HealthcarePapers最新文献

Engagement-capable environments enable strategies and processes supporting patient engagement. However, research using this framework has not fully explored how leaders can help to shape organizational cultures that sustain engagement over time, even during crises such as the COVID-19 pandemic. Using interviews and documents from the Holland Bloorview Kids Rehabilitation Hospital in Toronto, ON, prior to and after the pandemic, we examine the maturation of their engagement practices and culture to illustrate how a supportive culture developed and shaped their responses to this crisis. Further exploration of such dynamics could inform leaders designing engagement strategies with greater impact and sustainment.

"The use of technology to support AIRP [aging in the right place] holds great promise," (Kokorelias et al. 2024: 16) and ethical and human rights considerations must be considered in the design, development and deployment of AgeTech solutions. This may be realized through interprofessional and intersectoral collaboration, as well as meaningful inclusion and engagement of lived expertise and experience from older adults and their caregivers. Theoretical frameworks and evidence-based design/research models can structure the consultation processes. They can guide the agile and iterative development of AgeTech based on input and feedback from end-users and community stakeholders. Funders and accelerator programs also play an important role in ensuring that AgeTech solutions that they endorse or sponsor would be ethical, accessible and feasible to older adult populations that are ethnically, culturally and linguistically diverse at various levels of digital literacy.

The COVID-19 pandemic has significantly disrupted patient engagement and exposed long-standing inequities within Canada's healthcare system. As a patient partner and caregiver, the author reflects on the exacerbated challenges during the pandemic, particularly for hardly reached communities and those managing chronic conditions. The crisis highlighted the absence of opportunities for patient partnership, with healthcare organizations halting engagement activities despite an increased need for communication and community involvement. The pandemic underlined the necessity of trauma-informed care and engagement-capable environments (ECE). To address these challenges, the author advocates for integrating trauma-informed practices with ECEs, thereby promoting a healthcare model that is both structurally supportive and responsive to individual trauma and resilience. By focusing on compassion, recognizing trauma and fostering engagement, such an approach could enhance patient outcomes and create a more adaptive, inclusive healthcare environment.

Technology to support aging in the right place (AIRP) has much promise, but the potential is not yet being met. In their paper outlining the opportunities and challenges in the use of technology to support AIRP, Kokorelias et al. (2024) provided a roadmap for the next steps. Our commentary focuses on two questions they raised: (1) How can technology be designed and developed to better meet the specific needs, preferences and abilities of older adults? (2) How do we evaluate technology in natural settings? Widespread technology adoption will emerge from consideration of the users; an understanding of their unique needs; iterative participatory design and user testing; and support for facilitating conditions to ease deployment into people's lives and minimize abandonment.

Aging in place (AIP) has emerged as a critical priority in policy to support older adults living in their homes and communities. However, achieving equitable support for older adults demands a multi-faceted approach that embraces their choices, capabilities and lived experiences while considering that place is a dynamic concept. This commentary explores the challenges older adults may encounter while AIP and identifies technological and policy areas to explore. Drawing insights from the UK, policy makers in Canada are urged to adopt inclusive definitions of AIP, prioritize technological solutions for recognized challenges and actively involve older adults in policy development.

The aging population presents pressing societal challenges, emphasizing the importance of aging in the right place to support older individuals' quality of life. Technology can play a crucial role in facilitating aging in place by enabling multiple factors such as remote healthcare monitoring, social connectivity and access to essential services. However, several challenges must be addressed to ensure widespread adoption and effective usage of technology among older adults. From integrating digital literacy into the United Nations' Sustainable Development Goals (United Nations n.d.) to promoting co-creation and fostering intergenerational dialogue, multiple solutions can be envisioned. This commentary emphasizes these opportunities, discusses these issues and provides a set of recommendations.

How can we effectively partner during crises? How can partnership with communities, patients, caregivers, providers and leaders be sustained and even evolve during difficult times? The opening paper of this special issue (Kuluski et al. 2024) probed these questions. The six response papers in this issue emphasized engagement that moves from partnership with individuals and communities to efforts that are led by communities; trauma-informed approaches at an individual and organizational level; and shed light on the interdependency of culture and leadership. By broadening our engagement efforts with communities, we are more apt to co-produce improvements in care that also address the social determinants of health.

The COVID-19 pandemic magnified the cracks in healthcare performance. Dysfunctionalities and exhaustion appeared, but so did resilience and innovation. Examination of these cracks offers opportunities for learning and potential for new developments just as in the Japanese art of kintsugi, which is about building new objects from pieces of broken ceramic and mending the cracks. Engagement and partnership activities came under strain in Canada, as well - a pioneer in the field. Some were put on hold; others proved resilient and contributed to surmounting the challenges of the pandemic. Applying their Engagement-Capable Environments Framework, Kuluski and colleagues (2024) studied kintsugi in partnership activities in Canada during the pandemic. The resulting case studies exemplify the factors facilitating engagement and partnership during crisis. Through a lens of co-production that we see as a precondition for understanding and improving healthcare during a crisis and beyond, we challenge the results of the study, hoping to open new perspectives and advance engagement and partnership.

While residential long-term care (LTC) settings can be the right places to age well, they have received relatively little attention in research and policy conversations about technology. In this commentary, we discuss how technologies are currently being integrated into LTC, the ethical challenges and considerations this raises and the potential for improving how technologies are designed and implemented to empower and make the lives of older residents better. We advocate for innovative policy reforms and standards to ensure that technology design and development are equitable and inclusive and better aligned with the wishes and values of older adults and their families.

This commentary focuses on the social determinants of health and how they may be more fully integrated into engagement-capable environments. In this commentary, the authors provide excerpts from their in-depth discussion that explored how the foundational principles of the Gattuso Centre for Social Medicine emphasize the importance of prioritizing care for populations that are marginalized and engaging communities to improve health outcomes. The article delves into some of the historic and current issues facing communities and individuals that are marginalized and describes how a large academic centre has leveraged its structures and resources to build partnerships with communities and community organizations to address these challenges.