Inadequate Hospital Funding
Hospital underfunding hurts patients.
Nurses provide most of the frontline care in Ontario’s hospitals, which gives them an up-close view of the impact funding shortfalls are having on patients.
Ontario ranks second-last in the country for per capita hospital funding. For several budget years since 2012, there was a freeze on base funding for Ontario’s hospitals. Resources are stretched. Nurses have less time for each patient, and that can make the hospital experience more difficult. Every minute of hands-on nursing care is precious because it helps patients get well faster, and decreases the risk of health complications.
Hospitals have made up funding shortfalls by making cuts to nursing positions, beds and other vital services. For every registered nurse cut, 2,000 hours of care are lost. This puts patients at increased risk of bedsores, sepsis, blood clots, pneumonia and other complications that can arise in the absence of sufficient nursing personnel.
Ontario nurses are stretched too thin.
Ontario has the worst ratio of registered nurses to population. We would need to hire more than 17,000 registered nurses just to catch up to the rest of the country.
This RN shortfall puts patients at risk. Adding one patient to the average workload of a registered nurse results in a seven per cent increase in patient complications and death. On the other hand, extensive research shows improved health outcomes for patients who receive more hours of RN care.
Increased workloads and an increased volume of complexity and acuity of patients put nurses at risk. Overwork has meant soaring rates of injury, illness and burnout for nurses and an increase in violent incidents in their workplaces as the fragile health care system struggles with understaffing and the resultant lengthier wait times for care.
RN Cuts & Statistics
Cuts to registered nurses are putting patients at risk.
Each year, more and more registered nursing positions are lost which means patients are receiving less skilled, frontline care. Since the beginning of 2015, cuts to registered nursing positions have meant the staggering loss of more than 3 million hours of care.
Registered nurses are highly trained to deal with complex needs, yet their share of nursing employment has been falling consistently over time, down seven per cent since 2004. This means nursing skill is being diminished, even as our population ages and patient needs are more complex. Deskilling our health care means threatening the quality of care patients receive.
Since 2015, more than 1600 RN positions have been cut in Ontario workplaces.
The following workplaces have announced RN cuts in 2015 and 2016:
THE OTTAWA HOSPITAL
QUINTE HEALTH CARE
TRILLIUM HEALTH PARTNERS
HEALTH SCIENCES NORTH
WINDSOR REGIONAL HOSPITAL
GREY BRUCE HEALTH SERVICES
GREY BRUCE HEALTH UNIT
ST. THOMAS ELGIN HOSPITAL
CAMBRIDGE MEMORIAL HOSPITAL
GRAND RIVER HOSPITAL
HAMILTON HEALTH SCIENCES
ST. JOSEPH’S HEALTHCARE, HAMILTON
WILLIAM OSLER HEALTH CENTRE
UNIVERSITY HEALTH NETWORK
ST. MICHAEL’S HOSPITAL
HUMBER RIVER REGIONAL HOSPITAL
SOUTHLAKE REGIONAL HEALTH CENTRE
HOTEL DIEU GRACE HEALTHCARE
HURON PERTH HEALTHCARE ALLIANCE
LONDON HEALTH SCIENCES CENTRE
TILLSONBURG DISTRICT MEMORIAL
GUELPH GENERAL HOSPITAL
NORTH YORK GENERAL HOSPITAL
ROUGE VALLEY HEALTH SYSTEM
HOTEL DIEU KINGSTON
PROVIDENCE ST. MARY’S ON THE LAKE
ARNPRIOR & DISTRICT MEMORIAL
CANADIAN BLOOD SERVICES, OTTAWA
CHILDREN’S HOSPITAL OF EASTERN ONTARIO
CORNWALL COMMUNITY HOSPITAL
PERLEY RIDEAU VETERANS HEALTH CENTRE
REVEERAL LONG TERM CARE INC.
ROYAL OTTAWA HOSPITAL HEALTH CARE GROUP
MUSKOKA ALGONQUIN HEALTHCARE
NORTH SIMCOE MUSKOKA CCAC
ORILLIA SOLDIER’S MEMORIAL HOSPITAL
ROYAL VICTORIA HOSPITAL
HEALTH SCIENCES NORTH
NORTH BAY REGIONAL HEALTH CENTRE
SAULT AREA HOSPITAL
LAKE OF THE WOODS
MENO-YA-WIN HEALTH CENTRE (SIOUX LOOKOUT)
RUNNYMEDE HEALTHCARE CENTRE
Offloading procedures onto private clinics puts quality public care on the chopping block.
The government plans to move clinical procedures out of hospitals into private clinics. These clinics would not be accountable under the Public Hospitals Act, and therefore not subject to the standards of care hospitals uphold. Hospitals are the best approach for safe, efficient and integrated quality patient care.
Politicians may herald private clinics as more efficient, but what is the real cost for patients? The 2012 annual Report of the Ontario Auditor General notes that 12 per cent of diagnostic imaging independent health facilities (IHFs) had not been assessed for quality within the last five years and 60 per cent of X-ray IHFs had not been inspected as frequently as required to check for excessive radiation levels.
Moving clinical procedures out of hospitals and into community-based clinics is not in the best interests of universal, safe and quality care for Ontario patients.
Workplace violence occurs most frequently in the health-care sector – more than in any other occupation.
Workplace violence is on the rise in Ontario’s health-care sector. And it’s nurses who are most likely to be affected. The facts are disturbing.
- Lost-Time Injuries Due to Violence at Work:
- 2014: 6.4% increase.
- 2015: 11% increase.
- Violence-related Injuries:
- 8 times more than workers in manufacturing.
- 68 times more than construction workers.
The majority of RNs say they have experienced physical violence in their workplace.
In the health-care sector, many violent incidents go unreported and undocumented. Even so, we know there are thousands of Code White emergencies in Ontario hospitals every year in addition to dangerous disruptions in other health-care settings.
When violence is extreme, the result can be career-ending injuries or trauma. But no matter what the outcome, any occurrence of violence is unacceptable.
This must be stopped – and it can be.
ONA, in collaboration with hospitals, has identified key areas for improvement.
- Accountable leadership among employers.
- Proactive risk assessment and incident management.
- Improved security measures.
- Ongoing staff training and education.
- Clear identification of potentially violent patients.
- Adequate staffing levels.
- Crisis support and counseling.