Pub Date : 2024-11-01Epub Date: 2024-08-16DOI: 10.1177/08404704241273965
Khalil B Ramadi, Saakshi More, Anshuman Shaji
Successful innovation clusters are notoriously difficult to establish, and many attempts fail. How can we go about designing such systems reliably? We describe how ecosystems can be strengthened through grassroots bottom-up efforts that empower user and community innovation, as opposed to economic policies that dictate innovation. Specifically focusing on the healthcare industry, we advocate that community hospitals which constitute 90% of all hospitals in Canada are the ideal setting for such community innovation efforts. We investigated the distribution of innovation output from hospitals over the past 13 years and found a decrease in predominance of major teaching hospitals, supporting the potential role for community hospitals in this space. We categorize different types of innovations and recommend institutional policies that can sustain bottom-up, micro-level efforts. Such policies could improve and enhance the development of micro-innovations and the creation of health innovation clusters.
{"title":"Making hospitals innovative: Macro-level policy to sustain micro-innovations in healthcare.","authors":"Khalil B Ramadi, Saakshi More, Anshuman Shaji","doi":"10.1177/08404704241273965","DOIUrl":"10.1177/08404704241273965","url":null,"abstract":"<p><p>Successful innovation clusters are notoriously difficult to establish, and many attempts fail. How can we go about designing such systems reliably? We describe how ecosystems can be strengthened through grassroots bottom-up efforts that empower user and community innovation, as opposed to economic policies that dictate innovation. Specifically focusing on the healthcare industry, we advocate that community hospitals which constitute 90% of all hospitals in Canada are the ideal setting for such community innovation efforts. We investigated the distribution of innovation output from hospitals over the past 13 years and found a decrease in predominance of major teaching hospitals, supporting the potential role for community hospitals in this space. We categorize different types of innovations and recommend institutional policies that can sustain bottom-up, micro-level efforts. Such policies could improve and enhance the development of micro-innovations and the creation of health innovation clusters.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"462-466"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-22DOI: 10.1177/08404704241271218
Pierre Pelletier, Aldo Geuna, Daniel Souza
This study explores the deployment of Artificial Intelligence (AI) in Canadian hospitals from 2000 to 2021, focusing on metropolitan areas. We investigate how local public and private research ecosystems and links to national and international AI hubs influence the adoption of AI in healthcare. Our analysis shows that AI research outputs from public institutions have a significant impact on AI competences in hospitals. In addition, collaborations between hospitals are critical to the successful integration of AI. Metropolitan areas such as Toronto, Montreal, and Vancouver are leading the way in AI deployment. These findings highlight the importance of local AI research capabilities and international hospital collaborations and provide guidance to policy-makers and health leaders to drive the diffusion of AI technology in healthcare.
{"title":"Artificial intelligence research in Canadian hospitals: The development of metropolitan competencies.","authors":"Pierre Pelletier, Aldo Geuna, Daniel Souza","doi":"10.1177/08404704241271218","DOIUrl":"10.1177/08404704241271218","url":null,"abstract":"<p><p>This study explores the deployment of Artificial Intelligence (AI) in Canadian hospitals from 2000 to 2021, focusing on metropolitan areas. We investigate how local public and private research ecosystems and links to national and international AI hubs influence the adoption of AI in healthcare. Our analysis shows that AI research outputs from public institutions have a significant impact on AI competences in hospitals. In addition, collaborations between hospitals are critical to the successful integration of AI. Metropolitan areas such as Toronto, Montreal, and Vancouver are leading the way in AI deployment. These findings highlight the importance of local AI research capabilities and international hospital collaborations and provide guidance to policy-makers and health leaders to drive the diffusion of AI technology in healthcare.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"445-450"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-29DOI: 10.1177/08404704241271164
Jennifer Zelmer
Scaling the innovative models of care, policies, practices, and technologies that deliver true value requires deliberate, focused effort. We need to simultaneously apply practical strategies that enable change agents to drive meaningful, sustainable impact to address particular challenges that a health system is facing, alongside implementing proven, evidence-informed approaches that broadly strengthen health system foundations. Both approaches matter; it's not about choosing between them. Rather, we need to respond to the health system's specific and immediate needs, while also growing culture, capacity, systems, and tools that enable transformation in quality and safety.
