Understanding ratios
In 2020, at the René-Lévesque CHSLD, the night ratio was one nurse and two licensed practical nurses for 224 patients (3/224).
It’s just one of many examples of dangerous ratios between healthcare professionals and patients in Quebec’s health network. And it’s the reason why the FIQ is fighting to implement safe healthcare professional-to-patient ratios.
Ratios are the key structural measure for healthcare systems around the world, and healthcare professionals in Quebec are campaigning for them to be implemented in Quebec.
What are safe ratios?
Safe ratios are the maximum number of patients assigned to a team of healthcare professionals to guarantee safe conditions both for the staff and patients.
For example, a safe ratio in a CHSLD could be: one nurse and one licensed practical nurse for 20 patients during the day (2/20), and for 37 patients at night (2/37).
Unfortunately, despite hundreds of studies demonstrating the effectiveness of safe ratios, the government continues to turn a deaf ear. It is therefore foregoing one of the best solutions to ensure the safety and quality of care and that there is enough staff in the public health network.
The FIQ’s ratio projects
In 2018-2019, in collaboration with the health minister, the FIQ led 16 ratio projects in different centre of activities in several Quebec regions. The results were highly convincing.
The ratio projects reduced the staff workload, ensured safer care, improved the working environment, and increased satisfaction among healthcare professionals and patients, thereby preventing an exodus to the private sector.
And yet, the CAQ government still hasn’t made a move to implement universal application. In the meantime, working conditions continue to deteriorate, care safety and quality is under threat and thousands of healthcare professionals are leaving the public network because they are not being heard and no concrete measures are being taken.
British Columbia (2023)
- Minimum ratios set out in the collective agreement, progressive deployment, dedicated budget, retention strategy.
Manitoba (2024)
- Progressive deployment planned by the collective agreement.
- Ratios and care settings to be determined.
Nova Scotia (2024)
- Maximum number of patients per nurse based on care hours.
- Already yielded increased recruitment.
Ontario (2024)
- Negotiations underway. Bill on ratios planned.
- Significant union mobilization.
Australia (state of Victoria)
- Two-phase implementation over 12 months.
- Increased hiring, lower turnover rate.
- More than 60,000 nurses trained or recruited between 2001 and 2007.
Australia
- Two-phase implementation over 12 months.
- Increased hiring, lower turnover rate.
- More than 60,000 nurses trained or recruited between 2001 and 2007.
France (2024)
- Adoption of a law requiring a minimum number of care providers per patient hospitalized in a public institution.
For the health network
- Better care safety and quality
- Reduction in errors, extended stays and costs
- Better planning and sufficient staffing
For care teams
- Less work overload and exhaustion
- Stable work teams, better access to leaves, more stability and less mandatory overtime
- Work recognition and better work-personal life balance
For the population
- Care that is more humane, safe and dignified
- Less complications, delays, and adverse events
- A reform that pays off more than it costs in the long term
Webinar 1 | Safe ratios: A gauge of care quality and safety
The results of a survey conducted in June 2023 among Quebec healthcare professionals are worrisome: a number of care tasks to which patients are entitled are not completely carried out according to professional standards. That means that healthcare professionals are not providing care in the way that they learned. Why? 83% of them blame the work overload.
Webinar 2 | Safe ratios: a smart investment for Quebec
The public health network is often portrayed as a financial sinkhole which gives the impression that safe healthcare professional-to-patient ratios are a luxury Quebec can’t afford. However, providing proper care is profitable, not only from a health perspective, but from a financial one as well.
Webinar 3 | Safe healthcare professional-to-patient ratios: the impetus to counteract the workforce shortage
People often think that more healthcare professionals are needed to implement safe ratios. But science and experience show that the opposite is true! By implementing safe ratios, healthcare professionals will be motivated to work in the public health network. That’s what happened in California and Australia.
