Healthcare Management Forum

An increase in reusable elastomeric half mask respirators among healthcare personnel has been documented during pandemic emergencies; however, research has not detailed leadership practices to support their use. Forty-three organizations implemented EHMRs received from the United States federal government which prompted interviews with 73 individuals who managed respirator distribution and fit testing between October 2021 and November 2022. Interview data was qualitatively analyzed. Themes around organizational culture and leadership practices emerged when discussing how elastomeric half mask respirators were integrated into health delivery settings including communication and outreach methods to aid worker support...

No abstract text is available yet for this article.

Leadership is vital to a well-functioning and effective health system. This importance was underscored during the COVID-19 pandemic. As disparities in infection and mortality rates became pronounced, greater calls for equity-informed healthcare emerged. These calls led some leaders to use the Learning Health System (LHS) approach to quickly transform research into healthcare practice to mitigate inequities causing these rates. The LHS is a relatively new framework informed by many within and outside health systems, supported by decision-makers and financial arrangements and encouraged by a culture that fosters quick learning and improvements...

No abstract text is available yet for this article.

This article explores the increasing impact of natural disasters on healthcare leadership and disaster preparedness, particularly in Fort McMurray, Alberta. It underscores the importance of building disaster resilience in healthcare, distinguishing between emergencies, disasters, and catastrophes, and advocating for a multi-dimensional resilience approach. The need for robust electronic communication channels and comprehensive family-oriented evacuation plans, considering family and pet safety, is emphasized...

Unattachment to a regular primary care professional can affect children's and adolescents' well-being, considering their unique health needs. Having no alternative, many turn to emergency departments for non-urgent conditions. To help unattached patients access healthcare services while on waitlists, Quebec's government implemented single access points in each administrative region across the province. Our study aimed to describe the paediatric population using single access points and identify associations between their characteristics and need for a medical appointment...

The Canadian health system is reeling following the COVID-19 pandemic. Strains have become growing cracks, with long emergency department wait times, shortage of human health resources, and growing dissatisfaction from both clinicians and patients. To address long needed health system reform in Canada, a modernization of training is required for the next generation health leaders. The Canadian Institutes of Health Research Health System Impact Fellowship is an example of a well-funded and connected training program which prioritizes embedded research and embedding technically trained scholars with health system partners...

Understanding how cognitive biases, mental models, and mindsets impact leadership in health systems is essential. This article supports the notion of cognitive biases as flawed thinking or cognitive traps which negatively influence leadership. Mental models that do not fit with current evidence limit our ability to comprehend and respond to system issues. Resulting mindsets affect cognition, behaviour, and decision-making. Metacognition is critical. The wicked problems in today's complex health system require leaders and everyone involved to elevate their personal, organizational, and disciplinary perspectives to a systems level...

Conversations about evidence have become much more personal and more divisive over the course of the COVID-19 pandemic. Using a metaphor to carefully consider all the different aspects of "seeing" evidence can remind us that assembling a complete picture of information on any topic is necessarily a communal effort, made more robust by actively seeking to learn about and mitigate our blind spots. An approach to evidence that is curious, humble, and seeks relationship and partnership with others can help us see more clearly and completely...

Including post-event support planning as part of crisis preparedness is necessary to meet the emotional and psychological needs of those most affected. This necessarily requires engagement with health and community organization leaders best positioned to provide immediate, short- and long-term post-event supports as part of the response planning for a crisis. Drawing on the findings of the Mass Casualty Commission, the public inquiry tasked with investigating Canada's worst mass shooting, the critical role of post-event supports is explored as a critical element of crisis preparedness...

Health inequities are increasing in Canada and across the globe. They pose a substantial threat to the health and well-being of millions of people. Organizational leadership, if it is to effectively contribute to tackling these inequities, must become more systematically infused with competencies that address power and the structural determinants of health. Health equity contexts for 2SLGBTQIA+ (Two Spirit, Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual, and Plus) remain a neglected area of focus in organizational leadership...

