Let's talk about AB's HC workforce, a 🧵 :
The graph is for all of Canada, but this trend continues and is getting worse in AB.
Many reasons but key ones:
- "refocusing" has eliminated any ability for our province to do workforce planning. NO COORDINATED work being done 1/7
- there are so many orgs now, and all with "acting" appointed temporary leads, that one hand has no idea what the other is doing
- HCWs can work in mulitple orgs in our siloed HC "system", and so the orgs are finding themselves competing against each other for same supply!
2/7
- there are 4 ministries, w 4 ministers, and numerous "acting" CEOs within the orgs and within the service providers within the orgs... it's a gongshow... pure choas
- as each org struggles to recruit it will be less inclined to coordinate w the other orgs!
3/7
- Ex: even if ACA needs Recover AB to be fully staffed to discharge pts from hospitals, one org has no idea what the other org is doing to be fully staffed... and of course they are directly or indirectly competing against each other for hiring!
- ZERO operational oversight
4/7
It's pure choas, and only getting worse.
We're heading into a very dangerous fall/winter season in dissarray, with a leadership structure that is mostly appointed "acting" inexperienced leads... w their prime focus being the goal of not getting fired like all the rest!
5/7
What this means for AB:
- We'll compete with ourselves and pay more for staff
- there will be NO strategic planning or coordination
- fingers will be pointed everywhere with no one acccountable
- pts will suffer, and we will bleed more HCWs to functioning HC systems
6/7
The Premier has achieved her political goal of killing AHS, w AH bureacrats openly celebrating "mission accomplished"!
Many heads have rolled and consultants have created a completely unworkable HC system given it has ABSOLUTELY NO operational oversight or control.
7/7
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Some concerns from former AHS CEOs sworn affidavit 005 - Some issues re CSFs🧵:
- Let's break down some specific concerns raised by the former AHS CEO around CSFs in AB.
- I will talk about CSFs in general... details about specific CSFs are opaque and hidden
1/12
One important note: there is nothing innately wrong with the idea of doing select surgeries in chartered facilities. The key issue is ensuring proper coordination, oversight, safety reporting, transparency, and accountability.
Ensuring they work for the public!
2/12
Point 21 - Concerns about the ability to coodinate workforce.
- one of the biggest rate limited resources is our anesthesiologist workforce, we simply do not have enough to cover hospitals AND CSFs
- NO ONE is coordinating this workforce in any way whatsoever
3/12
Some concerns from former AHS CEOs sworn affidavit 004 - HCW Intimidation and Silencing🧵:
- pg 16
- concerns raised of govt being punitive and silencing "critics"
- this should be very alarming when a former AHS CEO raises this concern.
1/10
- if it proves to be true that actual screen shots of this behaviour exist, and from people still in positions of power over HCWs, all ABs should be very worried.
What I can speak to from firsthand knowledge:
- almost daily HCWs tell me they are terrified to advocate
2/10
- we do NOT have a JUST culture in our HC environments, and this will have very negative outcomes for pts and the system.
- a well functioning HC system relies on HCWs being about to advocate and whistle blow when things are not working for pts
3/10
Regarding "refocusing' - which should be nominated for the euphemism of the year award - ABs should pause and reflect on what is happening w the disintegration of our HC system 🧵:
- first off "disintergration" is used intentionally w respect to what's happening 1/8
- govt is both blowing up the system and breaking down any and all INTEGRATION
- they are creating silos, redundant bureaucratic orgs, and moving clinical HC dollars to support more admin and bureaucrats
But what is really important is the HOW they are doing it:
2/8
- without a plan, roadmap or any change mgt processes
- Premier said destroy AHS, and first step was to gut its leadership, announce a bunch of new orgs, and then to pay consultants to figure out how to build the plane into a helicopter while we are flying it
3/8
Some concerns from former AHS CEOs sworn affidavit 003 - Refocusing🧵:
- pg 19
- Some concerns about the chaos of "refocusing"...
- There really was no plan, Premier said blow-up AHS, so they blew it up and then set consultants and bureaucrats to create "anything"... 1/6
Some key concerns:
- NDAs have been used wantonly by this govt - the right hand can't even talk to the left hand...
- people could be on multiple refocusing committees and not be able to share info between the groups!
- AHS couldn't inform HCWs
- everyone flying BLIND
2/6
- there were no BUDGETS for the work, or for the new orgs created out of the rubble...
- no process mapping, no change management... just destroy and then pay consultants MILLIONS/day to try to come up with something
- non-expert consultants leading the disintegration...
3/6
Some concerns from former AHS CEOs sworn affidavit 002 - Surgical Coordination🧵:
- from page 12
- It is critical to understand that payments for surgery in AB all come out of the EXACT SAME POT. 1/9
- doing more low acuity surgeries in community, w same or less funding = something has to give
- we know from objective data what gave: life and limb saving surgeries, bowel and transplant surgeries, and cancer surgeries... all wait times went up for them.
2/9
- also critical to understand: the workforce to do these surgeries comes out of the same pool
- we have limited nurses and anesthesia = something has to give
- without very thoughtful coordination of a complex system there can be extensive consequences spread throughout
3/9
Some concerns from former AHS CEOs sworn affidavit 001🧵:
- from page 23
- Concern: govt did not budget HC for pop growth and inflation
- this is factual, and very important to understand
- the Premier even confirmed this during her budget announcement
1/10
Why is this important:
- our pop is BOOMING, and inflation is making it more expensive to provide HC
- govt isn't even doing its most basic duty = ensuring/insuring HC is adequately funded from yr to yr ("insuring" intentional as they are the health insurance provider!)
2/10
- so govt intentionally underfunded AHS (they are doing exact same thing with the Physician Services Budget = pot of money to pay docs to care for ALL pts in AB)
- dec funding to public delivered complex hosp care, and FORCE inc payments to private delivered community care
3/10