{"title":"Lean Six Sigma Projects and the Impact to Patient Satisfaction in United States Healthcare Settings: A Systematic Literature Review.","authors":"Matthew Sheehan, Ashley Y Metcalf","doi":"10.1177/08404704251386864","DOIUrl":"10.1177/08404704251386864","url":null,"abstract":"<p><p>This study examines the effects of Lean Six Sigma (LSS) projects on patient satisfaction within United States healthcare facilities. Focused on the principles of waste reduction and defect minimization, LSS has increasingly been applied in healthcare settings to enhance service quality and operational outcomes. This literature review provides a summary of the existing literature relating LSS in healthcare to patient satisfaction metrics. By using a Systematic Literature Review approach to analyze studies published from 2011 to 2024, this review synthesizes findings from seven significant papers selected based on stringent inclusion criteria related to LSS project impact to patient satisfaction in United States healthcare facilities. The results demonstrate that LSS interventions can significantly improve patient satisfaction while also reducing inefficiencies in various healthcare processes such as wait times, scheduling, and discharge procedures. A research agenda for future work is proposed.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"228-233"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439524","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}
{"title":"Are You Leading an Artificial Intelligence-Capable Healthcare Organization?","authors":"Angel Arnaout","doi":"10.1177/08404704251375388","DOIUrl":"10.1177/08404704251375388","url":null,"abstract":"<p><p>Health leaders are increasingly embracing Artificial Intelligence (AI) to enhance patient care, streamline operations, and support healthcare providers. But are they truly leading an AI-capable organization-one that can harness AI's full potential and long-term value while mitigating its risks? An AI-capable organization possesses the necessary infrastructure, governance, technical expertise, and cultural mindset to effectively develop, deploy, and manage AI systems. It ensures the safe, ethical, and strategic use of AI across its operations, aligning AI adoption with organizational priorities. This article outlines the essential components of an AI-capable organization, provides a framework for assessing AI maturity, and introduces a risk-proportionate approach to building an AI tool pipeline for healthcare delivery. We explore key leadership considerations, including the decision to build or buy AI solutions, and conclude with special considerations, including the rise of Bring Your Own AI and its implications for governance and oversight.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"205-212"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151405","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}
Kian Rego, Elaina Orlando, Gail Riihimaki, Harpreet Bassi, Jennifer L Y Tsang
{"title":"Establishing a Research Institute in an Ontario Community Hospital: Reflections and Lessons Learned.","authors":"Kian Rego, Elaina Orlando, Gail Riihimaki, Harpreet Bassi, Jennifer L Y Tsang","doi":"10.1177/08404704251380461","DOIUrl":"10.1177/08404704251380461","url":null,"abstract":"<p><p>Integrating research into health service delivery is essential for building an equitable learning health system that values continuous improvement, innovation, and patient-centred care. At the organizational level, evidence shows that research-active hospitals achieve better patient outcomes and experiences, increased staff satisfaction and retention, enhanced operational efficiency, and greater opportunities for innovation and revenue generation. Yet, most Canadian hospitals are community hospitals which lack the infrastructure and organizational supports to conduct research. This article presents a case study of a research institute within a community hospital in Southern Ontario, describing its development, early outcomes, and strategic impact in establishing research as an organizational priority. We also introduce a novel adaptation of the balanced scorecard to guide the implementation and evaluation of research programs in community hospital settings. Reflections from this case highlight patient and organizational benefits, offering practical insights for community hospitals leaders seeking to build research capacity in their organizations.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"213-220"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201009","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}
Penny Phillips, Nahya Awada, Dean Fergusson, Cameron Love, Stuart Nicholls, Virginia Roth
