In the mid 1990s, when the government of Ontario was closing hospitals and laying off nurses at a brisk pace, Saint Elizabeth Health Care, a leading homecare provider, was going around hiring as many laid-off “wound care specialists” as it could afford, thinking they might come in handy in the burgeoning field of home care. Wound care specialists are usually registered nurses specially trained to deal with the aftercare from surgeries; emergency procedures and such work had traditionally been done during a patient’s post-op stay in hospital. Saint Elizabeth, which had begun in 1908 with four nurses who visited Toronto patients on foot or by streetcar, initially imagined it would send its newly acquired staff out to patients’ homes, but soon realized that was not a very efficient strategy. So they rethought the process.
Instead of having these wound care specialists—who are both expensive and highly skilled—visit six or eight patients a day, Saint Elizabeth set up...
Michael Decter is the board chair of Patients Canada, Medavie Blue Cross and The Walrus Foundation. He has served as Ontario’s deputy minister of health and chair of the Canadian Institute for Health Information. He is the author of Healing Medicare: Managing Health System Change the Canadian Way (McGilligan Books, 1996), Four Strong Winds: Understanding the Growing Challenges to Health Care (Stoddart, 2000) and the co-author with Francesca Grosso of Navigating Canada’s Health Care: A User’s Guide to Getting the Care You Need (Penguin, 2006).
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