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Warmth When It Matters Most: Addressing the Overnight Needs of Homeless Emergency Room Patients. 最重要的时候是温暖：解决无家可归的急诊室病人的过夜需求。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27808
Melissa McCallum, Jennifer Bonner, Leslie Gillies, Brooke Cowell, Alim Pardhan, Andriana Lukich
{"title":"Warmth When It Matters Most: Addressing the Overnight Needs of Homeless Emergency Room Patients.","authors":"Melissa McCallum, Jennifer Bonner, Leslie Gillies, Brooke Cowell, Alim Pardhan, Andriana Lukich","doi":"10.12927/hcq.2026.27808","DOIUrl":"10.12927/hcq.2026.27808","url":null,"abstract":"<p><p>Amid a growing housing and homelessness crisis in Hamilton, Ontario, an innovative four-way alliance responded with urgency and compassion to address a critical service gap: the overnight discharge of homeless patients from hospital emergency departments. Spearheaded by the Greater Hamilton Health Network Ontario Health Team, this cross-sector initiative united healthcare, social services, education and community partners to create a warming program at The Hub - a trauma-informed, low-barrier warming space operating nightly throughout the winter. Within one week, a tri-partner funding model was launched, supported by a streamlined hospital discharge process using a single-call system. Staffed by students in medicine, social work and policing, The Hub provided a unique blend of shelter, stabilization and support services, while equipping future professionals with hands-on interdisciplinary training. The program resulted in 3,278 visits and redirected 307 emergency room discharges to a safe, dignified space - freeing hospital beds and easing moral distress among healthcare workers. Key takeaways include: the power of rapid cross-sector alignment, the effectiveness of integrated discharge pathways and the replicability of student-led care models rooted in dignity and trust. This initiative demonstrates how community-driven collaboration can bridge healthcare and housing, offering a practical framework for organizations and municipalities seeking sustainable, human-centred solutions to homelessness and system strain.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731089","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
A Framework for Sensemaking and Advancing the Continuum of Integrated Care: From Condition-Based Pathways to Population Health. 构建和推进综合护理连续体的框架：从基于条件的途径到人口健康。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27812
Anne Wojtak, Jodeme Goldhar
{"title":"A Framework for Sensemaking and Advancing the Continuum of Integrated Care: From Condition-Based Pathways to Population Health.","authors":"Anne Wojtak, Jodeme Goldhar","doi":"10.12927/hcq.2026.27812","DOIUrl":"10.12927/hcq.2026.27812","url":null,"abstract":"<p><p>Integration of health and social care is increasingly central to improving outcomes, experience and sustainability; however, integrated care is not a single construct. This article presents a novel framework to categorize and conceptualize different approaches to integrated care, illustrating variations in attributes, context, complexity and impact. Drawing on international literature, three approaches to integration - condition-based, multi-condition and population-based - are examined along a continuum. Condition-based approaches focus on defined patient groups using standardized clinical pathways requiring limited coordination. Multi-condition integration supports populations with complex chronic conditions, requiring comprehensive, multi-sectoral coordination and interconnected structures. Population-based integration represents the broadest approach, organizing health and social care around community needs and social determinants of health and necessitating system-level governance with aligned policy and funding. While integrated care models can advance without explicitly delivering population health outcomes, population health cannot be advanced without integration as a foundational enabler.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"19-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731124","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
From the Editors. 来自编辑。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27816
Anne Wojtak, Richard Lewanczuk
{"title":"From the Editors.","authors":"Anne Wojtak, Richard Lewanczuk","doi":"10.12927/hcq.2026.27816","DOIUrl":"10.12927/hcq.2026.27816","url":null,"abstract":"<p><p>Canada's healthcare systems, as with others around the world, are under enormous strain. We are witnessing the confluence of pressures from an aging population, higher rates of chronic disease and mental health issues, growing patient complexity, workforce destabilization and insufficient capacity to deal with the growing demand for care. A profound transformation is needed, one that necessitates shifting from an illness-focused system to one that prioritizes health, wellness and person-centred care.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731026","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
Community First: A Scalable Approach to Integrated Care in Naturally Occurring Retirement Communities. 社区第一：自然发生的退休社区综合护理的可扩展方法。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27806
