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Towards abundant intelligences: Considerations for Indigenous perspectives in adopting artificial intelligence technology. 走向丰富的智能:在采用人工智能技术时对土著观点的考虑。
Q3 Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-03 DOI: 10.1177/08404704241257144
Julia A Silano

Artificial Intelligence (AI) applications in healthcare are evolving rapidly. The integration of AI into the Canadian healthcare system has demonstrated significant potential for enhancing the efficiency of care and improving patient outcomes. However, as this transformative technology continues to advance, it is crucial to take into account the unique perspectives and requirements of Indigenous Peoples in Canada. This article delves into the political, ethical, and practical considerations associated with introducing AI into Indigenous healthcare, emphasizing the paramount importance of equity and inclusion, which are rooted in the Two-Eyed AI framework. It also underscores the significance of co-creating AI technology in collaboration with Indigenous communities and multidisciplinary development teams. To illustrate these principles, this article spotlights an international AI epistemology-focused working group example. Healthcare professionals who engage with AI, whether it be through research, management, development, or leadership are implicated with this contemporary paradigm shift in decolonizing novel AI technology.

人工智能(AI)在医疗保健领域的应用发展迅速。将人工智能融入加拿大医疗保健系统已显示出其在提高医疗保健效率和改善患者治疗效果方面的巨大潜力。然而,随着这一变革性技术的不断进步,考虑到加拿大原住民的独特视角和要求至关重要。本文深入探讨了将人工智能引入土著医疗保健的相关政治、伦理和实际考虑因素,强调了根植于 "双眼人工智能 "框架中的公平性和包容性的极端重要性。它还强调了与原住民社区和多学科开发团队合作共同创造人工智能技术的重要性。为了说明这些原则,本评论着重介绍了一个以人工智能认识论为重点的国际工作组实例。无论是通过研究、管理、开发还是领导,与人工智能打交道的医疗保健专业人员都与这种新型人工智能技术去殖民化的当代范式转变息息相关。
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引用次数: 0
Engagement with partners is a leading practice in health workforce planning: What health leaders need to know. 与合作伙伴共同参与是卫生人力规划中的一种领先做法:卫生领导者需要了解什么。
Q3 Medicine Pub Date : 2024-09-01 Epub Date: 2024-07-21 DOI: 10.1177/08404704241263015
Zeenat Ladak, Henrietta Akuamoah-Boateng, Cynthia Damba, Rachel Frohlich, Shelly-Ann Hall, Joy Ikeh, Renata Khalikova, Sarah Simkin, Ruth Trainor, Catherine Yu, Ivy Lynn Bourgeault

Workforce planning ensures that the health workforce is aligned with current and future population needs. Engagement with partners and knowledge users is a leading practice in planning and is essential for planning to be successful. The goal of this study was to explore the considerations and processes involved in integrating engagement into workforce planning. Through a case study of primary care workforce planning in Toronto, we address the role of engagement, how it can be integrated into planning, and how lessons from engagement support spread and scale of effective workforce planning. In the course of engagement with five Ontario Health Teams between September 2023 and February 2024, we learned that there is considerable enthusiasm for planning, but that support is needed, and that engagement guides investment and strengthens relationships. We offer guidance for leaders with respect to actualizing engagement and building capacity for health workforce planning across the health system.

医务人员队伍规划可确保医务人员队伍符合当前和未来的人口需求。让合作伙伴和知识使用者参与进来是规划的主要做法,也是规划取得成功的关键。本研究的目的是探讨将参与融入劳动力规划的考虑因素和过程。通过对多伦多初级医疗劳动力规划的案例研究,我们探讨了参与的作用、如何将其纳入规划,以及参与的经验如何支持有效劳动力规划的推广和规模化。在 2023 年 9 月至 2024 年 2 月与安大略省五个医疗团队的接触过程中,我们了解到,人们对规划有相当大的热情,但也需要支持,而参与则能引导投资并加强关系。我们为领导者提供了指导,帮助他们在整个卫生系统中实现参与并建设卫生人力规划的能力。
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引用次数: 0
Healthcare innovations: Enhancing patient privacy and security in the digital era. 医疗创新:在数字时代加强病人的隐私和安全。
Q3 Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-22 DOI: 10.1177/08404704241254820
Patrick Lo

Technology integration in the healthcare industry has resulted in unparalleled efficiency and accessibility to healthcare services. However, this digital transformation has also created new vulnerabilities, particularly in cyberattacks, which pose significant patient safety and privacy threats. To address this issue, healthcare providers must proactively safeguard patient data and mitigate cybersecurity risks. This includes implementing robust security protocols, adhering to established privacy regulations, and selecting digital health solutions from vendors prioritizing privacy and security. By doing so, the healthcare industry can ensure that patients' personal and personal health information remains private and secure while maintaining the efficiency and accessibility of healthcare services.