{"title":"From Insights to Action: Enhancing Clinical Research at The Ottawa Hospital through a Mixed-Methods Improvement Project.","authors":"Penny Phillips, Nahya Awada, Dean Fergusson, Cameron Love, Stuart Nicholls, Virginia Roth","doi":"10.1177/08404704251403159","DOIUrl":"10.1177/08404704251403159","url":null,"abstract":"<p><p>The Ottawa Hospital-one of Canada's largest academic health sciences centres-and its research arm, the Ottawa Hospital Research Institute, undertook a comprehensive review of the hospital's clinical research ecosystem in 2022 to identify systemic challenges and opportunities to better integrate clinical research within hospital operations and patient care. Interest holders were engaged through qualitative interviews and pre- and post-review quantitative surveys. Barriers identified included limited funding access, lack of protected research time, fragmented technology infrastructure, inconsistent support for non-physician researchers, and limited access to patients for research purposes. Findings informed an action plan comprising over 30 initiatives under four strategic goals: strengthening infrastructure, building capacity and culture, enhancing patient access to research opportunities, and streamlining governance. Progress was evaluated by the 2025 post-review survey data. This performance improvement project offers a replicable roadmap and framework for healthcare and research centres seeking to build a supportive, collaborative, and patient-centred research environment.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"263-267"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114335","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}
Hollis Owens, Nazia Nadir Shah, Michelle Lin, Rochelle Chauhan, Joan Assali, Amrit Bhullar, Kurtis Stewart, Kendall Ho, Anne Lesack, Erika Pritchard, Helen Novak Lauscher
{"title":"Healthcare Providers' Experiences Accessing Real-Time Virtual Support: Informing More Equitable and Inclusive Healthcare Access in British Columbia's Rural, Remote, First Nations, and Other Indigenous Peoples and Communities.","authors":"Hollis Owens, Nazia Nadir Shah, Michelle Lin, Rochelle Chauhan, Joan Assali, Amrit Bhullar, Kurtis Stewart, Kendall Ho, Anne Lesack, Erika Pritchard, Helen Novak Lauscher","doi":"10.1177/08404704251405215","DOIUrl":"10.1177/08404704251405215","url":null,"abstract":"<p><p>Healthcare Providers (HCPs) serving Rural, Remote, First Nations, and other Indigenous (RRFNI) communities face unique challenges in delivering longitudinal care due to geographic isolation. The Real-Time Virtual Support Services (RTVS) network aims to improve equitable access to healthcare and provide collegial support for HCPs in RRFNI communities across British Columbia. The objective of this study was to understand HCPs' experiences with RTVS and identify improvement areas. Data were collected through semi-structured interviews with HCPs that were recorded, transcribed, and openly coded. Twenty HCPs using RTVS were interviewed during 2022-2023. The constant comparative method was used to develop themes. Themes focused on RTVS's benefits and outcomes including increased clinical confidence, reduced provider anxiety, respectful and collegial support, reduced administrative burden, and recruitment and retention support. Challenges included occasional service disruptions and limited Wi-Fi availability. These findings provide in-depth and contextualized feedback informing the development of RTVS.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"276-284"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132601","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}
{"title":"\"Fail-Fast\" Implementation of The Happiness Programme in Canadian Long-Term Care.","authors":"Niloofar Heidarinejad, Rebecca J Seymour, Mieke Ewen, Jean-Eric Tarride, Deborah Fernandes, Alyson Rowe, Mackensey Bacon","doi":"10.1177/08404704251411454","DOIUrl":"10.1177/08404704251411454","url":null,"abstract":"<p><p>As Canada's population ages, Long-Term Care (LTC) homes face increasing pressure to deliver effective care amid staffing shortages and growing resident complexity. Technology-based recreational interventions may be promising tools to support resident well-being. We evaluated the implementation of The Happiness Programme, a light-projection-based recreational technology, using a \"fail-fast\" method. Training was provided and the program was integrated into routine care for 6 months. Data were collected through surveys, along with usage of metrics and tracking of resident engagement. Surveys showed that the technology was easy to use and especially useful for residents with limited mobility or lower cognitive function. Technical issues impeded consistent use. Our findings suggest that while The Happiness Programme offers value for specific subgroups of residents, its broader impact is contingent on strong infrastructure, staff capacity, and ongoing support. This study emphasizes the overall value in \"failing fast\" when evaluating innovations in a long-term care setting.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"291-296"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120547","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}
