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Healthcare Quarterly

Kerry Campbell, Jessica Jaiven, Kimberly Banfield, Corinne Begg, Janice Butler, Leanne Thain
British Columbia Emergency Health Services (BCEHS) uses an internationally recognized Medical Priority Dispatch System to assign appropriate responses to 9-1-1 calls based on patients' clinical acuity. In 2015, 71% of Omega calls (classified as calls involving low acuity injuries) were assigned an ambulance. To better meet patients' needs, BCEHS collaborated with HealthLink BC's Nursing Services (HLBC NS) to audit over 2,000 calls. Based on the results, three Plan, Do, Study, Act (PDSA) cycles were implemented, yielding a 35% decrease in ambulances assigned and a 173% increase in referrals to HLBC NS to provide more suitable support...
2017: Healthcare Quarterly
Nina Ahuja
Coding accuracy is an important factor in ensuring hospitals receive adequate reimbursement from the government for healthcare services rendered. A retrospective review of 100 charts, the purpose of this study was to determine the degree of coding accuracy from the surgeon perspective, for outpatient procedures performed for ophthalmic services at St. Joseph's Healthcare Hamilton from July to December 2016. Using ICD-10-CA, Canadian Classification of Health Interventions, Quality-Based Procedures criteria where applicable, and the 3M Coding and Reimbursement system, this paper reveals three primary sources of coding errors and presents recommendations to increase accuracy of reimbursement for the benefit of both the Ministry of Health and hospital organizations...
2017: Healthcare Quarterly
Rob Kean, Ron Johnson, Michael Doyle
In 2016, NL's largest RHA was faced with serious challenges stemming from the discovery of stained surgical instruments at its two largest hospitals. This discovery prompted a series of postponed surgeries, an extensive internal mobilization of labour and the purchase of millions of dollars of new equipment. In tackling these challenges, the organization not only acquired a better understanding of its surgical tools, but it also gained renewed appreciation for the resilience of its human resources. By describing this incident and the lessons learned, we hope to offer insight to providers in similar circumstances...
2017: Healthcare Quarterly
Marjan Abbasi, Sheny Khera, Julia Dabravolskaj, Linda Xia
Improving Care Experiences, Efficiencies and Quality of Care for Seniors in Alberta Forum was held to explore the current challenges and opportunities in seniors' care. A diverse group of 53 attendees, representing a cross section of healthcare organizations, front-line healthcare providers, researchers and patients, participated in facilitative, small group discussions to share and propose solutions to barriers to coordinating and integrating care for the senior population across the continuum within the Edmonton zone, to comment on a standardized assessment that may inform integrated care and support planning and to outline steps towards health information continuity...
2017: Healthcare Quarterly
Ruby Emily Grymonpre, Mubashir Aslam Arain, Lesley Ann Bainbridge, Siegrid Deutschlander, Elizabeth Louise Harrison, Ruth A Koenig, Máire McAdams, Grace Maureen Mickelson, Esther Suter
In response to the shortage of healthcare professionals, the Canadian government has supported two innovative health workforce planning strategies: interprofessional education for interprofessional collaboration and recruiting internationally educated health professionals (IEHPs). Interprofessional collaboration is increasingly expected by Canadian-educated healthcare professionals; IEHPs must also be oriented to this practice model. An environmental scan and iterative assessments and evaluations informed the development of an online interprofessional competency toolkit aimed at training and assessing interprofessional collaboration for IEHPs...
2017: Healthcare Quarterly
Neil Seeman, Bob Seeman
Reaching the recipient of online health messages is necessary to Web-based health promotion applications. To measure willingness to adhere to a health-related Web message, we explored the frequency with which more than 13 million Web users ignored or opted to receive a random inbound message. The findings suggest declining curiosity among Web users about online messages, and that certain days may be more propitious than others for communicating with users. This approach can be modified to gather more granular insights into how messages, including timing and design features, can be tailored to promote improved public health messaging...
2017: Healthcare Quarterly
Katherine M Atkinson, Ziad El-Khatib, Geoffery Barnum, Cameron Bell, Marie-Claude Turcotte, Malia S Q Murphy, Mari Teitelbaum, Pranesh Chakraborty, Lucie Laflamme, Kumanan Wilson
Medicine is experiencing a paradigm shift, where patients are increasingly involved in the management of their health data. We created a mobile app which permitted parental reporting of immunization status to public health authorities. We describe app use as a proxy for feasibility and acceptability as well as data utility for public health surveillance. The evaluation period ran from April 27, 2015, to April 18, 2017, during which time 2,653 unique children's records were transmitted, containing 36,105 vaccinations...
2017: Healthcare Quarterly
Josie Barbita, Susana Neves-Silva
Chronic obstructive pulmonary disease (COPD) and heart failure are responsible for significant healthcare costs in Ontario. One program developed to improve the management of these conditions is Telehomecare, which provides six months of health status monitoring and patient self-management education at no cost to participating COPD and heart failure patients. The Toronto Central Local Health Integration Network (LHIN; formerly the Toronto Central Community Care Access Centre), an early participant, enrolled over 3,000 Telehomecare patients between 2012 and 2016...