Melissa Chang, Jen Recknagel
{"title":"Community First: A Scalable Approach to Integrated Care in Naturally Occurring Retirement Communities.","authors":"Melissa Chang, Jen Recknagel","doi":"10.12927/hcq.2026.27806","DOIUrl":"10.12927/hcq.2026.27806","url":null,"abstract":"<p><p>The naturally occurring retirement communities (NORC) Innovation Centre (NIC) at University Health Network (UHN) is reshaping aging in place through the UHN NORC model - a scalable, values-driven approach that integrates health and social care in NORCs. Currently implemented in 30 sites supporting more than 4,500 older adults, the model builds capacity for adaptive leadership and relational care practices to ensure that older adults can age well at home. Guided by local leaders, inter-professional teams and community partners, the model brings together social support, health promotion and timely access to care. Early results show increased sense of belonging, reduced emergency visits, improved experience and outcomes and stronger system integration. The UHN NORC model offers a solution to enable community-based care for older adults and a viable path to relieve growing system pressure.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"61-68"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730905","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
Big New Metrics That Matter for Health System Integration. 对卫生系统整合至关重要的新指标。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27813
Neil Seeman
{"title":"Big New Metrics That Matter for Health System Integration.","authors":"Neil Seeman","doi":"10.12927/hcq.2026.27813","DOIUrl":"10.12927/hcq.2026.27813","url":null,"abstract":"<p><p>As Canadian healthcare moves toward integrated care, it lacks \"North Star\" metrics, relying instead on hospital-centric indicators that miss the patient experience. Building on the integrated care framework by Anne Wojtak and Jodeme Goldhar, this paper argues for shifting from measuring system activity to measuring the burden placed on patients and caregivers. It proposes three new metrics: the System Friction Ratio, the Caregiver Latency Index and the Patient-Reported Burden Score. To achieve true population health, we must stop counting hospital-focused administrative outputs and start measuring the friction patients and families face when navigating the system.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"16-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730885","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
Reproductive Pathways Across the Lifespan and Their Mental Health Impacts. 生命周期中的生殖途径及其对心理健康的影响。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2026-01-01 DOI: 10.12927/hcq.2026.27815
Maria P Velez, Natalie Dayan, Simone N Vigod, Joel G Ray
{"title":"Reproductive Pathways Across the Lifespan and Their Mental Health Impacts.","authors":"Maria P Velez, Natalie Dayan, Simone N Vigod, Joel G Ray","doi":"10.12927/hcq.2026.27815","DOIUrl":"10.12927/hcq.2026.27815","url":null,"abstract":"<p><p>Reproductive health unfolds across the lifespan, and individuals may move through diverse pathways - including infertility, chronic gynecologic conditions such as endometriosis, pregnancy complications, assisted reproduction or gestational carriage. These experiences can heighten vulnerability to new-onset or recurrent mental illness. Using population-based ICES data, our recent work demonstrates that mental health risks arise across the entire reproductive trajectory. Integrating mental health support within fertility care, gynecology, obstetrics and primary care is essential for equitable and person-centred reproductive health in Canada's universal healthcare system.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 4","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731131","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
Advancing Healthcare Equity Monitoring and Progress: A Framework to Assess Measures for Sensitivity to Inequities. 推进医疗公平监测和进展：一个评估不公平敏感性措施的框架。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2025-10-01 DOI: 10.12927/hcq.2025.27738
Khandideh K A Williams, Josh Fagbemi
{"title":"Advancing Healthcare Equity Monitoring and Progress: A Framework to Assess Measures for Sensitivity to Inequities.","authors":"Khandideh K A Williams, Josh Fagbemi","doi":"10.12927/hcq.2025.27738","DOIUrl":"https://doi.org/10.12927/hcq.2025.27738","url":null,"abstract":"<p><p>Equitable healthcare is needed to improve population health outcomes. However, a lack of comprehensive analytical tools and data impedes efforts to monitor and improve equity in care. Measures often do not include stratified statistics, providing insufficient information about variations in access, quality or outcomes across population subgroups. Measures that are equity-sensitive leverage disaggregated data to detect differences in care among population groups and across institutions, serving as one mechanism toward identifying and tracking healthcare inequities across the care continuum. This report presents a framework to assess measures for equity sensitivity that may be used across diverse settings.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 3","pages":"12-16"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727907","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
