Healthcare quarterly (Toronto, Ont.)最新文献

In each edition of Healthcare Quarterly, our editorial team publishes articles on themes that are either top-of-mind for healthcare leaders or emergent issues that are starting to bubble up across the system. From time to time, we also identify extended themes that run across multiple editions, including on topics such as mental health and integrated care, where the depth of the issues and the breadth of solutions warrant a more profound exploration.

With the potential of expanding access to care, interest in virtual care has increased in recent years. In August 2023, the Centre for Addiction and Mental Health (CAMH) opened a virtual urgent care (VUC) clinic, focused on mental healthcare. This nurse practitioner-led clinic offers several consultations a day. This paper aims to share the initial experience of CAMH's VUC. Of the patients in this study, 87% are satisfied with VUC and 31% mentioned going to their nearest emergency department were VUC unavailable, indicating some progress in meeting patient needs and improving system navigation and utilization. We believe that the findings will help all virtual care initiatives.

Internet-delivered cognitive behavioural therapy (ICBT) is the most researched form of digital mental health care, with strong evidence across diverse conditions. This article presents 15 years of ICBT implementation in Saskatchewan through the Online Therapy Unit (OTU), Canada's longest-running publicly funded ICBT service. With over 14,300 clients served, the OTU integrates service delivery and research, offering transdiagnostic and condition-specific courses with brief therapist support. Key facilitators include program credibility, adaptability, strong partnerships, dedicated infrastructure and personnel and a learning health system approach. Challenges include evolving technological expectations and improving public awareness. The OTU provides a compelling model for scaling ICBT.

Up to one-third of resident transfers to the emergency department (ED) from long-term care (LTC) homes are considered avoidable. New models of care are needed to improve care for LTC residents in their homes. The North York Congregate Access and Support Team (NYCAST) model, a partnership between the local Ontario Health Team's hospital and LTC homes, is a promising and scalable model with three aims: direct clinical support provision via a digital platform, education and capacity building and cross-sectoral collaboration. We describe the NYCAST program through a visual program model and logic model, emphasizing its key design elements and intended outcomes. Preliminary data indicate streamlined access to specialized supports, increased LTC care capacity and reduced avoidable ED transfers. The NYCAST model can be a valuable template for jurisdictions seeking to enhance integration between LTC and acute care sectors.

Our Quarterly Reflections columnist, Neil Seeman (NS), is in conversation with Anthony (Tony) Sanfilippo (TS), a Kingston, Ontario-based cardiologist, former senior advisor for Educational Expansion and Innovation at Queen's Health Sciences and former associate dean at Queen's Medical School. Tony sparked a national conversation with his popular 2025 book, The Doctors We Need: Imagining a New Path for Physician Recruitment, Training, and Support. That has inspired Tony to write a new, forthcoming book on trust.

As polypharmacy continues to rise in Canada, its impact on patient care and healthcare systems becomes more significant. This article explores the consequences of polypharmacy, including increased patient risks, environmental footprint, financial strain and added workload for staff. It also highlights effective strategies for mitigating polypharmacy, such as deprescribing, non-pharmacological interventions, medication stewardship programs and mandatory medication review or stop dates. By adopting these approaches, healthcare institutions can reduce polypharmacy, improve patient outcomes, optimize staff efficiency, reduce medication costs and lessen their environmental impact.

Canada's health systems remain vulnerable to supply disruptions due to overreliance on globally sourced health products and limited visibility into domestic manufacturing capacity. This study presents an empirically tested, artificial intelligence-enabled search platform designed to automate the sourcing of health products from Canadian companies. The platform enables supply chain teams to efficiently identify Canadian suppliers for health products, overcoming the lack of awareness of Canadian manufacturers of health products, and builds a "Canada First" supply chain strategy. The platform has the potential to identify Canadian suppliers, reduce the burden of manual searches, support jurisdictions seeking to diversify Canadian sources and prioritize economic growth.

Loneliness is a growing public health crisis, with profound implications for mental and physical health. Social prescribing offers a proactive solution by connecting individuals to non-clinical supports, such as arts programs, peer networks and physical activities. In Canada, social prescribing is gaining traction, with initiatives addressing loneliness among youth, caregivers and older adults. By integrating social prescribing into healthcare systems, policy makers can enhance well-being, reduce healthcare strain and promote social inclusion. This paper explores social prescribing's role in addressing loneliness, its implementation across different life stages and its potential to transform mental health care in Canada.

Addressing loneliness is a global public health priority; however, its complexity necessitates collaboration across multiple sectors. Intersectoral collaborations (ISCs) connect diverse stakeholders to take collective action on social issues. In 2022, Women's Age Lab formed an ISC to address loneliness in older adults in Canada, comprising national, provincial and local organizations. The ISC identified stigma, system fragmentation and ineffective solutions as challenges to addressing loneliness. Mapping existing initiatives, advocating for a national strategy and prioritizing research were discussed as opportunities for collective action. These findings can help support other communities wishing to unite organizations to address loneliness.

The Integrated interRAI Reporting System (IRRS) supports timely, connected and person-centred senior care in Canada. IRRS enables system-to-system communication and near real-time data submission for the home care and long-term care sectors. It houses new interRAI data standards that offer improved commonality and standardization of language. With IRRS, users can explore organizational-level data, compare results across jurisdictions and see trends over time in a dynamic and user-friendly interactive business intelligence tool. IRRS will better support the sectors' ability to respond to emerging pan-Canadian needs to analyze, benchmark and compare data.