2017: Healthcare Quarterly
Joanne Maxwell, Keith Adamson, Amir Karmali, Lee Verweel
Electronic health records (EHRs) and consumer health portals have implications for improving the quality and cost-effectiveness of healthcare and make it much easier for patients and families to access health information in a timely and convenient manner. However, the accessibility of information afforded by EHRs and health portals changes the dynamic of control over health information in very significant ways. Institutions and their clinicians have typically been the caretakers of these documents; therefore, the introduction of portals represents a major cultural shift in healthcare...
2017: Healthcare Quarterly
Corinne Eggert, Kenneth Moselle, Denis Protti, Dale Sanders
Closed Loop Analytics© is receiving growing interest in healthcare as a term referring to information technology, local data and clinical analytics working together to generate evidence for improvement. The Closed Loop Analytics model consists of three loops corresponding to the decision-making levels of an organization and the associated data within each loop - Patients, Protocols, and Populations. The authors propose that each of these levels should utilize the same ecosystem of electronic health record (EHR) and enterprise data warehouse (EDW) enabled data, in a closed-loop fashion, with that data being repackaged and delivered to suit the analytic and decision support needs of each level, in support of better outcomes...
2017: Healthcare Quarterly
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
Katerina Gapanenko, David Lam, Michelle Parker, Jennifer D'Silva, Tracy Johnson
No abstract text is available yet for this article.
2017: Healthcare Quarterly
Maria Chiu
There is strong evidence of ethnic disparities in chronic medical conditions, such as diabetes and cardiovascular diseases; however, less is known about ethnic differences in mental illness and health service utilization. Previous studies have shown that Asians are more likely to avoid or delay seeking help for their mental illness. We conducted a population-based study using Ontario health administrative data to examine ethnic differences in mental illness severity at hospital presentation. We found that Chinese and South Asian psychiatric patients were significantly more likely to be involuntarily admitted and exhibited more aggressive behaviours and psychotic symptoms compared to the general population...
2017: Healthcare Quarterly
(no author information available yet)
No abstract text is available yet for this article.
2017: Healthcare Quarterly
Caitlin Champion, Joseph Sadek, Husein Moloo
Strategic change principles are widely cited in business and healthcare management literature, but not in the surgical quality improvement literature despite the need for effective change management skills to successfully enable quality improvement projects. The Ottawa Hospital (TOH) Comprehensive Unit-Based Safety Program (CUSP) model within the Division of General Surgery applied strategic change management principles to support the development and implementation of surgical quality improvement initiatives...
2017: Healthcare Quarterly
Brian A Kuzik, Chee P Chen, Miriam J Hansen, Paula L Montgomery
In 2011, we reported that our paediatric asthma clinic (PAC) appeared to significantly reduce the burden of paediatric asthma in our community. Supported by these results, the PAC underwent a gradual threefold expansion while maintaining the same model of care. We now report on the outcome of that expansion and demonstrate that our PAC continues to significantly reduce the burden of paediatric asthma in our community. As previously, newly enrolled PAC patients continue to show a 12-month reduction in asthma-related emergency department (ED) visits and admissions exceeding 60% and 80%, respectively...
2017: Healthcare Quarterly
Roger Cheng, Yu Daisy Yang, Matthew Chan, Tejal Patel
Medication errors involving antiepileptic drugs (AEDs) are not well studied but have the potential to cause significant harm. We investigated the occurrence of medication incidents in Canadian hospitals that involve AEDs, their severity and contributing factors by analyzing data from two national databases. Our multi-incident analysis revealed that while medication errors were rarely fatal, errors do occur of which some are serious. Medication incidents were most commonly caused by dose omissions, the dose or its frequency being incorrect and the wrong AED being given...
2017: Healthcare Quarterly
Christopher Ashton, Denise Duffie, Jeffrey Millar
The Economic Value of Community Paramedicine Programs Study was a randomized controlled trial in two Eastern Ontario communities ߝ one urban and one rural ߝ to determine whether community paramedicine services (the intervention through home visits) would have a positive economic impact through influencing self-perceived quality of life and determining a monetized value. A total of 200 clients who were high-users of healthcare services and had one or more of five chronic diseases (congestive heart failure, chronic obstructive pulmonary disease, hypertension, stroke and diabetes) were recruited in early 2015...
2017: Healthcare Quarterly
Elaine Burr, Sandra Dickau
Providers across the healthcare system want to provide the right care, in the right place, in a timely manner. Patients listed as alternate level of care (ALC) are often not in the right place to receive the necessary care. In 2014, using a standardized approach, the Toronto Central Community Care Access Centre (CCAC), now Toronto Central Local Health Integration Network (LHIN), set out to reduce the number of ALC beds in hospitals to ensure that more people received the most appropriate level and type of care...
2017: Healthcare Quarterly
Paula Chidwick, Jill Oliver, Daniel Ball, Christopher Parkes, Terri Lynn Hansen, Francesca Fiumara, Kiki Ferrari, Cindy Hawkswell, Karyn Lumsden
A significant issue affecting the healthcare system across Ontario is the number of patients admitted to hospitals that are then subsequently being designated alternate level of care (ALC). In 2016, 14.5% of Ontario in-patient beds were occupied by ALC-designated patients. Contributing to this phenomenon are ethical errors that can affect decision-making around discharge. Since 2012, William Osler Health System has redesigned their discharge process to eliminate ethical errors and align more fully with the Health Care Consent Act (HCCA) and the Public Hospitals Act (PHA)...
2017: Healthcare Quarterly
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