Healthcare Management Forum最新文献

Our Canadian multi-site academic health sciences centre uses a standardized process to review critical patient safety incidents and develop recommendations to prevent incident reoccurrence. We recognized an opportunity to enhance recommendation development by integrating the Hierarchy of Intervention Effectiveness (HIE), a human factors framework, into the incident review process. This project aimed to increase the proportion of system-focused recommendations from critical incident reviews from 16 to 30% over 16 months. A multi-intervention strategy included (1) standardizing the incident analysis review template; (2) earmarking time for recommendation development during reviews; (3) providing participants with just-in-time education and tools; and (4) initiating HIE-based recommendation classification during incident reviews. Statistical process control p-Chart analysis showed an increase in system-focused recommendations from 16 to 30% over 16 months. The HIE promotes system-level change to prevent critical incidents, which other organizations may benefit from incorporating in their patient safety reviews.

Remote Patient Monitoring (RPM) technologies, including blood pressure monitor, pulse oximeter, thermometer, scale, and tablet, allow eligible patients to monitor and share their vitals with their healthcare team from the comfort of their home. When procuring new RPM devices, human factors specialists sought feedback from patients and clinicians using the RPM devices and conducted usability testing with patient advisors to inform the purchasing decision. Usability testing is a validated human factors technique that evaluates the ease of use and safety of medical devices and equipment. A device that is easy to use can increase patient adherence to reporting their vitals, reduce stress for the patient, and increase the pool of patients who can use the devices easily at home. Lessons learned on how to incorporate usability testing into the procurement cycle, and the value of involving end-users in patient facing medical device evaluations will be provided.

Quality mental healthcare delivery in Canada continues to face challenges in consistency and effectiveness. To address these gaps and respond to the evolving mental health landscape post-COVID, HealthCareCAN and the Mental Health Commission of Canada revised the Quality Mental Healthcare Framework (QMHCF) and developed an implementation toolkit. A multi-phase approach was used, including an environmental scan, key informant interviews, and consultations with people with lived and living experience to refine the framework and inform implementation strategies. The QMHCF identifies eight core dimensions of quality, emphasizing care as equitable, trauma-informed, recovery-oriented, evidence-based, integrated, stigma-free and inclusive, appropriate, and delivered in a positive work-life environment. The implementation toolkit includes practical guidance, case studies, and evaluation tools to support adoption. Both the revised framework and toolkit provide healthcare organizations with evidence-informed resources to enhance the delivery of mental health services across diverse care settings in Canada.

This is a case study about University Health Network (UHN) and West Park (WP) Healthcare Centre's merger in April 2024, marking a significant milestone in organizational transformation. As part of this integration, Occupational Health departments at both organizations were unified into a single team. Data collection, process mapping, and gap analysis were employed to conduct current-state assessments, which identified key differences in organizational structure, database systems, technology platforms, and operational processes. By addressing these gaps, the team clarified roles, centralized infrastructure, aligned policies, and standardized workflows. Four key domains were targeted for integration: organizational structure, database systems, technology platforms, and operational processes. Challenges in change management, resource allocation, and training were addressed strategically. This integration approach improved multidisciplinary communications, standardized protocols, reduced manually intensive administrative workload, and enhanced safety, emphasizing project scoping, cross-functional collaboration, and innovative solutions for operational excellence.

This article presents how the Registered Nurses' Association of Ontario developed the People-Centred Care, 3^rd edition best practice guideline and describes its use in advancing patient advocacy by implementing the three guiding principles, two evidence-based recommendations and five good practice statements. Furthermore, the guideline equips leaders and organizations with implementation tips to promote patient autonomy, address systemic barriers, and foster inclusive, advocacy-driven care. We emphasize leadership's role in fostering cultures of engagement, collaboration, and empowerment. This is a critical tool for organizations, leaders, and providers seeking to embed patient advocacy within practice and policy. It underscores the transformative potential of leadership-driven advocacy in advancing people-centred care and ensuring health systems prioritize the voices, needs, and experiences of those they serve.

This article focuses on the implementation of interRAI instruments at a national health system level. It is based on a narrative review undertaken by the authors from several interRAI member countries. Implementation experiences from several countries and searches of PubMed and other databases, grey literature sources, policy reports, and the interRAI repository, identified practical insights and recommendations relevant for health system implementation. Key considerations are outlined. These include policy and legal considerations, resourcing considerations, training and education considerations, and data considerations.

This article aimed to examine the philosophy of Artificial Intelligence (AI) in healthcare and present a novel framework that could bridge philosophy, ethics, and leadership to promote the responsible and human-centered integration of AI. Moving beyond efficiency and innovation, it explored the deeper philosophical, moral, and human dimensions of AI's evolving role in care delivery. The proposed framework incorporated teleology, ontology, epistemology, axiology, and ethics to provide a structured foundation for guiding AI development, implementation, and governance through purpose, knowledge, values, and moral action. Grounded in these principles, it highlights the leadership approaches that foster accountability, organizational readiness, and ethical stewardship in AI adoption. These insights informed the development of a framework designed to align AI with human values and to promote compassionate, ethical, and sustainable applications that enhance healthcare outcomes while preserving the essence of human care.

Healthcare organizations face accelerating digital transformation, yet sustainable change depends on empowering the people at the centre of care. This article presents a human-centred change management approach that positions clinical leaders as effective advocates for innovation. Drawing on experience within a large integrated health system, we explore how inclusion and agency mitigate resistance and foster adoption. Two digital use cases-a nurse handoff tool and a scheduling and staffing platform-illustrate how co-authorship in design and implementation builds a sense of ownership and advocacy. By embedding representation and control into change processes, organizations not only improve adoption but cultivate a culture in which clinicians champion transformation. This approach reframes change management as a strategic lever for advocacy, aligning digital innovation with patient-centred values and frontline realities.

Improving aged care quality is a global priority. Effective monitoring and evaluation systems are the mechanism through which this priority can be realized. The interRAI consortium offers an integrated clinical information system that spans multiple care settings to support quality improvement in clinical care, meeting policy, industry, and recipient needs. However, the economic value of implementing these systems remains unknown, complicated by challenges in monetizing relevant costs and benefits. Using Campbell and Brown's cost-benefit methodology, we present a flexible framework to evaluate the cost-benefit of implementing interRAI as a minimum dataset for aged care, focused on the cost-benefit domain of care quality. Our framework provides a comprehensive foundation for cost-benefit analysis of interRAI implementation. It presents an informative starting-point for high-level decision-makers to reliably estimate the value of implementing integrated clinical information systems at multiple levels.