Canadian Healthcare Major Challenges

Health Canada

The Honourable Ginette Petitpas Taylor, Minister of Health - (Ms. Petitpas Taylor grew up in Dieppe, New Brunswick, and graduated from l'Université de Moncton with a Bachelor's degree in social work.)

Dirty hospitals: Hidden camera investigation

CBC Marketplace, Jul 15, 2015

OPINION - Wynne (Premier of Ontario) is offering solutions to health care problems her government created

(CBC News, May 14, 2018)

More than 200,000 patients get infections every year while receiving healthcare in Canada; more than 8,000 of these patients die as a result

(Public Health Agency of Canada)

1 in 18 Canadian hospital patients experience harm from preventable errors: report - 138,000 people admitted to a Canadian hospital per year faced a harmful event that was potentially preventable

(CBC News)

'It is discrimination': Sick worker wins groundbreaking case against WSIB (Ontario, Canada): "Landmark ruling could set a precedent for people exposed to the same chemical in different workplaces" "Then his doctor raised flags about benzene, a chemical in the solvents he'd used to clean the presses. It was a known carcinogen, but LaPrade says he'd never been provided with protective gear like gloves or masks. Once he realized the chemical could be behind his illness, he purchased his own mask to wear, often putting up with laughter from coworkers and managers."

(CBC News, May 07, 2018)

Canadian Institute for Health Information

Emergency department wait times in Canada continuing to rise "The amount of time most Canadians spend waiting in emergency departments to be admitted to hospital is on the rise, new data from the Canadian Institute for Health Information

The Inconvenient Truths About Canadian Health Care

Daniel Muzyka, Glen Hodgson, and Gabriela Prada - The Conference Board of Canada

Suicide Among Physicians Is A Public Health Crisis

Amitha Kalaichandran - (

Burnout Among Health Professionals and Its Effect on Patient Safety

Audrey Lyndon, PhD (Agency for Healthcare Research and Quality)

The real challenge to Canada's health system is not wait times


Unleashing Innovation: Excellent Healthcare for Canada

Report of the Advisory Panel on Healthcare Innovation

How Healthy Is The Canadian Health-Care System?

Queen's University, 2017

Managing the Risk of Fraud

("While both Health Canada and Public Services and Procurement Canada had fraud risk management frameworks in place, neither completed a fraud risk assessment" - "Health Canada's response. Agreed. Health Canada is in the process of conducting a comprehensive fraud risk assessment, to be completed by 31 March 2018") Auditor General of Canada, 2017

Toronto hospital fires 31 employees after audit finds $200,000 in irregular health benefits claims

("While both Health Canada and Public Services and Procurement Canada had fraud risk management frameworks in place, neither completed a fraud risk assessment" - "Health Canada's response. Agreed. Health Canada is in the process of conducting a comprehensive fraud risk assessment, to be completed by 31 March 2018") Auditor General of Canada, 2017

Ontario failing to recover millions in fraudulent OHIP billings by doctors

Research by CBC/Radio-Canada reveals little progress on collecting dodgy payments - New Health Minister - "We certainly have a very robust mechanism and process to look at potential OHIP overbilling," said Health Minister Helena Jaczek in an interview." (CBC News, Mar 22, 2018)

Code of Ethical Conduct

The Mount Sinai Hospital Code of Ethical Conduct

What Really Motivates People to be Honest in Business

TED Presentation by Alexander Wagner

Managing for Organizational Integrity

Lynn S. Paine, Harvard Business Review

Organizational Climate of Staff Working Conditions and Safety—An Integrative Model

Patricia W. Stone, Michael I. Harrison, Penny Feldman, Mark Linzer, Timothy Peng, Douglas Roblin, Jill Scott-Cawiezell, Nicholas Warren, and Eric S. Williams

Pinnacle Enterprises Canada

"Committed to Healthcare Occupational Health and Safety Management Performance Excellence and Safe Patient Care"

Healthcare Safety Info-eLink™ - "Committed to Safe Patient Care Through Healthcare Occupational Health and Safety Management Performance Excellence"

