Environmental Scan - Government of Nova Scotia

More documents

Recommendations

Info

Physician Resource PlanningAn Environmental Scanrequired deliverables of full academic positions prior to their creation.Anatomical PathologyThe most frequently cited benchmark for anatomic pathology is specimens per FTE. The United Kingdom RoyalCollege benchmark is 4,000 149 specimens per FTE. A large Canadian regional and provincially centralized labsystem is able to process 4,500-4,800 specimens per budgeted FTE 150 or approximately 3,200-3,400 surgicalcases per clinical FTE. This average throughput was achieved with a mix of 27% full-time academic pathologistsand 73% clinical pathologists. The academic pathologists averaged 30% less clinical time per week than theirclinical pathologist colleagues. This degree of throughput is a combination of efficiencies in centralizedthroughput, subspecialization, and system integration. The throughput of specimens is provided in anenvironment were the average work week per FTE is 53.5 hours. The findings were further validated throughthe detailed time study analysis cited in the prior paragraph.General PathologyCurrently, and in comparison to, Nova Scotia:• There are 6.25 adult and paediatric General Pathologist FTEs or 1.0 FTE per 150,801 population in NovaScotia.• Benchmark(s)• In Calgary in 2006 there was 1:149,333 serving a city population of 1,120,000.Greater outpatient focus has seen an ongoing shift from inpatient surgery and procedures to outpatientprocedures and short-stay surgery. The impact on regional lab services has been to increase the demand forrapid results and point-of-care testing. While much of the impact of this is absorbed through new technology,the demand for evening, night and weekend coverage is increasing. 151 (turn-around times) are a key indicatorof internal performance and they are assessed and reported on a monthly basis.Test processing in Chemistry, Haematology and Microbiology are largely automated and or performed bytechnologists, and therefore require little direct physician intervention or supervision. The issues for thesedepartments for technology relate more to the development and assessment of new tests and newtechnologies to determine how to implement them and how to address new diseases. This is evident in lookingat the research efforts ongoing within the CLS physicians.One of the core technologies for laboratory efficiency and effectiveness is the easiest to overlook. That is aunified and integrated patient-centred information system. 152Another key impact of technology is the development, assessment and application of new diagnostic tests inresponse to increased incidence of certain diseases. The increase in the number of hospital-acquired infectionsand methicillin-resistant Staphylococcus aureus (MRSA) cases in Canada are increasing. This affects servicedelivery requirements in two ways; firstly, it significantly increases the amount of research and developmentexpended to identify the cause, accurately test and analyze, and then automate the testing process.149U.K. Royal College of Pathologists, Guidelines on staffing and workload for histopathology and cytopathologydepartments, July, 2003.150 SSM Inc., PRP for Pathology and Laboratory Medicine, 2006.151 Ontario Hospital Association, Laboratory Service System Issues for Ontario Report, An OHA Discussion Paper, August2000152 Bayne, Lillian, BC Laboratory Services Review Report, July 2003248 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
Medical BiochemistryPhysician Resource PlanningAn Environmental ScanThe Royal College of Pathologists (2010) response to the NHS call for Reconfiguration of NHS PathologyServices identified a current and target ratio of chemical pathologists (medical biochemists) of 1:355,263 and1:491,000 (Source: U.K. NHS Centre for Workforce Intelligence, August 2010)Currently in NS there is 1:314,169 population.Medical MicrobiologyThe impact of globalization on disease is increasingly being felt 153 . New Canadians are immigrants from diversewide-ranging countries. Some examples of the effect of globalization on the spread of disease include:• The emergence of HIV/AIDS, which originated in Africa, as the number one killer of young men aged15-45 in the United States;• Mosquitoes capable of carrying west Nile virus and other infectious diseases introduced to NorthAmerica through tires imported from Asia.