Healthcare Management Forum最新文献

Health worker burnout is not a new phenomenon; it existed before the COVID-19 pandemic but has worsened since. Organizations have implemented various interventions to help staff recover from burnout, but few have focused on preventing or addressing sources of burnout. This article addresses this gap by focusing on promising practices and interventions that can be utilized to prevent and address burnout. By using a mixed-method approach, we learned that listening to frontline staff is essential for creating a short list of interventions that can be tailored to meet the unique needs of different organizations. Time, money, and other resources are required to implement sustainable change, along with balancing a top-down and bottom-up approach. Finally, building on an inherent desire for more connection both within individual sites and across organizations is key. Health leaders are encouraged to engage staff members regarding their concerns and dedicate sufficient resources to support necessary changes.

Starting with the question of "why would anyone choose to become a health leader?", this column shares reflections on the nature of ethical leadership. Different features of health leaders and their practice that support engaging in organizational (systems-level) ethics issues in accordance with relevant values are discussed. The possibility of experiencing moral injury as a leader is highlighted as an important aspect of preparing health leaders for this role. Related reflections on moral resilience and moral integrity further support the need to ensure that training for health leaders captures the complexity of organizational ethics work and navigating fundamental challenges to one's sense of self as a leader.

Emerging health leaders are no longer tasked with only clinical, financial, and workforce management, they must foster authentic human connection, steer a digital transformation, and steward sustainability into the future. This article explores the intersection of authentic leadership, digital fluency, and ecosystem thinking as the core competency triad for the next generation of health leaders. It offers fresh perspectives on what it will take to lead with heart, technical agility, and global conscientiousness-anchored in health quality-into an increasingly complex future.

Leadership is a core expectation of nursing practice, yet leadership development curricula in academia and healthcare organizations fall short of equipping nurses to lead in today's complex healthcare environment. This article outlines a framework-driven approach to leadership education through two courses designed for undergraduate and graduate nursing students, developed and iteratively refined using the Knowledge-to-Action framework and annual Plan-Do-Study-Act cycles. Grounded in relational leadership theories, the RNAO model for developing and sustaining leadership, and the LEADS in a Caring Environment framework, courses integrate participatory learning strategies to bridge theory and practice. Students engage in team-based projects, reflective exercises, and experiential activities to build self-awareness and confidence. By aligning curricula with professional standards and practice-relevant frameworks, these courses cultivate leadership, positioning nurses to influence the quality of care and contribute to health system transformation. Organizations can build on this foundation to provide leadership development and support professional growth.

With an ageing population and the highest disability rate in Canada, Nova Scotia continues to see demand for continuing care services grow. While focus has been placed on addressing persistent frontline staffing challenges, less attention has been paid to the ongoing need for new leaders. The many Continuing Care Assistants (CCAs) and Licensed Practical Nurses (LPNs) working in continuing care are a diverse, educated, and experienced workforce bringing new ideas and perspectives into healthcare leadership. Mount Saint Vincent University's Ready to Lead (R2L) program is a microcredential series designed to prepare CCAs and LPNs to progress into continuing care leadership roles. R2L can also serve as a unique recruitment and retention tool attracting individuals seeking career paths including continuing care leadership opportunities. This article details R2L's design, development, and outcomes from the inaugural R2L program offering insights for health leaders wanting to identify effective training and retention strategies.

This article, situated within the strategy-as-practice field, explores how healthcare middle managers interpret, contextualize, and adapt sociotechnical systems to achieve strategic objectives. It begins by recognizing how formulation, implementation, and monitoring/evaluation are not separate steps in policy and strategy; rather they are entangled and working in concert to deliver outcomes that meet an intent based on principles and planning assumptions. Next it provides insights into the coevolution of middle manager practices and the sociotechnical systems that guide alignment and misalignment. It then concludes with four recommendations to improve middle manager practices in policy and strategy implementation.

Prior research has identified gaps in the ability of hospital systems to efficiently and meaningfully characterize older adults with complex health needs. We recruited community-dwelling older adults presenting to 10 Emergency Departments (EDs) across Ontario, Quebec, and Newfoundland, Canada, from April 2017 to July 2018. We deployed a staged assessment strategy based on the interRAI Acute Care Suite to identify and characterize older adults at high risk of Alternate Level of Care designation. More than 5,700 patients underwent the ED-Screener, 53.3% of whom were not self-reliant. Subsequent focused screening and assessment identified 457 patients, 93.3% of whom were not self-reliant, and who had significant impairments in function, mobility, and cognition, as well as social vulnerability. A staged assessment approach based upon the interRAI Acute Care Suite can efficiently identify older adults with risk factors for Alternative Level of Care designation.

Long-Term Care (LTC) in Canada faces persistent challenges in quality, staffing, and accountability. InterRAI assessment instruments, used nationally and internationally, provide validated scales, quality indicators, and care planning tools that support evidence-based resident assessment. Yet, their potential has been limited by delayed access, facility-level aggregation, and lack of integration with workforce and operational data. OnSPARK (Ontario Supporting Partnerships to Advance Care and Knowledge in Long-Term Care) addresses this gap as Canada's largest sector-governed LTC data platform. By integrating de-identified interRAI assessments, electronic health records, and staffing data from more than 200 Ontario homes, OnSPARK delivers unit-level analytics, near real-time performance reporting, and a secure environment for embedded research and artificial intelligence development. This article describes how OnSPARK enables interRAI to function as the backbone of a learning health system in LTC, advancing unit-level reporting, workforce-outcome linkages, artificial intelligence-enabled tools, and collaboratives such as the Seniors Quality Leap Initiative.

Data from routine interRAI assessments can inform healthcare decisions at individual, organizational, and system levels. A well-designed, sustainable education strategy for all target audiences is essential to support both implementation and ongoing use of interRAI systems. Instructional design strategies and considerations for developing an educational program are described, as well as specific delivery suggestions for three audiences: (1) interRAI assessors who complete accurate assessments or coordinate them within teams; (2) clinicians who utilize interRAI assessment outcomes without conducting the assessments themselves; and (3) end users such as administrators, officials, and researchers who use interRAI data for management, governance, service delivery, performance measurement, policy, and research.