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88 records – page 1 of 9.

Acute care has an innovative approach to the bed crisis!

https://arctichealth.org/en/permalink/ahliterature199854
Source
Healthc Manage Forum. 1999;12(3):54-6
Publication Type
Article
Date
1999
Author
D. Goulard
C. Simpson
Author Affiliation
Patient Transition Services, Peter Lougheed Centre, Calgary, Alberta.
Source
Healthc Manage Forum. 1999;12(3):54-6
Date
1999
Language
English
Publication Type
Article
Keywords
Acute Disease
Alberta
Bed Occupancy
Health Facility Closure
Hospital Restructuring
Humans
National Health Programs
Organizational Innovation
Patient Discharge
Regional Health Planning - organization & administration
Abstract
The regionalization of healthcare in Alberta has been instrumental in changing the way we deliver healthcare to the population. In Calgary, the restructuring involved the closing of three acute care hospitals and a significant reduction in beds per capita. This reduction in inpatient beds behooved Senior Management in acute care to be innovative and responsive to the utilization of existing resources. The Department of Patient Transition Services was conceived with a mandate to provide assistance and support in utilization management and discharge planning, administrative coordination, system support and integration support. The evolution of this unique department is described.
PubMed ID
10623171 View in PubMed
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Addressing the non-medical determinants of health: a survey of Canada's health regions.

https://arctichealth.org/en/permalink/ahliterature165318
Source
Can J Public Health. 2007 Jan-Feb;98(1):41-7
Publication Type
Article
Author
C James Frankish
Glen E Moulton
Darryl Quantz
Arlene J Carson
Ann L Casebeer
John D Eyles
Ronald Labonte
Brian E Evoy
Author Affiliation
Institute of Health Promotion Research, University of British Columbia, Vancouver. Frankish@interchange.ubc.ca
Source
Can J Public Health. 2007 Jan-Feb;98(1):41-7
Language
English
Publication Type
Article
Keywords
Canada
Cooperative Behavior
Health Care Reform - organization & administration
Health Priorities - organization & administration
Health Status Indicators
Humans
Interinstitutional Relations
Public Health Administration
Regional Health Planning - organization & administration
Rural Health
Socioeconomic Factors
Sociology, Medical
Urban health
Abstract
The Canadian health system is undergoing reform. Over the past decade a prominent trend has been creation of health regions. This structural shift is concurrent with a greater emphasis on population health and the broad determinants of health. In parallel, there is a movement toward more intersectoral collaboration (i.e., collaboration between diverse segments of the health system, and between the health system and other sectors of society). The purpose of this exploratory study is to determine the self-reported level of internal action (within regional health authorities) and intersectoral collaboration around 10 determinants of health by regional health authorities across Canada.
From September 2003 to February 2004, we undertook a survey of regional health authorities in Canadian provinces (N = 69). Using SPSS 12.0, we generated frequencies for the self-reported level of internal and intersectoral action for each determinant. Other analyses were done to compare rural/suburban and urban regions, and to compare Western, Central and Eastern Canada.
Of the 10 determinants of health surveyed, child development and personal health practices were self-reported by the majority of health regions to receive greatest attention, both internally and through intersectoral activities. Culture, gender and employment/working conditions received least attention in most regions.
The exploratory survey results give us the first Canadian snapshot of health regions' activities in relation to the broad range of non-medical determinants of health. They provide a starting data set for baselining future progress, and for beginning deeper analyses of specific areas of action and intersectoral collaboration.
PubMed ID
17278677 View in PubMed
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Advancing the population health agenda.

https://arctichealth.org/en/permalink/ahliterature170442
Source
Healthc Manage Forum. 2005;18(4):17-21
Publication Type
Article
Date
2005
Author
Alan Davidson
Author Affiliation
UBC-Okanagan, British Columbia.
Source
Healthc Manage Forum. 2005;18(4):17-21
Date
2005
Language
English
Publication Type
Article
Keywords
British Columbia
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Health Priorities
Humans
Interinstitutional Relations
Models, organizational
Organizational Objectives
Public Health
Public Health Administration
Regional Health Planning - organization & administration
Socioeconomic Factors
Abstract
Using the case of the B.C. Interior Health Authority, the paper teases out some of the bases for practical success and failure in advancing population health in a regionalized health system.
PubMed ID
16509277 View in PubMed
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The Alberta Cardiac Access Collaborative: improving the cardiac patient journey.