{"title":"Getting better at getting better: Advancing quality and safety in healthcare.","authors":"Jennifer Zelmer","doi":"10.1177/08404704241271164","DOIUrl":"10.1177/08404704241271164","url":null,"abstract":"<p><p>Scaling the innovative models of care, policies, practices, and technologies that deliver true value requires deliberate, focused effort. We need to simultaneously apply practical strategies that enable change agents to drive meaningful, sustainable impact to address particular challenges that a health system is facing, alongside implementing proven, evidence-informed approaches that broadly strengthen health system foundations. Both approaches matter; it's not about choosing between them. Rather, we need to respond to the health system's specific and immediate needs, while also growing culture, capacity, systems, and tools that enable transformation in quality and safety.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"429-433"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-19DOI: 10.1177/08404704241273997
Renate Ilse
Innovation is essential for advancing and sustaining healthcare systems, particularly in hospitals. While innovation offers solutions to challenges such as chronic disease management, access to care, and patient safety, it also introduces significant ethical dilemmas for health leaders. This column explores the broad ethical issues associated with healthcare innovation, focusing on resource allocation, support for diverse healthcare professions, equitable access to care, and the emphasis on technology-based innovations. It highlights the complexities of funding innovation through government, private sector, universities, donors, and the unpaid work of healthcare providers. The column also addresses the disparities in innovation support across different professions and the potential for innovation to exacerbate healthcare inequities. Potential solutions are proposed, including the establishment of interdisciplinary councils, dedicated innovation funds, and public-private partnerships. By prioritizing ethical leadership and balanced innovation strategies, health leaders can ensure that advancements benefit all stakeholders, fostering a more equitable and sustainable healthcare system in Canada.
{"title":"Ethical challenges in healthcare innovation: A leadership perspective.","authors":"Renate Ilse","doi":"10.1177/08404704241273997","DOIUrl":"10.1177/08404704241273997","url":null,"abstract":"<p><p>Innovation is essential for advancing and sustaining healthcare systems, particularly in hospitals. While innovation offers solutions to challenges such as chronic disease management, access to care, and patient safety, it also introduces significant ethical dilemmas for health leaders. This column explores the broad ethical issues associated with healthcare innovation, focusing on resource allocation, support for diverse healthcare professions, equitable access to care, and the emphasis on technology-based innovations. It highlights the complexities of funding innovation through government, private sector, universities, donors, and the unpaid work of healthcare providers. The column also addresses the disparities in innovation support across different professions and the potential for innovation to exacerbate healthcare inequities. Potential solutions are proposed, including the establishment of interdisciplinary councils, dedicated innovation funds, and public-private partnerships. By prioritizing ethical leadership and balanced innovation strategies, health leaders can ensure that advancements benefit all stakeholders, fostering a more equitable and sustainable healthcare system in Canada.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"467-470"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1177/08404704241290777
Jae Yon Jones, Amanda Leddy, Gloria Real
In Long-Term Care (LTC) settings, the potentially inappropriate use of antipsychotics for behavioural and psychological symptoms of dementia is a persistent issue, with high rates despite limited benefit and serious risk. Best practice is a non-pharmacological, person-centred approach to care, though this can be challenging in LTC settings. To help address this gap, we developed the PIECESTM HCA Care Coach Program and described its implementation and outcomes observed at 13 LTC homes. This program empowers Health Care aides with training, tools, and processes to practice the principles of person-centred care and provide peer mentorship to the care team. After 1 year, we found declining antipsychotics use (by 4.4%) and positive indicators of improved staff experience and improved resident quality of life. The Care Coach Program can be adapted and spread to a variety of LTC settings to help reduce potentially inappropriate antipsychotic use and better support people living with dementia.
{"title":"HCA PIECES<sup>TM</sup> Care Coach Program: Peer to peer approach to promote person-centred care in long-term care.","authors":"Jae Yon Jones, Amanda Leddy, Gloria Real","doi":"10.1177/08404704241290777","DOIUrl":"https://doi.org/10.1177/08404704241290777","url":null,"abstract":"<p><p>In Long-Term Care (LTC) settings, the potentially inappropriate use of antipsychotics for behavioural and psychological symptoms of dementia is a persistent issue, with high rates despite limited benefit and serious risk. Best practice is a non-pharmacological, person-centred approach to care, though this can be challenging in LTC settings. To help address this gap, we developed the PIECES<sup>TM</sup> HCA Care Coach Program and described its implementation and outcomes observed at 13 LTC homes. This program empowers Health Care aides with training, tools, and processes to practice the principles of person-centred care and provide peer mentorship to the care team. After 1 year, we found declining antipsychotics use (by 4.4%) and positive indicators of improved staff experience and improved resident quality of life. The Care Coach Program can be adapted and spread to a variety of LTC settings to help reduce potentially inappropriate antipsychotic use and better support people living with dementia.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704241290777"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1177/08404704241293051
George A Heckman, Sarah Gimbel, Chantelle Mensink, Brittany Kroetsch, Aaron Jones, Anooshah Nasim, Melissa Northwood, Jacobi Elliott, Adam Morrison
Many older adults have complex needs and experience high rates of acute care use and institutionalization. Comprehensive Geriatric Assessment (CGA) is a specialized multidimensional interprofessional intervention to prevent such outcomes, but access to CGA in the community is limited. The Integrated Care Team (ICT) is a proactive case-finding intervention to support older adults with complex needs in primary care. The ICT provides nurse practitioner-led shared-care supported by a pharmacist, family physician, and geriatrician. Patients undergo a CGA, and a person-centred plan of care is implemented. We conducted a mixed-methods evaluation of the ICT. Patients were 81 ± 9.2 years old, 71% were women. Patients had a high burden of dementia and multimorbidity and received 12.8 ± 5.8 prescriptions daily. The ICT improved prescribing and reduced emergency department visits by 49.5% (P = 0.0001). Patients, care partners, and referring physicians reported high satisfaction with care. The ICT is currently being expanded to support additional primary care providers.
