As you thumb through this issue of Healthcare Quarterly, you will notice that our articles are now organized around themes – hopefully this will be a helpful change for you as a reader. This issue includes articles that discuss pandemic planning, governance, patient safety, quality improvement, innovations in care and health human resources. All the articles provide fascinating information on "hot topics."
"Contextualizing Ethics: Ventilators, H1N1 and Marginalized Populations," by Diego S. Silva, Jason X. Nie, Kate Rossiter, Sachin Sahni and Ross E.G. Upshur, considers potential effects if the H1N1 pandemic worsens. Specifically focusing on the availability of ventilators to care for those with respiratory failure, the authors discuss ethical principles that require consideration during an influenza pandemic, such as equity and need.
The topic of governance is tackled in four of this issue's articles. G. Ross Baker, Jean-Louis Denis, Marie-Pascale Pomey and Anu MacIntosh-Murray, in their article "Effective Governance for Quality and Safety in Canadian Healthcare," examine the growing interest in strategies employed by healthcare governing boards to make improvements in their organizations. Traditionally focusing on finances and community relations, recent developments have shifted governing boards' focus to quality of care. This shift in focus is also addressed in Don Carlow's article "Role of Healthcare Boards in Quality and Safety." Carlow outlines the progress seen thus far and the challenges that need to be overcome. In "From Boardroom to Bedside: Defining and Measuring Hospital Quality," Michael Heenan, Haajra Khan and Dorothy Binkley discuss the release of St. Joseph's Healthcare Hamilton's strategic plan and the organization's recognition of the importance in engaging its governing board. In this issue's final article on governance, "Recruiting a High-Performance Hospital Board," Ron Robertson and Melanie Serjak explain The Ottawa Hospital's unusual decision to adopt a rigorous approach to selecting members of the hospital board, similar to the method taken by major banks.
Patient safety is discussed in three of this issue's articles. First, Roger Walker, Natalie St. Pierre-Hansen, Helen Cromarty, Len Kelly and Bryanne Minty discuss a cross-cultural patient safety model implemented by the Sioux Lookout Meno Ya Win Health Centre in Northern Ontario and explore the correlation between organizational performance and measurable patient outcomes in their article "Measuring Cross-Cultural Patient Safety: Identifying Barriers and Developing Performance Indicators." In "Implementation of an Enterprise Risk Management Program in a Community Teaching Hospital," Genefer Behamdouni and Kathy Millar discuss the tools used and lessons learned in St. Joseph's Health Centre's two-year journey from a traditional focus on clinical risk management to an enterprise-wide risk management approach. And, finally, Barbara Tiessen, Cheryl Deter and Anne Snowdon, in "Continuing the Journey to a Culture of Patient Safety: From Falls Prevention to Falls Management," document the process of transforming to a patient care model that culminates in a more elder-friendly environment complemented by a respect for patients' choices, even when those choices include personal risk.
Quality improvement is addressed by Sara Lankshear, James D. Brierley, Kevin Imrie and Marta Yurcan as they describe the knowledge transfer strategies employed by Cancer Care Ontario in their article "Changing Physician Practice: An Evaluation of Knowledge Transfer Strategies to Enhance Physician Documentation of a Cancer Stage." Strategies employed included the use of local opinion leaders, educational sessions, academic detailing and audit/feedback loops. In "Did Ontario's End-of-Life Care Strategy Reduce Acute Care Service Use?" Hsien Seow, Lisa Barbera, Doris Howell and Sydney M. Dy tackle the issue of quality improvement in their evaluation of this strategy. Despite its goal to shift care from acute settings to the home, the authors note that a year after the strategy's implementation, the use of end-of-life home care and acute care services remained unchanged. Additional evaluation across regions may help to further analyze this aspect of quality improvement. In the third article on this topic, "Effects of Alternate Payment Plan on Pediatric Surgical Practice in an Academic Setting: The Role of Corporate Indicators," Juan Bass, Luis Guerra and Baxter Willis emphasize the role of corporate indicators and find that the alternate payment plan had little influence on clinical practice patterns at their institutions.
Lastly, this issue of Healthcare Quarterly also takes on issues in innovations in care and in health human resources. Mathew Mercuri, James L. Velianou, Michelle Welsford, Leslie Gauthier and Madhu K. Natarajan explore "Improving the Timeliness of Care for Patients with Acute ST-Elevated Myocardial Infarction: Implications of 'Self-Transport' versus Use of EMS." They emphasize the importance of EMS in minimizing delays to reperfusion. In "The Call of the Canadian Physician," Lynda Buske and Melanie Comeau examine the breakdown of physicians serving in an on-call capacity, and provide a detailed picture of this essential part of healthcare work.
On a final note, I am pleased to announce the addition of Ross Baker to the Healthcare Quarterly editorial advisory board. Ross will serve as our associate editor – welcome!
-Peggy Leatt, PhD
About the Author
Peggy Leatt, PhD
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