What are the 3 approached to health care?
1) Medical
2) Behavioral
3) Socio-environmental
How was the “medical” approach?
- Focused more on curing
- Medical intervention was to restore health
- Heavy reliance on physicians/hospital care
- No focus on prevention
- Payment out of pocket
How was the “behavioural” approach?
- Increased gov’t spending on healthcare but no significant improvement
- Lalonde report: health is broader than just sickness and quality of health care services
- Lalonde also Proposed the determinants of health as environment, biology, health services and lifestyle.
Define the Epp Report
- Expanded Lalonde so it included disadvantaged groups, prevented disease, detect and managed chronic disease, enhanced coping, creating healthy environment despite economic status
- Decrease inequities in social systems (economic stability)
How was the “socio-environmental” approach?
- An understanding of social determinants of health led the way for a socioenvironmental approach to health.
- Acknowledges health is self defined
Define Canada health act
Protect, promote and restore the physical and mental well-being of residents. To facilitate reasonable access to health services without financial or other barriers”
- Guaranteed access to essential medical services (regardless of employment, finances, and health)
Describe the pillars of the Canada Health Act
Provinces administers health care by following:
- public administration
- comprehensiveness
- universality
- portability
- accessibility
Top to bottom the organization of health care system
1) Federal administration aka health Canada
2) Federal branches and agencies
3) Provinces and territories
4) regionalization
4 levels of accessing health care
1) primary healthcare
- Family doctor, NP, long term care, telehealth
2) Secondary healthcare
- Referrals to specialists, community hospitals, long terms care
3) Tertiary
- Acute care teaching hospital
4) quaternary
- health care typically specialized acute care hospital such as pediatric hospital
Define healthcare reform
changes made by the government through the creation of health policy that influences the delivery of healthcare.
What are the 2 types of reform?
1) Primary health care reform
- Shift to team-based care (interprofessional)
- Shift to health promotion and prevention
- Telemedicine
2) Secondary health reform
- Restructuring of hospitals
- Electronic health records
What are the 2 branches of law?
1) Public law
- Aka criminal law
- Gov’t vs citizen
- Crimes and actions considered harmful to society
2) Private law
- Individual vs individual
- Governed by 2 legal traditions: common law in most of Canada and civil law in Quebec
- Includes contract and tort law which is negligence
Define tort law
Defined as the cornerstone of the Canadian legal system. This law deals with harm to a person or a person’s property.
- involves a victim and a wrongdoer
- crime may be intentional (though no physical injury is required and unintentional(negligence)
Define unintentional and intentional tort
Intentional tort: battery, defamation, false imprisonment, invasion of privacy
Unintentional: negligence in duty of care, injury, causation (nurse causing harm), breach of standard of care.
What are the 4 elements that must be proven by plaintiff before negligence claim is made?
1) The defendant (nurse) must owe the plaintiff (patient) a duty of care
2) The defendant must breach the standard of care established by law
3) The plaintiff must suffer an injury or loss
4) The defendant’s conduct must cause the plaintiff’s injury
What are some defenses?
Error of judgment, approved practice, vicarious liability
How to avoid negligence?
- provide competent care
- follow standards of practice, protocols, procedures
- insist on appropriate staffing
Define PHIPA under the CNO
Governs the health care information privacy act in Ontario
- Information is how their health info is collected, used and disclosed.
Which branch is professional misconduct under?
The CNO professional misconduct
