Healthcare Organizations Face Research Articles

Ensuring Data Accuracy and Compliance in Remote Healthcare Monitoring

Remote healthcare delivery and clinical trials have undergone a dramatic transformation, necessitating robust frameworks for ensuring data accuracy and regulatory compliance in virtual settings. This comprehensive article explores the intricate challenges healthcare organizations face when implementing remote monitoring systems while maintaining data integrity and adhering to stringent regulatory requirements. Through examination of current technological infrastructure, quality control methodologies, and regulatory frameworks, this article presents a structured approach to achieving reliable data collection in remote care environments. The article addresses critical aspects, including device validation protocols, HIPAA compliance in virtual settings, and standardized procedures for remote patient monitoring, while offering practical solutions for common challenges in technology adoption and data discrepancy management. This article indicates that the successful implementation of remote healthcare data systems requires a three-pronged approach: robust technical infrastructure, comprehensive staff training programs, and patient-centric education initiatives. Furthermore, this article identifies emerging trends in artificial intelligence and predictive analytics that promise to enhance data validation processes and compliance monitoring in remote healthcare settings. This article provides healthcare professionals and organizations with actionable insights for establishing and maintaining reliable remote data collection systems while ensuring regulatory compliance and optimal patient care outcomes.

Healthcare Data Migration: A Technical Framework for Digital Transformation Success

This comprehensive article analysis explores the critical aspects of healthcare data migration within the context of digital transformation. The article examines the challenges, technologies, and implementation frameworks that healthcare organizations face during migration initiatives. It addresses the complexities of managing diverse medical data types, regulatory compliance requirements, and technical infrastructure needs while maintaining continuous patient care operations. The article investigates enterprise solutions, including VMware vMotion and Dell EMC PowerPath, alongside cloud-native approaches for optimizing migration processes. Through extensive case studies and real-world applications, the article demonstrates the significance of structured planning, quality assurance protocols, and resource allocation in successful migration projects. Furthermore, it evaluates the financial implications and return on investment of migration initiatives while considering future technological trends and strategic recommendations for healthcare organizations undertaking digital transformation journeys. The findings emphasize the importance of a balanced approach between technological advancement and maintaining healthcare service quality throughout the migration process.

Integrating FinOps in healthcare for optimized financial efficiency and enhanced care

The integration of Financial Operations (FinOps) in healthcare is increasingly recognized as a critical strategy for optimizing financial efficiency and enhancing patient care. This paper explores the principles and practices of FinOps, emphasizing its role in improving cost management, fostering financial transparency, and ensuring better resource allocation in healthcare organizations. By addressing traditional inefficiencies in healthcare financial management, FinOps promotes collaboration between finance and operations, enabling real-time financial decision-making that aligns with both operational goals and patient outcomes. Additionally, the paper outlines the challenges healthcare organizations face in managing rising costs and complex billing systems, and provides practical strategies for the successful implementation of FinOps, including the use of advanced technologies such as cloud-based platforms and data analytics tools. Ultimately, the adoption of FinOps not only enhances short-term financial efficiency but also contributes to the long-term sustainability and scalability of healthcare services.

Impact of caring leadership on nurses’ work engagement: examining the chain mediating effect of calling and affective organization commitment

BackgroundPrevious studies have established a positive link between nurse managers’ caring leadership and nurses’ work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses’ work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement.MethodsA robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research.ResultsThe results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses’ work engagement (p < 0.001). Specifically, caring leadership was significantly associated with nurses’ calling (β = 0.55, p < 0.001), affective organizational commitment (β = 0.21, p < 0.001), and work engagement (β = 0.05, p < 0.001). And the analysis further revealed that calling and affective organizational commitment mediate the process between caring leadership and work engagement(Effect: 0.17, 0.03, 0.05), with a relative effect size of 89.3% for the total indirect effect. These findings highlight the crucial role of these factors in enhancing nurses’ work engagement, providing valuable insights for healthcare leaders and policymakers.ConclusionCaring leadership positively predicts nurses’ work engagement and indirectly mediates calling and affective organizational commitment. The results of this study revealed that the mechanisms of caring leadership influence nurses’ work engagement, which provides a new approach to strengthening nurses’ work engagement and improving patient healthcare outcomes and organizational performance. Healthcare organizations face continuous challenges; this study embodies the significance of caring leadership in improving nurses’ work experience and increasing their work engagement. Nursing managers should enhance their knowledge of caring leadership and receive caring leadership training, thus actively improving their leadership behaviors in nurse management, enhancing leadership effectiveness, and creating more possibilities for developing healthcare organizations.

