Healthcare Management Forum最新文献

This article presents the development of the Equity, Diversity, Inclusivity, and Accessibility (EDIA) Cross-Cutting Theme Project within the Team Primary Care (TPC) initiative, aimed at addressing systemic inequities through innovative educational strategies. Grounded in the social accountability of health professions framework, this project aims to equip primary care teams with the knowledge, skills, and attitudes necessary to promote health equity. The EDIA Integrated Educational Experience (IEE) model includes a self-assessment tool, digital learning space, and national mentorship network, providing a comprehensive approach for primary care teams to promote health equity. The IEE model utilizes a layered micro, meso, and macro approach to support cultural transformation within highly complex healthcare environments. Key lessons learned involve trust- and relationship-building processes to help dismantle historical silos and encourage open dialogue. Future efforts focus on implementation, ensuring adaptability, scalability, and sustainability, positioning the model as a catalyst for equitable primary care delivery.

Canada has been unique in the modern era for limiting midwives from providing sexual health and perinatal care to families. Prohibitions on midwifery practice were finally lifted in Prince Edward Island in 2024, yet midwives' scope of practice continues to be restricted in most jurisdictions. The Canadian Midwifery Regulators Council recently recommended midwives should be able to practice their full scope. Our midwifery pilot project, located in the city of Victoria, British Columbia, implemented this recommendation in 2023-2024. Below we demonstrate the benefits of integrating midwifery into a primary healthcare clinic and the continued challenges midwives and their teams face in securing salaried employment long-term. We focus on the specialized cultural and clinical skillset that Indigenous registered midwives in particular bring to primary care, and the life-saving outcomes that can occur for youth clients if interprofessional collaboration and cooperation are well-established.

In March 2020, as the COVID-19 cases began to rise in Ontario, Canada, the central role of Occupational Health and Safety (OHS) to ensure the well-being of hospital workforce became highly visible. While Ontario's hospitals concentrated efforts to meet each challenging and uncertain wave stressing the system, it was apparent that there is a lack of consistency in best practices and policy response across the healthcare sector. Additionally, the unprecedented pressure on healthcare workforce as they attempted to meet the pandemic's new surging demands resulted in workforce shortages and increased levels of burnout, making it difficult to engage, support, and retain the staff necessary for delivering highest quality of services. The Toronto Academic Health Science Network (TAHSN), a dynamic consortium of 14 healthcare organizations, established a collaborative to implement an integrated effort and align on structure, processes, and standards that will increase strength and defensibility of TAHSN programs. To foster community building, identify areas of common concern, and co-create practices during and beyond the COVID-19 pandemic, a structured network of 14 OHS directors across the healthcare organizations was established. This article discusses the origin of the TAHSN collaborative, the thriving community vision for partnership, and the case study methodology used to combine capabilities to showcase innovation and excellence in care together.

The psychological health and safety of healthcare workers workplaces and learning environments impacts the quality of healthcare services. To facilitate the psychological health and safety of interprofessional primary care teams, we curated a bilingual toolkit of 122 psychological health and safety resources comprising a multi-level categorization addressing individual, team, organization, and system-level interventions. The resources in the toolkit are organized by 7 themes, based on a clustering of the 15 psychosocial factors. Adopting the framework built on the 7 themes, this article describes the toolkit development process and how it addresses the key factors for psychologically healthy and safe workplaces to foster interprofessional collaboration. Implementation of the interventions in the toolkit is an important next step for which health system leadership is critical. Additionally, we identify several gaps and call on researchers, educators, and health leaders to address them in their future work.

