TORONTO, June 28, 2012 /CNW/ - A set of recommendations released today promises Ontarians improved access to quality primary care, system integration and effectiveness, and cost savings for the government and taxpayers.
The recommendations are contained in a provincial Task Force report led by the Registered Nurses' Association of Ontario (RNAO) with representatives from key organizations that work in primary care. RNAO launched the Task Force in February in response to the gross under-utilization of primary care nurses, and the belief that the sustainability of Ontario's health-care system depends on the success of primary care reform. "Our system is based on an illness model and we need to shift it to one that places greater emphasis on health promotion, disease prevention, and chronic disease management," says Rhonda Seidman-Carlson, president of RNAO, adding that "the full utilization of nurses is the key to our primary care success."
Primary Solutions for Primary Care lists 20 recommendations and ambitious timelines to maximize and expand the role of Ontario's 4,285 primary care nurses - Registered Nurses and Registered Practical Nurses - to eliminate the care gaps that prevent patients from receiving same day care and co-ordinated health system navigation.
The Task Force calls for its recommendations to be implemented in two phases. Phase one, to begin immediately, focuses on maximizing the current scope of practice of RNs and RPNs. Phase two, to be implemented over a two-year period from 2013 to 2015, looks at expanding the scope of practice for primary care nurses to further benefit patients and the health system.
Among the recommendations:
- The Ontario government immediately appoint a committee, co-sponsored by RNAO and the Ministry of Health and Long-Term Care to roll out Task Force recommendations
- The government and LHINs issue immediate directives to employers to utilize RNs and RPNs to their full scope of practice
- Employers, educators, associations and nurses work together to ensure RNs are empowered to conduct a broad range of clinical assessments and interventions, health education, and chronic disease prevention and management
- Government and regulator work on legislative changes required to authorize RNs to prescribe and dispense medications
- Government and regulator work on legislative changes to authorize RNs to identify and communicate a diagnosis
- Government and regulator work on legislative changes to authorize RNs to order diagnostic and lab tests
- LHINs and primary care organizations utilize RNs to co-ordinate care and patient system navigation
- Employers, educators, associations and nurses work together to ensure RPNs are empowered to take leadership roles in evidence-based clinical and educational health programs
Primary care nurses work in Aboriginal health access centres, community health centres, family health teams, nurse practitioner-led clinics and physicians' offices. A recent survey revealed that only 61 per cent of RNs in primary care work to their full scope, with most saying they are capable of doing much more.
"Our research revealed that RNs and RPNs who work in primary care nursing aren't being utilized effectively. There is an incredible amount of untapped potential and we need to change that so nurses can do more for their patients and make our system more efficient," says Judie Surridge, co-chair of the Task Force and president of the Ontario Family Practice Nurses.
Doris Grinspun, chief executive officer of RNAO - who, along with Surridge, co-chaired the Task Force - says the leadership that resulted in Canada's first nurse practitioner-led clinic in Sudbury in 2007 and 24 NP-led clinics five years later is exactly what needs to happen now with primary care nurses. "We commend the Ontario government for the bold action it took to expand the scope of practice of nurse practitioners so they can fully serve the public. It has benefitted patients in spades. Now, we need to do the same with RNs and RPNs. If RNs can prescribe in the UK, why not in Ontario?" says Grinspun, adding that "the changes proposed in the report are long overdue, and implementing the recommendations will lead to higher satisfaction and better health outcomes for patients, improved system effectiveness, and reduced costs for taxpayers."
RNAO says the report's recommendations are in line with what the Drummond Commission concluded about Ontario's health system. Reiterating Don Drummond's assertion that expanding the scope of practice of nurses is one way to guarantee the sustainability of the province's publicly-funded, not-for-profit health system, RNAO is calling on the government, employers, associations, regulators, unions, and nurses themselves to act immediately on the Task Force's recommendations to benefit Ontarians.
The Registered Nurses' Association of Ontario is the professional association representing registered nurses in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve.
Download a copy of the Task Force's report www.rnao.ca/primary_care_report.
"Nurses play an integral role in Ontario's health-care system. Our government is committed to ensuring our health-care providers, including our primary care nurses, are working to their full scope of practice. Working with our health-care providers, we have made tremendous progress in the advancement of primary health-care delivery and we look forward to continuing to make even further progress to realize the increased role our primary care nurses can provide to Ontarians."