"An Integrated Healthcare Safety Management System - The Link Between Staff and Patient Safety" An Innovative Total Quality Holistic Approach for Effective Healthcare Safety Management — Christopher J. Lipowski CRSP - (ppt)

Modern Healthcare Safety Management — "A Systems Approach"

Pinnacle Enterprises Canada

CAN/CSA-Z1000-14 - Occupational health and safety management

"This is the second edition of CSA Z1000, Occupational health and safety management. It supersedes the first edition published in 2006. As a fundamental concept, and to identify the inclusiveness of an occupational health and safety management system, this Standard defines "occupational health and safety" as: the promotion in the workplace of the physical, mental, and social wellbeing of workers and the protection of workers from, and the prevention of, workplace conditions and factors adverse to their health and safety. Many organizations have a system in which the workplace parties are accountable for health and safety within their respective control or authority. When used in this context, CSA Z1000 provides a model for establishing, implementing, and maintaining an occupational health and safety management system. Such a system encourages a more systematic approach to meeting defined occupational health and safety objectives and increases awareness of health and safety in the workplace. It can also assist organizations seeking certification under federal, provincial, and sector-based certification programs (e.g., Certificates of Recognition)"
(Canadian Center for Occupational Health and Safety)


A New Mandate for Human Resources

Dave Ulrich - Harvard Business Review

Health Leaders and Managers in Canada: The Human Resource Dilemma

The Canadian College of Health Service Executives (pdf)

Adopting a Health & Safety Management System: A New Leadership Imperative

Joseline Sikorski (pdf)

Raising the Bar for People Practices: Helping All Health Organizations Become "Preferred Employers"

Graham S. Lowe, Healthcare Quarterly, 8(1) : 60-63

Workplace Violence and Workplace Harassment (Ontario, Canada)

"Everyone should be able to work in a safe and healthy workplace. The Occupational Health and Safety Act sets out roles and responsibilities of workplace parties with respect to workplace violence and workplace harassment, including developing and implementing policies and programs and providing information and instruction on these." (MOL. May 2017)

Royal Ottawa Hospital (Ontario) fined $75K after nurse stabbed at Brockville facility - patient stabbed nurse in head, neck in 2014

(CBC News, Aug 16, 2017)

'Kicked, spat on, bit, pushed': Violence against front-line hospital staff on the rise - (victim - Sharp said he has had difficulty getting compensation from the Workplace Safety and Insurance Board (WSIB), which refused to pay for some of his medications)

(CBC News, Nov 05, 2017)

The Ministry of Labour

"The Ministry of Labour's mission is to advance safe, fair and harmonious workplace practices that are essential to the social and economic well-being of the people of Ontario" - (Kevin Flynn, Ontario Minister of Labour)

The Rise of Toxic Leadership and Toxic Workplaces

Ray Williams, (Psychology Today - 01-27-2016

Safety in the workplace

KGH is committed to ensuring a safe and healthy work environment for everyone who works, learns or volunteers here. By integrating health and safety into our daily work, applying a continuous improvement philosophy, and embedding the prevention mindset into everything we do, our aim is to build a strong safety culture and eliminate all preventable harm to staff - (KINGSTON GENERAL HOSPITAL, 2017) - (a model to emulate)

More Registered Nurses Cut from The Ottawa Hospital: RNs gravely concerned as 25 more nursing cuts announced

"This is an untenable situation for the dedicated registered nurses working to care for patients in the Ottawa community," added Haslam-Stroud. "Morale is being devastated, RNs are deeply concerned about the impact on both their patients and colleagues, and they are deeply distressed by this news." (SOURCE: Ontario Nurses' Association, April 24, 2013)

Construction contractors file defences to Ottawa Hospital fraud lawsuit

Ottawa Hospital filed lawsuit in January alleging a kickback scheme (Amanda Pfeffer, CBC News - Jul 07, 2016)

Attacks on Ottawa Hospital staff trigger provincial investigation

Since April 2011 the Ministry of Labour has investigated The Ottawa Hospital for workplace violence 12 times. Provincial inspectors conducted 43 field visits and issued 26 orders to the hospital. "We have to take the position that any violent episode is one too many violent episodes and what it's done is lead the hospital to think we need to do a lot better when it comes to health and safety," said Debra Bournes, Vice-President of Clinical Services. "We're really good about paying attention to patient safety, but staff safety has often not been as much of a focus in health care, and I don't think that our hospital is any different than anywhere else," she said." (CBC News - Jun 22, 2016)

