Pioneering Digital Health in NB: A Pathway to Transformation in Health Care Delivery

Accountability to Population Health in the COVID-19 Pandemic: Designing Health Care Delivery Within a Social Responsibility Framework.

Opportunities and Challenges in Health Care Equity

In 1999, an Institute of Medicine report spurred health care organizations to implement systems-based quality improve ment efforts and tackle patient safety. Simultaneously, the Accreditation Council for Graduate Medical Education asked residency programs to address Practice-Based Learning and Systems-Based Practice competencies. Medical educators now advocate incorporation of these competencies in undergraduate medical education.The authors examine the success of these efforts both from the health care delivery and systems perspective as well as from the perspective of educators as they aspire to engage medical students and residents in these domains. The authors argue that the missing element that prevents health care systems from the full realization of the promise of quality improvement is bidirectional alignment. Included are examples from the literature to demonstrate how medical educators are moving toward alignment of learners with health system quality improvement and safety needs. Finally, the authors explore business and information technology governance literature in support of the hypothesis that bidirectional alignment should be the next step in moving from reactive to proactive systems of care.

For Pharmacist Awareness Month 2015, the Canadian Pharmacists Association (CPhA) commissioned a national survey to determine Canadians’ perceptions and attitudes toward pharmacists and the range of health care services they provide. The survey, conducted by Abacus Data from February 14 to 22, 2015, with a sample of 2937 Canadians, yielded a range of positive results, demonstrating the high level of trust and confidence Canadians place in pharmacists. The number and scope of services that pharmacists can provide to patients has increased significantly over the past several years, and the survey results demonstrate that Canadians continue to support these expanded services. A large majority of Canadians trust pharmacists to provide advice on vaccinations (88%), the management of chronic conditions (88%), healthy lifestyle changes such as smoking cessation and weight loss (91%) and the management of common ailments like the cold or flu (94%). This high level of trust reflects the expanding role pharmacists are undertaking—and being recognized for—in the delivery of health care in Canada. Canadians not only trust pharmacists to provide a range of health care services, but according to the survey results, they are also very likely to use them. When asked whether or not they would consider going to their pharmacist to receive health care services, a majority indicated that they would consider going to their pharmacist for a flu shot or other vaccine (79%), for advice on medications (89%), for an appointment to review and discuss medications (82%), for smoking cessation advice (75%), for prescribing medications for minor health conditions (78%), for screening for medical conditions such as diabetes (66%) and for advice on the management of chronic disease such as diabetes or hypertension (69%). Canadians also make the connection between an expanded role for pharmacists and better health outcomes. Ninety-six percent of respondents had a positive impression of pharmacists, and 82% believed that pharmacists play a central or important role in the delivery of health care. Most Canadians agree that expanding the role of pharmacists would improve patients’ overall quality of life (82%), reduce overcrowding in emergency rooms and walk-in clinics (85%) and reduce overall health care costs (79%). Canadians clearly agree that the health care system would be improved by further enhancing the role of pharmacists in the delivery of health care services. Pharmacist Awareness Month is an opportunity to celebrate pharmacists and educate Canadians on the contribution that pharmacists make in the delivery of quality health care. The tagline for 2015, “Pharmacists: Trusted Care When and Where You Need It,” conveys the message that pharmacists are not only trusted leaders in the provision of frontline care but, as one of the most accessible health care providers in Canada, are able to provide quality care conveniently and quickly—a message that is clearly demonstrated in these survey results. More information about the survey, including province-specific results, can be located on the Pharmacist Awareness Month website at www.pharmacists.ca/pam.■

Has traditional medicine had its day? The need to redefine academic medicine

Review question/objective The objective of the review is to synthesise the existing evidence on family and/or health providers’ experience of family-centred models of care for hospitalised children aged 0-12 years (excluding premature neonates). (*Some sections of this protocol are adopted or adapted from the Cochrane Systematic Review of family-centred care in hospitalised children 0-12 years (2007)1 and its update (2012)2 and are published here with permission from Wiley. A more detailed discussion of the development of the concept of family-centred care is available in these publications.) This review will consider studies that include hospitalised children aged 0-12 years (but excluding premature neonates), their family and/or health providers. Definitions Child/children: throughout this review, the term 'child' or 'children' is used to include all newborn infants, babies and children up to the age of 12 years being cared for in hospital; and all parts of hospitals that provide a service to children. The definitions of childhood can vary, and age limits are arbitrary. For the purpose of this review the National Library of Medicine's medical subject headings were used to define the age cut off of 12 years. However, we have excluded neonates born prematurely and who are patients in a neonatal intensive or special care nursery, as their requirements for family-centred care, and the ethics and philosophies of care around this particular group, are different to those in a ward/unit where full term infants and children are nursed.40 We have excluded studies about adolescents for similar reasons. Families: throughout the review the following definition of the family will be applied: The family is a basic social unit having as its nucleus two or more persons, irrespective of age, in which each of the following conditions are present: the members are related by blood, or marriage, or adoption, or by a contract which is either explicit or implied;the members communicate with each other in terms of defined social roles such as mother, father, wife, husband, daughter, son, brother, sister, grandfather, grandmother, uncle, aunt; and they adopt or create and maintain common customs and traditions. TRUNCATED AT 350 WORDS

II. Research in the delivery of female health care: What shall be the role of the university department of obstetrics and gynecology?

BackgroundCompassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, and thus this relationship between compassion and digital health care needs to be better understood.ObjectiveThis scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care.MethodsWe conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019.ResultsOf the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of picture-in-picture feedback to evaluate social cues.ConclusionsImplementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.

Research in the delivery of health care: Evolution of a maternity and infant care project

<scp>AORN</scp> Position Statement on the Role of the Health Care Industry Representative in Perioperative Settings

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

In the late summer of 2004, the Veterans Health Administration (VHA) convened an invitational symposium, one in a series of state-of-the-art (SOTA) conferences. VHA's SOTAs are high-level “think tank” sessions with a defined agenda focusing on a specific health care topic. The theme of this SOTA conference was “Implementing the Evidence: Transforming Practices, Systems, and Organizations.” About 100 individuals from across North America, not just from within VHA, gathered for 2 days in the Nation's capital. These were the perceived thought leaders in the implementation sciences, enriched by a few influential “movers” within the largest single health care system in the United States (the VHA). To maximize the yield of the 2 days of SOTA conference brainstorming, VHA commissioned papers to be circulated in draft form before the SOTA, with the intent of priming the pump for discussions organized into specific work groups. This issue of the Journal presents these commissioned papers, revised after the conference, selected and refined through peer review, and augmented by additional manuscripts from SOTA participants and their collaborators who responded to a thematic solicitation.

Patient Safety: Grantmakers Join The Effort To Reduce Medical Errors

The integration of precision emergency medicine (EM) into our conceptualization of the health care system affords the opportunity to improve health care access, delivery, and outcomes for patients. As part of the Society for Academic Emergency Medicine (SAEM) Consensus Conference, we conducted a rapid literature review to characterize the current state of knowledge pertaining to the intersection of precision EM (defined as the use of big data and technology to deliver acute care for individual patients and their communities) with health care delivery and access. We then used our findings to develop a proposed conceptual model and research agenda. We completed a rapid review of the existing literature on the utilization of big data and technology to ensure and enhance access to acute/unscheduled care for individual patients and their communities. Literature searches were conducted using Ovid MEDLINE, Embase.com, Cochrane CENTRAL via Ovid, and ClinicalTrials.gov in January 2023. Using the identified articles, we determined core domains, developed a framework to guide the conceptualization of precision EM in health care delivery and access, and used these to identify a research agenda. Of the 815 studies identified for initial screening, 60 underwent full-text review by our technical expert panel and 21 were included in the evaluation. Core domains identified included expedited/personalized prehospital care, delivery to the right level of care, personalized ED care, alternatives to ED care/post-ED care, prediction tools for system readiness, and creation of equitable systems of care. A research agenda with four priority research questions was defined following identification of the core domains. Precision EM includes consideration of the health care delivery system as a mechanism for improving access to emergency care using data-driven strategies. This provides a unique opportunity to use data and technology to advance systems of care while also centering patients, communities, and equity in these advances.

Healthcare organization–education partnerships and career ladder programs for health care workers