Patients and families in critical care have a high likelihood of previous and re-experienced trauma. Unaddressed, physical, and psychological impacts of these traumas can worsen outcomes for patients and families. A trauma-informed care approach has been proposed for critical care; however, training programs do not include relational competencies or de-escalation techniques, risking the re-traumatization of patients and families in critical care and negatively impacting clinicians. This article describes a strategy that can be adopted by critical care teams towards the creation of a trauma-informed critical care unit including the use of a framework for relational training...

The field of health leadership is shifting rapidly, and there is an opportunity to learn with health leaders about what is needed to support health leadership education, research, and practice. In 2022, to augment student feedback and faculty praxis, Royal Roads University (RRU) conducted 12 virtual interviews with senior health system leaders across various settings to learn how health leaders can better respond to emerging and future leadership needs and priorities facing health systems. Findings from this study informed the development of a health-specific elective for the MAL-H program entitled Considerations for Health Systems Renewal...

Public safety results from an effective interaction of three separate systems- public health, mental health, and policing. In too many communities today, the crisis in our mental health system creates the perfect storm. Solving the issues of silo-based care necessitates creating an oversight data management structure supporting cross-sector data integration on all levels ensuring that both operational and technical frameworks exist to maintain the security of client data. Safer communities isn't just about being sophisticated, technologically advanced but using an intensifying laser-focus analysis on harmful criminality, and on stakeholders responsible for delivering to those in need of mental health services...

In this short article we consider leadership in the context of managing increasingly complex networks. Our approach draws on multiple perspectives that support the use of collective approaches to leadership and the processes that underpin them. We highlight the importance of creating spaces for co-productive work and the use of rapid insight generation to accelerate learning and impact based on our experience of working on complex change programs.

Nurses comprise the largest portion of the healthcare workforce across Canada, yet there have been ongoing shortages for the last decade. This shortage has been pronounced with the recent COVID-19 pandemic. Healthcare spending has also been increasing steadily in Canada. The Canadian provincial governments, such as Ontario, see this as an opportunity to stabilize its fiscal healthcare spending by implementing a policy to freeze nurses' wages. The focus of this policy analysis is to address the question: how did Bill-124 reach the Ontario government's agenda in the midst of a nursing shortage? Why was this specific policy action successful in being implemented as a possible solution to remediate provincial debt burden? The authors will be using the Kingdon's framework to help analyze this policy...

Leadership models that uphold feminist qualities of mutuality, collaboration, and distribution of power can foster organizational and community success. Utilizing a systems perspective grounded in land-based analogies can assist with understanding the diversity and strength that come from entire ecosystems around wicked social issues. While Indigenous leadership models have supported such perspectives since time immemorial, current and ongoing acts of colonialism driven by patriarchal systems and violent gender-based policies and procedures have eroded matriarchal leadership models that sustained what is now known as Canada for generations...

A rational decision-making process enables a leader to process information clearly and logically and thus allows for accurate perception and interpretation of the event. It is believed this process prevents leaders from excessively distorting reality and being impacted by cognitive biases, both of which are possible, particularly under stressful conditions. But what happens when the decision-making environment is rapidly changing and the leader does not have time to deploy a thorough, comprehensive rational decision-making process? In time-compressed decision-making environments, leaders must often make quick, accurate decisions, with incomplete, inaccurate, or rapidly changing information, under extremely stressful conditions...

The organic systems framework is a conceptual social sciences theoretical framework developed by renowned author Barry Oshry. Oshry outlines how we are often blind to the context we are in and our reactions to those conditions, which leads to certain experiences. This article emanates from the author's reflections on bringing organic systems insights to groups and organizations worldwide and how such strategies in relational systems may apply to patients and care providers working together in partnership. As patients and care providers engage in such partnerships, they enter distinctly different contexts, each with unique challenges and opportunities...

Challenges in the delivery of high-quality patient centric care in Canada is plagued by staff and medical supplies shortages and spiking burnout rates leading to closures of more than a thousand emergency rooms in 2023. A literature review was conducted to examine the crisis preparedness and responsiveness of healthcare establishments in Ukraine in a warfare context, with the intent of exacting recommendations to respond to shortages in Canadian hospitals. Utilizing queries on distinct databases, more than 17,500 entries were found, narrowed, and selected for review...