Commitment to Ongoing Improvement, Strong Staff Engagement Keys to Accreditation Success (Accreditation Canada Announcement)

On May 31, 2017, The Ottawa Hospital issued a press release to announce that it had received the highest rating possible from Accreditation Canada (Accreditation Canada, Jun 19, 2017) - ""It's been an amazing process and it's really because we took a different approach this time," says Samantha Hamilton, Director of Quality and Patient Safety at TOH. Instead of focusing on a particular standing, TOH focused on engaging its staff and celebrating the hospital's successes. In the year leading up to the survey, TOH staff were not informed about the different accreditation levels awarded by AC. "We did not aim for Exemplary Standing. We approached the survey from a continuous quality improvement approach. We were looking to improve our quality of care through the process of getting ready for accreditation," Hamilton says. She says TOH saw the rigourous survey process as a chance to share their work and the passion for what they do with surveyors from across Canada. "It was an opportunity to show these people why it's so special to work at TOH and why it's special to be a patient or a family member here," Hamilton said. She adds that as celebrating success was TOH's common theme throughout the survey process, staff were more engaged in learning, improving and working towards the organization's long-term goals. "[This focus] connected people by their hearts," Hamilton says. "They were committed and they cared.""

Ottawa Hospital Audit News

Chief operating officer cleared in forensic audit "Work done by hospital contractors on Cameron Love's (executive vice-president and chief operating officer) home paid for personally, audit finds"- (CBC News, Jan 14, 2016)

Ottawa Hospital apologizes after patient told to lie on ER floor, former nurse calls it 'demeaning'

The Ottawa Hospital has apologized after a staff member told a patient who was in pain last week to lie on the emergency room floor when he asked for a place to rest (Global News - November 27, 2017)

Patients with emergency surgery delays have higher risk of dying, study finds

Nearly 20 per cent of Ottawa Hospital patients experienced a delay, researchers found (CBC News - Jul 10, 2017)

Emails reveal inside look into bidding process for Ottawa Hospital contracts

(Elizabeth Payne, Ottawa Citizen - February 2, 2017)

Editorial from OTTAWA CITIZEN EDITORIAL BOARD re Ottawa Hospital Fraud Allegations

"Answers needed on Ottawa Hospital fraud allegations. The allegations of fraud come at a time when the hospital is in the midst of planning for its biggest construction project ever — a new Civic campus, which is estimated to cost more than $2 billion and requires a community-raised share of up to $400 million" - (OTTAWA CITIZEN EDITORIAL BOARD - February 3, 2017)

Ottawa Hospital files lawsuit against former directors, contractors

"Alleged kickbacks include luxury trips, discounts on cars, free personal home renos" (CBC News, Jan 06, 2016)

Editorial: Answers needed on Ottawa Hospital fraud allegations


The Rise of Toxic Leadership and Toxic Workplaces

Ray Williams, (Psychology Today - 01-27-2016

The Ottawa Hospital Senior Management - (Renée Légaré Executive Vice-President and Chief Human Resources Officer)

"Prior to joining TOH, Renée was the Senior Vice President, People at the Canadian Air Transport Security Authority (CATSA), where she was recognized for her strong leadership skills, her passion for people and her desire to make a difference. She brings to the organization over 20 years of extensive experience in human resources such as change management, performance management and measurement, employee and labour relations, coaching, mentoring, and talent management and development. Renée earned her Master's degree in Industrial Relations from Université du Québec en Outaouais and an Honours degree in Economics from Université de Sherbrooke. She has also completed her Director's Education Program with the Institute of Corporate Directors. Renée is currently studying to receive her PHD in Industrial Relations." TOH

Why Leadership Development Efforts Will Continue to Fail

By Shawn M. Galloway (June 2017, Occupational Health & Safety)

Ottawa Hospital files lawsuit against former directors, contractors

"Alleged kickbacks include luxury trips, discounts on cars, free personal home renos" (CBC News, Jan 06, 2016)

Former director fires back at Ottawa Hospital over fraud claim

"Frank Medwenitsch 'had his reputation destroyed,' says counterclaim seeking more than $350K"(CBC News, Jun 03, 2016)

Ottawa Hospital denies defaming former director accused in kickback scheme

(CBC News, Aug 01, 2017)

Ottawa Hospital director accused of fraud was 'loyal and honest,' defence claim says

(CBC News, July 29, 2017)

New site could add costs to Ottawa Hospital construction: Poilievre ""The Ottawa Hospital is responsible for the cost of the construction project."

