As the months roll by, healthcare providers and consumers alike await the final reports of both the Standing Committee on Social Affairs, Science and Technology (Kirby Commission) and the Commission on the Future of Health Care in Canada (Romanow Commission) with great anticipation. What will they recommend for the funding and provision of health services in Canada? What impact will they have on our healthcare system? Will more change be coming? In an exclusive interview, Duncan Sinclair spoke candidly with Senator Kirby about the work of his commission, and we are fortunate to be able to present a preview of some of the ideas that might be in the final report.

As always, this issue of Hospital Quarterly has an eclectic mix of topics and evidence-based reviews that reflect the journal's goal of promoting best practices. Berger presents interesting insights about the public attitude to privacy and access to patient records based on his research for the Berger Population Health Monitor, while Hollaman offers a legal opinion on the potential impact of proposed privacy legislation.

On another theme, Lowe outlines how the quality of the work environment can be a core determinant of success. Reflecting upon thinking across many social science disciplines, he describes how workplace culture, structures, rewards, resources and relationships shape the extent to which people can be productive in their work. He concludes that it is critical for organizations to build their human resources capacity to be successful.

Patient safety is another prominent theme in our healthcare system, with the Canadian Institute for Health Information and Canadian Institute of Health Research funding a major research initiative by Ross Baker at the University of Toronto and Peter Norton at the University of Calgary which will explore system errors in Canada. As well, the Royal College of Physicians and Surgeons of Canada has struck a committee, chaired by John Wade, former Dean of Medicine at the University of Manitoba, to look at the issue. Hospital Quarterly will follow the progress of these committees and report on evidence and recommendations as they unfold. To begin, we are pleased to have a paper from Jarvi et al. discussing a multi-professional mortality review process that York Central Hospital has developed. We also have a commentary from Nemerovsky who discusses the importance of including patients' families in the internal review process.

We continue our focus on nursing, with McGillis-Hall and her colleagues providing the results of a study that looked at nurse staffing in Ontario teaching hospitals, with particular focus on nurses working in medicine, surgery and obstetrics. More than one-third of the nurses were working on a part-time or casual capacity, and apparently had no interest in moving to full-time employment. The study points out to hospital managers the real potential of a staffing crisis as nurses age and retire. A paper from Nelligan et al. discusses implementing client-centred care under the guidelines developed by the Registered Nurses Association of Ontario.

Population health is now included as a measure in accreditation. What will this mean for health system regions, hospitals and other organizations which have not traditionally included population health within their mandate. Millar provides thoughtful commentary and recommendations.

McLeod provides us with interesting insights in to the problems associated with the transfer of stable patients between healthcare facilities. The problem hospitals and healthcare facilities are faced with is long wait times for ambulances. To the individual whose condition is stable, long waits for stressful rides in expensive, emergency vehicles is not the best way to achieve cost-effective healthcare. McLeod offered a model for the transfer of stable patients that has the potential to improve the service and cost less. Waddington and Neal profile the award winning efforts of the Brandon Health Authority in improving energy efficiency. We are delighted to profile Camille Orridge, Executive Director of the Toronto Community Care Access Centre.

I am pleased to announce that Judith Shamian, Executive Director, Office of Nursing Policy for Health Canada, has agreed to join Hospital Quarterly's editorial advisory board. Dr. Shamian's wealth of knowledge and global recognition will be a tremendous asset to the team.

Finally, I urge readers review the most recent issue of HealthcarePapers, which examines the issue of Canada's drug policy. As the cost of drugs sky-rockets, provincial governments, private insurers and consumers are looking for solutions. Authors of the invited essay, Laupacis, Anderson and O'Brien, advocate improving the evidence used to make decisions. Commentary on their model from a range of experts fills out the debate.

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