Healthcare Quarterly

Healthcare Quarterly 11(2) March 2008 : 1-1.doi:10.12927/hcq.2008.19605


Peggy Leatt


This issue of Healthcare Quarterly covers a diverse set of issues all having implications for the quality of health services. Here are some highlights.
A feature is presented by Jafna Cox, David Johnstone, Joanna Nemis-White and Terrence Montague, who were members of a major province-wide research initiative - The Improving Cardiovascular Outcomes in Nova Scotia (ICONS) project.   In this paper, the authors discuss the results of the project that examined whether a community-oriented health management partnership - combining resources from the public and private sectors - would lead to enhanced care and improved outcomes across an entire healthcare system.

In the next feature, "The Role of Healthcare Work Environ-ments in Shaping a Safety Culture," Graham Lowe suggests that patient safety is a basic goal of all Canadian healthcare organizations. Yet we still have much to learn about the determinants of safety. For instance, little is known about the how workplace environment factors that have an influence on employee behaviour also have implications for patient safety.  

This issue also features two Perspective pieces that offer unique insights into particular management issues.   First, Justin Young, Robert Bell, Adil Khalfan and Evert Lindquist from Toronto's University Health Network report on their experiences with implementing and evaluating a balanced scorecard (BSC) in the organization. The authors look specifically at the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives.  

The next Perspective is provided by Isser L. Dubinsky, Moshe Greengarten, Larry Grossman, Mark Hundert, Diane Sawatzky and Bill Whittaker, who describe their work with implementing a physician leader compensation program. Since physician leaders are increasingly being seen by hospital boards and executives as key to achieving strategic and operational outcomes, it is critical that organizations are able to recruit and retain individuals who demonstrate the skills required to fulfill these critical roles or commit themselves to acquiring them.

In Ideas at Work, we present two innovative real-life solutions to the current shortage of orthopedic surgeons. Alice B. Aiken, Mark M. Harrison, Marg Atkinson and John Hope in Kingston, Ontario, describe their solution to managing the increased demand for total joint replacement in their organization, that involved a physiotherapist and orthopedic surgeons assessing all patients referred for surgery. Interestingly, they found that 34% did not require surgery at all.

Next, Susan Robarts, Deborah Kennedy, Anne Marie MacLeod, Helen Findlay and Jeffrey Gollish outline the new model of care that has been implemented at the Sunnybrook Holland Orthopaedic and Arthritic Centre. An advanced practice physiotherapist (APP) role was created to support both referral management and post-operative care to reduce surgeon workload and better streamline services. This article describes the nine-step framework for implementing an APP role and can be used as a template for other organizations evolving similar roles.

A case study by Cheryl Anne Smith illustrates how the Ottawa Hospital developed an evidence-based nursing internship program to meet the challenges of new graduates. The program provides support to new graduates by offering opportunities for growth and autonomy, leading to active participation as team members. The hospital was able to decrease new graduate turnover from 23% at two years to 10%, with $360,000 in savings from the reduced turnover.

In the FutureThink column, Michael Decter looks into the future for us in a paper organized in five brief sections beginning with looking backward to look forward and proceeding through key trends and organizational evolution by sector and concluding with 10 implications for health human resources.

In the Longwoods Review, a group of Canadian nurse researchers, led by Heather Spence Laschinger, profile the findings of a major research project that looked at nursing leadership Canada. The results of the study revealed that nursing leaders in Canada see themselves as an empowered and influential group within their organizations. Overall, nurse leaders at all levels were positive about their work life and confident in their ability to provide effective leadership on nursing affairs within their organizations.

All in all, some very interesting reading!

About the cover: Watch for grafitti as a signal that a collective will is creating a movement and the momentum for safer healthcare now!

About the Author(s)

Peggy Leatt, PhD


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