(Ottawa Sun, June 23, 2017)

Ottawa Hospital clean-up could be more costly than previously announced

(Ottawa Metro News)

Patients with emergency surgery delays have higher risk of dying, study finds - Nearly 20 per cent of Ottawa Hospital patients experienced a delay, researchers found

(CBC News, Jul 10, 2017)

No ride home, no kidney stone surgery, Ottawa man told - "A military veteran suffering from a painful kidney stone had his surgery at an Ottawa hospital abruptly cancelled last month when a doctor discovered he didn't have a ride home"

(CBC News, Oct 02, 2017)

Hospital staff rally in Ottawa for more beds, end to funding cuts

(CBC News, Oct 27, 2017)

Jack Kitts, Ottawa Hospital president, says he won't step down amid contracts scandal

(CBC News, Mar 07, 2016)

Accreditation Canada

Health and Social Services Standards

Accreditation Canada

Commitment to Ongoing Improvement, Strong Staff Engagement Keys to Accreditation Success: The Ottawa Hospital, Jun 19, 2017 - On May 31, 2017, the Ottawa Hospital (TOH) issued a press release to announce that it had received the highest rating possible from Accreditation Canada (AC) – Accredited with Exemplary Standing. The hospital is the largest organization in Canada to receive that award, a cause for celebration, according to officials.

Absenteeism at The Ottawa Hospital: An Implementation Research Approach -
Thomas Hayes, BASc, MHA, MBA, Director of Safety and Security, The Ottawa Hospital

Ottawa Hospital targets high absenteeism - Union blames burnout from workplace stress "The Ottawa Hospital will keep an eye on how often its employees call in sick in an effort to address its unusually high absenteeism rate. "This is not about telling people that they have to come to work when they're sick,' said Thomas Hayes, director of occupational health and safety at the Ottawa Hospital". The rate is "significantly worse than most of our peers across the province" and is costing the hospital more than $20 million a year, said a memo to staff from CEO Dr. Jack Kitts this week. "There is an impact on our patients and co-workers when staff are not able to come to work," the memo said. "For those reasons we need you to make every effort to attend regularly at work." It went on to announce that the hospital's occupational health and safety department is launching a program to monitor and improve absenteeism levels. The average Ottawa Hospital employee calls in sick 12 or 13 times a year, and sick leave makes up five to six per cent of total work hours, said Thomas Hayes, director of occupational health and safety for the hospital. That is a problem, he added, because patients say it's important for them to be cared for by the same staff from day to day. Other staff may also face an increased workload when some of their co-workers are absent". "The fact that people don't show up for work is often … a reaction to the fact that people are burned out, are working too much, don't feel support enough at work," said Lalonde, national representative for the Canadian Union of Public Employees. He added that the hospital has cut more than 100 positions in the last few months. (CBC News, May 7, 2010)

Accreditation Canada - Leslee J. Thompson, CEO

"Having successfully led many organizations and systems through tough periods of change, including the high-profile turnaround of a major teaching hospital where she was CEO, Leslee is frequently asked to speak, write, and serve on influential boards and panels. She has been Board Chair of the Canadian Foundation for Healthcare Improvement, Chair of Council of Academic Hospital Ontario, Assistant Professor at Queen's University and a member of Ontario Health Innovation Council to name a few."

