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Considerations for emergency department virtual triage. 急诊科虚拟分诊的注意事项。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-11-08 DOI: 10.1177/08404704241298643
Laila Nasser, Emily Morris, Irene Mathias, Justin N Hall
{"title":"Considerations for emergency department virtual triage.","authors":"Laila Nasser, Emily Morris, Irene Mathias, Justin N Hall","doi":"10.1177/08404704241298643","DOIUrl":"10.1177/08404704241298643","url":null,"abstract":"<p><p>Health leaders are increasingly interested in harnessing Artificial Intelligence (AI) to remotely conduct virtual triage for Emergency Department (ED) patients. This study explores equity considerations and patient attitudes to virtual triage in a Canadian ED. A cross-sectional study surveyed 150 ED patients, with 32 additional patients interviewed in-depth. Descriptive statistics and qualitative descriptive methodology were employed: 84.7% of patients would consider virtual triage, 71.3% were comfortable following advice to seek alternate care, including their General Practitioner or virtual ED. Approximately 38.2% of patients >60 years would require assistance using virtual triage, with confidence in using technology to direct care decreasing with age. Thematic analysis revealed five key themes: value of decision support; care access expectations; technological literacy demographics; trust in AI; and confidentiality. In conclusion, virtual triage is a viable and promising tool if barriers to technological literacy are addressed, and tools are endorsed by health providers and patients.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From fragmentation to functionality: Enhancing coherence of digital health integration in health systems. 从分散到功能：加强卫生系统数字卫生整合的一致性。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-10-28 DOI: 10.1177/08404704241294255
Samuel Petrie, Shelley McLeod, Kendall Ho
{"title":"From fragmentation to functionality: Enhancing coherence of digital health integration in health systems.","authors":"Samuel Petrie, Shelley McLeod, Kendall Ho","doi":"10.1177/08404704241294255","DOIUrl":"10.1177/08404704241294255","url":null,"abstract":"<p><p>Digital health programs continue to be implemented within Canadian health systems at a steady pace. The effectiveness of digital health initiatives has been rigorously analyzed, with both benefits and drawbacks extensively commented on. While the discussion about digital health continues, both positive and negative perspectives of it are approaching saturation in their themes. Accepting that digital health is here to stay post-pandemic, the focus should shift to strategies and supports needed to avoid the fragmentation of care through digital health implementation. This short article poses three questions which policy-makers and decision-makers should explore as part of a level-setting exercise with involved stakeholders at the outset of a digital health program's consideration. An implementation team should design the digital health program to have equity as its foundational focus, conduct value-based evaluations, and position the program in a learning health system framework to guard against the fragmentation of care.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"120-124"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523335","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
Unlocking the potential: Responsibly embracing artificial intelligence to advance the use of health data and analytics at the Canadian Institute for Health Information. 释放潜能：加拿大健康信息研究所（Canadian Institute for Health Information）以负责任的方式利用人工智能推进健康数据和分析的使用。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-10-10 DOI: 10.1177/08404704241271196
Shez Daya, Babita Gupta, Nasir Kenea
{"title":"Unlocking the potential: Responsibly embracing artificial intelligence to advance the use of health data and analytics at the Canadian Institute for Health Information.","authors":"Shez Daya, Babita Gupta, Nasir Kenea","doi":"10.1177/08404704241271196","DOIUrl":"10.1177/08404704241271196","url":null,"abstract":"<p><p>Canadian Institute for Health Information (CIHI) is looking to modernize and adopt new ways of working. This incudes the use of new technology, including the application of Artificial Intelligence (AI). To begin in a purposeful manner, the organization developed an AI strategy which was informed through feedback from key stakeholders and partners, from its staff and from a review of international research. The research informed several ways AI could add value to CIHI's internal operations and to the external role CIHI could play in advancing responsible AI adoption in health systems across Canada. This article describes the strategy development process and the areas of focus within the strategy.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"131-134"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113120","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
Mapping the landscape of front door frailty in the United Kingdom: Lessons for further afield. 绘制英国前门虚弱状况图：为更远的地方提供借鉴。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-10-28 DOI: 10.1177/08404704241293317
Elinor Burn, Amy Armstrong, Natalie Offord