A Regional Surgical Partnership Program: Lessons Learned in System Transformation of Pediatric Surgical Care. 区域外科合作项目：儿科外科护理系统转型的经验教训。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2025-10-01 DOI: 10.12927/hcq.2025.27727
Jessica Ivan, Natasha Bruno, Mary Chen, Bonnie Fleming-Carroll, Daniela D'Annunzio, Alicia Hayes, Jacqueline Howling, Karen Kinnear Rn, Abhaya V Kulkarni, Tharini Paramananthan, Lisa Pendergast, Jeannette So, Thomas D Walters, Julia Orkin
{"title":"A Regional Surgical Partnership Program: Lessons Learned in System Transformation of Pediatric Surgical Care.","authors":"Jessica Ivan, Natasha Bruno, Mary Chen, Bonnie Fleming-Carroll, Daniela D'Annunzio, Alicia Hayes, Jacqueline Howling, Karen Kinnear Rn, Abhaya V Kulkarni, Tharini Paramananthan, Lisa Pendergast, Jeannette So, Thomas D Walters, Julia Orkin","doi":"10.12927/hcq.2025.27727","DOIUrl":"https://doi.org/10.12927/hcq.2025.27727","url":null,"abstract":"<p><p>The province of Ontario has seen significant growth in the waitlists for both pediatric surgery and pediatric endoscopy. Due to long-standing resource constraints exacerbated by the COVID-19 pandemic, the surgical waitlist at a pediatric tertiary hospital in Toronto had risen to over 6,500 patients by April 2023, with 65% beyond nationally validated wait time targets (out-of-window). A regional Surgical and Endoscopy Community Partnerships program was developed with five partner hospital sites to build capacity and decentralize pediatric surgical care by transferring select low-acuity patients, primarily targeting the longest-waiting cases, from the pediatric tertiary hospital waitlists to partner hospitals closer to their homes. Each of the partner hospitals had pre-existing pediatric surgical programs and the necessary infrastructure and staffing to support the referred patients. Between April 2023 and March 2024, this program transitioned more than 650 pediatric cases to partner hospitals, reducing the waitlist by approximately 10%. Early program success has demonstrated that an integrated system-wide approach to the provision of pediatric surgical care is a viable model for future surgical care delivery.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 3","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727923","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
Health Quality 5.0: The Future Is NOW. 健康质量5.0：未来就是现在。
Healthcare quarterly (Toronto, Ont.) Pub Date : 2025-10-01 DOI: 10.12927/hcq.2025.27732
Leslee J Thompson, Jeremy Veillard
{"title":"Health Quality 5.0: The Future Is NOW.","authors":"Leslee J Thompson, Jeremy Veillard","doi":"10.12927/hcq.2025.27732","DOIUrl":"https://doi.org/10.12927/hcq.2025.27732","url":null,"abstract":"<p><p>Quality does not exist in a vacuum. It is shaped by the sweeping societal changes and forces that affect the way people work and live, industries and economies operate, and how technology is used. When context changes, the ways in which we think about healthcare, quality and leadership need to change as well. This is the final article in a series that sets out a bold and multi-dimensional view of quality that is built around the themes of human centricity, trust, resilience, sustainability and prosperity. As themes are explored, specific shifts required to move us toward Quality 5.0 are described, ways of measuring and monitoring progress are proposed and a new set of leadership competencies for the future is presented. Together with the previous five articles in this series, this article is meant to inspire change that improves outcomes at individual, community and system levels.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 3","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728161","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
A Manhattan Project for Canadian Healthcare? 加拿大医疗保健的曼哈顿计划？
Healthcare quarterly (Toronto, Ont.) Pub Date : 2025-10-01 DOI: 10.12927/hcq.2025.27737
Neil Seeman
{"title":"A Manhattan Project for Canadian Healthcare?","authors":"Neil Seeman","doi":"10.12927/hcq.2025.27737","DOIUrl":"10.12927/hcq.2025.27737","url":null,"abstract":"<p><p>Canada's healthcare system faces mounting crises, from dementia to homecare shortages, yet responses remain mired in stakeholder consultation. Some experts now call for a \"Manhattan Project\" approach. However, the Manhattan Project's centralized wartime model is incompatible with Canada's federated healthcare system. A better template is DARPA - the Defense Advanced Research Projects Agency - which enables rapid, parallel experimentation across distributed jurisdictions. A Canadian healthcare DARPA would require leadership willing to abandon consensus, protection for failure, compressed timelines and, crucially, reallocation of existing resources rather than new bureaucracy. This model replaces inertia with iteration, creating mechanisms that learn faster than disease spreads.</p>","PeriodicalId":520276,"journal":{"name":"Healthcare quarterly (Toronto, Ont.)","volume":"28 3","pages":"17-19"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727949","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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