Warning message

Please note that this page is from our archives. There may be more up-to-date content about this topic on our website. Use our search engine to find out.


Workload and Patient Care Survey – Summary of Findings
Since its election in 1995, the current Ontario government instituted a policy of cutbacks to chronic care hospitals. The government decided that many patients in chronic care facilities should make do with significantly less support and care. Thousands of beds were shut and thousands more were scheduled to be shut. A key part of this policy is that patients previously taken care of in chronic care facilities would be moved to long term care facilities – facilities with much less funding.
Recently, the government has been forced to partially change directions. Four chronic care hospitals scheduled to close down will now stay open. But funding is still being reduced for other facilities.
In June of 2000, the Chronic Care / Long Term Care Committee of the Ontario Council of Hospital Unions/CUPE (1) initiated a survey of workers in current and former chronic care hospitals in Ontario. The survey was developed by front line health care employees working in conjunction with CUPE Research and sociologist David Hubka. The study assesses the impact of funding cuts on workload and patient care, and provides a voice for front-line workers in these facilities. (2)
The findings indicate that workers are faced with serious problems with unpaid work, workload, and patient care. (3)
Unpaid Work
Over half of the respondents reported at least one type of unpaid work.
A majority (54%) reported working before or after hours without pay. A similar proportion (57%) report working during lunch breaks without pay. Approximately 16% of all respondents to the survey report working 30 minutes or more unpaid work per day. 47% report working more unpaid work than four years ago.
Impact on Health of Workers
A clear majority believe their workload is hurting their health.
Almost 92% of respondents report their workload is increasing and 79% believe their workload is hurting their health. (Almost 96% of responding health care aids and personal support workers believe their workload is hurting their health.)
Impact on Health of Patients and Residents
Many report that they have patients who can get out of bed or wheelchair, but seldom do due to a lack of resources.
29% report that they have patients who seldom get out of bed due to a lack of resources. 60% of respondents report that at least one of the patients they work with would get out of their wheelchair if they could get more exercise. 35% report this is an increase from four years ago.
Impact on the Quality of Life of Patients and Residents
More than half say staff are able to take patients outside less than once a month. Half of respondents say they have less than five minutes per day to talk socially with each patient.
57% of respondents report that staff are able to take patients outside less than once a month; this is only slightly more than the 52% who reported the same for four years ago. Over half (52%) say they have less than 5 minutes per day to talk socially with
each of their patients. 82% of respondents report that they have less time to speak socially than four years ago.
What Happens When Funds are Cut?
The study also provided a comparison of respondents from a hospital that is undergoing the transition from chronic care to long term care (the Perley Rideau Veterans Health Care Centre) and hospitals that still provide chronic care.
The Perley Rideau Veteran’s Health Care centre was until recently a chronic care hospital. The government has turned the facility into a long term care (LTC) facility. LTC facilities (nursing homes and homes for the aged) typically operate with about half of the funding as chronic care hospitals. (From over $200 per patient per day to less than $100 per resident per day.) Accordingly, the government has reduced funding to the Perley. At the time of the study, it stood at approximately $150 per resident per day. As indicated earlier, the reduction in funding to the Perley is part of a broader Ontario government policy of reducing chronic care beds and replacing them by cheaper long term care beds. The Perley is one of the first facilities to experience these cuts, so it is instructive to compare the experience of workers at this facility to workers at chronic care hospitals.
Respondents at the Perley usually noted more workload problems. (4) They were more likely to report working before or after hours without pay (73% versus 53% at the surveyed hospitals). They were more likely to report working during their lunch period (67% versus 54% ). They more often reported that they were doing more unpaid work than four years previous (54% versus 45%). They were more likely to report that their workload is increasing (100% versus 90%). They were more likely to report that their workload is hurting their health (86% versus 77% of respondents at the hospitals).
Similarly, respondents usually noted more quality of care problems. Perley respondents were more likely to report that patients have one tub bath or shower per week or less than respondents at other facilities (96% versus 68%).
Perley respondents were more likely to report that they have patients who seldom get out of bed due to a lack of resources (48% versus 25%).
They were more likely to report having patients who do not get out of bed due to a lack of exercise (76% versus 57%); 44% of Perley respondents report this is an increase from four years ago, compared with 34% of other respondents. They were more likely to report that they had less than five minutes per day to talk socially with each patient (69% versus 49%). They were also more likely to report that they had less time that four years ago - 93% compared to 80% of other respondents.
Conclusion
Overall, these findings suggest that funding cuts and the resulting staffing shortages are having a measurable, negative impact on the quality of care provided in chronic care hospitals - Another piece of evidence that the integrity of the Ontario health care system being seriously compromised by government funding cutbacks.

Notes


1. OCHU/CUPE is the central bargaining agent for 20,000 hospital employees in Ontario, including employees working in chronic care and former chronic care facilities.
2. A random sample of 424 members was taken from a population of approximately 2400 members in 6 hospitals and 1 long term care facility. The sample size is 17.7% of the population. CUPE members were surveyed at St. Peter’s in Hamilton, St. Vincent in Brockville, St. Joseph’s in Guelph, the Perley Rideau Veteran’s Health Centre in Ottawa, the Toronto Rehabilitation Institute in Toronto, the Shaver Hospital in St. Catharines, and the Providence Continuing Care Centre in Toronto.
3. The margin of error for sample proportions is +/-5.1% 19 times out of 20.
4. All differences between Perley and other hospitals are significant at the .05 level of significance.

Workload and Patient Care Survey: Finding Highlights
The current Ontario government has enacted a policy of cutbacks to chronic care hospitals.
This study assesses the impact of funding cuts on workload and patient care, and provides a voice for front-line workers in these facilities.
The research provides another piece of evidence that the integrity of the Ontario health care system being compromised by government funding cutbacks.
Overall Findings
A majority (54%) reported working before or after hours without pay.
92% of respondents report their workload is increasing and 79% believe their workload is hurting their health.
29% report that they have patients who seldom get out of bed due to a lack of resources.
Over half (52%) say they have less than 5 minutes per day to talk socially with
each of their patients.
The Perley Case
The funding cuts at the Perley are part of a broader Ontario government policy of reducing chronic care beds and replacing them by cheaper long term care beds.
Perley respondents were more likely to report working before or after hours without pay (73% versus 53% at the other surveyed hospitals).
Perley respondents were more likely to report that their workload is hurting their health (86% versus 77% at the other surveyed hospitals).
Perley respondents were more likely to report that they have patients who seldom get out of bed due to a lack of resources (48% versus 25% at the other surveyed hospitals).
Perley respondents were more likely to report that they had less than five minutes per day to talk socially with each patient (69% versus 49% at the other surveyed hospitals).
opeiu 491