Healthcare Management Forum最新文献

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.

Physicians are increasingly called to lead beyond clinical care, addressing system inefficiencies through innovation and entrepreneurial action. This qualitative multiple-case study examined how 21 physicians in the United States developed and applied "dual acumen," the integration of scientific expertise and entrepreneurial intelligence to advance healthcare innovation. Guided by effectuation theory, data were analyzed by NVivo 12 for thematic coding. Findings demonstrate how physician entrepreneurs navigated uncertainty through five effectual principles: bird-in-hand, affordable loss, crazy quilt, lemonade, and pilot-in-the-plane. These principles informed the development of the Dual Acumen Model, an empirically derived framework explaining how physicians translate clinical insights into entrepreneurial practice and system-level innovation. The study contributes empirical evidence that hybrid physician leaders advance healthcare improvement by integrating scientific and innovation competencies that build leadership capacity and organizational adaptability.

In January 2025, the Ministry of Health and Social Services commissioned an independent expert panel to make recommendations to guide the first government policy addressing the primary care crisis in Quebec. Conducted over a period of 4 months, this work combines a targeted literature review, 59 consultations with more than 200 stakeholders, and a provincial forum to develop recommendations grounded in evidence and local realities. Findings from the consultations revealed a fragmented, hospital-centred system characterized by inequitable access and insufficient continuity. The expert committee formulated six coherent and locally adaptable key recommendations aligned with international best practices. This provides a pragmatic and comprehensive roadmap to strengthen primary care in Quebec through interdisciplinary teams, territorial governance, protected and dedicated funding, data infrastructure, and user involvement. A concrete action plan is essential to achieve the proposed vision, which will require time, consistency, and structured planning.

This article explores how living with complex mental health conditions can serve as a valuable asset in health leadership. It uses the author's personal journey after receiving a borderline personality disorder diagnosis before beginning a career in healthcare, and her decision to disclose her diagnosis despite the risks to her career. This decision was made in part due to her belief that personal disclosure could combat stigma, encourage understanding, and be an asset to her career rather than a detriment. The author reflects on reframing her disorder as a source of leadership strength rather than weakness. This article encourages other health leaders to lead by example, normalize discussions about mental health, and embrace the innovative ideas of individuals with lived experiences. Ultimately, this article serves as a call to action for reducing stigma surrounding borderline personality disorder and other mental health challenges, fostering inclusivity, and promoting authenticity in the workplace.

Electronic Health Record (EHR) systems can help to improve patient safety by reducing common errors, but they can also introduce new safety risks associated with the technology itself. The application of Human Factor (HF) methods in an EHR implementation project is critical to identify usability issues early and optimize the build to ensure safety, efficiency, and alignment with clinical workflows. Despite the benefits, inclusion of HF evaluations can have time and resource costs which must be accounted for in the overall project plans and timelines. Based on our experiences with a large-scale EHR implementation project, this article outlines recommendations on how to incorporate HF evaluation methods into EHR design. Over the 7-year roll-out, the HF team had the opportunity to engage with over 400 clinical end users in 30 usability evaluations across the EHR project, which yielded over 2,000 recommendations for improvement to address usability issues.

Since its legalization in 2016, Medical Assistance in Dying (MAiD) in Canada has undergone significant development, yet the roles of Unregulated Support Providers (USPs) remain largely overlooked in research and policy discussions. This study investigates the experiences of and challenges faced by USPs supporting patients choosing MAiD in Canada. We conducted semi-structured interviews with 19 USPs across Canada, recruited via purposive sampling. Thematic analysis was employed to explore experiences and identify patterns of service provision, collaboration, and barriers to care. USPs offer emotional, educational, and logistical support to patients and families navigating MAiD-related decisions. Despite their contributions, they face barriers, such as financial inaccessibility and lack of formal recognition. Participants advocated for greater integration into the formal healthcare system and regulation to enhance accountability, accessibility, and patient safety. USPs can play an important yet overlooked role in MAiD. Their formal recognition could enhance psychosocial care for patients.