医疗保健行业的技术整合带来了无与伦比的效率和医疗保健服务的可及性。然而,这种数字化转型也带来了新的漏洞,特别是在网络攻击方面,这对患者的安全和隐私构成了重大威胁。为解决这一问题,医疗服务提供商必须积极保护患者数据并降低网络安全风险。这包括实施强大的安全协议,遵守既定的隐私法规,并从优先考虑隐私和安全的供应商处选择数字医疗解决方案。通过这样做,医疗保健行业可以确保患者的个人和个人健康信息的私密性和安全性,同时保持医疗保健服务的效率和可及性。
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引用次数: 0
Developing a comprehensive curriculum program for nurse practitioners delivering primary care in the long-term care setting. 为在长期护理环境中提供初级护理的执业护士制定综合课程计划。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1177/08404704241259900
Adhiba Nilormi, Carrier Heer, Erin Ziegler

In the Long-Term Care (LTC) setting, comprehensive primary care is often provided by Nurse Practitioners (NPs). NPs are uniquely positioned to meet the evolving primary care needs of LTC residents. However, caring for this population requires additional education and training due to its special considerations. To meet the learning needs of NPs entering the LTC workplace, a Certificate Program was designed to enhance primary care competencies within the LTC setting. The aim of the program is to increase knowledge, capacity, and confidence of NPs to deliver quality, evidence-based, integrated, and interprofessional primary care to LTC residents. This curriculum is anticipated to address the growing need for LTC services and improve the delivery of high-quality primary care.

在长期护理(LTC)环境中,综合初级护理通常由执业护士(NPs)提供。执业护师在满足 LTC 居民不断变化的初级保健需求方面具有得天独厚的优势。然而,由于其特殊性,对这一人群的护理需要额外的教育和培训。为了满足即将进入 LTC 工作岗位的 NP 的学习需求,我们设计了一项证书课程,以提高 LTC 环境中的初级护理能力。该课程的目的是提高护士的知识、能力和信心,以便为长期护理中心的居民提供优质、循证、综合和跨专业的初级护理。预计该课程将满足对长寿护理服务日益增长的需求,并改善高质量初级护理的提供。
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引用次数: 0
Bioplastics: No solution to healthcare's plastic pollution problem. 生物塑料:无法解决医疗塑料污染问题。
Q3 Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-17 DOI: 10.1177/08404704241259652
Jasmine T Yu, Miriam L Diamond, Brittany Maguire, Fiona A Miller

As Canadian policy-makers recognize the urgency for concerted actions to reduce plastics (e.g., Canada's involvement in the international plastics treaty negotiations, zero plastic waste strategy, and single-use plastics regulations), the healthcare sector must also consider a more sustainable plastics system. In this context, the potential for novel bioplastics to mitigate healthcare's substantial plastic waste problem must be carefully interrogated. Our analysis examines the complexities of bioplastics, highlighting the technical challenges of identifying legitimate sustainable alternatives, and the practical barriers for implementing bioplastics as substitutes for consumable plastics in healthcare. We focus on the Canadian healthcare sector and regulatory landscape with the insights gained being applicable to other sectors and countries. Given the limitations identified, the focus on reducing consumption should remain the priority.

随着加拿大政策制定者认识到采取一致行动减少塑料的紧迫性(例如,加拿大参与《国际塑料条约》谈判、"零塑料废物战略 "和一次性塑料法规),医疗保健行业也必须考虑建立一个更具可持续性的塑料系统。在这种情况下,必须仔细研究新型生物塑料在缓解医疗保健行业大量塑料废物问题方面的潜力。我们的分析探讨了生物塑料的复杂性,强调了确定合法的可持续替代品所面临的技术挑战,以及在医疗保健领域实施生物塑料作为消耗塑料替代品所面临的实际障碍。我们将重点放在加拿大的医疗保健行业和监管环境上,所获得的见解也适用于其他行业和国家。鉴于所发现的局限性,降低消耗仍应是当务之急。
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引用次数: 0
Co-development of a national, bilingual, post-licensure accredited educational program for registered nurses in primary care: A knowledge-to-action exemplar. 共同开发全国性、双语、执照后认可的初级保健注册护士教育计划:从知识到行动的典范。
Q3 Medicine Pub Date : 2024-09-01 DOI: 10.1177/08404704241259929
Marie-Eve Poitras, Julia Lukewich, Treena Klassen, Mireille Guérin, Dana Ryan, Anne-Sophie Langlois, Suzanne Braithwaite, Anaëlle Morin, Deanne Curnew, Crystal Vaughan, Monica McGraw, Robin Devey-Burry, Marie-Dominique Poirier, Toni Leamon, Sheila Epp, Donna Bulman

