Healthcare quarterly (Toronto, Ont.)
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This issue of Healthcare Quarterly includes the second of a three-part series developed by Ontario's The Change Foundation featuring international perspectives on health service delivery models that improve system integration and ensure seamless services and better coordination. Part 1 featured Chris Ham, chief executive of the London-based King's Fund think tank. In this issue, Geoff Huggins, director for Health and Social Care Integration in Scotland, discusses Scotland's experience and lessons learned after legislating integrated health and social care in 2015.
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Cancer patients experience a high symptom burden throughout their illness. Quality cancer symptom management has been shown to improve patient quality of life and prevent emergency department use. ⋯ However, patient symptom information is not always sufficiently addressed. To address these gaps, patient and family advisors collaborated with clinicians, administrators and health system leaders from across the Province in a Symptom Management Summit to share perspectives and co-design context-specific solutions to improve care in their region.
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Although geared towards a common goal - improved patient-centred care - quality improvement strategies and patient engagement-focused approaches are often developed and conducted in silos. The lack of integration may lead, on the one hand, to the uptake of patient suggestions that do not always take into consideration implications for the delivery of quality care and, on the other hand, to inadequate understanding of patient views required to create optimal services. ⋯ Preliminary assessments of this project revealed that the integration of these two approaches is feasible and that it was well received by both staff and families. There is important synergy to be found between patient engagement and quality improvement that needs to be leveraged by organizational structures and processes to fulfill the commitments inherent in both fields.
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The dramatic rise in prescription opioid use in the past two decades across Canada and the United States has been accompanied by increased rates of adverse events, including premature death and neonatal abstinence syndrome. In Ontario, policies and programs designed to address inappropriate prescribing have been implemented with varying degrees of success. Emerging issues that require ongoing attention include the introduction of abuse-deterrent formulations of opioids and generic versions of long-acting oxycodone. As issues related to opioid misuse, abuse and premature overdose death continue to evolve, it is clear that they can only be addressed by more cautious prescribing practices and the provision of support to those already suffering from addiction.
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Emergency departments (ED) function to diagnose, stabilize, manage and dispose patients as efficiently as possible. Although problems may be suspected at triage, ED physician input is required at each step of the patient journey through the ED, from diagnosis to disposition. ⋯ This article discusses the key concepts of ED patient flow, value and efficiency. Based on these fundamentals, it describes the significant impact of ED process improvements implemented on measures of ED efficiency at a large community ED in Ontario, Canada.