Healthcare Management Forum最新文献

This study explored the perspectives of trauma patients, their families/proxies, and healthcare providers to understand how a dedicated inpatient Trauma Consult Service (TCS) supports high-quality, coordinated care and to identify opportunities for improvement. Over 26 months, a mixed-methods survey collected ratings across five domains of care quality along with open-ended feedback. Responses were analyzed descriptively and inductively to identify themes. Feedback across respondent groups was consistently positive, highlighting three main themes: optimized system, skilled team, and patient-centred care. The TCS was perceived as enhancing continuity, collaboration, and overall care quality. These findings suggest that dedicated consultative services can strengthen coordination and support patient recovery and satisfaction in complex inpatient settings.

Burnout among healthcare workers in Canada remains a critical challenge with implications for workforce retention, patient safety, and system sustainability. Traditional responses have often emphasized individual coping strategies rather than structural change. This article argues that Artificial Intelligence (AI) might offer new opportunities to address some of the organizational drivers of burnout. We outline three domains where AI may provide value: (1) enhancing the measurement and understanding of burnout, (2) strengthening workforce planning and operational decision-making, and (3) mitigating workplace risks through process redesign and automation. By shifting attention from "fixing workers" to "fixing work," AI might be part of the "solution" to support healthier, more sustainable healthcare environments.

Despite the relatively high turnover rates and increasing demand for homecare, little is known about the costs of turnover for homecare employers. To create effective policies to reduce turnover and associated costs, employers require an understanding of what factors contribute to the costs of turnover. Building upon existing models from labour economic and human resources theories, we worked with subject matter experts from a large homecare employer organization to co-design the first known homecare cost of turnover model. The resulting model accounts for sector-specific cost differences and can be used to estimate the costs of homecare worker turnover. As homecare continues to face high workforce instability, clear estimates of the cost of turnover can guide organizations and decision-makers in the evidence-based design of retention policies and programs to the benefit of homecare workers, funders, those seeking homecare, and the broader health and social care system.

Artificial intelligence for health holds enormous transformative potential. It has already proven successful in enhancing patient outcomes, facilitating the duties of professional caregivers, and their organizations. Its potential applications in the field of healthcare architecture are similarly being explored. This article discusses the role and function of generative artificial intelligence with respect to the professionals who work in close collaboration with healthcare organizational clients and their direct-care constituencies in decision framing the planning, design, construction, and management of healthcare facilities. Opportunities and challenges associated with generative artificial intelligence in the facility procurement process are discussed, including the role of ethics and societal responsibility at this critical juncture.

Healthcare Providers (HCPs) serving Rural, Remote, First Nations, and other Indigenous (RRFNI) communities face unique challenges in delivering longitudinal care due to geographic isolation. The Real-Time Virtual Support Services (RTVS) network aims to improve equitable access to healthcare and provide collegial support for HCPs in RRFNI communities across British Columbia. The objective of this study was to understand HCPs' experiences with RTVS and identify improvement areas. Data were collected through semi-structured interviews with HCPs that were recorded, transcribed, and openly coded. Twenty HCPs using RTVS were interviewed during 2022-2023. The constant comparative method was used to develop themes. Themes focused on RTVS's benefits and outcomes including increased clinical confidence, reduced provider anxiety, respectful and collegial support, reduced administrative burden, and recruitment and retention support. Challenges included occasional service disruptions and limited Wi-Fi availability. These findings provide in-depth and contextualized feedback informing the development of RTVS.

Health systems provide essential resources to optimize, maintain, or restore the health of populations. The extent to which a health system can meet the needs of a local community can be considered the system's "capacity"; however, it is unclear what this constitutes. We conducted a standardized rapid review to understand how health system capacity has been conceptualized in academic and grey literature. We conducted duplicate screening and data extraction. We summarized document characteristics descriptively and definitions/frameworks narratively. We identified 22 relevant documents; three (14%) provided a definition and 20 (91%) provided a framework. Each definition provided was unique. We synthesized reported frameworks into 11 key elements of health system capacity. We identified an infrequent and inconsistent conceptualization of health system capacity in published literature; however, this review may be used as a starting point for defining and describing key elements of capacity.

As Canada's population ages, Long-Term Care (LTC) homes face increasing pressure to deliver effective care amid staffing shortages and growing resident complexity. Technology-based recreational interventions may be promising tools to support resident well-being. We evaluated the implementation of The Happiness Programme, a light-projection-based recreational technology, using a "fail-fast" method. Training was provided and the program was integrated into routine care for 6 months. Data were collected through surveys, along with usage of metrics and tracking of resident engagement. Surveys showed that the technology was easy to use and especially useful for residents with limited mobility or lower cognitive function. Technical issues impeded consistent use. Our findings suggest that while The Happiness Programme offers value for specific subgroups of residents, its broader impact is contingent on strong infrastructure, staff capacity, and ongoing support. This study emphasizes the overall value in "failing fast" when evaluating innovations in a long-term care setting.

The Ottawa Hospital-one of Canada's largest academic health sciences centres-and its research arm, the Ottawa Hospital Research Institute, undertook a comprehensive review of the hospital's clinical research ecosystem in 2022 to identify systemic challenges and opportunities to better integrate clinical research within hospital operations and patient care. Interest holders were engaged through qualitative interviews and pre- and post-review quantitative surveys. Barriers identified included limited funding access, lack of protected research time fragmented technology infrastructure, inconsistent support for non-physician researchers, and limited access to patients for research purposes. Findings informed an action plan comprising over 30 initiatives under four strategic goals: strengthening infrastructure, building capacity and culture, enhancing patient access to research opportunities, and streamlining governance. Progress was evaluated by the 2025 post-review survey data. This Performance improvement project offers a replicable roadmap and framework for healthcare and research centres seeking to build a supportive, collaborative, and patient-centred research environment.

There is a growing awareness of the benefits of comprehensive, standardized, and accessible data on the health workforce to support more timely and robust planning. We found that provincial regulation and data privacy legislation could be better aligned to strengthen the infrastructure for high-quality health workforce planning data. This article identifies existing legal and regulatory mechanisms that enable the collection and sharing of more standardized health workforce data. We propose a framework that enables the collection and sharing of standardized data by scaling up existing leading practices in certain provinces into a more cohesive approach. Key facilitators include umbrella legislation, privacy frameworks that contemplate data use for workforce planning, efforts to collect anti-discrimination data, and secure data access infrastructure. Together, these facilitators support a viable foundation for improved health workforce data standardization and utilization for planning to improve healthcare delivery across Canada in the existing legal context.

Risk management disclosure is one of the so-called ethical processes that illustrate the culture of fairness (just culture) and no-blame. On the field, however, this culture is not always felt by staff. Disclosure is open to criticism and difficulties and raises ethical issues such as fears of being blamed and fears of the consequences for users. These criticisms and difficulties are linked to ethical values and principles, as is disclosure itself. Thus, many ethical dilemmas are experienced by staff. Fortunately, it is possible to optimize the disclosure process by examining the possibilities offered by organizational ethics to optimize the disclosure process. Using the concepts and tools of organizational ethics helps to overcome the limitations of the risk management process as a whole and to optimize it. It is therefore reasonable to hypothesize that organizational ethics can help to do the same for disclosure.