppages and protracted guerilla warfare at the school board level.

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Narine, L., G. Pink, and P. Leatt. "Prediction of the financial performance of Ontario hospitals: A Test of Environmental Determinist and Adaptationist Perspectives." Health Services Management Research 9, no. 3 (August 1996): 137–55. http://dx.doi.org/10.1177/095148489600900301.

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While other industries for many years have been concerned with the problem of financial distress, it is only recently that this issue has become a matter of interest to hospital managers, policy makers, and the general public. However, the determinants of hospital financial performance are neither well studied nor understood. The objectives of this study were to identify factors that affect the financial performance of Ontario hospitals and to construct a model that could be used to predict financial performance in the future. A number of organization and environmental factors that could influence financial performance were postulated and then tested for their statistical impact and predictive ability. Cross-sectional data over the 3-year-period 1986–1988 for 223 Ontario public hospitals were used. The first 2 years of data served as a derivation sample for hypothesis testing and development of a predictive model. The third year of data was used as a holdout sample for cross validation. Information on the variables investigated came from secondary sources, in particular Statistics Canada's Annual Hospital Returns. Univariate analyses revealed distressed hospitals were more likely to earn more revenues from non-government sources, to be non-teaching institutions and have longer chronic lengths of stay, and to be found in areas with higher per capita incomes, number of females in the population, physician supply, and area wage rates. A five variable prediction model was developed which accounted for 25% of the variance in financial performance in the derivation sample and on cross validation dropped to 21%. The model identified greater hospital size, older plants, higher technological complexity, more intensive care services, and location in areas with more females to be significant predictors of financial distress. Overall, environmental factors (community and structural characteristics) were more important in influencing financial performance. The implication for hospital managers is to underscore that an important dimension of successful leadership requires they remain outwardly focused and involved in managing the external environment. For policy makers the need is to develop funding formulae which encourage efficiency and are also responsive to differences in community and structural characteristics across hospitals.

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Oudshoorn, Abram. "A Right to Vote: A Case Study in Nursing Advocacy for Public Policy Reform." Witness: The Canadian Journal of Critical Nursing Discourse 1, no. 2 (December 17, 2019): 64–72. http://dx.doi.org/10.25071/2291-5796.27.

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In February 2014, the Government of Canada under Stephen Harper introduced the ‘Fair Elections Act’. This reform to the elections act removed provisions for access to voting for individuals lacking certain forms of identification. Noting that this would have a disproportionate impact on people experiencing homelessness, nursing advocates joined with other activists to try to prevent then subsequently overturn this legislation. The purpose of this paper is to explore the 93rd competency of the College of Nurses of Ontario, “Advocates and promotes healthy public policy and social justice,” by unpacking a case example of advocacy for voting rights. This paper addresses the challenges faced by nurses in doing public policy advocacy and concludes with lessons learned. Fulfilling our college mandated requirement to be politically active means ensuring that public policies are just, equitable, and reflective of the progressive values of Nursing.

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Levene, Alysa, Martin Powell, and John Stewart. "The Development of Municipal General Hospitals in English County Boroughs in the 1930s." Medical History 50, no. 1 (January 1, 2006): 3–28. http://dx.doi.org/10.1017/s002572730000942x.

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When thinking of spurs to hospital development in the first half of the last century, it would be easy to assume that the greatest watershed was provided by the 1946 National Health Service Act. In this article, however, we focus on an earlier and often overlooked piece of legislation, which had a perhaps equally significant impact on the development of hospitals in England and Wales. This was the 1929 Local Government Act, which changed both the ownership and the focus of many of the largest hospitals in the country. As Robert Pinker has observed, the act “radically altered the percentage distribution of hospital beds in the public sector”. Such observations notwithstanding, municipal medicine in the 1930s has not received the historical attention it deserves, an omission which this article seeks in part to remedy. The terms of the act in respect of hospital development were permissive, and the extent to which local authorities acted had a great effect on the way in which their municipal hospital services developed, and hence the beds and facilities available at the time of the nationalization of the health services. The reaction of local authorities to the act, however, depended partly on their own choices, and partly on constraints over which they had less control.

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Kemp, Tracey. "A Profile of ICD-9-CM Coding Staff in NSW and ACT Hospitals." Health Information Management 24, no. 3 (September 1994): 94–100. http://dx.doi.org/10.1177/183335839402400305.

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The ICD-9-CM coder workforce is on the brink of major changes given impetus by increasing commitments to casemix-based funding and management strategies within the public and private hospital sectors. A study of the ICD-9-CM coding process in NSW and ACT hospitals was undertaken by the School of Health Information Management, Faculty of Health Sciences, The University of Sydney during 1991. This article profiles the composition of the ICD-9-CM coder workforce in NSW and the ACT based on the findings of this study. Recent developments pertaining to national coder workforce issues are also discussed.

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Schwarz, Joshua L., and Karen S. Koziara. "The Effect of Hospital Bargaining Unit Structure on Industrial Relations Outcomes." ILR Review 45, no. 3 (April 1992): 573–90. http://dx.doi.org/10.1177/001979399204500311.

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Since the passage of the 1974 Health Care Amendments to the National Labor Relations Act, an implicit premise of public policy has been that multiple bargaining units in hospitals would lead to an increased incidence of wage leapfrogging, jurisdictional disputes, and strikes. This examination of two sets of hospitals in 1988, which had bargaining units ranging in number from zero to ten, finds little support for these assumed relationships. Only hospitals with five or six units had wage settlements that were higher than in hospitals with one unit, and then only for two of six occupations studied. Only hospitals with three or four units had more work assignment disputes than hospitals with one unit. Hospitals with four, six, or seven units averaged one more strike than hospitals with one unit over the 1980–88 period, but strikes per contract were higher only for hospitals with six units.

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O’Grady, Bill, Stephen Gaetz, and Kristy Buccieri. "Tickets … and More Tickets: A Case Study of the Enforcement of the Ontario Safe Streets Act." Canadian Public Policy 39, no. 4 (December 2013): 541–58. http://dx.doi.org/10.3138/cpp.39.4.541.

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Journal articles on the topic 'Ontario. Public Hospitals Act'

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