Healthcare quarterly (Toronto, Ont.)最新文献

Much has been written about the interplay between mental health and substance use disorders. However, there is a third dimension, which often complicates the provision of care and renders many mainstream approaches less effective. Cognitive impairments, including those that arise from traumatic brain injury, are increasingly being recognized as an important consideration in addictions programming. This article will discuss the findings from a cross-sectorial partnership between the Centre for Addiction and Mental Health (CAMH) and Community Head Injury Resource Services of Toronto (CHIRS). Four recommendations for program administrators are proposed: (1) support screening for brain injury; (2) use free resources to train staff members to recognize, accommodate and address neurocognitive impairment; (3) establish cross-sector partnerships to facilitate collaborative programming and cross training for the most complex clients being served; (4) when developing new programming, include structures and behavioural interventions that have been shown to benefit individuals with cognitive impairment.

Increased workloads, fear of illness, social disconnection and high burnout rates during the COVID-19 pandemic caused significant trauma throughout the medical community. Using evidence-based insights from Mental Health Research Canada's quantitative and qualitative data, this article explores how the healthcare community was impacted by the COVID-19 pandemic. Recent trends in national mental health indicators support a theory of a new normal, but some Canadians continue to fall behind. Overall, these insights highlight the need for sustained efforts from leaders, policy makers and researchers that are crucial to supporting the rebuilding of the healthcare sector in Canada.

Early in the year 2024, my mother, Mary V. Seeman (MD, DSc, OC, FRCPC), received news that would recognize her lifelong goal, which was to humanize and empower some of the most stigmatized members of society - the severely mentally ill and their parents and, in particular, their mothers. The American Psychiatric Association had chosen to honour her with the 2024 Adolf Meyer Lifetime Achievement Award, a prestigious tribute to her life's work in improving women's mental health. This accolade arrived in her e-mail in January; she died three months later, on April 23, 2024.

Canada's healthcare system is experiencing a health and human resource (HHR) crisis. The available evidence of the scope of the problem and potential solutions, however, is not commensurate with the scale and urgency of the crisis. The use of linked health administrative data to study the health, well-being and work patterns of the health workforce offers critical insights into how the workforce is functioning at a population level. Efforts to rapidly expand the use of these data are needed to understand the scope of the HHR crisis, find opportunities for improvement and drive change.

The healthcare system is wrestling with the impact of demographics on demand for care. We hear anecdotally of heightened patient acuity and increased prevalence of chronic disease. Southlake is a leading healthcare organization serving the northern York Region and southern Simcoe County. We have analyzed all in-patient data over the last four years and observed massive increases in multi-comorbidity levels in older in-patient cohorts. This article will review the analysis and highlight the impact of this phenomenon on critical areas of hospital operations such as patient flow, care transitions and cost. It will also review the medical management implications of increased chronic disease prevalence in this patient population. Finally, we share a series of initiatives that have been successful in helping the hospital respond to these challenges. We believe these are relevant for acute hospitals and their community-based partners across Canada.

We usually start our Healthcare Quarterly (HQ) editorial with reflections on the current landscape in healthcare and what is top of mind for healthcare leaders. In this issue, we are instead starting with two welcomes and a fond farewell. Our first welcome is for Richard Lewanczuk as our new co-editor-in-chief alongside Anne Wojtak. Richard is the senior medical director of Health System Integration for Alberta Health Services and was previously the senior medical director of Primary Care for the same organization. He is also a professor emeritus in the Department of Medicine at the University of Alberta where he continues to co-chair the Social Determinants of Health Working Group. Our second welcome is for Ruby Brown who is a special guest editor for our theme on mental health (Brown and Wojtak 2024). Ruby has led health systems across several provinces and territories, with an unrelenting commitment to improve the state of mental health. She believes that the key to tackling the complexity of mental health and substance use lies in our ability to maintain consistent and steadfast cooperation across all segments of society. By sharing knowledge, we can gain deeper insights into national and global proceedings, which, in turn, enlighten and obligate us all to implement approaches essential for the greater well-being of Canadians. We are excited to have both of these wonderful leaders join our editorial team.

Patients for Patient Safety Canada (PFPSC), a national volunteer organization with a vision of "Every Patient Safe" (Patients for Patient Safety Canada n.d.) commends the Canadian Institute for Health Information for collecting and publishing data that clearly demonstrate that the "[r]ates of harm to patients increased along with rates of staff absenteeism, overtime and use of agency staff" (Campbell et al. 2024: 11). It is important to acknowledge and recognize that these data were collected during the COVID-19 pandemic and clearly show the correlation between staffing challenges and patient safety. Unfortunately, but not surprisingly, this trend remains valid today.

The First Nations Health Authority (FNHA) completed a self-assessment of the organization's alignment to the British Columbia Cultural Safety and Humility Standard in collaboration with Elder Th'et-simiya and a group of Sisemó:ya Change Champions from across the organization (FNHA and HSO 2022). This article details the organization's processes, including the determination and selection of methods, self-assessment tools used and the lessons learned throughout. Other health and social services organizations are encouraged to use these learnings to guide their own self-assessment processes for continuous learning and development.

In this latest article in Leslee Thompson's Health Quality 5.0 series, she discusses the slow progress of patient engagement in healthcare over the past two decades, emphasizing the need for co-creation where patients and providers collaborate equally. It explores the challenges of overcoming traditional power dynamics and integrating patient knowledge into healthcare systems. Highlighting examples from around the world, the article identifies five success factors for global impact and stresses the importance of a holistic, inclusive approach to healthcare transformation. Co-creation is presented as essential for building resilient, high-performing health systems centred on patients' needs and experiences.

This article documents the contribution of peer support in reducing harms of substance use and advancing recovery. Data based on the experience of participants were collected using semi-structured interviews. Twenty-three participants were interviewed including four peer support workers. Findings were drawn from a thematic analysis of interview data and focused on strategies to improve the delivery of peer support services. We discuss services offered, how they impacted the lives of service recipients, what peer support workers found helpful; the value of peer support; and the challenges, barriers and next steps for peer support as an important, cost-efficient, low-barrier, low-intensive strategy.