Healthcare Management Forum最新文献

This article aimed to examine the philosophy of Artificial Intelligence (AI) in healthcare and present a novel framework that could bridge philosophy, ethics, and leadership to promote the responsible and human-centered integration of AI. Moving beyond efficiency and innovation, it explored the deeper philosophical, moral, and human dimensions of AI's evolving role in care delivery. The proposed framework incorporated teleology, ontology, epistemology, axiology, and ethics to provide a structured foundation for guiding AI development, implementation, and governance through purpose, knowledge, values, and moral action. Grounded in these principles, it highlights the leadership approaches that foster accountability, organizational readiness, and ethical stewardship in AI adoption. These insights informed the development of a framework designed to align AI with human values and to promote compassionate, ethical, and sustainable applications that enhance healthcare outcomes while preserving the essence of human care.

Healthcare organizations face accelerating digital transformation, yet sustainable change depends on empowering the people at the centre of care. This article presents a human-centred change management approach that positions clinical leaders as effective advocates for innovation. Drawing on experience within a large integrated health system, we explore how inclusion and agency mitigate resistance and foster adoption. Two digital use cases-a nurse handoff tool and a scheduling and staffing platform-illustrate how co-authorship in design and implementation builds a sense of ownership and advocacy. By embedding representation and control into change processes, organizations not only improve adoption but cultivate a culture in which clinicians champion transformation. This approach reframes change management as a strategic lever for advocacy, aligning digital innovation with patient-centred values and frontline realities.

Team-based primary care involving a pharmacist provides many benefits, including improved patient outcomes, increased efficiency, and enhanced patient and clinician satisfaction. This article reports findings from a provincial survey to describe primary care network administrators' experiences during integration of pharmacists into interprofessional team in primary care networks, and to describe the facilitators and barriers of team-based care. Health service administrators reported an overall high degree of satisfaction with their experiences collaborating with the program team and with pharmacists in a developing team-based primary care model. Barriers to team-based care included lack of integrated electronic medical record preventing efficient access and sharing of patient information/communication, lack of role clarity and scope of practice among team members, and lack of co-location precluding relationship building, timely care, and optimization of the team. These barriers should be addressed to optimize the effectiveness and efficiency of the team as the model of primary care continues to evolve.

This study examines the effects of Lean Six Sigma (LSS) projects on patient satisfaction within United States healthcare facilities. Focused on the principles of waste reduction and defect minimization, LSS has increasingly been applied in healthcare settings to enhance service quality and operational outcomes. This literature review provides a summary of the existing literature relating LSS in healthcare to patient satisfaction metrics. By using a Systematic Literature Review approach to analyze studies published from 2011 to 2024, this review synthesizes findings from 7 significant papers selected based on stringent inclusion criteria related to LSS project impact to patient satisfaction in United States healthcare facilities. The results demonstrate that LSS interventions can significantly improve patient satisfaction while also reducing inefficiencies in various healthcare processes such as wait times, scheduling, and discharge procedures. A research agenda for future work is proposed.

To support health system transformation, efforts are underway to implement multi-professional, population needs-based health workforce planning in the province of Nova Scotia. The purpose of this article is to report on these efforts as well as successes and challenges encountered to date. Implementation has progressed furthest in the COVID-19 response and continuing care sectors, with similar efforts underway in primary care and mental health and addictions. Key enablers of needs-based health workforce planning in Nova Scotia include the availability of robust data on workforce supply and collaborative relationships between health system partners. The main challenges with implementing needs-based health workforce planning in Nova Scotia are the absence of provincial-level clinical service planning or standardized levels of service provision, and a lack of systematic collection of data to measure provider workload or health service outcomes.

To make good decisions, health leaders need information about their communities and the health workforce available to meet their needs. Raw data and indicators of population needs and workforce capacity must be transformed into usable intelligence that can support decision-making. Using the case study of integrated primary care workforce planning in Toronto, we outline our workforce planning framework, and with a focus on workforce analysis, describe the inputs and outputs that are needed for planning, key steps in the conversion of data to intelligence, and the impact of the approach. Raw data flow from data partners through a planning model into a six-step workforce analysis that renders the results of data analysis, modelling, synthesis and visualization relevant, and accessible to planners and decision-makers. We highlight important challenges and considerations related to data standardization, comprehensiveness, granularity, accessibility, and timeliness, and envision a system that more effectively supports workforce planning and decision-making.

The use of population-based data sources can offer healthcare planners and organizations insights on whether the health workforce reflects the sociodemographic diversity of the population it is meant to serve. However, sources outside the traditional boundaries of the healthcare system are typically underused in assessing health workforce imbalances to inform planning. This article offers a guide for health leaders on using national census data to monitor health workforce imbalances by geography, gender, and other equity-oriented characteristics. A case study illustrates how census data can provide standardized quantitative information on the oral health workforce, using various dissemination tools (online census tabulators and full census databanks) and methods (including linkages with other sources for enhanced cohort and ecological analyses). We also address practical issues such as the value of fostering academic partnerships to help navigate the analytics competencies and other requirements for using census products to support decisions.

Canada's federal structure is the institutional reality informing our system of public health. While there are advantages to this decentralization, it can also lead to fragmentation and inefficiencies. Calls for stronger federal leadership or better collaboration between jurisdictions are common, but they do not directly address the question of why there has been so little progress in moving in either of these directions. Through the lens of six key public health functions, this article describes contextual realities and disparate interests of the jurisdictions. These underpin a dynamic for public health decision-making in which rational decisions can lead to suboptimal outcomes collectively. Understanding the dynamics of federalism underlying public health in Canada can help us to identify and address barriers to a more effective public health system.

Eight years ago, we were part of a team of authors who wrote about challenges facing public health at that time, indicating threats to public health that also threatened the health of the population and the sustainability of the healthcare system. Eight years later, the issues we discussed remain. In this article, we reflect on what "public health" is, its challenges, and its role both within and beyond the healthcare sector. In particular, we focus on the challenges of downgrading public health within governments and health authorities, of limiting the independence of public health officials, and of limiting public health's scope by combining it with primary and community care. We conclude with the role of public health in wider society and on what could be gained both within and beyond the health sector from a strong public health system that is oriented around a well-being society.

Indigenous Peoples have unique legislative considerations as employees that may have implications for researchers and health workforce leaders. This article aims to contextualize workforce surveys from an Indigenous employee perspective (What), identify legislation and taxation considerations for health workforce leaders regarding Indigenous employees (So What), and share organizational measurement tools and promising practices (Now What).