Mapping the landscape: A protocol of a jurisdictional scan of self-identified learning health systems DOI Creative Commons
Shelley Vanderhout, Marissa Bird, Antonia Giannarakos

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2023, Номер unknown

Опубликована: Окт. 27, 2023

Abstract Background There is a growing movement to implement learning health systems (LHS), in which real-time evidence, informatics, patient-provider partnerships and experiences, organizational culture are aligned support improvements care. However, what constitutes LHS varies based on context capacity, hindering standardization, scale-up, knowledge sharing. Further, often use “usual care” as the benchmark for comparing new approaches care, but disentangling usual care from multifarious modalities found across settings challenging. To advance robust LHS, comprehensive overview of existing including strengths opportunities growth needed. Objectives scope identify international to: 1) inform global landscape highlight common strengths, or improvement; 2) characteristics, emphases, assumptions, challenges described establishing counterfactuals LHS. Methods A jurisdictional scan will be conducted according modified PRISMA guidelines. identified through search peer-reviewed grey literature using Ovid Medline, Ebsco CINAHL, Embase, Clarivate Web Science, PubMed Non-Medline databases web along with informal discussions peer experts. Self-identified included if they sufficient detail, either during discussions, ≥4 10 criteria (core functionalities, analytics, co-design/implementation, evaluation, change management/governance structures, data sharing, training/capacity building, equity, sustainability) an framework characterize Search results screened, extracted, analyzed two descriptive reviews pertaining our main objectives. Data extracted pre-specified extraction form summarized descriptively. Implications This research current worldwide provide foundation promoting resource identifying next steps growth, improvement, evaluation

Язык: Английский

Addressing unmet need for primary care in Canada DOI
Richard H. Glazier

Healthcare Management Forum, Год журнала: 2024, Номер 37(6), С. 451 - 456

Опубликована: Авг. 9, 2024

Primary care is the key health system strategy for improving health, enhancing patient and clinician experience, saving money, promoting equity. Once a pioneer in primary care, Canada now fails to provide access millions of people. This crisis widely recognized, but policy responses are varied mostly incremental piecemeal. The goal providing everyone seems unrealistic elusive Canada, yet it has long been attained many other countries. Without an explicit all, most likely on geographic basis, will continue underinvest underperform with ramifications that include rapidly escalating costs, emergency department hospital overcrowding growing inequitable burden preventable suffering. A commitment work towards this needed ensure Canadians have high-quality well-organized everyone.

Язык: Английский

Процитировано

3
Developing a system response to health and homelessness: The important role of health leaders DOI Creative Commons

Kate Graham,

Matthew J Meyer

Healthcare Management Forum, Год журнала: 2024, Номер unknown

Опубликована: Июль 24, 2024

This article examines the role of health leaders in early stages a community response to address and homelessness London, Ontario. Specifically, we explore how from large healthcare-providing organizations have influenced dynamics entire response. We argue that high level engagement has been key ingredient successes new approach part because it validated reframing as healthcare issue-importantly, changing perceptions about who shares responsibility it.

Язык: Английский

Процитировано

2
The Integrated Care World is a Stage: Applying Goffman’s Theory of Dramaturgy to the Activities of Integrated Care DOI Creative Commons
Carolyn Steele Gray, James Shaw, G. Ross Baker

и другие.

International Journal of Integrated Care, Год журнала: 2024, Номер 24(3)

Опубликована: Янв. 1, 2024

Among the challenges in delivering integrated health and social care services is need to attend coordination of tasks, roles, activities, operations, while considering how these efforts are experienced by patients, carers communities. The literature has noted an important disconnect between providers leaders view their coordinate service delivery, patients perceive on receiving end. Our team provided guidance Ontario, Canada drawing Goffman's theory Dramaturgy help classify actions delivery as linked roles individuals play care. Using this framing helps uncover "backstage" processes (such team-functioning, funding models, digital infrastructures) create a necessary foundation which "frontstage" (or performances) can be effectively delivered.