Leslee J. Thompson - President and CEO of Kingston General Hospital

Celebrations take place for outgoing CEO Leslee Thompson - January 22, 2016

Leslee J. Thompson - President and CEO of Kingston General Hospital

Celebrations take place for outgoing CEO Leslee Thompson - January 22, 2016

78% of frontline hospital workers in Kingston have been assaulted in last year: CUPE poll - Kingston General Hospital

CUPE poll finds 78 % of Kingston front line hospital workers have been assaulted in the last year - November 9, 2017

Joanna Noonan, Manager of Occupational Health, Safety and Wellness - Kingston General Hospital

""People in many areas of the hospital spend a lot of time each day sitting down. This now gives groups an option of being a little more active when getting together," says Joanna Noonan, Manager of Occupational Health, Safety and Wellness. "Even if everyone agrees to stand up for just a part of a meeting, that's a great start." - July 29, 2015

The Failure-Tolerant Leader

Richard Farson and Ralph Keyes (Harvard Business Review)

Dysfunctional Leadership & Dysfunctional Organizations

Med Yones, International Institute of Management (pdf)

Study of Leading Indicators for Occupational Health and Safety Management Systems in Healthcare

Thomas Hayes, The Ottawa Hospital

Welcome to the 'Study of Leading Indicators for Occupational Health and Safety Management Systems in Healthcare' website

This project, funded by the Ministry of Labour, will examine a new approach to strengthening the occupational health and safety system in healthcare settings - "Ontario's healthcare sector employs more than 800,000 employees with hospitals being the largest employer. Every day, healthcare workers encounter physical risks from repetitive lifting and moving, chemical risks, risks of infection and threats of violence. For the past five years the healthcare sector has ranked second highest for lost-time injury rates (injuries that result in lost time from work) among the 16 Ontario sectors, with female healthcare workers currently ranked the highest among all occupations for lost-time claims (WSIB, 2014). In addition, approximately $2.5B is spent yearly on occupational injuries (WSIB, 2012). Despite an increased focus on improving Ontario's Occupational Health and Safety System, the injury statistics are not improving significantly. One of the potential keys to changing this trend is the development of a culture of healthy and safe workplaces, including the effective utilization of leading indicators within Occupational Health and Safety Management Systems (OHSMS). Leading indicators are workplace characteristics that precede occupational health and safety outcomes and, if changed, are expected to change these outcomes. Using leading indicators to measure health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare. Therefore, the aim of this study is to conduct a longitudinal study implementing leading indicators and evaluating the effectiveness of this intervention on improving selected health and safety workplace indicators" - (funded by the Ontario Ministry of Labour)

Credentials Versus Competence

by Glyn Jones (COS - Thomson Reuters Canada)

Does Poor Safety Equal Poor Management?

Does Poor Safety Equal Poor Management? - Terry L. Mathis | Nov 11, 2013 (EHSToday)

Queensway Carleton Hospital Administration Leadership - (Mr. Greg Hedgecoe, Vice President Human Resources & Organizational Effectiveness - former Ottawa Hospital Director of Talent Management and Leadership Development)


Hiring Qualified Employees


Ontario Public Sector Salary Disclosure 2016


Search Ontario's 2016 Sunshine List

(CNC News Mar 31, 2017)

Why People Lie

(Dr. Paul Ekman - 2009)

The Cost of Conflict Incompetence

Centre for Creative Leadership

Leading Indicators for Workplace Health and Safety: a user guide

(Work Safe Alberta)

The Ontario Ministry of Health and Long-Term Care

(The Minister of Health and Long-Term Care - Hon. Dr. Eric Hoskins - Resigns)

Construction fraud can be hard to nail down

Shannon Moneo , Journal Of Commerce

Defendant in MUHC fraud trial seeks to have charges tossed - One of the defendants in the McGill University Health Centre fraud trial

"what one investigator called "the biggest case of corruption fraud in Canadian history" — is seeking to have charges against him tossed, based on the Jordan ruling. (CBC News, Sep 27, 2017)

Defendant in MUHC fraud trial denied request to have charges stayed

"Yohann Elbaz's request to have his charges stayed in the McGill University Health Centre (MUHC) fraud trial was rejected Monday. Elbaz will have to stand trial in October 2018 after all, facing charges of conspiracy, recycling the proceeds of crime and using false documents. " (CBC News, Dec 18, 2017)