Developing a healthcare transformational leadership competency framework for disaster resilience and risk management

Climate change-induced hazards increasingly threaten healthcare systems worldwide, amplifying the frequency and severity of disasters and their adverse health effects. This necessitates fortified healthcare leadership and resilient systems capable of delivering quality care amidst escalating environmental challenges and emphasises the need for standardised competency frameworks to enhance disaster readiness and response. As healthcare organisations face evolving challenges, cultivating transformational leadership competencies becomes essential for building adaptive, resilient, and effective disaster management strategies. Purposeof this study: This conceptual paper addresses the research question: "How can healthcare leaders' competencies be developed to support healthcare disaster resilience?". MethodsThe study, conducted in 2023, used a narrative literature review, comparative analysis, and synthesis. It reviewed frameworks on transformational leadership and disaster resilience, employing comparative analysis to examine relationships and leadership competencies. A synthesized framework was developed to clarify dimensions and relationships. ResultsEight ‘domains’ of competencies were identified, in addition to other ‘transferring skills.’ The domains were analysed regarding their component competencies and were broadly classified into knowledge, cognitive and interpersonal skills, and attitudes. This classification is proposed as a ‘Healthcare Transformational Leadership Competency Framework’ (HTLCF) for disaster resilience and risk management. ConclusionThe HTLCF supports leaders in navigating complexities, anticipating risks, and facilitating collaboration, communication, and accountability, leveraging their transformative agency. This study suggests the use of the Healthcare Transformational Leadership Competency Framework to develop a standardised disaster management curriculum and continuous, ongoing training. This would equip leaders to enhance resilience and ensure coordinated, effective disaster responses for healthcare systems.

Artificial Intelligence in Health Care from Oncology to Perioperative Care

ABSTRACT Artificial intelligence (AI) is revolutionizing health care by addressing some of the important concerns, the health-care organizations face daily. All partners in the health system must understand AI technologies and how they might improve the effectiveness and accessibility of AI-based health services, leading to value-based care. Effective and proper use of AI in health care is the primary emphasis of this narrative review article, which also helps readers grasp the basic ideas underlying AI. Despite the fact that AI is still in its infancy in other sectors of health care, it has made tremendous strides in a variety of specializations, including radiodiagnosis and imaging, surgery (robotic-assisted procedures), oncology, especially radiation oncology, anesthesia, and pathology. However, ethical concerns about utilizing AI in health care may delay its widespread usage.

Speaking Up and Taking Action: Psychological Safety and Joint Problem-Solving Orientation in Safety Improvement.

Healthcare organizations face stubborn challenges in ensuring patient safety and mitigating clinician turnover. This paper aims to advance theory and research on patient safety by elucidating how the role of psychological safety in patient safety can be enhanced with joint problem-solving orientation (JPS). We hypothesized and tested for an interaction between JPS and psychological safety in relation to safety improvement, leveraging longitudinal survey data from a sample of 14,943 patient-facing healthcare workers. We found a moderation effect, in which psychological safety was positively associated with safety improvement, and the relationship was stronger in the presence of JPS. Psychological safety and JPS also interacted positively in predicting clinicians' intent to stay with the organization. For theory and research, our findings point to JPS as a measurable factor that may enhance the value of psychological safety for patient safety improvement-perhaps because voiced concerns about patient safety often require joint problem-solving to produce meaningful change. For practice, our conceptual framework, viewing psychological safety and JPS as complementary factors, can help organizations adopt a more granular approach towards assessing the interpersonal aspect of their safety climate. This will enable organizations to obtain a more nuanced understanding of their safety climate and identify areas for improvement accordingly.

For better or worse: Governing healthcare organisations in times of financial distress.

