5-Year Health Action Plan – Progress update

Becoming the Best: Alberta’s 5-Year Health Action Plan outlines 5 key strategies to drive improvements in our health system. Specific actions and clear performance measures support the strategies that will help us achieve our ultimate goal of creating the best-performing publicly funded health system in Canada.

Actions in the plan are marked by several completion date milestones: immediate actions by June 2011; short-term actions by March 2012; and mid- to long-term actions by March 2015.

Last updated: March 2013.      

Update 2

The summary below is on actions that were scheduled to be completed by March 2012. This is a status update reflecting that point in time. Note: Each item number corresponds to a strategy item in the 5-Year Health Action Plan

1.2 – Add 12 new treatment spaces to the emergency department at the Stollery Children's Hospital, plus a dedicated entrance and separate waiting room and triage desk for patients who are mobile.

Complete – Edmonton’s first emergency department dedicated to pediatric and family-centred care opened in January 2012. A $26.3-million renovation at Stollery Children’s Hospital expanded and separated the Stollery’s emergency department from the University of Alberta Hospital. Phase 1 opened in January 2012 with a separate ambulatory entrance for patients and their families, along with a separate child-friendly waiting room, triage area and registration area. About 1,240 square metres – 13,350 square feet – of newly constructed space have been added to the existing emergency department. Phase 2 is scheduled to fully open in late 2012.

1.8a – Expand the role of emergency medical technicians and paramedics to treat patients on-site instead of taking them to an emergency department, as appropriate.

Complete – In specific situations, Emergency Medical Services’ (EMS) paramedics can assess and treat patients on-scene without transporting them to hospital. For example, a call from an individual with diabetes whose sugar levels are too high/low can be treated on-scene. The stabilized patient is referred to followup with their family physician.

In January 2012, two new similar clinical protocols began being piloted in the Edmonton metropolitan area – one for fainting events in adult patients younger than 40 years of age and another for seizure events in patients with a history of seizures. Through the protocols, paramedics treat these patients on-scene and, if hospital transport is not required, patients are left in the care of a family member who can ensure there is no change in the patient’s condition after EMS leaves.

EMS can also now transport patients to urgent care centres in metropolitan areas where their care needs can best be met.

1.8b – Expand the role of emergency medical technicians and paramedics to identify older, at risk, individuals who may need screening for falls, home care, and other services (pilot in Calgary, Edmonton, and Parkland County).

Complete – The Community Health and Pre-Hospital Support program (CHAPS) has been rolled out across the province. Through CHAPS, individuals who may need home care or other services to lower their risk of falls and/or deteriorating health are identified by EMS practitioners using an assessment tool. Once at-risk individuals are identified, they are referred to home care. Pilot projects in Calgary, Edmonton and Parkland County showed the program reduced the number of repeat EMS calls and emergency department visits. In Calgary, for example, for all patients referred to CHAPS between October 2010 and October 2011, they had a total of 609 EMS events in the 90 days including, and prior to, the date of their CHAPS enrolment. In the 90 days following CHAPS enrolment, these same patients had a total of 369 EMS visits, for a decrease of 240 EMS events or a 60.5% reduction in EMS usage by these patients. The CHAPS program is part of the larger ‘Emergency to Home’ project.

1. 9 – Implement programs in emergency departments (Calgary, Edmonton, Red Deer, Lethbridge, and St. Albert) to enable seniors to return home with added home care support rather than be hospitalized.

Complete – The goal of the Emergency Department (ED) to Home program is to keep seniors safe and healthy in their communities and to help them avoid preventable hospital visits. Through the program, Registered Nurses connect ED patients (ages 65 and older), with other appropriate, community health-care services that can help them make necessary adjustments in their routines, medications and/or living environment. The program was implemented in Calgary, Edmonton, Red Deer and St. Albert throughout 2010, and was expanded to Medicine Hat, Ponoka and Wetaskiwin last year. During the 2010 pilot project, 17% of seniors who visited an ED in Edmonton, Calgary and Red Deer were connected with community home care programs to better manage their health needs.

1.14 – Perform an additional 400 endoscopies (medical procedure to view the digestive tract).

Complete – Approximately 3,555 additional screening colonoscopies were completed between September 2011 and March 2012. Work is underway on the Alberta Colorectal Cancer Screening Program to increase the number of screening colonoscopies performed. This provincial colorectal cancer screening program is co-ordinated by AHS in partnership with health care providers. The program is dedicated to increasing the number of men and women aged 50 to 74 who have regular colorectal cancer screening.

1.18 – Develop a provincial plan for cancer that considers immediate and future needs for treatment, specialists, and other resources.

Complete – The Alberta Cancer Plan has been developed in consultation with stakeholders and will be released in the near future.

1.20 – Develop a standardized approach to assess, refer and book patients with specialists (cancer, cardiac, hip/knee, and cataract).

Complete – AHS has developed a standardized referral approach that ensures patient information is fully and freely shared between general practitioners and specialists across the province. This approach will ensure that patients receive high quality, streamlined care as well as timely followup with their family doctor or primary health care team. Work is underway regarding the implementation of this approach.

Meanwhile, two "rapid access" clinics, operating in tandem in Calgary and Edmonton, are now providing a single point of entry for lung cancer patients across the province, as part of the Expedited Management of Lung Cancer Program. Specially trained nurses and nurse practitioners, with physician support, assess and triage patients before navigating them through the many diagnostic tests needed before a treatment decision can be made. About 4,000 patients a year are expected to be referred to the clinics by 2013. The goal is that by March 2013, 75% of patients will wait no longer than 30 days from the time of referral from their primary care physician to when a treatment decision is made. Also, that patients will wait no longer than 60 days from the time of referral from their primary care physician to surgery.