https://arctichealth.org/en/permalink/ahliterature146165
Source
Healthc Q. 2009;13 Spec No:85-90
Publication Type
Article
Date
2009
Author
Robyn Blackadar
Mishaela Houle
Author Affiliation
Alberta Cardiac Access Collaborative.
Source
Healthc Q. 2009;13 Spec No:85-90
Date
2009
Language
English
Publication Type
Article
Keywords
Alberta
Angioplasty, Balloon, Coronary
Benchmarking - organization & administration
Continuity of Patient Care - organization & administration
Coronary Artery Bypass
Evidence-Based Practice
Health Care Reform - organization & administration
Health Plan Implementation
Health Services Accessibility - organization & administration
Heart Diseases - therapy
Humans
National health programs - organization & administration
Organizational Case Studies
Program Development
Program Evaluation
Regional Health Planning - organization & administration
Systems Integration
Total Quality Management - organization & administration
Waiting Lists
Abstract
The Alberta Cardiac Access Collaborative (ACAC) is a joint initiative of Alberta's health system to improve access to adult cardiac services across the patient journey. ACAC has created new care delivery models and implemented best practices across Alberta in four streams across the continuum: heart attack, patient navigation, heart failure and arrhythmia. Emergency medical providers, nurses, primary care physicians, hospitals, cardiac specialists and clinicians are all working together to integrate services, bridge jurisdictions and geography with one aim--improving the patient journey for adults in need of cardiac care.
PubMed ID
20057256 View in PubMed
Less detail
Source
Infirm Que. 1999 Mar-Apr;6(4):4-7
Publication Type
Article

An investigation of satellite hemodialysis fallbacks in the province of Ontario.

https://arctichealth.org/en/permalink/ahliterature152264
Source
Clin J Am Soc Nephrol. 2009 Mar;4(3):603-8
Publication Type
Article
Date
Mar-2009
Author
Robert M Lindsay
Janet Hux
David Holland
Steven Nadler
Robert Richardson
Charmaine Lok
Louise Moist
David Churchill
Author Affiliation
The University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada. Robert.lindsay@lhsc.on.ca
Source
Clin J Am Soc Nephrol. 2009 Mar;4(3):603-8
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Community Health Centers - organization & administration
Delivery of Health Care - organization & administration
Female
Hospitalization
Hospitals, Satellite - organization & administration
Humans
Kidney Transplantation
Length of Stay
Male
Middle Aged
National health programs - organization & administration
Nephrology - organization & administration
Ontario - epidemiology
Outcome and Process Assessment (Health Care)
Patient Transfer - organization & administration
Personnel Staffing and Scheduling - organization & administration
Regional Health Planning - organization & administration
Renal Dialysis - adverse effects - mortality
Risk assessment
Risk factors
Treatment Outcome
Young Adult
Abstract
In Ontario, Canada, hemodialysis services are organized in a "hub and spoke" model comprised of regional centers (hubs), satellites, and independent health facilities (IHFs; spokes). Rarely is a nephrologist on site when dialysis treatments take place at satellite units or IHFs. Situations occur that require transfer of the patient back ("fallbacks") to the regional center that necessitate either in- or outpatient care. Growth in the satellite dialysis population has led to an increased burden on the regional centers. This study was carried out to determine the incidence, nature, and outcome of such fallbacks to aid resource planning.
Data were collected on 565 patients from five regional centers over 1 yr. These regional centers controlled 19 satellite dialysis centers including 7 IHFs.
There were 681 fallbacks in 328 patients: 1.21 incidents per patient or 2.1 incidents per patient year. Multiple fallbacks occurred in 170 patients. Fallback episodes lasted a mean of 10.3 d, requiring 4.6 dialysis treatments. Forty-five percent of fallbacks required hospitalization with a mean stay of 16.7 d. Access-related problems (33%) and nondialysis medical causes (32%) were the major causes of fallback. Resolution of the problem occurred in 87.8%, with the patient returning to the satellite. By the end of the study 77.3% were still satellite patients, 10.8% died, 3.8% returned to the regional center, 3.4% were transplanted, and 4.7% were transferred to other treatment modalities.
Fallbacks are common, yet the model operates well.
Notes
Comment In: Clin J Am Soc Nephrol. 2009 Mar;4(3):523-419261831
PubMed ID
19261829 View in PubMed
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Assessing the volume-outcome hypothesis and region-level quality improvement interventions: pancreas cancer surgery in two Canadian Provinces.