Registered nurses' practice in primary care varies and is sometimes sub-optimal. To fill the gap in primary care-specific knowledge, we co-constructed a national educational program to reinforce the nursing workforce. We based our project on the knowledge-to-action approach. Many lessons were learned during the development phase: (1) The experiential knowledge of patient partners and stakeholders allows an education program based on real needs; (2) The development of a national education program requires high-intensity investment from all involved persons; (3) An in-person meeting at the beginning of the project enables robust discussions and optimal co-creation; and (4) In a country where two official languages are spoken, it's essential to create a safe environment and a translation infrastructure that allows everyone to express themselves in the language of their choice. Finally, other initiatives in healthcare education or professional practice improvement could leverage our findings to realize national-scale projects using knowledge creation approaches.

注册护士在初级护理方面的实践各不相同,有时甚至不尽如人意。为了填补初级护理方面的知识空白,我们共同制定了一项全国性教育计划,以加强护理人员队伍建设。我们的项目基于 "从知识到行动 "的方法。在开发阶段,我们汲取了许多经验教训:(1)患者合作伙伴和利益相关者的经验知识有助于根据实际需求制定教育计划;(2)国家教育计划的开发需要所有相关人员的高强度投入;(3)在项目开始时召开一次面对面会议,可以进行热烈的讨论,实现最佳的共同创造;以及(4)在一个使用两种官方语言的国家,必须创造一个安全的环境和翻译基础设施,让每个人都能用自己选择的语言表达自己的观点。最后,医疗保健教育或专业实践改进方面的其他倡议可以利用我们的研究成果,使用知识创造方法实现全国规模的项目。
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引用次数: 0
Approaching collaboration in primary care differently: Exploring boundaries and boundary objects. 以不同的方式开展初级保健合作:探索边界和边界对象。
Q3 Medicine Pub Date : 2024-08-13 DOI: 10.1177/08404704241271150
Monique Walsh

In recent primary care policy, collaboration is often understood as an outcome, such as the delivery of team-based care or an integrated health system. This outcome-based understanding of collaboration in policy has proven challenging to achieve in practice. This article introduces the concepts of constructing boundaries and boundary objects used in other disciplines, to support our understanding of collaboration by observing the collaborative process. Multiple methods, such as semi-structured interviews, discourse analysis, and member-checking, were used to compare primary care collaborations across three distinct time periods during the onset of COVID-19 within Interior British Columbia. Data analysis revealed the changing nature of boundaries and boundary objects, providing insights into the collaborative process. Through the exploration of boundaries and boundary objects, this article provides a way to approach collaboration in practice differently. By better understanding the process of collaboration, this research could potentially improve collaborative outcomes.

在最近的初级医疗政策中,合作通常被理解为一种结果,如提供团队医疗服务或综合医疗系统。事实证明,在实践中实现政策中这种基于结果的合作理解具有挑战性。本文介绍了其他学科中使用的构建边界和边界对象的概念,通过观察合作过程来支持我们对合作的理解。文章采用半结构式访谈、话语分析和成员检查等多种方法,对不列颠哥伦比亚省内陆地区 COVID-19 开始实施期间三个不同时期的初级医疗合作进行了比较。数据分析揭示了边界和边界对象不断变化的性质,提供了对合作过程的见解。通过对边界和边界对象的探索,本文提供了一种在实践中以不同方式开展合作的方法。通过更好地了解合作过程,这项研究有可能改善合作成果。
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引用次数: 0
Innovation Pipeline: A framework for value-based decision making. 创新管道:基于价值的决策框架。
Q3 Medicine Pub Date : 2024-08-12 DOI: 10.1177/08404704241271186
Arianna Waye, Barbara Hughes, Kelly Mrklas, Nancy Fraser, Tracy Wasylak, Marc Leduc, Anderson Chuck

The concept of value-based healthcare and focus on health outcomes is not new. While these ideas have been shared for decades, health systems still struggle to implement value-based decision making. This article describes the Innovation Pipeline, a framework that embeds value-based decision making in a healthcare organization. The Innovation Pipeline outlines the measurable evidence requirements needed to demonstrate organizational definitions of value. This evidence of value allows health leaders to make decisions supported by rigorous data, evidence, and evaluation, ensuring initiatives that bring organizational value progress from good ideas that require testing to evidence-based services embedded and sustained in operational workflows. The Innovation Pipeline is rigorous and customizable to all levels of the health system and designed to streamline evidence-generation activities, focusing on collecting evidence needed to demonstrate value and inform funding and resource allocation decisions.

