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Perspectives is the quarterly newsletter of the New Brunswick Health Council

In this issue...

Stéphane Robichaud
CEO of the NBHC

Message from the CEO


When it comes to health services, everyone seems to have an opinion.  Perspectives can differ greatly depending on whether you receive, provide or manage health services.  "Our Health. Our Perspectives. Our Solutions." was the title of our first provincial citizen engagement initiative in June of 2010.  Hundreds of citizens from across the province participated in full day discussions. They listened to information regarding the state of population health, health service quality and the sustainability of the provincial health care system. Among all the valuable contributions citizens brought to these discussions, one recurring comment underlined the value of these dialogue sessions: "What I have heard has changed how I think about our provincial health services".

Having healthier engaged citizens, improved health service quality and a sustainable health services system are the aims that have guided the development and evolution of our various public reporting tools.  At the very beginning, we recognized the absence of provincially standardized information regarding the health of citizens, health service quality and the level of health service resources across the province.  When we considered the overall spending trend, we were on our way to spending $1 billion more over the following five year period.  Meanwhile, there were no indications that this spending would lead to either a healthier population or improved health services quality.  This spending trend was significantly reduced in recent years, but the challenge will be to control spending in the long run.

What is called the provincial health care system has evolved over many decades in the absence of provincially standardized information. This means that management practices, from the front-line service providers to the briefings of the Minister, have evolved without the availability of this information. As our public reporting tools have evolved, health service managers, policy advisors and political leaders have responded positively to the availability of this information. Meanwhile, current management practices have been built on decades of experience and learned habits. Current management practices are designed to deliver the results seen in our reporting tools. Many of these results must be improved and we should not underestimate the challenges associated with these changes.

As the NBHC Council members took stock of the work that has been achieved to date, they recognized the value of what has been learned through our reports.  Meanwhile, they also recognize that far more people should be aware of this information.  Therefore, we will be focusing on improving our ability to inform and we are starting with this new edition of "Perspectives".

My Community at a Glance: How and why the NBHC created 33 community profiles


Last spring, the New Brunswick Health Council (NBHC) published 33 community profiles entitled My Community at a Glance. This new tool providing individuals with a snapshot of their community is the first of its kind to be published in New Brunswick. Each profile contains information that gives a comprehensive view about the people who live, learn, work and take part in community life in this area. The development of these profiles stems from the excellent work of Karine LeBlanc Gagnon, NBHC's Information Analyst, Health Status. She has accepted to answer a few questions. 

Question - Karine, how did the idea of developing such profiles come to you?

In 2009, we published our first report on Population Health that contained 42 indicators. The Population Health Snapshot was prepared for the health zones. The demand for a Youth Snapshot was quickly felt. In cooperation with NB's Office of the Child and Youth Advocate, the Child and Youth Snapshot was prepared, compiling 250 provincial indicators. 

Many of our partners mentioned that they would like to have access to such information on a community level. Among those were community groups who more and more frequently need to provide information that measures their success, as well as Regional Health Authorities which were being asked to evaluate the needs of their community. That’s where the idea of creating community profiles came from.  
 
Q - What has been the process with your partners?

We started by looking at what other jurisdictions do, nationally and internationally. We then met with over 20 stakeholder groups (from the government, business and not-for-profit sectors) to figure out what information they would want to have to help them with their planning and strategies, as well as what is currently available in New Brunswick to measure population health at the community level.

Whether working closely with various government departments within the province, the RCMP staff, or even Statistics Canada, it has truly been a pleasure to work with individuals who are passionate about their data and excited to think that it can help tell their communities’ story to New Brunswickers.  In some cases, the data providers sent us their data grouped by community – for example, Statistics Canada recalculated all the National Household Survey information (replacing the long form census) for our community boundaries – while in other cases, we had to do the calculations ourselves.
 
Q - Have you heard about any projects based on information from the profiles?

Until now, the reaction has been very positive! There is a keen interest for such detailed information in every part of the province. There were a great number of hits on our website, requesting presentations and printed documents. Many organizations and individuals mentioned that they use the profiles.

The Kent, Chaleur and Restigouche Wellness Networks already refer to My Community at a Glance to help plan their activities. NBHC has been invited to make a presentation on the results at the Regional Wellness Forums. Each of these forums invited the region’s population to participate in an inclusive dialogue in order to identify a common vision and thus enhance the wellness culture. My Community at a Glance was instrumental in helping establish the priorities of the municipalities at these forums.
 
Q - Finally, what is on the horizon for the profiles?

We are working hard behind the scenes to provide you with related tools, such as the upcoming release of a video clip.

