Canada is considered one of the most culturally diverse countries in the world, and for many of us, this diversity is a source of pride. Yet, it is not without its challenges. The implications for health system managers are clear - different languages and cultural perceptions can create tremendous barriers to communication and care delivery. Sensitivity to the values of diverse groups is a subject that is receiving increasing attention in the media as well as in professional publications. Ray Grady, who is President and CEO of the Evanston Hospital in Illinois, gave an inspiring presentation at a meeting of health educators and practitioners I attended last year. In this issue, we are pleased to have a modified version of his presentation. With passion, Mr. Grady describes the challenges for leaders in removing barriers and in reaffirming basic values and beliefs about multiculturalism. To supplement this paper, we have two Canadian commentaries. First Brenda Evans discusses the approach to multicultural leadership taken by the Vancouver/Richmond Health Board. Next, Elizabeth Hanna describes a more hands-on application of multicultural values in a specific patient care program.

The events of September 11th were disturbing to everyone. For healthcare managers, along with the horror of the situation, there was also concern about the extraordinary challenges such a catastrophic event would place upon the system. In this issue, we are pleased to publish the emergency response strategy developed by Ontario's Ministry of Health and Long-Term Care. We would be equally pleased to publish strategies from other provinces.

Recently, the Canadian Institute for Health Information released an extensive report, "Canada's Health Care Providers" (www.cihi.ca), that offers a comprehensive overview of this topic in Canada. In this issue, Jennifer Zelmer and Kira Leeb summarize key facts from the CIHI report that will enlighten the reader as to the depth of the human resource problem and offer insights for planners and policy makers. We will continue the focus on Canada's healthcare providers in an upcoming issue of the journal HealthcarePapers to be published in spring 2002. Watch for details on www.longwoods.com.

An article from Doris Grinspun, Tazim Virani and Irmajean Bajnok introduces the Registered Nurses Association of Ontario's Nursing Best Practice Guidelines. Watch for more about this project in the spring issue of Hospital Quarterly.

Susan Germain, a physician and environmentalist at Vancouver's Lions Gate Hospital, was willing to contribute an article on her work in creating the first-ever environmental footprint of a hospital. Some of her research results are astonishing and offer provocative reading for all managers. The media recently opened a debate on reuse of single-use medical devices. Phil Spencer, Glenn Zakaib and Emily Winter weigh up the potential legal liability versus the cost savings. Another controversial topic is mixed gender wards - what are the pros and cons? Sharon Rogers examined the topic on behalf of the University Health Network and reports on her findings in the "Ideas at Work" section.

While there has been considerable public debate in the media regarding the moral and ethical implications of new innovations such as cloning and the use of stem cells, little has been written on the implications of these developments for health services management and policies. We are pleased to publish an article by Russell C. Coile, Jr. that summarizes ten key advances in genomics and offers some predictions as to where they will take us.

In an in-depth personal profile of Dr. Alan Hudson, former President and CEO of the University Health Network, we offer his insights into why he has been so successful in his professional life while keeping his sanity in his personal life - perhaps some of the credit for this belongs to his wife, Susan!

A special brief from HealthcarePapers on the controversial Alberta Mazankowski Report will be published later this month. It is important from an editorial and publishing point of view for us to be able to provide timely commentaries on new reports as they are published. We have compiled reactions about the report from key policy analysts from across Canada and internationally. So … stay tuned for some very provocative reading!

Thank you to all who have taken the time to contact us with your ideas and recommendations. We encourage these discussions; they assist us in ensuring that Hospital Quarterly continues to be relevant and timely.

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