{"title":"The Integrated Care Team: A primary care based-approach to support older adults with complex health needs.","authors":"George A Heckman, Sarah Gimbel, Chantelle Mensink, Brittany Kroetsch, Aaron Jones, Anooshah Nasim, Melissa Northwood, Jacobi Elliott, Adam Morrison","doi":"10.1177/08404704241293051","DOIUrl":"https://doi.org/10.1177/08404704241293051","url":null,"abstract":"<p><p>Many older adults have complex needs and experience high rates of acute care use and institutionalization. Comprehensive Geriatric Assessment (CGA) is a specialized multidimensional interprofessional intervention to prevent such outcomes, but access to CGA in the community is limited. The Integrated Care Team (ICT) is a proactive case-finding intervention to support older adults with complex needs in primary care. The ICT provides nurse practitioner-led shared-care supported by a pharmacist, family physician, and geriatrician. Patients undergo a CGA, and a person-centred plan of care is implemented. We conducted a mixed-methods evaluation of the ICT. Patients were 81 ± 9.2 years old, 71% were women. Patients had a high burden of dementia and multimorbidity and received 12.8 ± 5.8 prescriptions daily. The ICT improved prescribing and reduced emergency department visits by 49.5% (<i>P</i> = 0.0001). Patients, care partners, and referring physicians reported high satisfaction with care. The ICT is currently being expanded to support additional primary care providers.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704241293051"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-13DOI: 10.1177/08404704241289095
Loren Tisdelle
The Attendance, Wellness, and Engagement (AWE) Model of Workplace Satisfaction is an innovative approach to promoting a sustainable, healthy, and engaged workforce. Implemented at Louis Brier Home and Hospital, the AWE Model encapsulates a people strategy aimed at nurturing a supportive and fulfilling work environment. Attendance promotion is accomplished by acknowledging absences while providing a comprehensive support system to address personal challenges faced by healthcare workers. The wellness component is underscored by increasing resource utilization, offering on-site health services, and cultivating social groups to enhance holistic well-being. Additionally, engagement is characterized by staff recognition rituals, community-building initiatives, and celebratory events. Importantly, this article presents a compelling position that the AWE Model creates a positive impact on reducing absenteeism, enhancing staff satisfaction, and transforming organizational culture. As health leaders grapple with workforce challenges, the AWE Model serves as a pragmatic framework to cultivate environments where employees regularly attend work healthy and engaged.
{"title":"Attendance, Wellness, and Engagement: The AWE Model of Workplace Satisfaction.","authors":"Loren Tisdelle","doi":"10.1177/08404704241289095","DOIUrl":"https://doi.org/10.1177/08404704241289095","url":null,"abstract":"<p><p>The Attendance, Wellness, and Engagement (AWE) Model of Workplace Satisfaction is an innovative approach to promoting a sustainable, healthy, and engaged workforce. Implemented at Louis Brier Home and Hospital, the AWE Model encapsulates a people strategy aimed at nurturing a supportive and fulfilling work environment. Attendance promotion is accomplished by acknowledging absences while providing a comprehensive support system to address personal challenges faced by healthcare workers. The wellness component is underscored by increasing resource utilization, offering on-site health services, and cultivating social groups to enhance holistic well-being. Additionally, engagement is characterized by staff recognition rituals, community-building initiatives, and celebratory events. Importantly, this article presents a compelling position that the AWE Model creates a positive impact on reducing absenteeism, enhancing staff satisfaction, and transforming organizational culture. As health leaders grapple with workforce challenges, the AWE Model serves as a pragmatic framework to cultivate environments where employees regularly attend work healthy and engaged.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704241289095"},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-06DOI: 10.1177/08404704241288458
Grace Liu, Kristina Kokorelias, Amanda Knoepfli, Tracey DasGupta, Naomi Ziegler, Emma Elliot, Sara J T Guilcher, Sander L Hitzig
A Patient Navigation (PN) model of care was introduced in a large metropolitan hospital in Ontario (Canada) to support transitions in care for older adults in 2019. The patient navigator is a community social worker or "community transitional lead" embedded in the hospital's in care teams to assist with discharge planning and provide follow-up care to older adults, their families, and/or care partners for up to 90 days. Initially, the PN program supported acute care patients and has since expanded in the Emergency Department and Reactivation Care Centre. In this cohort retrospective observational study, we described the new PN model of care by analyzing the clinical notes collected by the patient navigator. This article provides preliminary insights for health leaders who are interested in implementing this novel PN model to improve transitions of care in a hospital setting. Funding was provided by the SLAIGHT Family Foundation.