1.23 – Develop integrated care and treatment plans for at least three major diseases, including mental illness, heart conditions and bone and joint health.

Complete – The target for this action was exceeded. More than three clinical pathways (redesigned protocols for care and treatment) were developed, including:

  • Arthritis – The goal of the pathway is to improve effectiveness and efficiency for arthritis patients across their continuum of care, as well as to increase public awareness, education and satisfaction within the arthritis care continuum. Provincial integrated care pathways for osteoarthritis and rheumatoid arthritis were created by a multidisciplinary working group.
  • Hip and Knee Arthroplasty – By implementing a standardized clinical pathway, 12 arthroplasty sites across Alberta have developed individualized plans that are targeted to reduce length of stay, reduce surgery wait times, and improve patient experience and patient safety. It is projected that the provincewide implementation of this clinical pathway will have the potential to free up 16,000 hospital days, ultimately creating improved patient access throughout the province.
  • Hip Fracture – Acute Care – The goal of the hip fracture clinical pathway is to have patients receive surgery within 48 hours of injury and have patients mobilized one day after surgery. The Bone & Joint Clinical Network oversees the hip fracture clinical pathway, developed by multi-disciplinary clinicians across the province to ensure a clinical pathway for hip fracture is implemented provincewide.
  • Depression – A depression pathway for use by primary care physicians ensures that patients who present with depression are provided with a plan of care supported by evidence-based practice. The pathway was developed by the Addiction & Mental Health Clinical Network. The goal is to collaboratively spread this pathway to the rest of Alberta, with frontline clinicians adapting it to their local services and resources.

1.26 – Consult with health-care professionals to develop policies for a primary navigation model for use in Alberta’s health system.

Complete – Albertans have expressed their difficulties in accessing health services in an integrated manner, particularly as they transition from one service to another. As a result, Alberta Health and Wellness AHS have developed the foundation of a provincewide Health System Patient Navigation plan. The plan will improve Albertans’ access to health services and their health care experiences, especially during key life transitions and transitions among services. The navigation plan will provide a range of supports to assist Albertans in practising wellness and self-care, and when necessary, help them to make their way through the health system. The plan will also improve continuity and co-ordination of care, and contribute to the efficiency of the health-care system through appropriate use of resources. Alberta Health and Wellness and AHS are working on a proposal for the phased-in implementation of Health System Patient Navigation across the province.

2.1 – Add at least 2,300 continuing care spaces to support seniors and people with disabilities.

In progress – AHS is working with the Government of Alberta to add more than 3,000 continuing care beds across the province over the next three years as part of a strategy to increase access and care choices for seniors. These spaces are in addition to the more than 21,683 continuing care spaces currently in Alberta. There were 2,157 spaces of 2,300 target spaces opened as of March 31, 2012. AHS expects to meet the 2,300 target in the summer of 2012. AHS anticipates the additional beds added in the next three years will significantly reduce the number of people waiting for placement and the length of time they have to wait.

2.4 – Expand home care hours to allow at least 3,000 more people to receive home care services.

Complete – The target in this action was exceeded. Approximately 105,000 Albertans received home care services in 2011-12 compared to 100,300 the previous year, an increase of 4,400 individuals – or 4.4%. The target was to add 3,000 by March 31, 2012. AHS continues home care redesign work in partnership with Alberta Health and Wellness.

2.5 – Update policies and services to ensure consistency in home care services across the province.

Complete – Alberta Health and Wellness is working collaboratively with Alberta Health Services through the Home Care Redesign Initiative to identify and address provincial variation in home care service delivery within Alberta. The goal is to provide seniors with access to services and supports to help them remain healthy and independent as long as possible.

2.7 – Test effectiveness of selected new technologies – such as monitoring devices for dementia clients and prompting devices to assist clients to take medication as prescribed – in two pilot communities (Grande Prairie and Medicine Hat).

Complete – A Continuing Care Health Technology Project was completed in Grande Prairie and Medicine Hat. The project tested two personal emergency response systems and one medication reminder system.

2.10 – Increase and enhance education, care, respite, and support services provided to family caregivers.

Complete – A Caregiver Support and Enhanced Respite Demonstration Project was completed in the Edmonton Zone. The project developed a co-ordinated approach to identify at risk caregivers, assess their need for caregiver support services and provide needed services.

2.11 – Pilot a “community initiatives” program in Edmonton and Jasper that connects seniors, neighbours, and volunteers to support seniors aging in their homes.

Complete – Grant funding was provided to the municipality of Jasper and the City of Edmonton to develop, pilot and evaluate different models of community engagement. The models were intended to encourage neighbours and volunteers to support seniors and persons with disabilities to live active, independent lives in the community.

2.14 – Add additional palliative care.

Complete – The 20-bed Santuri Hospice opened in November 2010 at the Peter Lougheed Centre in Calgary, increasing the total number of hospice beds in the Calgary zone to 134, a 17% increase. Hospice care, also known as palliative care, provides support to patients and their families/caregivers to prepare for, and manage, end-of-life and the dying process and to cope with associated loss and grief.

2.15 – Increase supportive-living beds for people with dementia.