To download your community profile, visit http://www.nbhc.ca/community-profiles
Did you know?

New Brunswick has more family physicians and more nurses per capita than the Canadian average, but this hasn't led to better health outcomes.

As a province, we don't necessarily need more human resources – we need to deploy them differently to better respond to the specific needs of our population.

Evaluating the effectiveness of diabetes clinics in the province

In June 2012, the New Brunswick Health Council (NBHC), in cooperation with the Department of Health (DH), began a project to assess service delivery for patients with diabetes in the province. The primary objective of the project was to evaluate the effectiveness of diabetes education centres and clinics in New Brunswick.

"Through this project, we wanted to help the Department of Health and the Regional Health Authorities (RHA) improve the quality of diabetes related health services in the province", said  Michelina Mancuso, NBHC's Executive Director, Performance Measurement.

Key points:
  • 37 diabetes clinics in the province
  • More than 69,000 New Brunswickers suffer from diabetes
  • A clinic visit costs between $33 and $158
  • The economic burden of diabetes in N.B. was estimated at $298 million in 2010
Conducted over a two-year period, the project was based, among other things, on an evaluation of privacy related factors aimed at establish data sharing parameters.

The comprehensive study reveals that there are 37 points of contact for diabetes education services and enhanced care. Although diabetes is a serious disease and affects more than 69,000 New Brunswickers (2011), or 9.2% of the population, the survey concludes that having more human resources is not necessarily an indication of better outcomes and that most of the efficient or effective clinics are those that have implemented patient centered health care.  

In other words, ensuring flexibility in service delivery and creating and maintaining strong links with primary care providers, other health services and other community resources allows for the enhancement, integration and coordination of services.  
 
“We develop programs and services in order to obtain certain results. To be able to measure their performance based on those results is the ultimate value for all New Brunswickers, whatever their individual characteristics or geographical location”, says Stéphane Robichaud, CEO of the NBHC.

The study led by the NBHC and the Department of Health highlights the comparison of results based on various characteristics, such as geographical differences and clinic types, as well as a comparison between patients who receive care in a diabetes clinic or education centre and those who do not attend.

The results clearly show that by choosing a patient centered model of care, we develop a relationship based on the sharing of power and responsibility between the client/patient, clinician and caregivers.

The report contains a list of recommendations which you can review at: http://www.nbhc.ca/what-we-do/evaluation-diabetes-education-centres

Did you know?

New Brunswick is the province that has the highest percentage of citizens with a regular medical doctor: 93% compared to the national average of 85%.

This does not mean better access, however, as we are not able to get an appointment with our family doctors as quickly as other Canadians do.

Provincial Wellness Conference in Moncton


The 2014 Wellness conference was held in Moncton on May 14 and 15 under the theme "Championing the Wellness Movement in New Brunswick". This conference brought together over 260 delegates from the public, private and not-for-profit sector, with various ties to wellness. Such conferences represent a great opportunity for the NBHC to network with community stakeholders and promote its many tools.

Delegates were able to participate in many workshops and educational sessions, allowing them to acquire practical knowledge, and learn how we can grow the Wellness Movement in New Brunswick together. Among others, delegates were able to attend an expert panel on health determinants and a presentation by Rim Fayad from the NBHC entitled: Strength in Numbers to Strengthen Numbers: Bringing People Together Around Population Health. Mrs. Fayad’s presentation explored the links between the wellness strategy pillars and the population health model, then showed an overview of how youth and adults in New Brunswick have performed over the past few years. Trends for the general population were presented by the province's seven health regions, along with the community profiles and how they are meant to be used to support community mobilization and assist in planning, prioritization, and measurement of success.
 
It was the third conference of this kind, made possible by a partnership between the Department of Healthy and Inclusive Communities, the Healthy Eating and Physical Activity Coalition of NB, the First Nation/Aboriginal People Network, the New Brunswick Anti-Tobacco Coalition, the Mouvement acadien des communautés en santé du Nouveau-Brunswick, the NB Food Security Action Network and the Société Santé et Mieux-être en français du Nouveau-Brunswick.
  
The NBHC staff hopes to welcome you at their kiosk at the next edition of this event! 
Did you know?

The quantity of medical equipment in New Brunswick is comparable - sometimes even superior - to the rest of the country: for example, we have more CT scanners and hospital beds per capita than the Canadian average.

Our challenge as a system, therefore, is to learn to do better with our current level of resources.
The NBHC has been established as an independent organization that measures, monitors and evaluates New Brunswick’s health care system performance and population health, and that engages citizens in the improvement of health service quality.
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