In the letters to the editor section of the Chronicle Journal, October
23, 2004, I am glad to see that the chairman of the board of the
Thunder Bay Regional Hospital, Mr. Ron Nelson is moving to increase
the number of full time nurses jobs at the hospital. It was a point
that I brought forward two years ago at the annual hospital board
meeting years ago and was one of the reasons we were losing qualified
nurses to the US; graduate nurses could not find full time
employment.

It is interesting to note that Mr. Ron Nelson was one of my professors
at Lakehead University School of Business some 25 years ago, and at
that time it was taught to me that the way of the future was to
implement a ‘system’s approach’ to decision making in organizations.
In fact it was described as linear matrix, where everyone was equally
important and involved in the decision making process.

I say this because just last week I attended a presentation whereby
Dr. Yaro Kotalik announced that the province of Ontario was moving to
impliment a ‘systems approach’ to health care, the last province to do
so.

So while the province of Ontario lags behind many of the generally
accepted approaches to health care, I take this opportunity to offer
my former professor, the chair of the Board of Govenors, the following
recommendations.

1. Expand the environment that will hold a greater compassion towards
the staff, nurses, doctors, and administrators in dealing with the
complex challenges of a changing world. We MUST NOT expect perfection,
there is always room for improvements; nothing is perfect.

2. Expand the system to develop a complete integrated vertical matrix
system of ALL affected parties in and outside the hospital relating to
health services provided. More staff representation on decision making
committees. (Sars has taught us the important role of cleaning staff
and procedures)

3. Hire more specialized qualified nursing staff, ie Geriatric Nurses.
Use a team approach. (The hospital just announced that they are hiring
more full time staff)

4. Improve the integrity of review services to investigate
compliments, and more importantly complaints to determine, with hind
site the important details that would avoid such problems in the
future. Mandatory feedback forms. (To improve a system you want to
know whats wrong- the devil is in the (missing) details.

4. Develop a framework for staff to deal with the negative effects of
prescription drugs.

Ie Vioxx, and PPA – side effects, adverse effects, paradoxical
effects.

5. Expand the use of modern technology to improve the efficiency of
services.

6. Prevention is the cure. Analysis of clients to find core problems
and make suggestions.( Ie: Baseball safety first base developed to
avoid injuries. ) More focus on client behaviors that lead to
hospitalization. .

7. More security in the hospitals for visitors. While staff have
professional codes, visitors do not. Family visitors should receive
free parking passes.

8. Pressure the government to make our system a truer public system,
our system is merely an univerally funded government insurance plan.
Most services are provided by private sectors except for hospitals.
and place doctors on a per capita salary. The current fee structure
creates an inverse relationship between a doctor’s revenue and the
patients health. The current fee per visit system employed by Medicare
towards family doctors as it rewards inefficiencies, ineffective
treatments, and a doctor shortage; all of which put more an more
pressure on the hospitals.

9. Non-profit hospitals normally operate in the red, and use a great
deal of public funds to build, private hospitals while competition to
the public hospitals, if they bill through the medicare program, like
clinics, they are a great suppliment to our overburdened health
system.

10. Judging by the lack of participation in the election of hospital
board members at the annual meeting it is hoped the the province is
allow for a democractic election of representatives perhaps at
municipal elections.

Let us make the hospitals more democratic, we are in Canada.