Hospitals Management And Use Of Surgical Facilities Section 3 09 2007 Annual Report Of The Auditor General Of Ontario

Healthcare service systems are of profound importance in promoting the public health and wellness of people. This book introduces a data-driven complex systems modeling approach (D2CSM) to systematically understand and improve the essence of healthcare service systems. In particular, this data-driven approach provides new perspectives on health service performance by unveiling the causes for service disparity, such as spatio-temporal variations in wait times across different hospitals. The approach integrates four methods -- Structural Equation Modeling (SEM)-based analysis; integrated projection; service management strategy design and evaluation; and behavior-based autonomy-oriented modeling -- to address respective challenges encountered in performing data analytics and modeling studies on healthcare services. The thrust and uniqueness of this approach lies in the following aspects: Ability to explore underlying complex relationships between observed or latent impact factors and service performance. Ability to predict the changes and demonstrate the corresponding dynamics of service utilization and service performance. Ability to strategically manage service resources with the adaptation of unpredictable patient arrivals. Ability to figure out the working mechanisms that account for certain spatio-temporal patterns of service utilization and performance. To show the practical effectiveness of the proposed systematic approach, this book provides a series of pilot studies within the context of cardiac care in Ontario, Canada. The exemplified studies have unveiled some novel findings, e.g., (1) service accessibility and education may relieve the pressure of population size on service utilization; (2) functionally coupled units may have a certain cross-unit wait-time relationship potentially because of a delay cascade phenomena; (3) strategically allocating time blocks in operating rooms (ORs) based on a feedback mechanism may benefit OR utilization; (4) patients’ and hospitals’ autonomous behavior, and their interactions via wait times may bear the responsible for the emergence of spatio-temporal patterns observed in the real-world cardiac care system. Furthermore, this book presents an intelligent healthcare decision support (iHDS) system, an integrated architecture for implementing the data-driven complex systems modeling approach to developing, analyzing, investigating, supporting and advising healthcare related decisions. In summary, this book provides a data-driven systematic approach for addressing practical decision-support problems confronted in healthcare service management. This approach will provide policy makers, researchers, and practitioners with a practically useful way for examining service utilization and service performance in various ``what-if" scenarios, inspiring the design of effectiveness resource-allocation strategies, and deepening the understanding of the nature of complex healthcare service systems.

The Auditor General of Ontario released his Special Report: Prevention and Control of Hospital-Acquired Infections (HAI) on September 29, 2008. The audit's objective was to assess whether selected hospitals followed effective policies and procedures for the prevention and control of HAIs. The audit focused on Clostrdium difficile (C. difficile), Febrile Respiratory Illness (FRI), methicillin-resistant Staphyloccus aureus (MRSA), vancomycin-resistant enterococci (VRE), central-line infections, surgical-site infections, and ventilator-associated pneumonia. The Standing Committee on Public Accounts held hearings on the report on October 29, 2008. This report constitutes the Committee's findings and recommendations as they related to those areas of concern to Committee members.--Document.

The Standing Committee on Public Accounts held hearings on the Auditor General's report on the Ministry of Health and Long-Term Care's Land Ambulance Services on March 2, 2006. The audit objective was to assess whether the Ministry had procedures in place to ensure that: its expectations for the delivery of land ambulance services, including compliance with applicable legislation and policies, were being met in a cost effective manner; and performance in delivering land ambulance services was properly measured and reported. This report consists of introductory information in each section based directly on the Auditor's 2005 report, followed by an overview of the hearings, and as appropriate, Committee recommendations.--Document.

Organ transplantation has been one of the miracles of modern-day medicine but, in addition to presenting enormous technical and clinical challenges, it throws up major ethical and legal issues principally from the perspective of the donor. Evolving capabilities in the spheres of both organ and tissue transplantation, coupled with rapidly-escalating demand, assert consistent and critical pressure on our ethical and legal principles and frameworks, including the expansion of the potential donor pool beyond the conventional categories of donor. This volume brings together seminal papers analyzing such matters in the context of an ever-increasingly important area of clinical practice.