Canada’s healthcare system provides healthcare to residents mostly free of charge. The healthcare system in Canada is mainly funded by governments, with private payers (e.g. private insurers and individual users) covering about one third of the costs.1
Healthcare is delivered in various settings in Canada, for example, primary healthcare clinics, community health organizations, hospitals, rehabilitation centres, Long-Term Care homes, homecare agencies etc. Dietitians’ services may be accessed at no cost to clients in some healthcare environments (e.g. hospitals), whereas they may be paid for privately in others.
The healthcare system (and dietetics practice) in Canada aims to provide services which are client-centred. This influences how the healthcare system operates. Many values underlie client-centred practice.2
Review the information below to learn about the values of the Canadian healthcare system and their relevancy to dietetics practice.
Client as a collaborating partner
Clients are experts in their own lives and have a right to engage as a partner in their care.
Relevancy to Dietetics Practice
Dietitians have the responsibility to create opportunities for clients to share their perspectives and values, feel that these perspectives and values are respected, ask questions, and make decisions about their health.
Client autonomy and choice
Clients have the right to make decisions about their health and the services they receive, without pressure.
Relevancy to Dietetics Practice
Dietitians should focus on clients’ needs and goals, and support clients in making informed decisions by providing all possible options and related information in an effective way.
Privacy and confidentiality3
Privacy and confidentiality are related, but different concepts. Together, they refer to what information is collected from a client and how the privacy of that information is protected. In the Canadian context, “personal health information belongs to the client, not the practitioner.” (College of Dietitians of Ontario, 2015, p. 54).4
Relevancy to Dietetics Practice
Dietitians act as custodians (trustees or keepers) of personal health information for the benefit of the client.
There are laws across the country related to privacy that dietitians need to follow. For example, any personal information that a dietitian collects from a client must be purposeful and a dietitian must have the authority to collect it (for example, a client has provided consent for its collection and use). There are also laws governing how confidential information is safeguarded (kept safe).
Equity and universal access5
Clients should be able to access medically necessary healthcare services based on need, regardless of economic status, religious beliefs, sexual orientation, age, gender, geographic location, marital status, ethnic background, skin colour, or education level.6
Relevancy to Dietetics Practice
Dietitians aim to provide and advocate for services that are accessible, equitably distributed, and prioritized based on need.
Accountability and transparency7
Priority is placed on the responsible use of resources and measuring the inputs, outcomes and effectiveness of services provided (also referred to as evidence-informed or evidence-based practice). Value is placed on honesty, clearly sharing information about decision-making processes and reasons for decisions with stakeholders, as well as accepting responsibility for one’s (or one’s organization’s) actions.8
Relevancy to Dietetics Practice
Dietetics practice is evidence-informed or evidence-based. This means dietitians rely on many different types and sources of evidence to make decisions and to support clients in making decisions.
For example, evidence may include research findings described in scholarly journals, evaluation data, client experiences, promising practices or success stories from the field, among others.
Dietitians must be able to explain and justify decisions and actions, and accept accountability for both. They must be able to generate evidence related to their work. For example, by evaluating and reporting on program outcomes.
Quality of healthcare9
Value is placed on continually striving for the best possible practices and outcomes in healthcare using available resources.
Relevancy to Dietetics Practice
Dietitians are responsible for integrating current knowledge from the scientific community and other evidence sources.
Value is placed on continuous quality improvement of healthcare services, which means dietitians contribute to evaluations related to their practice, and share observations and ideas for service improvements.
Continuity of care10
Services should feel connected and coherent, and be responsive to client needs. With the client’s consent, information should be shared about the client’s medical condition, values, preferences, and social context, and complementary care plans across multiple healthcare providers. There should be relationship continuity with healthcare providers (e.g. a client sees one dietitian instead of seeing a different dietitian every time they come to a clinic), where possible, and clients should be linked to future care as needed.
Relevancy to Dietetics Practice
Continuity of care means dietitians are responsible for communicating and collaborating effectively within an interprofessional healthcare team.
To learn more about Canada’s healthcare system, consider:
1 Canadian Institute for Health Information. (2011). Health care cost drivers: the facts. Retrieved October 30, 2015 from https://secure.cihi.ca/free_products/health_care_cost_drivers_the_facts_en.pdf
2 College of Dietitians of Ontario. (2013). From the client’s perspective. Retrieved October 30, 2015 from http://www.collegeofdietitians.org/Resources/Client-Centred-Services/Client-Centred/ClientPerspective.aspx
3 College of Dietitians of Ontario. (2015). Jurisprudence handbook for dietitians in Ontario (Web ed.). Retrieved October 30, 2015 from https://www.collegeofdietitians.org/Resources/Publications-CDO/Jurisprudence-Handbook-for-Dietitians-in-Ontario-(.aspx
4 College of Dietitians of Ontario. (2015). Jurisprudence handbook for dietitians in Ontario (Web ed.). Retrieved October 30, 2015 from https://www.collegeofdietitians.org/Resources/Publications-CDO/Jurisprudence-Handbook-for-Dietitians-in-Ontario-(.aspx
5 Romanow, R. (2002). Building on values. The future of health care in Canada. Retrieved October 30, 2015 from http://www.cbc.ca/healthcare/final_report.pdf; College of Dietitians of Ontario. (2013). From the client’s perspective. Retrieved October 30, 2015 from http://www.collegeofdietitians.org/Resources/Client-Centred-Services/Client-Centred/ClientPerspective.aspx
6 Romanow, R. (2002). Building on values. The future of health care in Canada. Retrieved October 30, 2015 from http://www.cbc.ca/healthcare/final_report.pdf; College of Dietitians of Ontario. (2013). From the client’s perspective. Retrieved October 30, 2015 from http://www.collegeofdietitians.org/Resources/Client-Centred-Services/Client-Centred/ClientPerspective.aspx
7 Romanow, R. (2002). Building on values. The future of health care in Canada. Retrieved October 30, 2015 from http://www.cbc.ca/healthcare/final_report.pdf
8 O’Hagan, J. & Persaud, D. (2009). Creating a culture of accountability in health care. The Health Care Manager, 28(2), 124-133. Retrieved October 30, 2015 from http://www.nursingcenter.com/static?pageid=935642
9 Health Quality Ontario. Government of Ontario. About us. Retrieved October 30, 2015 from http://www.hqontario.ca/About-Us/Our-Mandate
10 Haggerty, J., Reid, R., Freeman, G., Starfield, B., Adair, C., & McKendry, R. (2003). Continuity of care: a multidisciplinary review. British Medical Journal, 327 (7425), 1219-1221. Retrieved October 30, 2015 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC274066/;