• Pesticides banned in North America have been found on imported food; high levels of lead found incrayons from China, cosmetics from India and canned food from Latin America.25.1.2 Other SpecialtiesThe following specialties will be addressed in the forecast modeling, scenario development, and final reportand recommendations:• Clinical Pharmacology• Haematological Pathology• Medical Genetics• Neuropathology• Transfusion Medicine25.1.3 Radiation OncologyCurrently, and in comparison to, Nova Scotia:• There are 13.1 Radiation Oncologists FTEs or 1.0 FTE per 71,900 population in Nova Scotia. Out-ofprovinceworkload is estimated at 10%-14%.• Benchmark(s)• In Australia one radiation oncologist is expected to treat 250 new patients per year.• In Ireland a national workforce review recommended reducing individual caseloads per consultantto 350 new cases per radiation oncologist.• In Nova Scotia it is estimated there will be 6,100 new cancer cases in 2011 (Source: Canada Cancer2011) which at a 50% treatment rate translates to 3,050 new cases or 12.2 FTE radiationoncologists.• In the USA it is estimated there is 1.0 FTE per 16,234 population over age 65 154 or 1:126,000 totalpopulation.153 Lee, Jong-Wha, McKibbin, Warwick J., Globalization and Disease: The Case of SARS, Brookings Institution, May 20, 2003.154 Aneja, S., Yu, J.B., et.al., Geographic analysis of the Radiation Oncology Workforce, Int. J. Radiation Oncology Biol. Phys.,doi. 10.1016., pp. 1–7, 2011249 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
Page 1 and 2:
Social Sector Metrics Inc. & Health
Page 4 and 5:
Physician Resource PlanningAn Envir
Page 6 and 7:
Page 8 and 9:
Page 10:
3 KEY OBSERVATIONS3.1 IntroductionP
Page 13 and 14:
KEY OBSERVATIONSPhysician Resource
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
4.4 ConsultantPhysician Resource Pl
Page 33 and 34:
4.8 Methodology Guiding PrinciplesP
Page 35 and 36:
ContextooPhysician Resource Plannin
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
7 CONCEPTUAL MODELS7.1 Methodologie
Page 45 and 46:
7.4 BenchmarkingPhysician Resource
Page 47 and 48:
Figure 23 Population per Physician
Page 49 and 50:
Page 51 and 52:
8 NATIONAL ENVIRONMENT8.1 Quality o
Page 53 and 54:
All communities in all LHAs:oo−
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
8.4.3 NationalPhysician Resource Pl
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
9.5 Canadians Studying AbroadPhysic
Page 81 and 82:
Figure 53 Net in/(out) migration by
Page 83 and 84:
9.7 Worked HoursPhysician Resource
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
11 POPULATIONPhysician Resource Pla
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
INCIDENCEPhysician Resource Plannin
Page 99 and 100:
PHYSICIAN SERVICESPhysician Resourc
Page 101 and 102:
12.5 Renal DiseasePhysician Resourc
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
−−Physician Resource PlanningAn
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
−−−−−−−Physician Reso
Page 151 and 152:
POPULATION NEEDPhysician Resource P
Page 153 and 154:
• Specific Disciplines−−−
Page 155 and 156:
Background DataPhysician Resource P
Page 157 and 158:
Key (selected) ChallengesooooooPhys
Page 159 and 160:
Page 161 and 162:
Background DataPhysician Resource P
Page 163 and 164:
Page 165 and 166:
• Social-economic−Physician Sup
Page 167 and 168:
−Physician Resource PlanningAn En
Page 169 and 170:
Page 171 and 172:
−−−−−−Physician Resourc
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
19.1.2 GenderPhysician Resource Pla
Page 179 and 180:
Page 181 and 182:
19.1.4 Language - FrenchPhysician R
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
22 FAMILY MEDICINE22.1.1 NationalPh
Page 191 and 192:
PRIMARY CARE NETWORK - COORDINATED
Page 193 and 194:
Page 195 and 196:
Page 197 and 198: 23 MEDICAL DISCIPLINES23.1 National
Page 199 and 200: Physician Resource PlanningAn Envir
Page 207 and 208: • Benchmark(s):Physician Resource
Page 217 and 218: • Benchmark(s)Physician Resource
Page 219 and 220: 23.3.3 Paediatrics - PsychiatryPhys
Page 233 and 234: 24.3.9 Orthopaedic SurgeryCurrently
Page 245 and 246: Residency ProgramsPhysician Resourc
Page 247: Physician Resource PlanningAn Envir
Page 253 and 254: −Physician Resource PlanningAn En
Page 255 and 256: −−−Physician Resource Plannin
Page 259 and 260: −−−Physician Resource Plannin
Page 263 and 264: PHYSICIAN SUPPLY• Critical mass
Page 269 and 270: −Physician Resource PlanningAn En
Page 271 and 272: −−−−−Physician Resource P
Page 273 and 274: • Social-economic−−PHYSICIAN
Page 275 and 276: 26.5.3 OphthalmologyPhysician Resou
Page 293 and 294: 27.3.3 General - Not Cited - Papers
Page 297 and 298: 28 Interview 16-Aug Department ofHe
Page 299 and 300:
information18 Preliminarymeeting fo
Page 301 and 302:
20 Preliminarymeeting forinformatio
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327:
show all

Environmental Scan - Government of Nova Scotia

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?