IWK's finance chief steps down in wake of expense scandal

(CBC News, Sep 25, 2017) (CBC News, Sep 27, 2017)

Auditor general points to IWK expense scandal in warning about fraud risk

Michael Pickup says there were 'serious deficiencies in internal controls' at Halifax children's hospital - (CBC News, Oct 04, 2017)

Strategies for Learning from Failure

Amy C. Edmondson - Harvard Business Review

Canadians' health-care costs have skyrocketed: Study

(The Toronto Sun - August 1, 2017)

Comparing Performance of Universal Health Care Countries, 2017

(The Fraser Institute - 2017)

The Cost of Conflict Incompetence

Centre for Creative Leadership

Who Are The Difficult Employees? Psychopathological Attributions Of Their Co-workers - B. Kemelgor et al

B. Kemelgor et al (pdf)

Snakes in Suits - When Psychopaths Go to Work

Paul Babiak, Robert D. Hare

The Influence of Corporate Psychopaths on Corporate Social Responsibility and Organizational Commitment to Employees

JOURNAL OF BUSINESS ETHICS, Volume 97, Number 1, 1-19, DOI: 10.1007/s10551-010-0492-3

The Implications of Corporate Psychopaths for Business And Society: An Initial Examination And A Call To Arms

CLIVE R. BODDY - Middlesex University Business School (pdf)

The importance of human resources management in health care: a global context

Stefane M Kabene, Carole Orchard, John M H, Raymond Leduc, Human Resources for Health 2006, 4:20

A Think Piece: How HR Caused Toyota To Crash

ERE MEDIA - By Dr. John Sullivan

Whistleblowing Systems – A Guide

Canadian Standards Association
Reports have shown that whistleblowing is one of the most effective methods for identifying activities that could potentially cause harm to an organization. An effective whistleblowing system can also lead to reduced costs, better employee engagement, enhanced stakeholder confidence and improved performance. Whistleblowing Systems – A Guide is developed to help organizations establish and manage an effective mechanism for whistleblowing activities. The guide provides a background on existing Canadian laws and codes as they relate to whistleblowing as well as a summary of the key performance benefits associated with the implementation of a whistleblowing system.

Human Resource Management in Health Care: Principles and Practice

L. Fleming Fallon Jr., MD, DrPH, MBA, Bowling Green State University Charles R. McConnell, MBA, CM - ISBN-13: 9780763735319

Transformational Leadership and Evidence-Based Management

Committee on the Work Environment for Nurses and Patient Safety - Ann Page, Editor,

Management practices can make employees sick - The Leadership Factor

ACCIDENT PREVENTION January/February 2002 (PDF file)

Effects of Job Strain, Hospital Organizational Factors and Individual Characteristics on WorkAmong Nurses

Workplace Safety and Insurance Board (WSIB) of Ontario (pdf)


Willson Lewis LLP (ppt)

Nurse staffing and patient safety: current knowledge and implications for action

Jack Needleman, Harvard School of Public Health, Boston, MA USA and Peter Buerhaus, Vanderbilt University School of Nursing, Nashville, TN, USA -
International Journal for Quality in Health Care 15:275-277 (2003)

Keeping Patients Safe: Transforming the Work Environment of Nurses

National Academy of Sciences

Healthcare use before and after a workplace injury in British Columbia, Canada

J A Brown, P McDonough, C A Mustard, and H S Shannon
Occup Environ Med. 2006 June; 63(6): 396–403

Nursing Crisis: Retention Strategies for Hospital Administrators

Chan, C. C. A., McBey, K., Basset, M., O’Donnell, M. & Winter, R. (2004). Nursing Crisis: Retention Strategies for Hospital Administrators, Research and Practice in Human Resource Management, 12(2), 31-56.

Organizational safety: Which management practices are most effective in reducing employee injury rates?


IRSST (pdf)

Workforce Reduction Practices in Canadian Hospitals

Kent V. Rondeau, University of Alberta; Terry H. Wagar Wilfrid, Laurier University - (pdf)

A Snapshot of Worklife Measurement in Canadian Healthcare Organizations:
Indicator Survey Results

Quality Worklife-Quality Healthcare Collaborative - June, 2009 (pdf)

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