{"title":"A new patient navigation model of care to support older adults in transitions of care: Key considerations for implementation for policy-makers and health system leaders.","authors":"Grace Liu, Kristina Kokorelias, Amanda Knoepfli, Tracey DasGupta, Naomi Ziegler, Emma Elliot, Sara J T Guilcher, Sander L Hitzig","doi":"10.1177/08404704241288458","DOIUrl":"https://doi.org/10.1177/08404704241288458","url":null,"abstract":"<p><p>A Patient Navigation (PN) model of care was introduced in a large metropolitan hospital in Ontario (Canada) to support transitions in care for older adults in 2019. The patient navigator is a community social worker or \"community transitional lead\" embedded in the hospital's in care teams to assist with discharge planning and provide follow-up care to older adults, their families, and/or care partners for up to 90 days. Initially, the PN program supported acute care patients and has since expanded in the Emergency Department and Reactivation Care Centre. In this cohort retrospective observational study, we described the new PN model of care by analyzing the clinical notes collected by the patient navigator. This article provides preliminary insights for health leaders who are interested in implementing this novel PN model to improve transitions of care in a hospital setting. Funding was provided by the SLAIGHT Family Foundation.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704241288458"},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1177/08404704241271235
Kaiyan Fu, Sarah Tam Lee
Necessitated by the healthcare crisis and exacerbated by the pandemic, and building on model of care experimentation over the last decade, SE Health executed on an organizational change to bring the innovative model to life. This model is titled H.O.P.E. MODEL™ of Care-Home, Opportunity, People, Empowerment. The innovation in model of care design and implementation is guided by the Integrated-Promoting Action on Research Implementation in Health Services (i-PARiHS) framework. Our journey highlights the art of leadership and science of implementation for sustainable impact on care excellence and health system transformation. This implementation experience has also generated the following insights: reinforce the foundation, operationalizing practice, what gets measured gets done, technology enabling practice, and all roads lead to H.O.P.E.
在医疗危机和大流行病的双重影响下,东南欧医疗集团在过去十年的护理模式实验基础上,进行了组织变革,将创新模式付诸实践。这一模式被命名为 "H.O.P.E. MODEL™ of Care--家庭、机会、人、赋权"。护理模式的创新设计和实施以健康服务研究实施综合促进行动(i-PARiHS)框架为指导。我们的历程彰显了领导的艺术和实施的科学,从而对卓越护理和医疗系统转型产生可持续的影响。我们的实施经验还产生了以下启示:强化基础、实践操作化、量力而行、技术助力实践,以及所有道路都通向 H.O.P.E。
{"title":"Art of leadership and science of implementation for sustainable impact of organizational model of care.","authors":"Kaiyan Fu, Sarah Tam Lee","doi":"10.1177/08404704241271235","DOIUrl":"https://doi.org/10.1177/08404704241271235","url":null,"abstract":"<p><p>Necessitated by the healthcare crisis and exacerbated by the pandemic, and building on model of care experimentation over the last decade, SE Health executed on an organizational change to bring the innovative model to life. This model is titled H.O.P.E. MODEL™ of Care-Home, Opportunity, People, Empowerment. The innovation in model of care design and implementation is guided by the Integrated-Promoting Action on Research Implementation in Health Services (i-PARiHS) framework. Our journey highlights the art of leadership and science of implementation for sustainable impact on care excellence and health system transformation. This implementation experience has also generated the following insights: reinforce the foundation, operationalizing practice, what gets measured gets done, technology enabling practice, and all roads lead to H.O.P.E.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704241271235"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}