Complete – Over 300 net new Supportive Living Level 4 dementia spaces were opened as of March 31, 2011. Another 390 net new spaces in the same level of care were opened as of March 31, 2012. In addition, over 1,800 registered nurses were trained in dementia and delirium through the Nurses Improving the Care of Hospitalized Elderly (NICHE) program. Patients who require a supportive living Level 4 bed have medical needs that can be managed by licensed practical nurses under the guidance of a registered nurse. These individuals may have chronic diseases and/or dementia, and may require assistance with activities of daily living, such as hygiene, toileting and meals.

2.16 – Expand options for care to people who are disabled or have other special needs.

Complete – AHS is working with stakeholders across the province, and consulting with a medical ethicist, to develop an effective process for providing high quality care and a wide range of supports for individuals who are disabled or have other special needs.

2.21 – Develop and start to implement a five-year plan for continuing care. The plan will describe the full continuum of care from home care to long-term care, and will include capital plans and new ways of delivering continuing care services.

In progress – Alberta Health and Wellness is developing a continuing care policy framework that will outline policy directions for continuing care in Alberta. The framework will describe Alberta’s key policies going forward, help guide decision-making, improve the general public’s understanding of the system, and lay the groundwork for changes to the legislative framework.

2.23 – Revise standards to maintain quality and assurance.

Complete – The Continuing Care Health Service Standards are currently undergoing review and revision to ensure the continuing care system is flexible and responsive to the changing needs and expectations of its clients, to new models of care, and to emerging best practices. Compliance to the standards is mandatory for operators offering publicly-funded continuing care health services in Alberta. The revised standards will apply to all three streams of care: homecare, supportive living and long-term care.

3.1 – Expand Albertans' access to primary health-care teams, giving 100,000 more Albertans access to primary health care.

Complete – This action target was exceeded. As of March 31, 2012, there were a total of 40 Primary Care Networks (PCNs) serving over 2.8 million Albertans. This accounts for an additional 250,000 Albertans being served by a PCN during 2011-12. Alberta Health and Wellness continues to provide funding to PCNs to give Albertans increased access to primary health care. In addition, three Family Care Clinic pilots have opened in Slave Lake, East Edmonton and East Calgary to increase Albertans’ access to the health services they need. An evaluation process for the three pilots is in development.

3.2 – Increase involvement of nurse practitioners, physician assistants and other health-care providers in the delivery of primary health care.

Complete – Over the past year, more than 30 nurse practitioner-led outpatient clinics have opened in the province, improving access to a wide range of primary care services, from diabetes management to spinal injury care. Nurse practitioners are advanced practice nurses who, through additional education, are licensed to diagnose and manage chronic illnesses, order diagnostic tests and prescribe treatments and medications. They can manage independent clinics and carry their own patient caseload. Wait times for nurse practitioner clinics are typically shorter than for physician-led clinics.

In High River, hundreds of expectant moms are benefiting from an alternate model for maternity care in which physicians and midwives work collaboratively. Together, these health professionals offer women a wide range of maternity and birthing options to make their low-risk pregnancy a safe and highly personal experience.

3.2a – Better define "who does what" when providing primary health care.

Complete – Projects that have rolled out throughout AHS have defined the role of nurse practitioners and identified the changes and supports needed to best utilize the workforce. Nurse practitioners are highly qualified nurse specialists who are able to diagnose, order tests, prescribe treatment and medication as they manage independent clinics and carry their own patient caseload. Outpatients can book appointments directly with a nurse practitioner for initial assessments, treatment, care and followup. Wait times for nurse practitioner clinics are typically shorter than for physician-led clinics. These nurse practitioner-led clinics support adult and pediatric patients with renal disease, hypertension, spinal injuries and deformities, cardiac conditions, HIV, diabetes and epilepsy, among many other conditions.

3.2b – Expand role of pharmacists to help manage medication and provide injections.

Complete – Effective July 1, 2012, Albertans will be able to visit their pharmacist for prescription refills and six other publicly-funded health services previously provided mainly by doctors. Alberta pharmacists will be compensated for providing the new services, which include administering drug injections and altering prescriptions based on a patient’s health needs. The changes will make access to primary health care easier and more efficient. In addition to drug injections and prescription refills and changes, Alberta pharmacists will now bill for authorizing medication in a medical emergency, creating a Comprehensive Annual Care Plan, performing a Standard Medication Management Assessment and, if the pharmacist has additional prescribing authority, prescribing medication.

3.4 – Support the Access Improvement Measures (AIM) program as part of an overall quality improvement strategy to reduce wait times to see a primary care provider.

Complete – The AIM program brings family doctors and members of their teams together in learning collaboratives. They meet as a group with a facilitator four to six times a year to learn about measures and strategies to improve access. Between sessions, they try new strategies, learn what works and share best practices with the larger group. Since 2007, more than 1,000 physicians across the province have participated in AIM, and more than 85% of them say patient access has improved.

3.6 – Add at least 35 new mental health community spaces throughout Alberta.

Complete – AHS added nearly 25 mental health community spaces in 2010-11, and 43 mental health community spaces were added in 2011-12 in the Calgary, Central and Edmonton Zones. These are spaces in a community addiction program called Young Adult Treatment. It's aimed at 18- to 24-year-olds and teaches practical life skills. Patients receive three months of intensive residential treatment and pre- and post-care through outpatient services. An additional 21 addiction beds were also added in 2011-12 in the Calgary and Edmonton Zones.

