Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 107<br />
Specialized ambulatory services are generally provided in outpatient<br />
departments of hospitals. Although there is a noticeable trend towards<br />
providing such services in specialized clinics and physician practices, this has<br />
not yet become the dominant mode of delivery in part because of the public<br />
reaction to switching from delivery by non-profit-making hospitals to delivery<br />
by profit-making clinics. Organized labour, in particular, has been hostile to<br />
this development since it may involve moving from a unionized work<strong>for</strong>ce to a<br />
non-unionized work<strong>for</strong>ce, and one of the largest public sector unions in <strong>Canada</strong>,<br />
the Canadian Union of Public Employees, has been vocal in its opposition to<br />
private-sector contracting out (Canadian Union of Public Employees, 2005). In<br />
addition, the Canadian <strong>Health</strong> Coalition, a civil society organization dedicated<br />
to defending universal medicare in <strong>Canada</strong>, has also lobbied against provincial<br />
privatization initiatives including hospital public-private partnerships (P3s in<br />
<strong>Canada</strong>) (Shrybman, 2007).<br />
5.5 Emergency care<br />
Emergency care in <strong>Canada</strong> generally refers to the care provided in an<br />
emergency department, sometimes also referred to as an emergency ward<br />
or emergency room, of a hospital, staffed <strong>for</strong> 24 hours a day by emergency<br />
physicians and emergency nurses. Emergency care also includes the emergency<br />
medical services that provide transportation (e.g. road or air ambulance) and<br />
the pre-hospital or inter-hospital patient care during transportation, including<br />
the certified first responders and emergency medical technicians who<br />
stabilize the patient be<strong>for</strong>e and during transportation. Physicians who practise<br />
emergency medicine are either specialist fellows of the RCPSC or specialist<br />
family physicians who are certified through the College of Family Physicians<br />
of <strong>Canada</strong>. RNs can be certified as emergency nurses through the Canadian<br />
Nurses Association.<br />
There has been much concern about ED overcrowding and long waiting<br />
times in the past decade. In a 2004–2005 survey, 62% of ED directors perceived<br />
overcrowding to be a major or severe problem (CADTH, 2006). The evidence,<br />
although limited, supports the prevalent perception that the time from ED triage<br />
to treatment has increased significantly and the time patients spend in ED<br />
departments has also increased steadily (Bullard et al., 2009).<br />
In <strong>Canada</strong>, a man with acute appendicitis on a Sunday morning would take<br />
the following steps: