Patient–Physician Relational Continuity and Health System Utilization among Patients in Alberta
This study examined the association between relational continuity (continuity of care) and healthcare utilization patterns in this population. Relational continuity was assessed using health administrative data to calculate a Usual Provider Continuity (UPC) Index. The majority of patients with no or a low UPC Index were male, did not have CD and were healthy or non-users of healthcare. When grouped by UPC Index, regression modelling revealed that emergency department visits and unplanned hospitalization declined with increased continuity of care. Advanced state of disease(s) and location of residence increased the likeliho...
Source: Healthcare Quarterly - January 31, 2020 Category: International Medicine & Public Health Source Type: research
Measuring Access to Home and Community Care and to Mental Health and Addictions Services in Canada
Federal, provincial and territorial governments endorsed agreements in August of 2017 to focus on the shared health priorities of home, community, mental health and addictions care (Government of Canada 2017). The related $11 billion federal investment over a 10-year period aims to improve access for Canadians to effective and appropriate services in these areas (Government of Canada 2019).<a href="#fn1">1</a>
As part of this work, health ministers agreed to work collectively and with the Canadian Institute for Health Information (CIHI) to develop and report on a focused set of common indicators to m...
Source: Healthcare Quarterly - January 31, 2020 Category: International Medicine & Public Health Source Type: research
Making Informed CHOICES: The Launch of a “Big Data” Pragmatic Trial to Improve Cholesterol Management and Prevent Heart Disease in Ontario
Cholesterol-lowering statin medications are a safe and effective therapy to lower cholesterol and reduce the risk of cardiovascular events. Yet physician prescribing patterns and patient adherence remain suboptimal in Canada and the United States, often due to pervasive misconceptions. The Community Heart Outcomes Improvement and Cholesterol Education Study (CHOICES) is a pragmatic, registry-based, cluster randomized controlled trial that aims to improve cholesterol management through appropriate statin use in adults and to ultimately reduce cardiovascular events in high-risk communities across Ontario. The trial uses an i...
Source: Healthcare Quarterly - January 31, 2020 Category: International Medicine & Public Health Source Type: research
From the Editors
(Source: Healthcare Quarterly)
Source: Healthcare Quarterly - December 17, 2019 Category: International Medicine & Public Health Source Type: research
Going “Big Bang” into an Electronic Health Record: Four Recommendations from Leading a Dynamic Academic Health Sciences Hospital Through Transformational Change on Time, in Scope and Within Budget
This article presents the leadership's view on essential lessons learned with key recommendations for healthcare systems seeking successful implementation with this approach. (Source: Healthcare Quarterly)
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
The Role of Coaches within Academic Medical Departments: Is There Value to Integrating This into Academic Mentorship Programs?
This study evaluated the benefits of formal coaching within a mentorship program in a Canadian academic medical department. Between April 2016 and September 2018, an executive coach was made available to members of the Department of Oncology at the University of Calgary. Thirty-seven individuals sought and received formal coaching during this period, using up an average of four hourly sessions; of these individuals, 13% (20/150) are full-time faculty. Issues that facilitated interest in coaching included the following: needing to develop an individual life plan, wanting to improve work–life balance/time managemen...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Case Study: West End Quality Improvement Collaboration
The West End Quality Improvement Collaboration is a partnership of six community health centres in Toronto that was established with the goal of increasing the efficiency and effectiveness of service delivery by working alongside one another on quality indicators. Community health centres are funded to serve the most marginalized populations, which include people living in poverty, homeless people, street-involved people, newcomers and lesbian, gay, bisexual, transgender, queer (or questioning) people. In year 1 of the initiative, we chose to focus on cancer screening rates. After the results were analyzed and we had start...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
The Ted Freedman Award for Innovation in Education 2019
The Ted Freedman Award for Innovation in Education 2019 (Source: Healthcare Quarterly)
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
How Collaborative Mentoring Networks Are Building Capacity in Primary Care
The need for increased capacity in primary care to treat the growing numbers of patients with complex chronic health conditions is well established (Roberts et al. 2015). Meeting that need requires not only more family physicians but also more support and resources to handle challenging cases. The Collaborative Mentoring Networks (CMNs), created in 2001 by the Ontario College of Family Physicians and funded by the Ontario government, have provided that support and proven particularly successful in improving physicians' competence and confidence in caring for patients struggling with mental health, addictions and chronic pa...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Offering Patients a Medical Home – Not a Hallway – and a Stronger Health System
This article examines three family health teams (FHTs) in different Ontario communities that exemplify the features of a Patient's Medical Home (PMH), a vision developed by the College of Family Physicians of Canada. With PMH supports and foundations in place, these FHTs deliver high-quality care enabled by strong PMH functions: accessible, comprehensive, patient- and family-centred continuous care that is responsive to a community's unique needs. Adhering to PMH principles not only improves patient experience, health outcomes and provider satisfaction but also leads to fewer unnecessary hospital admissions and emergency r...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Implementation of a Physician–Patient Attachment Initiative in Alberta
This article describes a top-down approach with the ideologies of a bottom-up collaborative to address attachment within an Alberta primary care network. The steps taken to reduce the number of patients listed on multiple PCP panels from 27% to 4% will be described. Learnings from this initiative suggest that direct involvement with providers, coupled with engaged physician leadership, can create a local system of information delivery that supports the attachment of patients to their most responsible PCP. (Source: Healthcare Quarterly)
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Case Study: Innovation Procurement for a Patient and Caregiver Support Solution in the Home
This case describes an innovation partnership procurement strategy by a community care health organization to procure a digital solution able to support both caregivers and older adults receiving homecare services. Vendor submissions proposed both existing technologies and new solutions that were challenging to evaluate. An existing technology was procured and first pilot tested in a laboratory setting prior to a field trial with seniors and their caregivers in the home. Recruitment of seniors to participate was unsuccessful. The importance of early engagement of seniors and greater clarity in partnership expectations were...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Case Study: Innovation Procurement for a “Smart” Privacy Solution
Discussions and sharing feedback on solutions with vendors, followed by dialogue on solution pricing and service offerings, resulted in a vendor contract that allowed other hospitals to benefit from the established agreement. This approach supported scalability of the procured privacy solution. (Source: Healthcare Quarterly)
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Case Study: Innovation Procurement for a Digital Services Platform
This case describes a design contest strategy to procure a solution to coordination of care transitions across healthcare programs to strengthen patient outcomes. The fit of the vendors' approach with the organization and the potential for building a strong relationship with the vendor teams were evaluated. A consortium of small Canadian companies was selected to proceed to a proof-of-concept phase and full implementation of the digital solution across the region. This design contest approach resulted in a successful vendor partnership for the organization to co-design, develop, implement and scale an innovative solution t...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
Case Study: Innovation Procurement for a Cardiac Program
This case describes a competitive dialogue strategy to procure a cardiac program solution to strengthen performance, outcomes and value in an Ontario hospital. All major contracts for the cardiac program were expiring, offering a unique opportunity for procurement of innovation. Procurement was completed in two phases, with an additional request for proposals issued for the unique specialty products not included in the initial procurement. The implementation of contracts was monitored to ensure that outcomes and deliverables were achieved. The procurement for the entire cardiac program was complex; however, it resulted in ...
Source: Healthcare Quarterly - October 31, 2019 Category: International Medicine & Public Health Source Type: research