3.7 – Add 65 mental health staff to schools and clinics.

Complete – The Mental Health Capacity Building component of the Children’s Mental Health Plan has been fully implemented and staffed. Over 75 newly hired mental health professionals have implemented community mental health promotion, prevention and early intervention programs in nearly 120 schools in approximately 50 communities across the province.

3.8 – Train staff in organizations serving young adults to screen, assess and intervene in cases related to addiction (Edmonton, Red Deer and Calgary).

Complete – As part of the ongoing In Roads training project, 70 individuals from nearly 20 community agencies in Edmonton, Red Deer and Calgary have received training in how best to support young adults with substance-abuse issues. Training also included how to encourage these individuals to make positive lifestyle changes. Community agency staff who participate in the project are given tools and techniques about screening, assessment, intervention and referrals that will improve their ability to make a positive difference in the lives of these young adults.

3.15 – Share information and best practices to prevent and manage chronic diseases.

Complete – In September 2011, AHS launched a provincial Obesity Initiative, a comprehensive five-year plan to address the prevention and management of obesity. Obesity is linked to 22 other chronic diseases, including up to 90% of all Type 2 diabetes. The initiative includes a suite of services, from community-based programs to intensive medical intervention, all designed to reduce the burden of obesity. The initiative encompasses a province-wide chronic disease self-management program, known as Better Choices Better Health, designed to help people living with ongoing health conditions such as diabetes, heart disease, arthritis, asthma, high blood pressure, chronic pain and obesity. The Obesity Initiative also encompasses MEND (Mind, Exercise, Nutrition, Do It!), a program that promotes healthy weights among children ages two to 13 and their families. Better Choices Better Health and MEND will be offered in about 60 communities over the next year.

3.18 – Develop a primary health-care plan for the province that better integrates primary care programs and services with a range of community and mental health services, resulting in an integrated primary health-care service.

In progress – Work has commenced on the planning of a Provincial Primary Health Care Plan.

3.19 – Develop indicators to measure and improve quality of care.

Complete – Indicators are key elements to support evidence-based decision making. The Ministry of Health is working with AHS to develop primary health care performance indicators for the three pilot Family Care Clinics located in Edmonton, Calgary and Slave Lake.

4.1 – Promote healthy eating and active living to families, in schools, and in communities through initiatives such as Healthy U, Alberta Healthy School Community Wellness Fund, Ever Active Schools, Health Promotion Coordinators for Healthy Weights and Communities ChooseWell.

Complete – These programs are ongoing under the broader Healthy U initiative. The Healthy U campaign, the School Community Wellness Fund, and the network of Ever Active Schools, Community ChooseWell communities and health promotion co-ordinators work together to build capacity in communities to encourage Albertans to become more physically active and eat healthier. The goal is to increase the number of Albertans who are physically active and to increase the number of Albertans who eat a balanced diet following the Alberta Nutrition Guidelines.

4.2 – Increase programs to support healthy births, including those targeted at Fetal Alcohol Spectrum Disorder.

Complete – An updated literature review, a jurisdictional review of five provinces, and an environmental scan of current policies and programs in Alberta has been completed to guide the development of a provincial maternal-infant health strategy.

4.3 – Standardize screening practices for newborns. Treat and follow up on identified issues.

Complete – The Newborn Metabolic Screening Action Plan was implemented in January 2011 to standardize screening practices for newborns. Through the screening program, blood samples are tested for 17 disorders (14 metabolic disorders, two endocrine disorders and cystic fibrosis). In 2010-11, 50,561 infants were born and registered in Alberta. There were 99.41% of these infants screened, with 183 positive screening results reported.

4.9 – Start implementation of the Alberta Injury Control Strategy to reduce driving collisions.

Complete – A framework and a draft plan to reduce injuries, including motor vehicle collision injuries, has been developed based on the Alberta Injury Control Strategy. Alberta Health and Wellness is working with other ministries including Transportation and the Alberta Centre for Injury Control and Research on actions that can be taken to strengthen leadership and reduce injuries and deaths.

4.10 – Strengthen programs that increase seatbelt use and the use of child safety seats.

Complete – A $50,000 grant provided by Alberta Health and Wellness to the Alberta Centre for Injury Control and Research has contributed to the achievement of a 95.1% seatbelt usage rate in Alberta. The grant also aided ongoing initiatives to increase awareness about the benefits of using occupant restraints correctly.

4.14 – Encourage more Albertans to be screened for colorectal, breast and cervical cancers through general and targeted awareness programs.

Complete – The AHS Cervical Screening Program completed a multi-year project with three Primary Care Networks in 2011. The program encouraged women to be screened, mailed them their Pap test results and reminded them of overdue tests. In September 2011, the Alberta Cervical Cancer Screening Program was expanded to include more women and to ensure higher screening rates and better outcomes for those at risk of developing cancer. Rural and remote communities access breast cancer screening through the Screen Test program, where a mobile mammography trailer visits communities where the service is not regularly available. In addition, colorectal cancer screening resources have been updated and made available to the public and service providers, including translations into six common languages.

4.16 – Develop and provide public education materials for prevention of the most common chronic diseases – diabetes, hypertension, heart disease, kidney failure and depression – including information on where to get help in the community.

Complete – AHS launched a provincial Obesity Initiative in September 2011. The initiative is a comprehensive five-year plan to address the prevention and management of obesity. Obesity is linked to 22 other chronic diseases, including up to 90% of all Type 2 diabetes. The initiative includes a suite of services, from community-based programs to intensive medical intervention, all designed to reduce the burden of obesity.

