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Policy nudges toward medicalizing death and their impact on planetary health. 政策推动了死亡医学化及其对地球健康的影响。
Healthcare Management Forum Pub Date : 2025-06-19 DOI: 10.1177/08404704251348813
Hayden P Nix, Myles Sergeant, Nabha Shetty
{"title":"Policy nudges toward medicalizing death and their impact on planetary health.","authors":"Hayden P Nix, Myles Sergeant, Nabha Shetty","doi":"10.1177/08404704251348813","DOIUrl":"https://doi.org/10.1177/08404704251348813","url":null,"abstract":"<p><p>Despite most Canadians preferring to die at home, over 50% die in hospitals, a setting often discordant with patient-centered end-of-life care and environmentally harmful. This article argues that healthcare policies unintentionally \"nudge\" patients and providers towards the medicalization of death, contributing to low-value care and significant greenhouse gas emissions. We analyze how inaccessibility to primary and palliative care, default \"full code\" status, overspecialization, and inadequate home-care supports perpetuate hospital deaths. Using an illustrative case, we demonstrate how these policies influence care trajectories from outpatient to hospital admission and disposition planning. Our aim is to highlight these underrecognized downstream effects to inform health leaders about opportunities to improve end-of-life care quality, align with patient preferences, and secondarily, benefit planetary health.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251348813"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virtual care delivery in Saskatchewan: Multi-stakeholder perspectives on implementation, appropriateness, and evaluation. 萨斯喀彻温省的虚拟医疗服务：多方利益相关者对实施、适当性和评估的看法。
Healthcare Management Forum Pub Date : 2025-06-18 DOI: 10.1177/08404704251348858
Sarah-Marie Durr, Abd Alras, Stacey Lovo, Hamza Dani, Laureen McIntyre, Amy Zarzeczny, Paul Babyn, Scott J Adams, Ivar Mendez
{"title":"Virtual care delivery in Saskatchewan: Multi-stakeholder perspectives on implementation, appropriateness, and evaluation.","authors":"Sarah-Marie Durr, Abd Alras, Stacey Lovo, Hamza Dani, Laureen McIntyre, Amy Zarzeczny, Paul Babyn, Scott J Adams, Ivar Mendez","doi":"10.1177/08404704251348858","DOIUrl":"https://doi.org/10.1177/08404704251348858","url":null,"abstract":"<p><p>The purpose of this study was to provide an update on patients', clinicians', and health administrators' experiences and perspectives on opportunities, barriers, and priorities for virtual care to inform health policy and planning as virtual care programs continue to mature and develop. Three surveys were developed and distributed in Saskatchewan, Canada. Quantitative data were analyzed using descriptive statistics and chi-squared tests, and free-text responses were analyzed using thematic analysis. Chronic disease management and mental health disorders were identified as highly suitable for virtual care. Health administrators underscored cost savings and improved patient access as key advantages, though they lacked consistent frameworks to assess virtual care effectiveness. Key barriers included digital literacy, technology constraints, and compensation models not aligned with virtual service provision. Participants called for greater infrastructure investment, technical support, and integrated electronic platforms. These insights may inform policy and practice to strengthen virtual health delivery and support health equity.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251348858"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Achieving success through ethical introduction of artificial intelligence in the healthcare ecosystem. 通过在医疗生态系统中道德地引入人工智能来取得成功。
Healthcare Management Forum Pub Date : 2025-06-17 DOI: 10.1177/08404704251350766
Carolyn Petersen
{"title":"Achieving success through ethical introduction of artificial intelligence in the healthcare ecosystem.","authors":"Carolyn Petersen","doi":"10.1177/08404704251350766","DOIUrl":"https://doi.org/10.1177/08404704251350766","url":null,"abstract":"<p><p>Just as healthcare organizations must carefully consider how to incorporate Artificial Intelligence (AI) into patient-facing apps and messaging, so must they also think about how to ethically introduce AI into the workplace. Unreasonable expectations, lack of training, insufficient AI tool maintenance, and other barriers to effective use of AI create significant challenges for managers and leaders that can lead to lower productivity, less effectiveness at work, reduced satisfaction, and burnout. A thoughtful, measured approach to AI design and implementation that incorporates practices supporting user comfort and satisfaction is key to achieving success with AI in the workplace.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251350766"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physician assistants working in primary care in Canada: Findings from a national survey. 在加拿大初级保健工作的医师助理：来自全国调查的结果。
Healthcare Management Forum Pub Date : 2025-06-12 DOI: 10.1177/08404704251347908
Kristen Burrows, Leslie Nickell, Paul Krueger