{"title":"Mapping the landscape of front door frailty in the United Kingdom: Lessons for further afield.","authors":"Elinor Burn, Amy Armstrong, Natalie Offord","doi":"10.1177/08404704241293317","DOIUrl":"10.1177/08404704241293317","url":null,"abstract":"<p><p>The ageing global population is posing a significant challenge to healthcare systems worldwide. Healthcare needs have become more complex and the demand for services is ever increasing. Identification of frailty at the front door of hospitals can prompt comprehensive geriatric assessment and streamline patients to the most suitable clinical area. The United Kingdom has set a priority to develop front door services given the pressure on the National Health Service. A British Geriatrics Society survey has demonstrated that the majority of frailty assessments occur in the emergency department using the Clinical Frailty Scale. This survey prompted the creation of the setting up services guide and its key principles using a collaboration of experience from across the country. Understanding the systems that already exist and creating a network to enable a flow of care towards community teams is crucial to the successful provision of modern frailty attuned care.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523337","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 power of partnership: Strategies for pan-Canadian spread and scale of paramedics providing palliative care. 伙伴关系的力量：在全加拿大推广和扩大提供姑息关怀的辅助医务人员的战略。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-10-28 DOI: 10.1177/08404704241293299
Alix Carter, Cheryl Cameron, Danielle Stennett, Marianne Arab, Shaw-Moxam Raquel, Andrea C Coronado, Charlotte Pooler
{"title":"The power of partnership: Strategies for pan-Canadian spread and scale of paramedics providing palliative care.","authors":"Alix Carter, Cheryl Cameron, Danielle Stennett, Marianne Arab, Shaw-Moxam Raquel, Andrea C Coronado, Charlotte Pooler","doi":"10.1177/08404704241293299","DOIUrl":"10.1177/08404704241293299","url":null,"abstract":"<p><p>Paramedics and Palliative Care is an example of a promising practice (\"pilot\") that underwent successful spread and scale across Canada. Through the support of two pan-Canadian health organizations and concurrent evolution of the profession of paramedicine, this innovation has become integrated into practice. Evaluation of the innovation sites showed positive impact in all elements of the Quintuple Aim, and data from the expansion sites mirrors this success. Paramedic comfort and confidence is improved. Patient and family satisfaction is high. Quality indicators such as time spent at home, and home deaths, improved after program launch. There are time and cost savings with the program in place. The framework that enabled this spread and scale is presented and elaborated, to support further uptake of this innovation and provide a blueprint for successful expansion of other promising practices to support healthcare improvement across Canada.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical silos, social identity, and duty of care: A call for health leaders to improve transitions of care. 医疗孤岛、社会身份和护理责任：呼吁医疗领导者改善护理过渡。
Healthcare Management Forum Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1177/08404704241290689
Francis Bakewell
{"title":"Medical silos, social identity, and duty of care: A call for health leaders to improve transitions of care.","authors":"Francis Bakewell","doi":"10.1177/08404704241290689","DOIUrl":"10.1177/08404704241290689","url":null,"abstract":"<p><p>This article explores the concept of medical silos, particularly within hospital systems, and examines their deeper roots in social identity and the fiduciary duty of care of healthcare providers. While traditional perspectives focus on informational and communication barriers, this analysis highlights how professional identity and moral obligations contribute to the persistence of silos. Social identity theory reveals that strong in-group affiliations, formed during medical training and specialization, fosters collaboration within groups but also create divisions between them. Similarly, the fiduciary duty of care, central to ethical medical practice, may inadvertently reinforce silo boundaries in resource-limited environments. By emphasizing the role of centralized leadership, the article proposes that health system managers and leaders, with the broadest possible duty of care, must take action to dismantle these barriers. Recommendations include re-evaluating policies for patient transitions and fostering integrated care pathways to improve overall system flow, rather than simply balancing the agendas of stakeholders within their silos.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"148-151"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trust, technocracy, and the public servant's bargain: The evolving role of Canadian health leaders post-COVID. 信任、技术官僚和公务员的讨价还价：后covid加拿大卫生领导人的角色演变。
Healthcare Management Forum Pub Date : 2025-02-21 DOI: 10.1177/08404704251320301
Jared Wesley, Samuel Goertz
{"title":"Trust, technocracy, and the public servant's bargain: The evolving role of Canadian health leaders post-COVID.","authors":"Jared Wesley, Samuel Goertz","doi":"10.1177/08404704251320301","DOIUrl":"https://doi.org/10.1177/08404704251320301","url":null,"abstract":"<p><p>Public servants are central in helping Canadians navigate public health crises. Before, during, and after the COVID-19 pandemic, these professionals have been essential to implementing widespread government interventions, sometimes amid significant public scrutiny. These experiences highlight the delicate balance public health officials maintain in a democracy: providing expert advice to cabinet to define the public good and implementing decisions to help preserve public health. Notwithstanding varying scopes for autonomous decision-making, chief medical officers of health aid elected officials in weighing tradeoffs in the pursuit of communal objectives, not by dictating them but by enabling informed decision-making. In recent years, there have been calls for public health officials to substitute their judgement for that of elected officials in issuing directives. This article explores the role of public health officials as public servants and the perils of these officials misunderstanding their roles which may undermine the effectiveness and legitimacy of policy decisions.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704251320301"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469625","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