In May 2011, phase one of a new online health tool called MyHealth.Alberta.ca was launched. The website provides accurate, up-to-date health information and useful health tools.

4.18 – Implement an education and awareness campaign targeted at those at risk of getting a sexually-transmitted infection.

Complete – A provincewide syphilis prevention, education and awareness campaign was conducted in June 2011 to target people at risk for getting and spreading syphilis and other sexually-transmitted infections (STIs). The campaign included websites, TV ads, radio ads, posters, and video. An evaluation of the Syphilis Prevention Campaign indicated the campaign was successful in reaching Albertans. The majority (89%) of survey respondents across the province reported having seen or heard the campaign’s advertising. Most importantly, the increased awareness moved people to action as STI clinic nurses reported an increase in the volume of people visiting clinics and requesting STI tests. Results show STI testing increased by 17%. STI clinics saw an increase in positive test results for both chlamydia and gonorrhea.

4.19 – Increase availability of prevention co-ordinators to educate those at risk of getting a sexually-transmitted infection.

Complete – Twelve prevention co-ordinators were specifically hired to reach out to high-risk populations in an effort to increase knowledge about sexually transmitted infections and to change unsafe behaviours. An evaluation shows STI awareness increased as a result of the co-ordinators’ outreach efforts.

4.21 – Increase access to immunization for children under two years of age by increasing access to clinics.

Complete – AHS has implemented several strategies to eliminate potential barriers that could prevent parents or caregivers from immunizing their children. Reminder phone calls and mailouts are designed to reduce the number of no-shows at scheduled appointments. In some communities with high no-show rates, extra clinics – including some drop-in clinics – have been established to make immunization more convenient for parents and caregivers. AHS has also collaborated with community partners such as child care centres to identify under-immunized children.

4.22 – Increase access to influenza immunization for all Albertans by offering the vaccine in pharmacies and doctors’ offices.

Complete – Vaccine was distributed to additional community providers throughout the province by AHS Communicable Disease Control during the 2011-12 influenza season. These community providers included pharmacists and physicians. In Calgary and Edmonton for example, the vaccine was distributed to 15% more community providers than the previous season. In the 2011-12 influenza season, more than 874,000 doses of influenza immunization were administered across the province, a five% increase over the approximately 832,000 doses administered in 2010-11.

4.25 – Launch a long-term provincial plan on wellness – Health Alberta: A Wellness Framework – that will set the stage for government and other stakeholders to help Albertans improve their health.

Complete – A new draft strategy, entitled Wellness Alberta: A Strategy for Action 2012-2022, sets out goals and targets to address risk factors that contribute directly to the incidence and prevalence of the most common chronic diseases. The draft strategy will be taken to external stakeholders for consultation and input at the Action on Wellness Forum in fall 2012, before its release.

4.27 – Provide wellness information through www.HealthyAlberta.com, health providers and community services.

Complete – Healthy Eating and Active Living resources have been updated to align with the new Physical Activity Guidelines from the Canadian Society for Exercise Physiology and are available on the Healthy U website (no longer available.)

Building on the success of the International Action on Wellness Symposium that was held in the fall of 2011, a second International Symposium on Wellness is being planned for fall 2013. Participants will have opportunities to interact with leading experts from around the world and to develop new partners and strategies to promote wellness. The symposium aims to inspire new and current leaders by bringing together stakeholders from health, industry, communities, educational organizations, employers, all levels of government and others who have an interest in promoting wellness.

5.1 – Increase opportunities for training and education.

Complete – AHS reviewed its workforce needs and developed projections for specific health occupations as part of its Clinical Workforce Strategic Plan. AHS identified health care aides (HCAs) as a key occupation to be targeted for additional supports to education. Alberta Health and Wellness and AHS then partnered with Advanced Education and Technology and two post-secondary institutions to increase HCA educational capacity in a two-year pilot project.

Through the Health Workforce Action Plan, government's nine-year plan to address workforce issues in Alberta, $4.4 million was provided to implement year one of the pilot in 2011-12. During that year, 370 new HCA student spaces were created, which is a 21% increase over the previous year’s capacity. AHS used part of the funding to develop and execute a successful marketing campaign to attract students to fill the new spaces. The pilot project is continuing in 2012-13 with improvements based on lessons learned from year one. Approximately 1,000 HCAs graduate from publicly-funded programs annually.

5.2 – Improve workplace health and safety through certification and mentoring programs.

Complete – Safety modules for AHS’ leaders have been developed. Workplace Health and Safety learning and training activities related to asbestos awareness, incident investigation, hazard identification and control, workplace inspections and/or corrective action have been launched. It’s Your Move, a program that promotes safe handling of patients and clients, has trained more than 3,700 individuals.

5.3 – Recruit health-care providers to provide the right mix of health professionals in the province.

Complete – AHS developed a five-year Clinical Workforce Strategic Plan that outlines five strategies to best manage and utilize the clinical workforce to meet growing demands for health services. The strategies are: enhancing productivity (maintaining or improving outcomes while reducing costs); effectively utilizing the clinical workforce; increasing supply through targeted recruitment; using innovative approaches for attraction and retention, with a focus on student attraction and streamlining of hiring processes; and enhancing community-based services to decrease demand on acute care.

5.4 – Commit to recruiting at least 70% of registered nurses graduated in Alberta.

