Healthcare Management Forum最新文献

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.

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.

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.

Primary care is the key health system strategy for improving health, enhancing patient and clinician experience, saving money, and promoting equity. Once a pioneer in primary care, Canada now fails to provide access to millions of people. This crisis is widely recognized, but policy responses are varied and mostly incremental and piecemeal. The goal of providing primary care to everyone seems unrealistic and elusive in Canada, yet it has long been attained in many other countries. Without an explicit policy goal of primary care for all, most likely on a geographic basis, Canada will continue to underinvest and underperform in primary care, with ramifications that include rapidly escalating costs, emergency department and hospital overcrowding and a growing and inequitable burden of preventable suffering. A commitment to work towards this goal is needed now to ensure that Canadians have access to high-quality well-organized care for everyone.

Pharmaceutical companies claim that they need high drug prices to generate sufficient profits to invest in innovation. While this claim can be valid in principle, it is contradicted by the extent to which "Big Pharma" companies in the United States (US) distribute profits to shareholders in the form of cash dividends and stock buybacks. For 2013-2022, the 14 US-based pharmaceutical companies in the S&P 500 Index paid out 54% of net income as dividends and another 51% as buybacks. Incentivizing senior corporate executives to allocate resources in this financialized manner is, as we document, their stock-based compensation. In effect, these companies use high stock prices to boost stock yields at the expense of investing in innovation and compensating workers and taxpayers who make value-creating contributions to the corporation. Given the prominence of US-based pharmaceutical corporations in Canada, we explain how their financialization results in high Canadian drug prices and underinvestment in pharmaceutical research and development in Canada.

In today's evolving healthcare landscape, leaders must innovate and collaborate to ensure safe, accessible, and high-quality care. Addressing complex issues like climate change, workforce resiliency crises, and the erosion of public trust, alongside equity and inclusive services, is critical. This article offers insights into the role of quality standards and assessment programs as catalysts for innovation and future collective impact. Using examples from Health Standards Organization and Accreditation Canada, it illustrates how these levers of change enable leaders to improve patient and workforce safety, advance integrated care, and strengthen the health of communities. Embracing people-centred and evidence-informed solutions to enable new mindsets and ways of working lays the foundation for sustainable, resilient learning health systems.