Язык: Английский

Процитировано

2
Shifting gears: Creating equity informed leaders for effective learning health systems DOI Creative Commons
Nakia Lee‐Foon, Adalsteinn Brown, Robert J. Reid

и другие.

Healthcare Management Forum, Год журнала: 2024, Номер 37(3), С. 156 - 159

Опубликована: Янв. 8, 2024

Leadership is vital to a well-functioning and effective health system. This importance was underscored during the COVID-19 pandemic. As disparities in infection mortality rates became pronounced, greater calls for equity-informed healthcare emerged. These led some leaders use Learning Health System (LHS) approach quickly transform research into practice mitigate inequities causing these rates. The LHS relatively new framework informed by many within outside systems, supported decision-makers financial arrangements encouraged culture that fosters quick learning improvements. Although studies indicate can enhance patients’ outcomes, scarce literature exists on leaders’ incorporation of equity LHS. article begins addressing this gap examining how be incorporated activities discussing ways ensure considered achieved rapid cycles.

Язык: Английский

Процитировано

1
Commentary: Engagement for Research and Quality Improvement – More Than Just Words DOI Open Access
Kerry Kuluski, Katie N. Dainty, Kelly M. Smith

и другие.

Healthcare Quarterly, Год журнала: 2024, Номер 27(1), С. 51 - 55

Опубликована: Апрель 30, 2024

We reflect on the paper from Hahn-Goldberg et al. (2024) who shared key learnings a pan-Canadian quality improvement (QI) and patient engagement care transition initiative called Bridge-to-Home.In considering approach outcomes presented in their paper, we have generated reflections practical suggestions how to amplify work even further: (1) QI are about relationships; (2) seamlessly implementing complex interventions across siloed organizations continues be challenge, which alone cannot solve; (3) it is time for paradigm shift; (4) human behaviour change inherently messy; (5) embedding fulsome evaluation of essential.

Язык: Английский

Процитировано

1
Strengthening the Workforce for Equity-Centered Learning Health Systems: Reflections on Embedded Research and Research Generalism Comment on "Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program" DOI Creative Commons
Brianne Wood,

Roya Daneshmand

International Journal of Health Policy and Management, Год журнала: 2024, Номер 13, С. 8611 - 8611

Опубликована: Авг. 19, 2024

As embedded researchers in Northern Ontario, Canada, we offer our reflections on Kasaai and colleagues’ 2023 "Early Career Outcomes of Embedded Research Fellows: An Analysis the Health System Impact Fellowship Program." In commentary, draw experiences what is known about research training to examine how build strengthen workforce for equity-centered learning health systems. Does narrow understanding outcomes impacts Canada affect who benefits which systems can realize potential systems? We identify three areas deeper analysis: at individual, partnership, system level, knowledge social identities needs individuals partnerships, generalism as a complement research. Our recommendations suggest tailored approaches capacity Canada.

Язык: Английский

Процитировано

0
An Organizational Case Study of Mental Models among Health System Leaders during Early-Stage Implementation of a Population Health Approach DOI Creative Commons
Braeden A. Terpou, Marissa Bird, Diya Srinivasan

и другие.

Journal of Healthcare Leadership, Год журнала: 2024, Номер Volume 16, С. 389 - 401

Опубликована: Окт. 1, 2024

As the COVID-19 pandemic recedes, importance of population health has come into sharp focus, prompting many systems to explore leveraging data (PHD) for operational planning. This approach requires that healthcare leaders embrace dual priorities maintaining excellence in patient care while promoting overall populations. However, are new population-based thinking, posing a threat successful operationalization if mental models not aligned.

Язык: Английский

Процитировано

0
Evaluation methods, indicators, and outcomes in learning health systems: a protocol for a jurisdictional scan (Preprint) DOI Creative Commons
Shelley Vanderhout, Marissa Bird, Antonia Giannarakos

и другие.