Due to processes of financialisation, financial parties increasingly penetrate the healthcare domain and determine under which conditions care is delivered. Their influence becomes especially visible when healthcare organisations face financial distress. By zooming-in on two of such cases, we come to know more about the considerations, motives and actions of financial parties in healthcare. In this research, we were able to examine the social dynamics between healthcare executives, banks and health insurers involved in a Dutch hospital and mental healthcare organisation on the verge of bankruptcy. Informed by interviews, document analysis and translation theory, we reconstructed the motives and strategies of executives, banks and health insurers and show how they play a crucial role in decision-making processes surrounding the survival or downfall of healthcare organisations. While parties are bound by legislation and company procedures, the outcome of financial distress can still be influenced. Much depends on how executives are perceived by financial stakeholders and how they deal with threats of destabilisation of the network. We further draw attention to the consequences of financialisation processes on the practices of healthcare organisations in financial distress.

Nexus between technology enabled supply chain dynamic capabilities, integration, resilience, and sustainable performance: An empirical examination of healthcare organizations

Due to the twin impacts of the COVID-19 pandemic and sustainability requirements, many healthcare organizations face disruptions and uncertainties, which put patient safety at risk and decrease the overall quality of health services. Drawing on the dynamic capability view, this study aims at exploring the relationship among supply chain dynamic capabilities (SCDCs), supply chain integration (SCI), supply chain resilience (SCR), sustainable competitive advantage (SCA), and sustainable supply chain performance (SSCP). The study collected 325 usable responses from healthcare supply chain organizations in the developing country of Pakistan, including hospitals, pharmaceutical manufacturing firms, surgical and equipment manufacturing firms, etc. Structural equation modeling using Smart-PLS v.3.3.2 was adopted for the data analysis. The results indicate that SCDCs positively influence SCI, SCR, SCA, and SSCP. This study finds that SCA, SCI, and SCR mediate the relationship between SCDCs and SSCP. This study contributes by aligning the SC dynamic capabilities for supply chain visibilities (i.e., sensing, learning, and coordinating) in the healthcare context. It has examined the impacts of SCDC, SCI, and SCR collectively rather than addressing them piecemeal. Sensing, learning, and coordinating capabilities through frequent collaborative meetings offer healthcare firms SC integration, allowing them to respond to the changing environment quickly and resiliently, further improving their SCA and SSCP. Since disruptions are inevitable, healthcare organizations must turn uncertainties into opportunities and activate a dynamic and resilient strategy to absorb stress. SCA and SSCP improve when SCDCs/SCR and disruptions are properly balanced.

SG-APSIC1159: Control of hospital-acquired carbapenemase-producing carbapenem-resistant Enterobacteriaceae colonization: A descriptive study

Objectives: Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are nosocomial pathogens, and control of CP-CRE transmission is one of the most important infection control issues healthcare organizations face today. Increasing colonization acquisition and clinical infections of CP-CRE occurred in our institution in 2019. In this observational study, we monitored CP-CRE acquisition following implementation of multimodal control measures, and we describe the impact of this intervention on clinical infections. Methods: Increased hospital-acquired CP-CRE colonization and clinical infections were observed in early 2019. Increased CP-CRE surveillance was implemented to include CP-CRE contacts, patients with lengths of stay &gt;7 days, patients with a recent history of hospitalization in other hospitals, and renal dialysis patients. The following interventions were also implemented: (1) isolation or placing CP-CRE patients in cohorts in a designated multidrug-resistant organism (MDRO) ward; (2) emphasis on hand hygiene and contact precautions; (3) mandatory use of gown and gloves for predefined ‘high-risk’ nursing activities, including diaper changing, toilet assistance, wound dressing, and handling urine or stool; (4) enhanced environmental and equipment cleaning; (5) regular audit and feedback regarding compliance; and (6) weekly feedback on ward-level CP-CRE acquisition. CP-CRE colonization cases and clinical infections were tracked by infection prevention and control nurses. Results: The hospital-acquired CP-CRE colonization rate was 4.39 per 10,000 patient days in 2019; it decreased slightly to 3.61 in 2020 and remained steady at 3.77 in 2021. The predominant CP-CRE genes were NDM, OXA-48–like, and KPC. There were 12 hospital-acquired CP-CRE infections in 2019, a rate of 0.37 per 10,000 patient days. This incidence decreased to 6 infections in 2020 and 3 infections in 2021, with corresponding infection rates of 0.19 and 0.09 per 10,000 patient days, respectively. Conclusions: Control of CP-CRE remains extremely challenging in hospitals with multibed open wards. A bundle approach to infection control showed a gradual reduction in CP-CRE cases, with a significant impact on the prevention of clinical infections.

