Healthcare Management Forum最新文献

It is generally accepted that wicked problems cannot be addressed by a single organization and require multiorganizational arrangements across governmental jurisdictions and sectoral boundaries. Health leaders increasingly are being called upon to lead collaborative initiatives. However, doing so is fraught with complexity. This article draws on relevant organizational literature and an empirical study focused on public sector collaboration for the purpose of fostering climate resilience in the health system to put forward four guidelines for collaborative leaders.

Healthcare is a surprisingly large contributor to climate change, responsible for a significant quantity of global Greenhouse Gas (GHG) emissions. Global commitments to achieve "net zero" health systems, including by the federal government in Canada, suggest a growing need to understand and mobilize capacity for GHG emissions estimation across Canada's health sector. Our analysis highlights efforts by public sector healthcare organizations in Canada to estimate an increasingly broad scope of GHG emissions, building on longstanding efforts to report or reduce energy-related emissions from facilities. It also identifies why such efforts will not be sufficient. Developing capacity for routine system-wide greenhouse gas emissions estimation can help Canada's health systems to better understand their progress, including through international comparison. Yet emissions estimation is itself an investment, one that should not displace efforts to reduce the full scope of pollutants from the healthcare enterprise, and to build a truly sustainable health system.

An urban centre in southwestern Ontario continues to be faced with the extensive impacts of high rates of substance use. To more effectively meet the Quintuple Aim, in a way that authentically considers patients who use substances, the need for a cohesive, comprehensive organizational harm reduction strategy at the large academic acute care hospital providing community and regional healthcare services was clear. Community-based harm reduction expertise was leveraged to support the development work. Information gathered through literature review and interviews with patients, internal staff and leaders, partner healthcare agencies, and Canadian hospitals leading in harm reduction work provided key insights and supported the formulation of emerging recommendations that will be used to shape the acute care hospital's formal organizational harm reduction strategy.

That immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access. Recommendations are intended to help make sure that all health services are accessible to everyone, and move beyond a homogenizing category of "newcomers" into practical, meaningful strategies that attend to diverse and intersecting community needs.

Principles-focused evaluation reflects on the change process itself through examination of its underlying principles. The Centre for Advancing Collaborative Healthcare & Education (CACHE) worked to build interprofessional education programs and tools that attended to the Team Primary Care (TPC) principles. Our internally directed principles-focused evaluation, presented here, asks how CACHE adhered to these principles in the programs and tools it delivered to the TPC project. The article's main contribution is the creation of a new concept, organizational critically reflective practice, which describes an approach health leaders can use to mitigate the limitations of short-term initiatives while pursuing transformational change. We propose specific tools and steps that will help health leaders attempting to enact organizational critically reflective practice.

The concept of value-based healthcare and focus on health outcomes is not new. While these ideas have been shared for decades, health systems still struggle to implement value-based decision making. This article describes the Innovation Pipeline, a framework that embeds value-based decision making in a healthcare organization. The Innovation Pipeline outlines the measurable evidence requirements needed to demonstrate organizational definitions of value. This evidence of value allows health leaders to make decisions supported by rigorous data, evidence, and evaluation, ensuring initiatives that bring organizational value progress from good ideas that require testing to evidence-based services embedded and sustained in operational workflows. The Innovation Pipeline is rigorous and customizable to all levels of the health system and designed to streamline evidence-generation activities, focusing on collecting evidence needed to demonstrate value and inform funding and resource allocation decisions.

As immigration continues to drive Canada's growth, the newcomer serving sector remains pivotal in facilitating newcomers' integration into communities. However, this sector grapples with ongoing challenges, exacerbated by the federal government's priority to increase immigration levels, thereby complicating the settlement landscape. This article examines the funding and service delivery difficulties organizations encounter. It underscores a system that fosters funding competition, impedes interorganizational collaboration, complicates program outcome reporting, and entails high administrative costs. Additionally, it addresses the specific challenges faced by newcomer children, youth, and families settling in Canada. The recommendations emphasize that no single agency can resolve the settlement sector crisis alone. Urgent actions include piloting integrated networks over integrated services and adopting a new Immigration, Refugees and Citizenship Canada funding model that aligns with population and cultural needs. Moreover, eliminating silos is essential to establish a cohesive and efficient service delivery network committed to public outcomes and accountability.

The effects of laboratory mergers and acquisitions on the clinical performance of its workforce remain largely unknown. This study examined laboratory professionals' work engagement and productivity, and investigated the role of social support as a moderator during mergers and acquisitions. A 51 question on-line survey was designed to cover demographics, work engagement, productivity, and levels of social support. A sample t test was used to measure work engagement levels between laboratory professionals with higher social support to others with lower support. The finding that laboratory professionals with higher levels of social support are more engaged and productive at the workplace has important policy implications for leaders managing laboratories in times of mergers and acquisitions.

This article examines the leadership challenges of prison healthcare, specifically focusing on the ageing inmate population. It highlights the distinct health burdens faced by this demographic, including higher disease prevalence and an accelerated ageing process. The concept of prison activities of daily living is central to addressing these challenges, emphasizing the need to tailor health assessments and care plans to the unique prisoner-environment interactions. This article advocates for inclusive person-centred care. It suggests that involving older prisoners in their care planning, aligned with the "ageing in the right place" principle, can significantly improve their quality of life. Additionally, it explores strategies to combat social isolation and loneliness among older prisoners, such as intergenerational activities and prison-community partnerships. Health leaders can echo these findings in policy development and incorporate collaborative, inclusive, diverse, and intergenerational models that address the complex health needs of older prisoners.

Social Accountability (SA) in healthcare includes understanding and responding to how social determinants affect patient health. Altruistic healthcare professionals can improve socially accountable patient care at the individual patient or family level (micro), the population or community level (meso), and/or provincial, federal, or international levels (macro). There is a well-established healthcare equity gap for Sexual and Gender Diverse (SGD) people affected by cancer. In this article, I discuss how SA has played a role in my career. As a SGD healthcare professional, I offer some personal examples of SA in action that have made a difference. For socially accountable healthcare professionals, there is almost always something to contribute to improve care, from the patient to the policy level.