以价值为基础的医疗保健和注重医疗结果的概念并不新鲜。虽然这些理念已经流传了几十年,但医疗系统在实施基于价值的决策时仍然举步维艰。本文介绍了 "创新管道"(Innovation Pipeline),这是一个将基于价值的决策纳入医疗机构的框架。创新管道概述了展示组织价值定义所需的可衡量证据要求。这些价值证据使医疗机构的领导者能够在严格的数据、证据和评估支持下做出决策,确保能为组织带来价值的举措从需要测试的好想法发展为基于证据的服务,并在业务工作流程中得以嵌入和维持。创新管道 "非常严格,可根据卫生系统的各个层面进行定制,旨在简化证据生成活动,重点收集证明价值所需的证据,并为资金和资源分配决策提供依据。
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引用次数: 0
How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care. 移民如何造成健康方面的不利条件,医疗机构如何才能提供更加公平的医疗服务。
Q3 Medicine Pub Date : 2024-07-24 DOI: 10.1177/08404704241265675
Mei-Ling Wiedmeyer, Stefanie Machado, Elmira Tayyar, Cecilia Sierra-Heredia, Yasmin Bozorgi, Selamawit Hagos, Shira Goldenberg, Ruth Lavergne

That immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access. Recommendations are intended to help make sure that all health services are accessible to everyone, and move beyond a homogenizing category of "newcomers" into practical, meaningful strategies that attend to diverse and intersecting community needs.

移民是健康的一个决定因素,而移民制度本身也造成了结构性的不利因素,但这一问题在加拿大的医疗保健领域仍未得到充分重视。本文以不列颠哥伦比亚省的一个社区研究项目为基础,介绍了移民如何影响健康的背景,并就医疗系统如何更好地应对移民和移徙者(统称为移民/移徙者)的不同需求提出了建议。研究结果呼吁人们关注移民身份、获得医疗保险的机会、语言、创伤和歧视经历、缺乏医疗系统的支持等限制获得医疗服务的各种交叉方式,以及社区组织在支持获得医疗服务方面发挥的作用。这些建议旨在帮助确保所有人都能获得所有医疗服务,并超越 "新移民 "这一同质化类别,制定切实可行、有意义的战略,满足多样化和交叉性的社区需求。
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引用次数: 0
Self-identification and workplace experience surveys for equity and inclusion in healthcare. 医疗保健领域平等与包容的自我认同和工作场所经验调查。
Q3 Medicine Pub Date : 2024-07-24 DOI: 10.1177/08404704241266139
Naomi Mumbi Maina, Neila Miled, Melissa Crump

Data and evaluation have become integral to efforts aimed at transforming organizational cultures. This is true in Diversity, Equity, and Inclusion (DEI), where organizations are assessing their employee make-up and the impact of their programs and services on systematically marginalized communities. This article presents a case study of a self-identification and workplace experience survey that was the first of its kind at the Provincial Health Services Authority in British Columbia. With a 30.7% response rate, we share an overview of the survey, lessons learned, and recommendations for other healthcare institutions embarking on their DEI journey. Key takeaways include engaging leaders early and allowing adequate time and resources for planning and executing the survey. Confidentiality is a crucial element to ensure that everyone feels confident to take the survey. Ultimately, adequate implementation of actions from survey results will build trust among staff and advance DEI priorities in organizations.

数据和评估已成为旨在转变组织文化的努力不可或缺的一部分。在多元化、公平与包容(DEI)领域也是如此,各组织正在评估其员工构成及其项目和服务对系统边缘化社区的影响。本文介绍了不列颠哥伦比亚省卫生服务管理局首次开展的自我认同和工作场所经验调查的案例研究。该调查的回复率为 30.7%,我们将与读者分享该调查的概况、经验教训,以及对其他医疗机构在开展 DEI 之旅方面的建议。主要启示包括尽早让领导参与进来,并为计划和执行调查留出充足的时间和资源。保密是确保每个人都有信心参与调查的关键因素。最终,充分实施调查结果中的行动将在员工中建立信任,并推进组织中的 DEI 优先事项。
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引用次数: 0
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Healthcare Management Forum
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