Effects of Servant Leadership Style on Hindrance Stressors, Burnout, Job Satisfaction, Turnover Intentions, and Individual Performance in a Nursing Unit

Today’s healthcare organizations face burgeoning pressures to hire and retain nurses who face considerable workplace stress. Servant leadership behaviours are effective to mitigate workplace stressors impacting nurse burnout, job satisfaction, turnover intentions and performance. Based on a survey of 248 nursing professionals working in inpatient and outpatient care facilities, the results of this study confirm the direct buffering effects of servant leadership on hindrance stressors. Servant leadership decreases nurse burnout while increasing job satisfaction. Third, nurse burnout reduces job satisfaction, yet has no direct impact on turnover intentions or individual performance. Next, job satisfaction has a direct positive impact on individual performance and a direct negative impact on turnover intentions. The model also confirms that hindrance stressors partially mediate the relationship between servant leadership and burnout while burnout is a partial mediator between servant leadership and job satisfaction. Job satisfaction is a full mediator between servant leadership and performance and turnover intentions. Furthermore, the results show serial mediation involving hindrance stressors, burnout and job satisfaction as a link between servant leadership and performance and turnover. Finally, we provide a managerial discussion supporting servant leadership behaviours to impact overall working conditions for nurses.

Automated artificial intelligence-enabled proactive preparedness real-time system for accurate prediction of COVID-19 infections— Performance evaluation

COVID-19 is a contagious disease that has infected over half a billion people worldwide. Due to the rapid spread of the virus, countries are facing challenges to cope with the infection growth. In particular, healthcare organizations face difficulties efficiently provisioning medical staff, equipment, hospital beds, and quarantine centers. Machine and deep learning models have been used to predict infections, but the selection of the model is challenging for a data analyst. This paper proposes an automated Artificial Intelligence-enabled proactive preparedness real-time system that selects a learning model based on the temporal distribution of the evolution of infection. The proposed system integrates a novel methodology in determining the suitable learning model, producing an accurate forecasting algorithm with no human intervention. Numerical experiments and comparative analysis were carried out between our proposed and state-of-the-art approaches. The results show that the proposed system predicts infections with 72.1% less Mean Absolute Percentage Error (MAPE) and 65.2% lower Root Mean Square Error (RMSE) on average than state-of-the-art approaches.

Does empowerment enhance nurses' organizational commitment?

We examined whether psychological empowerment was significantly associated with the organizational commitment of licensed practical nurses. Healthcare organizations face unprecedented staffing challenges. This study provides insight into potential ways to ameliorate these issues. In early 2010, we distributed a 45-item questionnaire, based on established measures of psychological empowerment and organizational commitment, to the entire population of active, full-time licensed practical nurses throughout a Midwestern US state. Our sample consisted of 1165 respondents. The results of our data analysis suggest that even after controlling for a range of potentially confounding variables, three subscales (meaning, self-determination and impact) were positively and associated with organizational commitment. However, one subscale (competence) was negatively related to the outcome. The psychological empowerment dimensions of impact, meaning and self-determination are associated with increased organizational commitment among licensed practical nurses. Considering the profound staffing challenges facing the nursing profession-exacerbated by the current global pandemic and retirements-our findings provide nurse administrators with critical information to use in stemming the wave of nurses leaving the profession.

Preanalytic Competency Assessment: A Q-Probes Study Involving 46 Health Care Institutions, 447 Blood Collectors/Phlebotomists, and 2212 Individual Assessments.