{"title":"Physician assistants working in primary care in Canada: Findings from a national survey.","authors":"Kristen Burrows, Leslie Nickell, Paul Krueger","doi":"10.1177/08404704251347908","DOIUrl":"https://doi.org/10.1177/08404704251347908","url":null,"abstract":"<p><p>Physician Assistants (PAs) are increasingly recognized as part of the solution to addressing Canada's primary care shortage. This study reports findings from a national survey of 386 Canadian PAs with primary care experience. Respondents described delivering a broad scope of care, including direct patient management, teaching, mentorship, and quality improvement across settings such as elderly care, mental health, Indigenous health, refugee health, and rural communities. Most PAs reported high confidence in core competencies and effective integration into interprofessional teams. Despite this, systemic barriers persist including inadequate funding, role ambiguity, and resistance from other providers. Many PAs (71%) expressed job satisfaction, and 75% would recommend primary care practice. The study highlights opportunities to improve PA utilization and access to care through policy reform, better funding models, and expanded educational supports. These insights are valuable for policy-makers, administrators, and educators aiming to strengthen primary care delivery and PA role optimization.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251347908"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enabling decision-making and innovation in learning health systems through simulation modelling. 通过模拟建模促进卫生系统学习的决策和创新。
Healthcare Management Forum Pub Date : 2025-06-12 DOI: 10.1177/08404704251348857
Lysanne Lessard, Antoine Sauré
{"title":"Enabling decision-making and innovation in learning health systems through simulation modelling.","authors":"Lysanne Lessard, Antoine Sauré","doi":"10.1177/08404704251348857","DOIUrl":"https://doi.org/10.1177/08404704251348857","url":null,"abstract":"<p><p>Canadian healthcare systems require profound transformations to enhance patient experience, improve population health, reduce costs, and improve the work life of healthcare providers. Learning Health Systems (LHSs) are an approach for undertaking this transformation in an effective, efficient, and sustainable manner with digital technologies as a key enabler for change. However, the successful implementation of a LHS brings with it challenging and potentially risky changes to clinical practices and operations. Simulation modelling is an advanced analytics technique particularly well-suited for informing decision-making and planning prior to and during the transformation of complex systems such as LHSs. Yet, despite the use and demonstrated benefits of simulation modelling in many different industries including healthcare, its application in the context of LHSs has received limited attention. In this article, we discuss how simulation modelling can be leveraged to support better-informed, lower-risk decisions and innovation in LHSs.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251348857"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The ethical responsibility of psychological safety: Leadership at the intersection of safety culture. 心理安全的伦理责任：安全文化交叉点的领导。
Healthcare Management Forum Pub Date : 2025-06-10 DOI: 10.1177/08404704251348817
Yanka Campbell
{"title":"The ethical responsibility of psychological safety: Leadership at the intersection of safety culture.","authors":"Yanka Campbell","doi":"10.1177/08404704251348817","DOIUrl":"https://doi.org/10.1177/08404704251348817","url":null,"abstract":"<p><p>Psychological safety-the belief that one can speak up or report concerns without fear of retribution or humiliation-is a foundational element of highly reliable healthcare teams. While every industry and team can benefit from psychological safety, in healthcare, it is not just a \"nice-to-have\"-it can be life-saving. In the high-risk, emotionally charged context of cancer care, its importance is magnified. Oncology is one of the many extra high stress and high-stakes areas of medicine and patient care. There is also benefit from establishing a psychologically safe culture in these very well-known areas of healthcare, and that is they can serve as a model and beacon for other areas in healthcare. Conversely, a bad culture in a highly visible area can encourage bad behaviour elsewhere. Yet, while often framed as a quality or cultural issue, psychological safety is also an ethical imperative. Leaders in healthcare have a moral responsibility to cultivate environments where team members feel safe to raise concerns, challenge unsafe practices, and contribute to system learning. This article explores the ethical dimensions of psychological safety, how human factors influence speaking up, and how leadership practices can advance or inhibit a culture of safety. Drawing from safety science, organizational ethics, and the author's experience in oncology safety leadership, the argument is made that fostering psychological safety is not simply best practice-it is a moral obligation grounded in justice, trust, and the prevention of harm.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251348817"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The roles of the federal government in public health and public health crises. 联邦政府在公共卫生和公共卫生危机中的作用。
Healthcare Management Forum Pub Date : 2025-06-09 DOI: 10.1177/08404704251345060
Sudit Ranade
{"title":"The roles of the federal government in public health and public health crises.","authors":"Sudit Ranade","doi":"10.1177/08404704251345060","DOIUrl":"https://doi.org/10.1177/08404704251345060","url":null,"abstract":"<p><p>This article outlines the key functions and practices of government in addressing a public health crisis. Governments are responsible for planning and coordinating, resourcing and responding, and revising and evaluating. These three core functions are supported by cross-cutting practices in governance, accountability, and communication. Health leaders are advised to ensure that their organizational emergency plans intersect with those of government, and that they have processes to work with public health, government, and other partners to support robust responses to health crises.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251345060"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lived experience as a leadership asset. 作为领导资产的生活经验。