{"title":"A Message from the Guest Editor.","authors":"","doi":"10.1177/08404704261430538","DOIUrl":"10.1177/08404704261430538","url":null,"abstract":"","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"187-188"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366810","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}
Briana Milavec, Queenie Lux, Sarah Bryant, Laura Bermudez
{"title":"Building Advocacy in Transformative Change by Putting the Human in the Loop.","authors":"Briana Milavec, Queenie Lux, Sarah Bryant, Laura Bermudez","doi":"10.1177/08404704251391162","DOIUrl":"10.1177/08404704251391162","url":null,"abstract":"<p><p>Healthcare organizations face accelerating digital transformation, yet sustainable change depends on empowering the people at the centre of care. This article presents a human-centred change management approach that positions clinical leaders as effective advocates for innovation. Drawing on experience within a large integrated health system, we explore how inclusion and agency mitigate resistance and foster adoption. Two digital use cases-a nurse handoff tool and a scheduling and staffing platform-illustrate how co-authorship in design and implementation builds a sense of ownership and advocacy. By embedding representation and control into change processes, organizations not only improve adoption but cultivate a culture in which clinicians champion transformation. This approach reframes change management as a strategic lever for advocacy, aligning digital innovation with patient-centred values and frontline realities.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"189-193"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565791","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}
{"title":"Operationalizing Accountability for Integrated Care: A Qualitative Study of an Ontario Health Team.","authors":"Nusrat Farhana, Kian Rego, Jenna M Evans","doi":"10.1177/08404704251382221","DOIUrl":"10.1177/08404704251382221","url":null,"abstract":"<p><p>Shared accountability is widely emphasized in integrated care theory and policy but remains underspecified in practice. This study examined how shared accountability was operationalized and experienced within an Ontario Health Team (OHT) using data from 23 semi-structured interviews with OHT stakeholders. Six interrelated factors that shape shared accountability were identified: perceived organizational identity, clarity of leadership roles and consequences for non-compliance, clarity of partner organizations' roles and consequences for non-compliance, management of goals and interests, trust and psychological safety, and power dynamics. Together, these factors highlight that shared accountability is not merely a matter of assigning roles or measuring outcomes; rather, it is a complex, relational process. These findings offer practical guidance for strengthening shared accountability in integrated care networks.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"221-227"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13039216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253055","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}
{"title":"From Commitment to Practice: Advancing Indigenous Data Sovereignty in Health Systems.","authors":"Harmony Johnson, Laurel Lemchuk-Favel, Lindsay Beck","doi":"10.1177/08404704261444735","DOIUrl":"https://doi.org/10.1177/08404704261444735","url":null,"abstract":"<p><p>Health systems across Canada are increasingly committing to support First Nations, Inuit, and Métis data sovereignty and Indigenous-led data governance frameworks. However, many organizations struggle to translate these commitments into practice. Uncertainty regarding Indigenous data governance, combined with concerns about misusing Indigenous data or violating emerging sovereignty principles, has produced a \"freezing effect,\" where Indigenous data are collected but under-analyzed, under-reported, or avoided altogether. This hesitation can perpetuate the invisibility of anti-Indigenous racism and inequities in care. This article provides a brief overview of Indigenous data sovereignty and its grounding in Indigenous rights frameworks, including the United Nations Declaration on the Rights of Indigenous Peoples. Drawing on the experience of Providence Health Care in British Columbia, the article describes how Indigenous-led governance structures, data stewardship, and improvements in Indigenous self-identification processes can enable the ethical use of Indigenous health data to monitor inequities and inform quality improvement in health systems.</p>","PeriodicalId":39854,"journal":{"name":"Healthcare Management Forum","volume":" ","pages":"8404704261444735"},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784557","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}