https://arctichealth.org/en/permalink/ahliterature142218
Source
Ann Surg Oncol. 2010 Oct;17(10):2537-44
Publication Type
Article
Date
Oct-2010
Author
Marko Simunovic
David Urbach
Diane Major
Rinku Sutradhar
Nancy Baxter
Teresa To
Adalsteinn Brown
Dave Davis
Mark N Levine
Author Affiliation
Department of Surgery, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada. marko.simunovic@jcc.hhsc.ca
Source
Ann Surg Oncol. 2010 Oct;17(10):2537-44
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Delivery of Health Care - organization & administration - statistics & numerical data
Female
Hospital Mortality - trends
Humans
Male
Middle Aged
Ontario
Outcome and Process Assessment (Health Care) - statistics & numerical data
Pancreatic Neoplasms - mortality - surgery
Quality Improvement
Quebec
Regional Health Planning - organization & administration - statistics & numerical data
Survival Rate
Young Adult
Abstract
The volume-outcome hypothesis suggests that if increased provider procedure volume is associated with improved patient outcomes, then greater regionalization to high-volume providers should improve region-level outcomes. Quality improvement interventions for pancreas cancer surgery implemented in year 1999 in Ontario, Canada were designed to regionalize surgery to high-volume hospitals and decrease operative mortality. Similar interventions were not used in Quebec, Canada. We assessed the volume-outcome hypothesis and the impact of the Ontario quality improvement interventions.
Administrative databases helped identify pancreatic resections from years 1994 to 2004 and relevant patient and hospital characteristics. Hospitals were high-volume if they provided =10 procedures in a given calendar year. Outcomes were regionalization of surgery to high-volume providers and rates of operative mortality.
From 1994 to 2004 the percentage of cases in high-volume hospitals increased from 33 to 71% in Ontario and from 36 to 76% in Quebec. Annual rates of operative mortality dropped in Ontario (10.4-2.2% or less) and changed little in Quebec (7.2-9.8%). Changes in measures over time in both provinces were similar before and after year 1999.
Regionalization was associated with improved operative mortality in Ontario but not in Quebec, undermining the volume-outcome hypothesis. The Ontario quality improvement interventions likely were of little influence since patterns in regionalization and operative mortality were similar before and after year 1999.
Notes
Comment In: Ann Surg Oncol. 2010 Oct;17(10):2535-620499281
PubMed ID
20625843 View in PubMed
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Attitudes and perceptions of registered nurses during and shortly after acute care restructuring in Newfoundland and Labrador.

https://arctichealth.org/en/permalink/ahliterature172218
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:22-30
Publication Type
Article
Date
Oct-2005
Author
Christine Way
Deborah Gregory
Norma Baker
Sandra Lefort
Brendan Barrett
Patrick Parfrey
Author Affiliation
Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. cway@mun.ca
Source
J Health Serv Res Policy. 2005 Oct;10 Suppl 2:S2:22-30
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Health Care Reform
Hospital Planning
Hospital Restructuring
Humans
Newfoundland and Labrador
Nursing Staff, Hospital - psychology
Quality of Health Care
Questionnaires
Regional Health Planning - organization & administration
Utilization Review
Workplace
Abstract
To monitor changes in registered nurses' perceptions of the impact of seven years of health care restructuring in Newfoundland and Labrador (NL) and to measure the attitudinal and behavioural reactions over four years comparing the St John's region, where hospital aggregation occurred, to other regions of the province.
Data were collected on acute care nurses' personal characteristics and perceptions of the importance of reform and its impact on workplace conditions and health care quality in 1995, 1999, 2000 and 2002. Nurses' attitudes and intentions were monitored across three time periods (i.e. 1999, 2000 and 2002).
Perceived workplace conditions and health care quality, as well as attitudes and behaviours were generally negative. However, there was some improvement over time. The temporal sequence of scores suggests that restructuring had an adverse impact on nurses' attitudes. Few significant regional differences were observed.
Although health services restructuring had an adverse impact on nurses' attitudes, aggregation of hospitals in St John's region was achieved without further deterioration. Provincial wide initiatives are needed to promote more positive work environments and increase the organizational effectiveness.
PubMed ID
16259698 View in PubMed
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Au coeur de la vie: the Quebec Heart Health Dissemination Project.

https://arctichealth.org/en/permalink/ahliterature192726
Source
Promot Educ. 2001;Suppl 1:22-6
Publication Type
Article
Date
2001
Author
L. Renaud
G. Paradis
Author Affiliation
Direction de la santé publique de Montréal-Centre, Université de Montréal, département de médecine sociale et préventive, Montréal, Québec.
Source
Promot Educ. 2001;Suppl 1:22-6
Date
2001
Language
English
Publication Type
Article
Keywords
Diffusion of Innovation
Health Promotion - organization & administration
Heart Diseases - prevention & control
Humans
Information Services - organization & administration
National health programs - organization & administration
Primary Prevention - organization & administration
Program Development - methods
Program Evaluation
Quebec
Regional Health Planning - organization & administration
Abstract
"Au coeur de la vie" is a research project which aims to evaluate the impact of a heart health dissemination program on primary and secondary prevention practices in local community clinics in the province of Quebec, Canada. Because the project starts in 2001 and no data has been collected to date this paper presents the theoretical model, the objectives of the program, the description of the dissemination procedures, and a brief overview of the evaluation.
PubMed ID
11677819 View in PubMed
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88 records – page 1 of 9.