Complete – A program was developed to promote AHS as an employer of choice to new graduates at a number of academic institutions in Alberta. AHS hired 1,652 of the new registered nurse graduates available in 2011-12; 63% of whom were hired into regular (non-casual) positions. The 1,652 represents 98% of all new Alberta university/college registered nurse graduates. This is up from the previous fiscal year, when AHS hired 1,383, representing 87% of all new Alberta university/college registered nurse graduates.

5.8 – Improve provincial standards for prevention and control of infections in health-care facilities.

Complete – Two infection and prevention control standards have been revised and are posted on the Alberta Health website. The Standards for Infection Prevention and Control–Accountability and Reporting clarify the roles and responsibilities of AHS and outline AHS’ accountability for implementing, monitoring and reporting IPC standards, activities and concerns to the Ministry of Health. The Standards for Single-Use Medical Devices were developed for use in all health care facilities and settings and apply to critical and semi-critical medical devices. The standards provide a definition of a single-use medical device and outline responsibilities for written policies and compliance monitoring for use of single-use medical devices.

5.11 – Develop a province-wide system for tracking and controlling outbreaks of contagious diseases.

Complete – A robust, integrated information system is essential in our efforts to protect the health of Albertans. Alberta Health and Wellness and AHS are developing the Communicable Disease and Outbreak Management information system; a significant health information technology application that will be used by a large portion of public health workers in the province. Phase one – the notifiable disease and outbreak module – will be available for use in the fall of 2012. The larger initiative is ongoing and additional phases of the information system will be released over the next three to five years; sexually transmitted infections and tuberculosis in 2013, and immunization and adverse events following immunization in 2015.

5.12 – Ensure an approach to a health response plan is in place for all possible public emergencies including pandemic, acts of terrorism, and natural disasters.

Complete – An All-Hazards Health Emergency Management Approach document is being finalized. The Approach document will help define common roles, responsibilities and integration points between Alberta Health and Wellness and AHS during all types of emergencies. The goal is to provide a consistent way to plan for, and respond to, multiple types of hazards in the health system. The Approach document will be used as a foundation for the creation of an All-Hazards plan that will outline how Alberta Health and Wellness and AHS will respond to any emergency.

5.14 – Develop a process for evaluating the positive and negative impact of proposed public policy on the health of Albertans.

Complete – The Health Lens for Public Policy has been developed. It is a flexible and practical screening/assessment process for use when policies are developed and decisions are made on the potential health impacts (positive or negative) of a proposed government policy, plan or program. The Health Lens’ tools and process has been pilot tested. Plans to expand implementation for use both within the ministry and across government are being considered.

5.21 – Add electronic diagnostic imaging records (e.g., x-rays, MRIs, ultrasounds) to the provincial electronic health record.

Complete – As of March 31, 2012 90% of all DI Images performed in the province were captured and viewable on Alberta Netcare Portal. The Alberta Netcare Electronic Health Record Portal is an important tool for physicians, pharmacists and other health service providers to improve patient care by providing up-to-date information immediately at the point of care. Alberta is leading Canada in the successful implementation of a single, province-wide Electronic Health Record.

5.26 – Review the Public Health Act to incorporate changing roles and responsibilities.

Complete – The Public Health Act has been reviewed to consider any changes necessary to fully address the current and future public health needs of Albertans. The next step will be to develop policy directions to inform specific legislative revisions.

5.28 – Develop a new regulation under the Health Information Act that enables the creation of a warehouse of non-identifiable health data that can be used for health research.

In progress – Research on options for repository systems has been completed; however the regulation was not developed as the nature of this project has changed significantly. Work on the development of an Alberta Healthcare Data Repository (AHDR) is underway. The AHDR has the potential to broadly include health system information and to serve as a repository for researchers to access in the future. Policy options will be considered further as strategic work on the AHDR continues in 2012-13.

5.29 – Reduce duplication, streamline processes, and develop common information systems for all business functions.

Complete – AHS is reducing duplication and streamlining processes by implementing system-wide information and business systems that have replaced disparate, regionally-based systems. System-wide changes include a provincewide finance and supply chain application; a single budgeting and planning solution that will bring greater consistency, accuracy and transparency to AHS’ financial planning; and provincewide applications for storing and accessing patient data and records.

Update 1

The status update below is on actions that were scheduled to be completed by June 2011. Note: Each item number corresponds to a strategy item in the 5-Year Health Action Plan

Strategy 1 – Improve access and reduce wait times

Alberta is taking action to reduce wait times throughout the health system. We will do this by increasing beds and services, and looking at new and innovative ways of delivering programs. Read Alberta’s health system performance measures .

Reduce wait times in emergency departments

1.1 Develop and pilot two innovative medical assessment units (Royal Alexandra and Rockyview General Hospitals’ emergency departments) to allow inpatient treatment and admission to begin sooner.
  • Complete – The Rockyview General Hospital Medical Assessment Unit (MAU) opened in February 2010 and the Royal Alexandra Hospital MAU opened in October 2010. Patients who require admission to hospital may be transferred to an MAU after they've been assessed, instead of waiting in emergency. In the MAU, physicians and nurses can initiate consultations, treatment and diagnostics. As a result, wait times are reduced and access to hospital beds is improved. The MAUs are continually monitored to ensure efficient patient movement from emergency departments to patient care units.