JMIR Research Protocols, Год журнала: 2024, Номер 13, С. e57929 - e57929

Опубликована: Окт. 10, 2024

Background In learning health systems (LHSs), real-time evidence, informatics, patient-provider partnerships and experiences, organizational culture are combined to conduct “learning cycles” that support improvements in care. Although the concept of LHSs is fairly well established literature, evaluation methods, mechanisms, indicators less consistently described. Furthermore, often use “usual care” or “status quo” as a benchmark for comparing new approaches care, but disentangling usual care from multifarious modalities found across settings challenging. There need identify which methods used within LHSs, describe how LHS growth maturity conceptualized, determine what tools measures being evaluate at system level. Objective This study aimed (1) international examples their approaches, frameworks, indicators, outcomes; (2) common characteristics, emphases, assumptions, challenges establishing counterfactuals LHSs. Methods A jurisdictional scan, method explore, understand, assess problems have been framed by others given field, will be conducted according modified PRISMA (Preferred Reporting Items Systematic Reviews Meta-Analyses) guidelines. identified through search peer-reviewed gray literature using Ovid MEDLINE, EBSCO CINAHL, Embase, Clarivate Web Science, PubMed non-MEDLINE databases, web. We both cycle levels. To gain comprehensive understanding each LHS, including details specific evaluation, self-identified included if they described least 4 11 prespecified criteria (core functionalities, analytics, co-design implementation, change management governance structures, data sharing, knowledge training capacity building, equity, sustainability). Search results screened, extracted, analyzed inform descriptive review pertaining our main objectives. Evaluation cycles level, target outcomes, summarized descriptively. Across evaluations, challenges, contextual factors, mechanisms Results As October 2024, database searches above yielded 3503 citations after duplicate removal. Full-text screening 117 articles complete, 49 under analysis. expected early 2025. Conclusions research characterize current landscape provide foundation developing consistent scalable metrics growth, maturity, success. work also serve opportunities improving alignment with population needs, community priorities, strategic aims. Trial Registration Open Science Framework b5u7e; https://osf.io/b5u7e International Registered Report Identifier (IRRID) DERR1-10.2196/57929

Язык: Английский

Процитировано

0
Integration as innovation in healthcare systems DOI Creative Commons
David Petrie

Healthcare Management Forum, Год журнала: 2024, Номер unknown

Опубликована: Окт. 23, 2024

Healthcare systems in Canada are under pressure and require change-the status quo is no longer fit for purpose, if it ever was. Innovation often held up as a cure what ails us, but shiny new things or novel technologies alone have not been enough. This article will explore the concepts of differentiation integration being important drivers evolution living organisms, ecosystems, complex human organizations. The implications this deep pattern change essential to understanding roles specialization medicine, optionality primary care. Specifically, overspecialization without attention principles healthcare can lead fragmentation care worse patient outcomes. Finally, describe some practical examples system innovation form better public health delivery connections, homes, community coordination centres.

Язык: Английский

Процитировано

0
From fragmentation to functionality: Enhancing coherence of digital health integration in health systems DOI
Samuel Petrie, Shelley McLeod, Kendall Ho

и другие.

Healthcare Management Forum, Год журнала: 2024, Номер unknown

Опубликована: Окт. 28, 2024

Digital health programs continue to be implemented within Canadian systems at a steady pace. The effectiveness of digital initiatives has been rigorously analyzed, with both benefits and drawbacks extensively commented on. While the discussion about continues, positive negative perspectives it are approaching saturation in their themes. Accepting that is here stay post-pandemic, focus should shift strategies supports needed avoid fragmentation care through implementation. This short article poses three questions which policy-makers decision-makers explore as part level-setting exercise involved stakeholders outset program’s consideration. An implementation team design program have equity its foundational focus, conduct value-based evaluations, position learning system framework guard against care.

Язык: Английский

Процитировано

0