On the pathway to health equity: Creating a harm reduction strategy for a large academic acute care hospital. 健康公平之路：为一家大型学术性急症护理医院制定减少伤害战略。
Healthcare Management Forum Pub Date : 2025-01-01 Epub Date: 2024-07-22 DOI: 10.1177/08404704241264243
Heather Lokko, Wisdom M K Avor
{"title":"On the pathway to health equity: Creating a harm reduction strategy for a large academic acute care hospital.","authors":"Heather Lokko, Wisdom M K Avor","doi":"10.1177/08404704241264243","DOIUrl":"10.1177/08404704241264243","url":null,"abstract":"<p><p>An urban centre in southwestern Ontario continues to be faced with the extensive impacts of high rates of substance use. To more effectively meet the Quintuple Aim, in a way that authentically considers patients who use substances, the need for a cohesive, comprehensive organizational harm reduction strategy at the large academic acute care hospital providing community and regional healthcare services was clear. Community-based harm reduction expertise was leveraged to support the development work. Information gathered through literature review and interviews with patients, internal staff and leaders, partner healthcare agencies, and Canadian hospitals leading in harm reduction work provided key insights and supported the formulation of emerging recommendations that will be used to shape the acute care hospital's formal organizational harm reduction strategy.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735298","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
How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care. 移民如何造成健康方面的不利条件，医疗机构如何才能提供更加公平的医疗服务。
Healthcare Management Forum Pub Date : 2025-01-01 Epub Date: 2024-07-24 DOI: 10.1177/08404704241265675
Mei-Ling Wiedmeyer, Stefanie Machado, Elmira Tayyar, Cecilia Sierra-Heredia, Yasmin Bozorgi, Selamawit Hagos, Shira Goldenberg, Ruth Lavergne
{"title":"How immigration shapes health disadvantages and what healthcare organizations can do to deliver more equitable care.","authors":"Mei-Ling Wiedmeyer, Stefanie Machado, Elmira Tayyar, Cecilia Sierra-Heredia, Yasmin Bozorgi, Selamawit Hagos, Shira Goldenberg, Ruth Lavergne","doi":"10.1177/08404704241265675","DOIUrl":"10.1177/08404704241265675","url":null,"abstract":"<p><p>That immigration is a determinant of health and that immigration systems themselves contribute to structural disadvantage remains under-addressed within healthcare in Canada. This article offers context for how immigration shapes health, and recommendations for how health systems can be better prepared to respond to the diverse needs of immigrants and migrants (together referred to as im/migrants), based on a community-based research project in British Columbia. Findings call attention to the varied and intersecting ways in which immigration status, access to health insurance, language, experiences of trauma and discrimination, lack of support for health system limits access to healthcare, and the roles community-based organizations play in supporting access. Recommendations are intended to help make sure that all health services are accessible to everyone, and move beyond a homogenizing category of \"newcomers\" into practical, meaningful strategies that attend to diverse and intersecting community needs.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How national healthcare change initiatives balance emergent and deliberate change: A principles-focused evaluation. 国家医疗保健变革倡议如何平衡突发变革和蓄意变革：以原则为重点的评估。
Healthcare Management Forum Pub Date : 2025-01-01 Epub Date: 2024-09-12 DOI: 10.1177/08404704241279501
Tavis Apramian, Allia Karim, Kathryn Parker, Lynne Sinclair, Zeenat Ladak, Cheryl Ku, Sarah Gregor, Lily Winnebota, Denise Ponte, Stella Ng
{"title":"How national healthcare change initiatives balance emergent and deliberate change: A principles-focused evaluation.","authors":"Tavis Apramian, Allia Karim, Kathryn Parker, Lynne Sinclair, Zeenat Ladak, Cheryl Ku, Sarah Gregor, Lily Winnebota, Denise Ponte, Stella Ng","doi":"10.1177/08404704241279501","DOIUrl":"10.1177/08404704241279501","url":null,"abstract":"<p><p>Principles-focused evaluation reflects on the change process itself through examination of its underlying principles. The Centre for Advancing Collaborative Healthcare & Education (CACHE) worked to build interprofessional education programs and tools that attended to the Team Primary Care (TPC) principles. Our internally directed principles-focused evaluation, presented here, asks how CACHE adhered to these principles in the programs and tools it delivered to the TPC project. The article's main contribution is the creation of a new concept, organizational critically reflective practice, which describes an approach health leaders can use to mitigate the limitations of short-term initiatives while pursuing transformational change. We propose specific tools and steps that will help health leaders attempting to enact organizational critically reflective practice.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"52-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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