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Christian Duby reveals 50 priorities for health network reform

Quick access to a medical clinic, more surgeries, less bureaucracy: An ambitious project with 50 priorities has been launched to fix the mammoth that will become Quebec’s health network by 2025. “Quebecers deserve a better health care system,” Health Minister Christian Dube said on Tuesday. Despite the enormity of the challenge before him, the minister emphasized that “skeptics will be puzzled.” Newspaper Here he presents 15 key elements of improvement promised by the government.

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The patient will say

If the government intends to make health network administrators more accountable for system failures; Patients will also be asked to contribute.

Minister Dube noted that the next front-line access counter will also be “a place where you can rate the service you have just received”. In order to be most effective, the network will especially have to measure customer satisfaction.

Better caring environments

“Human-level” living environments will be at the heart of construction in the coming years, like homes for seniors promised by the government.

We also want to eliminate multiple rooms (with two, three or even four patients), which reduces transmission, especially in CHSLDs.

QMI photo, Joel LeMay

Command Centers

One of the models that the government intends to implement on a large scale is the command center model that was deployed in Montreal by the Jewish General Hospital.

It is made up of key people, in mental health, rehabilitation or home support, who work together to ensure the person who has been discharged continues to receive appropriate services. The goal is to reduce stress on emergencies. Mr. Dube noted that 25 hospitals in the Greater Montreal area have started implementing the system.

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Patient-Based Financing

A major change is taking place in the way care is managed: Funding will follow the patient. The principle is that the patient can choose more than where he receives his care, and the necessary budget will follow. Thus, this vision eliminates the idea that a hospital should honor a predetermined budget without taking into account real needs. However, this change will happen in small steps.

Professional order for processors

After many years of claiming this, paramedics have the right to create a professional system. Often overwhelmed by emergency calls, professionals on the front lines will be able to decide whether or not to transport the patient to the hospital. This change can reduce stress on the network by sending only urgent cases. We also promise to review the efficiency of the pre-hospital system.

Meals

Among all the measures aimed at improving the quality of life of seniors in CHSLDs, the government is ensuring that food is at the center of the upcoming changes. Cold or obnoxious dishes that have been criticized by residents and their loved ones for years will be a thing of the past. The government promises “concrete actions” and states that it has commissioned the Quebec Tourism and Hospitality Institute to improve the food supply.

model to follow

Verdun CLSC in Montreal is the only one in Quebec with a medical team that provides in-home palliative care. The government intends to take inspiration from it to expand it throughout the province.

“It already exists, but unfortunately, it is not applied everywhere,” Christian Dube lamented. When one nurse goes home, the patient’s condition should be assigned to the hospital if she considers that his condition is deteriorating or that the medication must be adjusted.

However, the in-home medical team at CLSC de Verdun allows 12 doctors to follow up on 1,100 patients and avoid painful stays in the emergency room.

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No additional time is mandatory

An election promise that the CAQ was unable to deliver, Minister Dube reiterated the government’s commitment to put an end to Forced Overtime Work (TSO), which nurses denounced. He emphasized that even if he recognized that TSO would be inevitable at times, it should become an exception rather than a management style. The government has even added that TSO use will be monitored and measured to see where it is a problem. However, there is no deadline.

Compare with the best

Minister Dube argued that the time for data confidentiality was over. Quebec will share data from its health network with the Canadian Institute of Health Information (CIHI) and other independent organizations to compare its performance with that of other provinces. Previously, Quebec was almost always excluded from comparisons made by CIHI, in particular.

network computing

The government wants to encourage initiatives such as the Clic Santé website, which has proven very useful in the fight against the epidemic in scheduling vaccinations. We also want to allow patients direct access to their file (the digital health record), and allow professionals to see more data. Cyber ​​security must also be prioritized. But Minister Dube did not promise the end of the fax machine by 2025.

  • Listen to Richard Martineau’s interview with Moncef Darraji on QUB Radio:

Front Line Access Desk (GAP)

Quebecers who do not have a family doctor will be able to schedule an emergency clinic appointment within 36 to 72 hours. GAP is already established in Bas-Saint-Laurent, and will be deployed in all regions. By the end of the summer, 50% of orphaned patients should be able to reach it. All FMGs will be connected to the system by the end of April. Patients may be treated by a health professional other than a doctor.

4000 extra beds

Minister Dube wants to provide the health network with about 4,000 additional hospital beds. “We’ve seen [pendant la pandémie] How beds are important,” he stressed. He intends to get the first 2,000 additional beds by hiring more staff, because at the moment, the beds are being closed due to staff shortages. The other 2,000 beds will come from new construction or expansions, as in Vaudreuil-Soulanges .

Special Boost

Without giving a specific target, the government will rely on the private sector to make up for its delays in surgeries.

Last year, 87,000 surgeries were performed by private clinics, at no cost to patients, which is approximately 14% of the operations performed annually in the province. With the pandemic, 160,000 people have waited, about 20,000 of them for more than a year. Christian Dube wants private sector help to narrow this list.

It also intends to increase the contribution of pharmacists to accelerating access to care, as happened during the COVID-19 vaccination campaign, for example.

decentralization of management

The government aims for a “radical shift in governance” to decentralize management, thus giving more power to the managers closest to the field. “The department is deeply involved in the day-to-day management of operations,” the statement read. Example: Each CHSLD has appointed local managers to facilitate decision-making and enhance accountability.

Towards mixed rewards

General practitioners will not only receive remuneration for the service, but it will also be partially fixed (maximum). This payment method takes into account the total of professional clients, and also encourages clinicians to see patients at risk. The change should take place in the spring of 2023, when a new employment contract is signed.