Health care organizations face a challenge of assessing preanalytic competency of blood collectors/phlebotomists (BC/Ps). To pilot a novel methodology for BC/P preanalytic competency assessment and identify potential areas for improvement. Study participants identified preanalytic errors present in 5 blood collection video vignettes. Submitted error descriptions were categorized and then consolidated into a list of standardized required errors for evaluation. The correct identification of required error rates across all videos viewed by 447 BC/Ps from 46 institutions ranged from 0.7% to 91.9%. The median phlebotomist score across all 5 videos was 55.9% for 440 eligible blood collectors and ranged between 38.2% (10th percentile) and 70.6% (90th percentile). The median institutional score from 42 eligible institutions was 55.9% (range, 43.3%-65.3% for the 10th to 90th percentiles). There were no significant associations between any laboratory practice characteristics and the institutional average overall phlebotomist scores. The following phlebotomist characteristics were significantly associated with overall phlebotomist scores: level of education (P = .01), having phlebotomy technician (American Society for Clinical Pathology) certification compared with no or other certifications (P = .002), years of experience in collecting blood specimens (P = .01), and higher average number of venipuncture specimens collected per shift (P = .001). Improvement of the awareness and knowledge of correct blood collection practices is needed, because the best performers (90th percentile) did not recognize approximately one-third of the errors. Using hypothetical blood collection scenarios that incorporate performance errors may be a way to assess preanalytic competency of BC/Ps and create opportunities for continuous improvement.

How technological innovations in performance measurement systems overcome management challenges in healthcare

PurposeThe aim of this paper is to analyse how technological innovations in performance measurement systems make it possible to overcome some of the challenges that public healthcare organizations face where management and control are concerned. The changes that could be applied to the performance measurement system of healthcare organisations were analysed together with an evaluation of the responses developed in order to achieve these changes.Design/methodology/approachThe paper contains an in-depth case-study of a public university hospital which utilises an innovative information system.FindingsThe case-study highlights how technological innovations in performance measurement systems impact the management and monitoring information system in a public university hospital, through the implementation of a multidimensional management dashboard.Research limitations/implicationsThe limitation of this paper is that only one case-study is analysed, albeit in depth, while it would be interesting to consider more public university hospitals.Practical implicationsThe paper highlights the fundamental role of middle management in change processes in the healthcare sector.Originality/valueThe case-study highlights how critical the active involvement of middle management is in performance measurement and management, and how this is achieved thanks to the adoption of a simple, clear method which ensures comprehensible communication of the objectives, as well as the measurement of performance by means of radar plots.

Consent, capacity, and client sexuality policies in healthcare.

Healthcare organizations face significant ethical complexity when developing policies related to the sexual activities of clients within their facilities. On one hand, admission to healthcare facilities should not require clients to abstain from all sexual activity. On the other hand, clients' sexual activities within facilities have implications for other people, and many clients may be at risk of sexual mistreatment. In response, organizations may be tempted to approach their clients' decisions about sexual activity on the model of decisions about medical treatment. In this article, we argue that this approach is more ethically problematic than it may first appear. We review asymmetries between the decisional contexts of medical treatment and sexual activity and argue that those asymmetries generate ethical issues for any policy that treats clients' decisions about sex as analogous to decisions about treatment. We also offer suggestions for the development of ethically justifiable policies related to client sexuality.

Developing the Graduate Nurse Residency: An Oral History With Dr. Colleen Goode and Dr. Mary Krugman.

Health care organizations face the challenge of needing newly licensed nurses to fill positions and facilitate competent care for patients. Wide variation in graduate nurse orientation programs, a growing complexity of care, and high graduate nurse turnover rates led to the development of nurse residency programs. The historical perspectives of two nursing pioneers involved in the development of a national model for nurse residency programs provide context to the importance of creating a vision, providing leadership, and applying an evidence-based rationale to structure a series of learning and work experiences designed to support graduate nurses as they transition into their first professional nursing position. [J Contin Educ Nurs. 2022;53(4):171-177.].

Toward a Learning Health Care System: A Systematic Review and Evidence-Based Conceptual Framework for Implementation of Clinical Analytics in a Digital Hospital.

