Much of this issue of Healthcare Quarterly focuses on the organization of our healthcare systems, as well as the evaluation and assessment of key areas within these systems. In today's ever-evolving world, it is important to maintain a vigilant eye on all aspects of healthcare and make changes as necessary.

Brian Hart, Glenna Raymond and Patricia Bradshaw focus on the practices and experiences of their centre in its effort to be a catalyst for community governance. Their article, "Creating Community Governance: A View from the Inside" is a strong contribution to the budding dialogue on this topic.

"Enhancing Lives Together: Reviewing the Process of an Organizational Amalgamation," by Emily Christoffersen, Donna Cripps, Lillian Badzioch, Mary Anne Sersen, Brenda Flaherty and Murray T. Martin, outlines the integration process and an eight-step framework used during the amalgamation of an acute hospital organization and a post-acute hospital. The union of two organizations can create change and uncertainty; this article presents an evaluation of the process used and the lessons learned from the experience.

Our section Managing Smarter covers various topics. The first article discusses the development of an alliance in order to best use scarce resources in "Strategic Implementation and Accountability: The Case of the Long Term Care Alliance," by Al Seaman, Maria Elias, Bill O'Neill and Karen Yatabe. In the second article, "Time for a Paradigm Shift: Managing Smarter by Moving from Data and Information to Knowledge and Wisdom in Healthcare Decision-Making," Marcus Hollander, Christopher Corbett and Paul Pallan present a new knowledge development system that should allow senior decision-makers and others to take their decision-making to the next level. Finally, Scott Cholewa, Kathy Moran and Yvonne Cheung's article "Evaluation of the Consensus-Building Process to Develop a Balanced Scorecard for York Region Public Health" discusses the development of a balanced scorecard for use as a performance measurement tool in public health.

In our Pandemic Planning section, Chris Kaposy, Natalie Bandrauk, Daryl Pullman, Rick Singleton and Fern Brunger, in "Adapting the Hamilton Health Sciences Critical Care Pandemic Triage Protocol," write of the changes they have made to this protocol to meet the specific needs of Newfoundland and Labrador during an influenza pandemic.

This issue of Healthcare Quarterly addresses patient safety in an article by Andrew M. Morris, Thomas E. Stewart, Maureen Shandling, Scott McIntaggart and W. Conrad Liles in which they describe "Establishing an Antimicrobial Stewardship Program" using change management and quality improvement principles.

Health human resources are discussed by Isser Dubinsky, Kelly Jennings, Moshe Greengarten and Amy Brans in "360-Degree Physician Performance Assessment" – a framework for assessment that is intended to support physician career planning and to enhance the quality of patient care.

Two articles speak to issues in mental health. In the first article, "Medical Clearance in the Psychiatric Emergency Setting: A Call for More Standardization," Tanya Pinto, Brittany Poynter and Janet Durbin propose the use of a standardized physical examination form for the medical clearance of patients who present to emergency rooms in psychiatric crisis. In "Ombudsman in a Mental Health Centre," Yuri Shpak and Yuval Melamed take us across the globe to Israel to examine ombudsman activities in Lev Hasharon Mental Health Center. The authors conclude that the office of the ombudsman improves dialogue with both patients and their families.

In the Technology Assessment section, two articles consider investments in technology. Larry Arshoff explores processes healthcare organizations should undergo in "Assessing Innovations: What Is the Optimal Approach for Healthcare Organizations?" On the flip side, Maurice McGregor attempts to determine the danger of repeated costs for technology acquisitions. In "Paying for Technology: The Cost of Ignoring Opportunity Costs," the author argues that for every new commitment of money, something has to be given up.

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