Healthcare Management Forum最新文献

Health leaders are increasingly interested in harnessing Artificial Intelligence (AI) to remotely conduct virtual triage for Emergency Department (ED) patients. This study explores equity considerations and patient attitudes to virtual triage in a Canadian ED. A cross-sectional study surveyed 150 ED patients, with 32 additional patients interviewed in-depth. Descriptive statistics and qualitative descriptive methodology were employed. 84.7% of patients would consider virtual triage. 71.3% were comfortable following advice to seek alternate care, including their General Practitioner or virtual ED. Approximately 38.2% of patients >60 years would require assistance using virtual triage, with confidence in using technology to direct care decreasing with age. Thematic analysis revealed five key themes: value of decision support; care access expectations; technological literacy demographics; trust in AI; and confidentiality. In conclusion, virtual triage is a viable and promising tool if barriers to technological literacy are addressed, and tools are endorsed by health providers and patients.

The redesign of the rehabilitation program at Runnymede Healthcare Centre (RHC) was designed to enhance patient care, staff satisfaction, and rehabilitation capacity. Aligned with RHC's strategic vision to become a centre of excellence for ageing and wellness, the initiative introduced a range of initiatives such as group therapy models, specific, measurable, achievable, relevant and time-bound rehabilitation goals, and enhanced leadership practices under the healthy engagement of older adults in rehabilitation therapy philosophy. Evaluation was integral to the initiative, with patient satisfaction, staff engagement, and key performance indicators continuously measured. Patient satisfaction scores, operational efficiency metrics, and staff engagement scores improved considerably. This project exemplifies how structured change management and embedded evaluation can lead to sustained improvements in patient care, staff experience, and rehabilitation outcomes.

The purpose of this article is to assess whether COVID-19 shaped Canadians' preferred settings of dying. We compared data collected using the same survey from two independent but comparable sets of panel respondents, prior to and after the onset of the pandemic. A vignette methodology was used to assess preferences for dying in each of four settings: home, acute/intensive care, palliative care, and long-term residential care. Although preferences for dying at home, in acute/intensive care and palliative care units did not change, preferences for dying in nursing homes significantly declined. In the pandemic's first and second waves, the spread of knowledge about problems of poor care, visitation restrictions, and fears of contagion in Canadian long-term residential care may have shaped public perceptions of and preferences for dying these settings. If this change persists, it may influence advance care planning decisions. That preferences for dying at home did not shift is, however, noteworthy.

Holistic care models aligned to population care needs are needed to help leaders shed pre-existing mindsets when determining skill mix and Multidisciplinary Team (MDT) composition. Using a PRISMA flowchart, a narrow eligibility criterion, and a research question, this scoping review resulted in 9 frameworks/models published between January 2000 and September 2023. Analysis showed common methodological elements such as a population needs-based approach, a systematic process, engagement, three or more professions reporting task or competency level analysis, change advocacy, and reliance on population and workforce supply data. Key system enablers were sponsorship, access to population needs-based and workforce supply data, a learning management system for MDT development, and health human resource policies and governance to drive health system redesign to distribute an equitable workforce. This scoping review offers health leaders and policy-makers options and next-step considerations to inspire fresh thinking for making evidence-informed decisions about skill mix and MDT composition.

The COVID-19 pandemic created an increased demand for healthcare professionals across all healthcare sectors globally. Attrition, retirement, delayed graduations, and sick leaves resulted in an inadequate supply of knowledgeable, skilled, and experienced nurses to care for hospitalized patients and help address hospital capacity pressures. In response to this health human resource crisis in Canada, the Ontario Ministry of Health offered hospitals funding to support the employment of Clinical Externs (CEs), that is, students in nursing, respiratory therapy, physiotherapy, occupational therapy medicine, and paramedicine, hired to work as unregulated staff, alongside an inter-professional team. This mixed-methods study evaluated the CE program that was implemented in one large academic hospital. The primary aim was to identify the outcomes of the clinical extern program from the perspectives of CEs, CE coordinators, and clinical leaders. Findings indicate the clinical extern program reinforces student confidence and supports their transition to formal nursing and respiratory therapy roles.

This scoping review of gender and healthcare leadership synthesized the barriers and facilitators at multiple levels employing a framework that integrates a specific focus on the concept of care. The 71 sources identified focus predominantly on barriers to women's leadership at the individual and team level and, to a lesser extent, at the organizational and system level. Facilitators tend to be presented as recommended actions than evaluated interventions. Healthcare leadership tends to ignore the gendered context of care elevating leaders who are least likely to provide such care. Where personal caregiving circumstances are considered, they are individualized, reflecting the literature in general. More critical analysis is needed to focus on women's experiences and how their gender can predetermine their success in achieving and being in leadership positions. Healthcare leadership researchers are encouraged to include gender and care-focused analyses and interventions to address the under-representation of women in healthcare leadership.

The One Health perspective highlights the potential synergies between the human, animal, and environmental health sciences, especially in an era of budget shortfalls, climate change, and emerging infectious diseases of zoonotic origin. Canadian physicians and veterinarians arguably lay the foundation of One Health in the late 19^th century, when they pioneered the study of "comparative medicine" in Montreal, but they fell into disciplinary silos before World War I to the lasting detriment of the Canadian population. This article explores both the advantages and impediments to cross-disciplinary healthcare collaboration in Canada, highlighting the country's vast size, sparse population, and political decentralization in particular, and offers a number of policy recommendations that would allow the country to reclaim its rightful role as a leader in the One Health movement.

This article investigates whether, in the context of rising nationalism, drawing attention to national innovation strategies influences public health behaviours, particularly vaccine uptake. It draws on an original two-wave panel study of United Kingdom (UK) respondents during the COVID pandemic. The survey included an experimental design, which primed respondents with a nationalist framing of COVID-19 vaccines, drawing attention to the UK's role in developing the AstraZeneca vaccine and in rapid approval and roll out of other vaccines. Our results show no significant impact of nationalist framing on vaccine willingness, even among those with nationalist or science-skeptical views. These findings suggest public health authorities should be cautious with nationalist framing, as it may be ineffective or counterproductive.

Private Equity (PE) investment in healthcare has grown substantially in recent years, raising alarm about its impact on patient care, healthcare professionals, and the overall integrity of the healthcare system. The influx of PE investments into healthcare has sparked debates regarding profit-driven motives, cost-cutting measures, and potential risks to patient safety and access to essential services. This article examines the extent and possible impacts of private equity in Canadian healthcare using data from a proprietary database. Drawing upon evidence from academic studies in the United States, this article provides evidence on the adverse impacts on the quality of care, the deterioration in working conditions, and degradation of the healthcare system. It provides suggestions to limit the predatory impacts of PE investment.

COVID-19 increased the use of technology in everyday life and highlighted critical applications for assistive technologies. This comparative research study explores how assistive technologies, including socially assistive robots, can be adopted by long-term care homes to mitigate the lasting effects of the pandemic. In particular, we investigated the types of assistive technologies used by long-term care facilities to help with the care of older residents and for what tasks. Furthermore, we identified barriers to adoption and proposed policy measures that encourage technology adoption.