Objective A learning health care system (LHS) uses routinely collected data to continuously monitor and improve health care outcomes. Little is reported on the challenges and methods used to implement the analytics underpinning an LHS. Our aim was to systematically review the literature for reports of real-time clinical analytics implementation in digital hospitals and to use these findings to synthesize a conceptual framework for LHS implementation. Methods Embase, PubMed, and Web of Science databases were searched for clinical analytics derived from electronic health records in adult inpatient and emergency department settings between 2015 and 2021. Evidence was coded from the final study selection that related to (1) dashboard implementation challenges, (2) methods to overcome implementation challenges, and (3) dashboard assessment and impact. The evidences obtained, together with evidence extracted from relevant prior reviews, were mapped to an existing digital health transformation model to derive a conceptual framework for LHS analytics implementation. Results A total of 238 candidate articles were reviewed and 14 met inclusion criteria. From the selected studies, we extracted 37 implementation challenges and 64 methods employed to overcome such challenges. We identified common approaches for evaluating the implementation of clinical dashboards. Six studies assessed clinical process outcomes and only four studies evaluated patient health outcomes. A conceptual framework for implementing the analytics of an LHS was developed. Conclusion Health care organizations face diverse challenges when trying to implement real-time data analytics. These challenges have shifted over the past decade. While prior reviews identified fundamental information problems, such as data size and complexity, our review uncovered more postpilot challenges, such as supporting diverse users, workflows, and user-interface screens. Our review identified practical methods to overcome these challenges which have been incorporated into a conceptual framework. It is hoped this framework will support health care organizations deploying near-real-time clinical dashboards and progress toward an LHS.

Challenges and Strategies for Improving COPD Primary Care Services in Quebec: Results of the Experience of the COMPAS+ Quality Improvement Collaborative.

IntroductionManagement of chronic obstructive pulmonary disease (COPD) remains a challenge in primary care and multiple barriers can limit implementation of COPD guidelines. Since 2016, a quality improvement (QI) collaborative, called COMPAS+, has been implemented across the province of Quebec (Canada) to support improvement of chronic disease management in primary care. The aim of this study was to describe the main COPD quality problems reported by participating teams and the strategies they proposed and implemented to improve COPD primary care services in Quebec.MethodsSixteen sites in four different regions of Quebec were engaged in the COMPAS+ intervention to improve primary care services delivered to people living with COPD. A total of 14 workshop reports, 31 QI action plans and 4 regional final reports underwent content analysis. Key COPD quality problems were first identified and, for each of them, root causes were classified according to the domains and constructs of the Consolidated Framework for Implementation Research. Proposed strategies were organized according to the intervention function types described in the Behavior Change Wheel.ResultsFour key COPD quality problems were identified: 1) lack of organization/coordination of COPD services, 2) lack of screening services coordination, 3) lack of interprofessional communication and collaboration and 4) lack of treatment adherence. Main root causes explaining these quality gaps were 1) lack of awareness of COPD, 2) lack of professional knowledge, 3) lack of definition of professional roles, 4) lack of resources and tools for COPD prevention, diagnosis, and follow-up, 5) lack of communication tools, 6) lack of integration of the patient-as-partner approach, and 7) lack of adaptation of patient education to their specific needs. Multiple strategies were proposed to improve healthcare professionals’ education and interprofessional collaboration and communication.ConclusionQI collaborative activities can support achieving understanding of QI challenges healthcare organizations face to improve COPD services.

"It's Not Just the Right Thing . . . It's a Survival Tactic": Disentangling Leaders' Motivations and Worries on Social Care.

Health care organizations face growing pressure to improve their patients’ social conditions, such as housing, food, and economic insecurity. Little is known about the motivations and concerns of health care organizations when implementing activities aimed at improving patients’ social conditions. We used semi-structured interviews with 29 health care organizations to explore their motivations and tensions around social care. Administrators described an interwoven set of motivations for delivering social care: (a) doing the right thing for their patients, (b) improving health outcomes, and (c) making the business case. Administrators expressed tensions around the optimal role for health care in social care including uncertainty around (a) who should be responsible, (b) whether health care has the needed capacity/skills, and (c) sustainability of social care activities. Health care administrators could use guidance and support from policy makers on how to effectively prioritize social care activities, partner with other sectors, and build the needed workforce.