As healthcare embraces the transformative potential of Artificial Intelligence (AI), it is imperative to safeguard patient and provider safety, equity, and trust in the healthcare system. This article outlines the approach taken by the British Columbia (BC) Provincial Health Services Authority (PHSA) to establish clinical governance for the responsible deployment of AI tools in healthcare. Leveraging its province-wide mandate and expertise, PHSA establishes the infrastructure and processes to proactively and systematically intake, assess, prioritize, and evaluate AI tools. PHSA proposes a coordinated approach in AI tool deployment in collaboration with regional health authorities to prevent duplication of efforts and ensure equitable access to existing and emerging AI tools across the province of BC, incorporating principles of anti-Indigenous racism, cultural safety, and humility. The proposed governance structure underscores the identification of clinical needs, proactive ethics review, rigorous risk assessment, data validation, transparent communication, provider training, and ongoing evaluation to ensure success.

Accurate and complete surgical and pathology reports are the cornerstone of treatment decisions and cancer care excellence. Synoptic reporting is a process for reporting specific data elements in a specific format in surgical and pathology reports. Since 2007, the Canadian Partnership Against Cancer has led the implementation of synoptic reporting mechanisms across multiple cancer disease sites and jurisdictions across Canada. While the implementation of synoptic reporting has been successful, its use to drive improvements in the quality of cancer care delivery has been lacking. Here we describe the 4-year, national multi-jurisdictional quality improvement initiative to catalyse the use synoptic data to drive cancer system improvements. Resources provided to the jurisdictions included operational funding, training in quality improvement methodology, national forums, expert coaches, and ad hoc monitoring and support. The program emphasized foundational concepts including data literacy, audit and feedback reports, communities of practice, and positive deviance methodology.

Contemporary healthcare at all levels increasingly uses Artificial Intelligence (AI). However, since the various levels involve different tasks, have different data needs, and different ethical obligations, the AIs that are used have to be differently structured. Also, since healthcare construed as a commodity involves different ethical parameters from healthcare construed as a right, and different ethical systems entail logically distinct considerations, this also necessitates the need for differently structured AIs. This column sketches how and why this is the case. It concludes with a brief look at why AIs programmed into quantum computers would not change this.

Although it is challenging to assess the greenhouse gas emission footprint associated with individual products and services, health leaders can play a pivotal role in emissions reduction by understanding and utilizing available tools and certifications that measure suppliers' operational environmental performance. Integrating environmental standards into procurement and supplier selection has the potential to greatly impact emissions production across the healthcare landscape as it will pressure suppliers to improve their operations in order to be selected. The purpose of this article is to emphasize the importance of the supply chain in addressing healthcare-related greenhouse gas emissions. We provide an overview of the types of tools available that can be used to evaluate the carbon footprints of individual companies and rate their performances, as well as certifications that formally recognize companies' sustainability practices and commitments.

Healthcare delivery systems in Canada are structured using three models: individual institutions, health regions, and single provincial systems, usually with smaller geographic zones. The comparative ability of these models to improve care, outcomes, and the Quadruple Aim is largely unstudied. We reviewed Canadian studies examining outcomes of provincial healthcare delivery system restructuring. Across models, results were inconsistent, and quality of evidence was low. For all provinces, primary care sits outside healthcare delivery systems, with limited governance and integration. The single provincial model can reduce costs of non-clinical support functions like finance, human resources, and analytics. This model may also be best at reducing variations in care, improving electronic information integration that enables clinical decision support and reporting, and supporting the provincial spread and scale of innovations, but further refinements are required and existing studies have major limitations, limiting definitive conclusions.

Lack of access, system inequities, and inefficiencies plague our current healthcare system. With a challenge this complex, no one intervention is sufficient; all will be necessary. The primary care system needs a strong health workforce prepared in bold new ways. Students represent an important voice, given their role as future leaders of health education and healthcare. For students to lead, educators must leverage education paradigms that position current students as leaders of transformation. Yet, in current health education systems, students are often seen as passive recipients of knowledge and skill. Transformative education seeks to foster critical reflection (an ongoing process of questioning unhelpful assumptions and power relations) and informed action in students to enable them to challenge and change norms and change practices, structures, and society. This article highlights the value of transformative education in cultivating thoughtful change agents and provides one tangible example of a new education/practice model that puts this paradigm into action.