Healthcare Management Forum Pub Date : 2025-06-07 DOI: 10.1177/08404704251347532
Laurie Edmundson
{"title":"Lived experience as a leadership asset.","authors":"Laurie Edmundson","doi":"10.1177/08404704251347532","DOIUrl":"https://doi.org/10.1177/08404704251347532","url":null,"abstract":"<p><p>This article explores how living with complex mental health conditions can serve as a valuable asset in health leadership. It uses the author's personal journey after receiving a borderline personality disorder diagnosis before beginning a career in healthcare, and her decision to disclose her diagnosis despite the risks to her career. This decision was made in part due to her belief that personal disclosure could combat stigma, encourage understanding, and be an asset to her career rather than a detriment. The author reflects on reframing her disorder as a source of leadership strength rather than weakness. This article encourages other health leaders to lead by example, normalize discussions about mental health, and embrace the innovative ideas of individuals with lived experiences. Ultimately, this article serves as a call to action for reducing stigma surrounding borderline personality disorder and other mental health challenges, fostering inclusivity, and promoting authenticity in the workplace.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251347532"},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using the hierarchy of intervention effectiveness to improve the quality of recommendations developed during critical patient safety incident reviews. 使用干预有效性层次来提高在重症患者安全事件审查期间提出的建议的质量。
Healthcare Management Forum Pub Date : 2025-06-06 DOI: 10.1177/08404704251343260
Melissa F Lan, Hilary Weatherby, Elisa Chimonides, Lucas B Chartier, Laura D Pozzobon
{"title":"Using the hierarchy of intervention effectiveness to improve the quality of recommendations developed during critical patient safety incident reviews.","authors":"Melissa F Lan, Hilary Weatherby, Elisa Chimonides, Lucas B Chartier, Laura D Pozzobon","doi":"10.1177/08404704251343260","DOIUrl":"https://doi.org/10.1177/08404704251343260","url":null,"abstract":"<p><p>Our Canadian multi-site academic health sciences centre uses a standardized process to review critical patient safety incidents and develop recommendations to prevent incident reoccurrence. We recognized an opportunity to enhance recommendation development by integrating the Hierarchy of Intervention Effectiveness (HIE), a human factors framework, into the incident review process. This project aimed to increase the proportion of system-focused recommendations from critical incident reviews from 16 to 30% over 16 months. A multi-intervention strategy included (1) standardizing the incident analysis review template; (2) earmarking time for recommendation development during reviews; (3) providing participants with just-in-time education and tools; and (4) initiating HIE-based recommendation classification during incident reviews. Statistical process control p-Chart analysis showed an increase in system-focused recommendations from 16 to 30% over 16 months. The HIE promotes system-level change to prevent critical incidents, which other organizations may benefit from incorporating in their patient safety reviews.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251343260"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing and implementing a new health information technology innovation to improve patient safety in the Canadian context. 开发和实施一项新的卫生信息技术创新，以改善加拿大的患者安全。
Healthcare Management Forum Pub Date : 2025-06-05 DOI: 10.1177/08404704251346951
Corinne M Hohl, Arnold Ikedichi Okpani, Craig Kuziemsky
{"title":"Developing and implementing a new health information technology innovation to improve patient safety in the Canadian context.","authors":"Corinne M Hohl, Arnold Ikedichi Okpani, Craig Kuziemsky","doi":"10.1177/08404704251346951","DOIUrl":"https://doi.org/10.1177/08404704251346951","url":null,"abstract":"<p><p>Adverse Drug Events (ADEs) are unintended and harmful events related to medication use. Many ADEs recur because patients are unintentionally re-exposed to medications that previously caused harm. To help address this, we designed ActionADE, an interoperable Health Information Technology (HIT) that allows clinicians to communicate ADEs across health sectors. We completed ethnographic workplace observations and a systematic review to inform design. After piloting, we integrated ActionADE with the provincial medication dispensing database to alert pharmacists when patients seek to fill a prescription for the same or a same-class drug as one that previously caused harm. Co-design, application of clinically meaningful field labels and data standards, and integration with other health information systems were critical to ActionADE's functionality and use. However, health system decision-makers need to proactively plan for how to spread and scale pilot project in the HIT ecosystem to ensure public benefit from successful innovation.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251346951"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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