AHS news releases: Feb. 25, 2010, and Nov. 8, 2010

1.3 Expand HealthLink to provide more advice to patients about their urgent and emergency care options.
  • Complete – HealthLink Alberta played an expanded, dual role in a public education campaign launched by Alberta Health Services in March 2011. This campaign promoted the provincewide telephone health information and advice service as one of a wide range of available health services, which also include family doctors, walk-in clinics and urgent care centres. During the campaign and on an ongoing basis, HealthLink Alberta also educates callers about these options. This campaign involved radio spots and signage at hospitals and other health-care facilities as part of the overall strategy to reduce pressures in emergency departments by ensuring Albertans receive the right care in the right place.

1.4 Introduce new processes to make hospital discharges more efficient and timely.
  • Complete – New computer software was implemented at the Rockyview General Hospital in December 2010 to help with patient discharge communication and to identify patients who are ready for discharge. The software is now being considered for implementation at other Alberta hospitals.

1.5 Implement a new overcapacity protocol to address crowding pressures and wait times in emergency departments.
  • Complete – New provincewide overcapacity protocols were launched in December 2010. The protocols are aimed at reducing peak pressures in emergency departments and other parts of the health system during periods of high patient volume. They build on current practices by setting new thresholds that, when reached, trigger immediate actions to reduce emergency department wait times. The initiative involves all areas of the health system working together to ensure patients receive timely access to care.

AHS news release: Dec. 17, 2010

1.11 Improve patient flow through hospitals by adding 360 new hospital beds.
  • Complete – 100% of the targeted 360 "net new" hospital beds were opened as of June 30, 2011. There were 214 beds opened in the Calgary area and 146 beds opened in the Edmonton area. The additional 360 beds include:
  • 12 detox beds;
  • 20 hospice beds (palliative care);
  • 33 medical assessment beds (for rapid patient assessment and diagnosis);
  • 2 medical observation beds (for patients who require a higher level of care, but not a critical care bed);
  • 249 transition beds (for patients who no longer require acute care, and are waiting for discharge to another community care setting); and
  • 44 geriatric mental health beds.

AHS news release: Feb. 14, 2011

Reduce wait times for surgery

1.13 Perform approximately 3,000 additional surgeries in 2010, including: 1,400 cataracts; 120 cornea transplants; and 200 orthopedic surgeries.
  • Complete – There were approximately 4,300 "net new" surgeries completed, in addition to the following:
  • Approximately 2,500 additional cataracts in Calgary and 2,500 more in Edmonton for a total of 5,000 more cataract surgeries;*
  • Approximately 200 additional cornea transplants; and
  • Approximately 290 additional orthopedic surgeries (hip and knee replacements);
  • Total additional surgeries = 9,790.

* With the addition of 5,000 surgeries, there were 33,700 cataract surgeries performed in 2010–11, up from 28,600 the previous year – an 18% increase.

AHS news release: Dec. 8, 2010

Reduce wait times for cancer care

1.16 Open a radiation therapy site in Lethbridge that will accommodate 600 patients per year.
  • Complete – Alberta Health Services opened a radiation therapy facility at the Lethbridge Cancer Centre on June 22, 2010 as part of a provincewide strategy to open a corridor of cancer treatment centres across Alberta. The Lethbridge Cancer Centre was renamed the Jack Ady Cancer Centre on Oct. 14, 2010. This facility means residents in southern Alberta will receive radiation therapy cancer treatment closer to home.

Help Albertans find their way around the health system

1.25 Establish a cancer patient navigation system that will improve the co-ordination of care, speed up patient access to resources and services, and help patients find answers to questions.
  • Complete – The "First Contact" program has been established so new patients can be contacted within 48 hours and given appointment dates. The program is operating at the Tom Baker Cancer Centre in Calgary for 4 tumour groups: genitourinary, breast, gastro-intestinal and hematology; and at the Cross Cancer Institute in Edmonton for 2 tumour groups: lung and breast. Implementation will continue for all cancer care sites and for all tumour groups by the end of 2012–13.

Strategy 2 – Provide more choice for continuing care

By 2030, 1 out of 5 Albertans will be more than 65 years old. We know seniors want to live independently for as long as possible. By 2015, we will add over 5,300 continuing care spaces in Alberta, the home care program will be strengthened, and more investment will be made in supportive-living options that combine housing with supports for daily living and health care. This will help reduce demand for hospital beds, ease congestion in emergency departments, and add capacity to the overall health-care system. Read Alberta’s health system performance measures PDF icon.

Enhance access, co-ordination and standards for continuing care

2.21 Develop and start to implement a 5-year plan for continuing care. The plan will describe the full continuum of care from home care to long-term care, and will include capital plans and new ways of delivering continuing care services.
  • Ongoing – Several government ministries (Alberta Health and Wellness, Alberta Seniors and Community Supports, Alberta Infrastructure, Alberta Housing and Urban Affairs) and Alberta Health Services are working together on a Continuing Care Implementation Plan that will address Alberta’s future continuing care service needs. The plan is currently being finalized.

Strategy 3 – Strengthen primary health care

Primary health care refers to the care a patient receives when they first enter the health-care system. By using a primary care team approach, patients see the health-care provider who can best address their needs, while ensuring the continuity of care that provides for the best health outcomes. By 2015, there will be further expansion and fine-tuning of primary health care, and addiction and mental health services will also become more integrated into the overall health system.

