Healthcare Management Forum最新文献

Alcohol Use Disorder (AUD) is a medical condition uniquely affecting the female population, requiring widespread restructuring of current services to increase treatment utilization and efficacy. This review synthesizes the literature on the service and treatment needs of women with AUD. A literature search and review were conducted following PRISMA guidelines. Key informant information was collected during interviews with health leaders. Data from literature searches and interviews were analyzed to identify common themes. Results found women face more barriers when accessing and receiving AUD treatment. Major barriers include stigma, location, transportation, and childcare, which contribute to the AUD treatment gap among women. Recommendations to reduce barriers include (1) implementing universal screening, (2) improving care provider education and awareness, (3) providing childcare services, (4) establishing a strong client-clinician relationship, (5) building a community approach for Indigenous clients, (6) improving Managed Alcohol Programs, and (7) expanding virtual substance use prescribing practices.

Social Accountability (SA) in healthcare includes understanding and responding to how social determinants affect patient health. Altruistic healthcare professionals can improve socially accountable patient care at the individual patient or family level (micro), the population or community level (meso), and/or provincial, federal, or international levels (macro). There is a well-established healthcare equity gap for Sexual and Gender Diverse (SGD) people affected by cancer. In this article, I discuss how SA has played a role in my career. As a SGD healthcare professional, I offer some personal examples of SA in action that have made a difference. For socially accountable healthcare professionals, there is almost always something to contribute to improve care, from the patient to the policy level.

This article examines the leadership challenges of prison healthcare, specifically focusing on the ageing inmate population. It highlights the distinct health burdens faced by this demographic, including higher disease prevalence and an accelerated ageing process. The concept of prison activities of daily living is central to addressing these challenges, emphasizing the need to tailor health assessments and care plans to the unique prisoner-environment interactions. This article advocates for inclusive person-centred care. It suggests that involving older prisoners in their care planning, aligned with the "ageing in the right place" principle, can significantly improve their quality of life. Additionally, it explores strategies to combat social isolation and loneliness among older prisoners, such as intergenerational activities and prison-community partnerships. Health leaders can echo these findings in policy development and incorporate collaborative, inclusive, diverse, and intergenerational models that address the complex health needs of older prisoners.

The Canadian health system is reeling following the COVID-19 pandemic. Strains have become growing cracks, with long emergency department wait times, shortage of human health resources, and growing dissatisfaction from both clinicians and patients. To address long-needed health system reform in Canada, a modernization of training is required for the next generation health leaders. The Canadian Institutes of Health Research Health System Impact Fellowship (HSIF) is an example of a well-funded and connected training program which prioritizes embedded research and embedding technically trained scholars with health system partners. The program has been successful in the scope and impact of its training outcomes as well as providing health system partners with a pool of connected and capable scholars. Looking forward, integrating aspects of evidence synthesis from both domestic and international sources and adapting a general contractor approach to implementation within the HSIF could help catalyze learning health system reform in Canada.

This article explores the concerning phenomenon of the narrowing effect in public discourse, particularly in the context of healthcare and Medicare. It discusses the challenges posed by this narrowing effect, the impact of cognitive biases, and the ethical dilemmas faced by healthcare providers and organizations when patients take their concerns public. The article also emphasizes the importance of responsible leadership and offers navigation for overcoming the narrowing of public discourse.

Understanding how cognitive biases, mental models, and mindsets impact leadership in health systems is essential. This article supports the notion of cognitive biases as flawed thinking or cognitive traps which negatively influence leadership. Mental models that do not fit with current evidence limit our ability to comprehend and respond to system issues. Resulting mindsets affect cognition, behaviour, and decision-making. Metacognition is critical. The wicked problems in today's complex health system require leaders and everyone involved to elevate their personal, organizational, and disciplinary perspectives to a systems level. Three examples of mental models/mindsets are reviewed. They do not change simply because we wish or will them to. The first step is being aware of what they are and how they impact our thinking and decision-making. Some tips for managing these traps are offered as examples of how to challenge our leadership approach in the health system.

A rational decision-making process enables a leader to process information clearly and logically and thus allows for accurate perception and interpretation of the event. It is believed this process prevents leaders from excessively distorting reality and being impacted by cognitive biases, both of which are possible, particularly under stressful conditions. But what happens when the decision-making environment is rapidly changing and the leader does not have time to deploy a thorough, comprehensive rational decision-making process? In time-compressed decision-making environments, leaders must often make quick, accurate decisions, with incomplete, inaccurate, or rapidly changing information, under extremely stressful conditions. To improve the ability of a leader to make high-stress, time-compressed decisions under rapidly changing conditions, we offer the intuitive decision-making process as an alternative to rational decision-making and discuss five components essential to improve intuitive decision-making outcomes.

Health inequities are increasing in Canada and across the globe. They pose a substantial threat to the health and well-being of millions of people. Organizational leadership, if it is to effectively contribute to tackling these inequities, must become more systematically infused with competencies that address power and the structural determinants of health. Health equity contexts for 2SLGBTQIA+ (Two Spirit, Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual, and Plus) remain a neglected area of focus in organizational leadership. The goals of this article are to provide: (1) a concise description of critical perspectives and critical leadership studies, (2) describe the urgency of theoretical and applied leadership approaches that more fulsomely integrate critical perspectives, and (3) illustrate an integration of a complex adaptive systems approach to support critical perspectives in advancing health equity for 2SLGBTQIA+ people.