If I could change one thing....

Residents have practical and innovative ideas about how to make the health care system better.  The Hamilton Niagara Haldimand Brant Local Health Integration Network has created a set of postcards to help residents share their ideas. 

• You can order postcards for your organization to share. 
• Residents can also share their feedback online. 
• Please Note:  Suggestions must follow our guidelines in order to be posted below. 

We have received over 925 completed postcards as of April 27, 2010

The postcards asked people to complete the sentence, “If I could change one thing to make the health care system better I would…”.  In some cases, people saw this as an opportunity to suggest fixes to the existing system, and others saw this as an opportunity to add to the system.  In both cases, accessibility, person-centred care, and accountability were core themes.  (For individual reponses, please read pages 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 of ideas)

Accessibility

The responses in the postcards confirmed the importance of accessibility.  People want access to health care services, when and where they need, without worrying about cost, discrimination, undue wait times, or distance.  People feel they should be equally able to take care of their health, no matter where in the LHIN they reside, how old they are, or what their need. 

Through the postcards, people requested that health services such as dental care, vision care, physiotherapy (and other complementary therapies), and prescription drugs be covered like other health services.  They expressed a need for more mental health and addictions services and general health services in French. 

• “Put dental and eye care back on OHIP. My teeth are getting pulled one by one, my boys teeth will be next.” 
• “I feel that eye exams should be covered for all - not just some - this encourages people to keep their eyes healthy.” 
• “Provide more funding to the addictions field to help people become productive citizens. “
• “Lower the prices for prescriptions.”
• “DENTAL! & MENTAL! Both need to be added to our system!”
• “Reward those who take responsibility for themselves and their health. Tax deductible-gym memberships and the cost of supplements-vitamins etc.”
• « Avoir des services réellement en français »

People shared their frustration with their ability to get basic quality care.  Many expressed this as a need for more doctors, nurses, and other medical staff.  Either they have a family doctor, but have to wait to see them and are rushed once seen, or they do not have a family doctor, and end out using the emergency room or going without. 

• “Put more money into training, hiring and supporting more doctors, nurses, and health care workers.”
• “Limit the amount of new patients doctors can take on so that we are able to book an appointment within a reasonable time & not have long waiting room visits.”
• “More time with the Doctor for my appointment”.
• “More doctors. My doctor takes weeks to see patients because she has so many & took 4 weeks vacation. Now I signed a paper and can't go into a walk-in clinic, only emergency.”
• “Have more Family physicians.  Then fewer people would visit Emergency Departments in hospitals and waiting times would be reduced - 7 hours is too long.”

People felt that the wait times for emergency and specialized care need to be dramatically reduced. 

• “Reduce ER wait times by adding more physicians”
• “Make Emergency Room in take time faster, not having to sit 5 hours with my screaming 3 year old.”
• “Reduce wait times in all areas. People have to wait for appointments with   specialists, surgery, at the E.M. and at hospital clinics etc. This must stop.”

Person-Centered Care

The responses in the postcards indicated the need for more person-centred care. 

People want to understand their care, be able to control it, and feel it addresses all of their needs, not just their medical ones.  People feel that they are more than a list of their problems, and want their care to reflect that.

• “Ensure doctors could NEVER say 'only problem only per visit." I am not a problem - I am a whole person.”
• “Stop using models/programs that compartmentalize people's health.  Consider a more holistic approach to helping people to heal.”

Through the postcards, people requested more time and better communication with their doctors or other health care providers so that they were both better able to share their story, as well as understand the care they receive. 

• “Train doctors to listen and communicate with patients and give them at least 10 minutes per appointment, rather than restricting patients to one problem each time.”
• “Minimize the use of medical jargon when talking to patients in favour of vocabulary more easily comprehended in a stressful situation.”
• “I would make it easier to really find out what is wrong.  Drs. are too busy to give proper care and health diagnosises.  Not enough time taken with each person.”
• “Have my own doctor go to the hospital if I were to be admitted instead of some other doctor who only scans the records for a minute or two.  - Someone who knows my conditions and CARES.”
• “More COMPASSION, less bureaucracy”

People want more support maintaining their own health; both by helping them keep healthy, as well as providing them with choices to manage their health issues. 

• “Implement more natural healing techniques.”
• “Make alternative healthcare therapies part of approved health care & teach healthcare options to more staff to learn about it or refer to alternative practitioners.”
• “Have maintenance programs for people with chronic conditions. If people had an affordable way to stay fit and healthy it would help keep them out of hospitals.”

Accountable 

The responses in the postcards showed frustration with how the health care system is managed.  People want to know that their taxes are being well spent and that the system is well managed, especially when the services they are receiving are changing.  People feel that cuts to the system are often made without consideration for, or consultation with, ‘the little guy’.

Through the postcards, people expressed their concerns with the changes to emergency departments and other hospital services.  Although some of the responses in the postcards show that there is still much misinformation circulating, the postcards clearly express the fear and anxiety that these changes have created.

• “Reducing the number of hospitals in Niagara is absurd.  Try and rush sick people from Fort Erie in a snowstorn in mid-winter to a poorly-run hospital in St. Catharines!”
• “Have an emergency ward at every hospital location so patients do NOT need to be sent away during an emergency situation!”

People argued that if cuts were to be made, the first cuts should be to executive salaries, not services.  And that hospitals and the LHIN need to be held more accountable. 

• “The hospitals are too top heavy.  Way too many managers and not enough front line workers.  No CEO on the planet needs to make $700,000 and not be expected to take a wage cut.”
• “Eliminate all (middle) management and stop reducing the number of front line staff.”
• “Cuts should not be made to our health system without it being an election issue.”
•  “We need an audit and investigation of (a Hospital Health System).  It has been terribly mismanaged.”
• “Get rid of the LHIN - they have destroyed the taxpayers faith.  The Ministry of Health must demand efficiency and transparency from the top down.”