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Mamawetan Churchill River Regional Health Authority – Delivering Provincially Funded Childhood Immunizations (Chapter 9)
Mamawetan Churchill River Regional Health Authority provides healthcare services to over 24,000 residents in over 23 municipalities and First Nations communities. In the region, Mamawetan delivers provincially funded immunization services to about 3,000 children living off reserve.
Provincial Auditor Judy Ferguson reports that while Mamawetan did a good job of making immunization services available in seven communities in the region and accommodating individuals who could not attend the clinics, it needs to make a few improvements. It needs to formally analyze and report childhood immunization rates by community to know if it is putting the right amount of effort into immunizations in the right communities. It also needs to follow the Saskatchewan Immunization Manual when storing vaccines and managing vaccine inventory to avoid providing ineffective vaccines.
Regina Qu’Appelle Regional Health Authority – Efficient Use of MRI (Chapter 10)
Regina Qu’Appelle Regional Health Authority (RQHR) provides MRI services directly through its two machines at the Regina General Hospital and through two contracted private MRI operators. Each year, RQHR strives to do 15,500 MRI scans. In 2016, it did 11,981. At December 2016, it had just over 2,600 patients waiting for an MRI.
Provincial Auditor Judy Ferguson examined RQHR’s processes to use MRIs efficiently. She found that it needed to improve several areas. RQHR needs to track the actual dates of each stage of MRI services, as well as reasons for rescheduling, and regularly analyze MRI data. This would help it determine the causes of significant MRI wait times and develop strategies to reduce wait times. Also, it needs to regularly monitor the number of patients and which patients it sends to private clinics for MRIs and the volume and timeliness of MRIs that contracted private MRI operators provide. This would help RQHR assess whether private clinics complete MRIs within wait-time guidelines.
Furthermore, RQHR needs to monitor formally (instead of informally) the quality of the services that radiologists provide. Formal monitoring of quality would help ensure radiologists accurately interpret MRI scans consistently, and provide the Board with valuable information when granting radiologists privileges. Timely MRI services and accurate interpretations of MRI scans help to improve patients’ outcomes.
Saskatoon Regional Health Authority – Overseeing Contracted Special-Care Homes (Chapter 12)
Saskatoon Regional Health Authority (Saskatoon RHA) contracts with private sector operators at 20 care homes to provide almost three-quarters of its long-term care services. In 2015-16, these contracted special-care homes provided long-term care to almost 1,600 residents at a cost of just over $100 million.
In the audit of Saskatoon RHA’s oversight of contracted homes’ compliance with the Ministry of Health’s minimum care standards, Provincial Auditor Judy Ferguson found the accountability relationship between the Ministry of Health, Saskatoon RHA, and the contracted special care homes was complex and confusing. Clarifying the accountability relationship would help special-care homes understand who they are responsible to and what they are responsible for. Also, contracts between Saskatoon RHA and each of its contracted homes did not contain clear provisions for the quality of care expected. A clarified relationship and more robust contract may help avoid overlap between the Ministry’s and the Saskatoon RHA’s monitoring of homes, and may enable better monitoring of the quality of care provided.
In addition, the audit noted contracted homes were consistently not achieving the Ministry’s quality-of-care targets. Saskatoon RHA did not check the accuracy of key information that contracted homes provided about their compliance with Ministry standards. The audit found information reported was not always accurate. Inspecting these homes routinely would confirm accuracy of information and help identify the reasons for not meeting targets. Also, it would help Saskatoon RHA to address underlying issues where homes provided lower than expected quality of care. Promptly addressing issues would help ensure residents consistently receive quality care. Poor quality of care may negatively affect the lives of residents in special-care homes.
Living Sky School Division No. 202 – Engaging Grades 7 to 12 students (Chapter 8)
Living Sky School Division educates approximately 5,700 students, about half of which are in Grades 7 to 12. Almost one-third of its students had self-identified as First Nations and Métis. Its overall 2016 graduation rate was 72%, whereas the graduation rate of its First Nations and Métis students was 32%.
Provincial Auditor Judy Ferguson reports that while Living Sky actively used several initiatives to engage students in education, it needs to make a few improvements. After students take the annual Ministry-led OurSCHOOL survey, Living Sky should seek input from its Elders’ Council on the survey results specific to First Nations and Métis students. This could lead to potential solutions to better engage First Nations and Métis students, with a goal of improving graduation rates.
Living Sky also needs to analyze the year-over-year OurSCHOOL survey results. This will help it focus resources on the initiatives making the biggest difference in improving student engagement, and decide which initiatives to discontinue or scale back.
A student, who is not sufficiently engaged, has an increased risk of not graduating, which may negatively affect the student’s future employment opportunities.
Mitigating the Effects of Climate Change
Ministry of Environment – Climate Change (Chapter 4)
Environment Canada reports that Canada is warming twice as fast as the global rate. Canada produces 2% of the world’s greenhouse gas emissions, of which 10% comes from Saskatchewan. Saskatchewan’s major industries (e.g., agriculture, electricity, mining, oil and gas) produce high amounts of emissions. From 2004 to 2014, Saskatchewan’s greenhouse gas emissions increased by 8%.
In March 2016, governments across Canada, including the Government of Saskatchewan, committed to implementing greenhouse gas reduction policies to reduce Canadian greenhouse gas emissions by 30% from 2005 levels by 2030.
Provincial Auditor Judy Ferguson looked at the steps the Ministry of Environment was taking to mitigate greenhouse gas emissions and adapt to climate change in Saskatchewan. In January 2017, the Government of Saskatchewan was in the midst of developing policies related to reducing greenhouse gas emissions and adapting to climate change—the Ministry of Environment was leading this development. In addition, the Ministry expects these policies to form the basis of provincial mitigation and co-ordinated adaptation plans, and targets for reduction of greenhouse gases in Saskatchewan. Not having clear and co-ordinated plans and targets increases the risk of Saskatchewan not fulfilling its commitment to help reduce greenhouse gas emissions in Canada by 2030—just thirteen years away.
For More Information
The full Provincial Auditor’s 2017 Report – Volume 1, which includes details on all of the Provincial Auditor’s recommendations, is available online at www.auditor.sk.ca.
Judy Ferguson, FCPA, FCA
Provincial Auditor of Saskatchewan
1500-1920 Broad Street
Regina, Saskatchewan S4P 3V2
1500-1920 Broad Street
Regina, Saskatchewan S4P 3V2