Hon. Deb Matthews, Minister of Health and Long-Term Care
"As the province faces a ballooning deficit and crippling debt, it's critical that both government and stakeholders come together to find cost savings and innovative solutions. The RNAO's expert panel Task Force has put some legitimate ideas on the table, now it's up to the government to develop these ideas into good policies. Ontario's Progressive Conservatives look forward to working with RNAO to make Ontario's health care system strong and sustainable."
Christine Elliott, MPP, Progressive Conservative Party
"Ontario's New Democrats overwhelmingly support the recommendations in RNAO's Primary Solutions for Primary Care report and feel that registered nurses and all other health professionals must be enabled to work to their full scope of practice across the health system. Expanding the scope of practice of RNs to include the ability to diagnose and treat common conditions will transform access and quality within primary care and across the health system. We call on the government to provide decisive action by promptly implementing all of the task force's recommendations for the benefit of Ontarians and the health system."
France Gelinas, MPP, New Democratic Party of Ontario
"Many reports, like the Commission on the Reform of Ontario's Public Services, have made recommendations to improve health care. But it is vital for those working in the sector to bring forward their ideas. It is wonderful to see the RNAO engage so thoughtfully with proposals to improve the effectiveness, efficiency, and quality of health care. The focus on scope of practice, including an expanded role for nurses, addresses an area the Commission believed holds considerable promise."
Don Drummond, Chair, Commission on the Reform of Ontario's Public Services
"The Canadian Nurses Association (CNA) is encouraged by this report, its recommendations and its emphasis on patient-centred care. This work underscores the important role interprofessional teams play in our publicly funded, not-for-profit health-care system. Having registered nurses and all other health professionals working to their full scope of practice in primary care teams produces better health outcomes, improves access to services, and will help sustain Medicare and strengthen it for future generations."
Barb Mildon, President, Canadian Nurses Association
"The Ontario Nurses' Association (ONA) was very pleased to participate in RNAO's Primary Care Nurse Task Force to respond to the gross under-utilization of thousands of nurses in Ontario's primary care system. The task force's solution-focused report addresses the key barriers to improving access to timely and quality care for Ontarians - and we urge government and employers to act now."
Linda Haslam-Stroud, President, Ontario Nurses' Association
"The Association of Ontario Health Centres (AOHC) believes the report of the Primary Care Nurse Task Force is a pivotal first step to ensuring that nurses and all members of the interprofessional team are fully utilized to deliver timely access to people and community-centred primary health care in Ontario. We are already acting on this report's recommendations. The Association's 73 Community Health Centres, 10 Aboriginal Health Access Centres and 15 Community Family Health Teams are working on a goal to ensure all health providers work to their full scope of practice within three years."
Adrianna Tetley, Executive Director, Association of Ontario Health Centres
"Ontario's 200 Family Health Teams recognize the significant role of nurses in delivering team-based primary care to patients. The Association of Family Health Teams of Ontario (AFHTO) feels strongly that nurses and all health professionals must be supported to deliver the best value possible to Ontario's patients. AFHTO was a proud member of this task force, and we commend the RNAO for assembling a wide group of stakeholders to examine the evidence and explore how our health system can reap the full benefit of the competencies, knowledge, and skills of our primary care nurses."
Angie Heydon, Executive Director, Association of Ontario Family Health Teams
"Enabling all health care professionals to work to their full scope of practice is something the Ontario Hospital Association has long supported, so we welcome the RNAO's report and will read it with interest. We also appreciate the importance of a focus on primary care, as the underpinning of a high-performing health system."
Pat Campbell, President and CEO, Ontario Hospital Association
"The Ontario Community Support Association (OCSA) applauds RNAO's leadership in bringing about clear and achievable recommendations for system transformation and enhancements. OCSA sees this groundbreaking report as a starting point to strengthen the ability of interprofessional teams and support staff to deliver accessible and high-quality care to Ontarians, while promoting health system effectiveness."
Susan Thorning, Chief Executive Officer, Ontario Community Support Association
For further information:
To arrange an interview with the chairs of the Task Force or a primary care nurse, please contact:
Director of Communications
Registered Nurses' Association of Ontario (RNAO)
Melissa Di Costanzo
Registered Nurses' Association of Ontario (RNAO)