Support Albertans with addiction and mental health issues

3.5 Add new hospital and transition beds for mental health patients (e.g., 10 in St. Paul; 44 in Edmonton).
  • Complete – 44 "net new" geriatric mental health beds have opened at Villa Caritas in Edmonton. The 150-bed facility provides appropriate, timely intervention and care for seniors with complex mental health and medical needs. There are 5 psychiatric unit beds at the St. Therese-St. Paul Healthcare Centre that will open by the end of September 2011. The remaining 5 beds will be operational in late 2011 as the unit becomes fully staffed.

3.9 Develop one provincial strategy for addressing addiction and mental health issues.
  • Complete – The Alberta Addiction and Mental Health Strategy – and an accompanying Action Plan – have been finalized.

Provide information

3.12 Give Albertans access to reliable and trusted information about staying well and health conditions and treatment options through the online Personal Health Portal.
  • Complete – A new online health tool called MyHealth.Alberta.ca was launched in May 2011 as part of the Personal Health Portal initiative. The website features nearly 9,000 health topics to connect Albertans to trusted health-care information and services, health tools and wellness management tips. The site’s content was reviewed by a panel of Alberta physicians and other health providers to ensure accuracy and relevancy. By 2015, the MyHealth.Alberta.ca website will provide Albertans with secure access to their personal health information through the province’s electronic health record system.

News release: May 4, 2011

Strategy 4 – Be healthy, stay healthy

By 2015, Alberta's health system will continue to add and improve the range of services that help people to stay well and avoid injuries and chronic diseases. The health system will offer relevant, accurate information to individuals and families, and proven programs and tools to help them achieve their best health.

Create healthier social and physical environments

4.24 Hold Minister’s Wellness Forums to raise awareness and create momentum for action on wellness.
  • Complete – Alberta's first "Minister's Action on Wellness Forum" was held in Edmonton, Dec. 1–3, 2010, with over 250 delegates participating. Significant pledges were made by many of the delegates to encourage wellness where Albertans live, learn, work and play. Pledges included improving workplace wellness strategies, better collaboration between industries, and more investment from the private sector. At the forum, government committed $20 million in renewed funding for wellness activities. The Minister's Action on Wellness International Symposium will be held Oct. 11–13, 2011, in Banff. The symposium will approach wellness through 4 themes: healthy eating, active living, mental well-being and addiction prevention.

News release: Dec. 3, 2010

Strategy 5 – Build one health system

Alberta Health and Wellness and Alberta Health Services will continue to work with health-care providers, government departments, voluntary and community organizations, as well as other Albertans to develop the best models of care for our health system. Our focus will include patient safety, research and technology, using the best available evidence, and new and integrated health legislation.

Improve public and patient safety

5.7 Establish a Patient Safety Framework to guide and support patient safety in Alberta.
  • Complete – The Health Quality Council of Alberta and Alberta Health Services are taking action to implement the Patient Safety Framework for Albertans, released on Sept. 20, 2010. The provincial framework will guide, direct and support continuous and measurable improvement of patient safety for Albertans. The framework's purpose is to develop and advance patient safety strategies in Alberta's health-care system with the goal of creating a safer system.

Make decisions based on sound research and evaluation

5.15 Assess a minimum of 12 new health technologies in the 2010–11 fiscal year.
  • Complete – There were 12 health technologies that went through a formal assessment process during 2010–11. As policies are developed, the technologies will be examined to determine whether they should be provided as part of the publicly funded health system.

5.18 Release Alberta’s Health Research and Innovation Strategy to support research focused on wellness and on health service delivery.
  • Complete – Alberta’s Health Research and Innovation Strategy was released in August 2010 after being co-developed by Alberta Health and Wellness and Alberta Advanced Education and Technology. More than 150 stakeholders were consulted for input on the strategy. It provides a high-level framework to guide health research and innovation investments, and decision-making to improve the health of Albertans and people around the world.

Use technology to share health information, while ensuring personal privacy

5.20 Encourage more health-care providers to use the province’s electronic health record system to input and access patient information electronically instead of manually.
  • Complete – Additional data continues to be added to the electronic health record (EHR) to provide a more comprehensive view of a patient’s health status, making it an even more valuable tool for clinicians. More health-care providers across the province continue accessing the EHR system; approximately 10,300 new users joined the EHR in 2010–11, bringing the total to over 43,600. As of June 24, 2011, diagnostic images can be accessed by health-care providers across the province through the EHR. This is a significant milestone in enhancing patient care, improving patient outcomes, and driving down repeat exams. Work is also on track to implement new EHR privacy and security technology by the end of 2011 that will streamline care-providers’ access to the system.

Update our health legislation to meet the changing needs of Albertans

5.23 Consult with Albertans and find out what they want included in legislation.
  • Complete – A 4-month long consultation process with Albertans was conducted in 2010 by an MLA-led 8-member advisory committee. The consultation process into the development of an Alberta Health Act involved more than 1,300 Albertans in 23 communities across the province. The consultation culminated in Putting People First, a report with two parts – 15 recommendations in part 1 and a comprehensive summary of Albertans’ input in part 2.

5.24 Develop and introduce an Alberta Health Act and a Health Charter (Phase 1).
  • Complete – The Alberta Health Act has been passed by the Legislative Assembly and is awaiting proclamation before it comes into force. The Act requires the Minister to establish a Health Charter and Health Advocate, which were recommendations in Putting People First, a consultation report on the development of an Alberta Health Act that included a draft Health Charter. Further consultation will be required before the Charter is finalized.