HealthcarePapers
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This commentary examines the inequitable access to healthcare services that Indigenous peoples in Canada face on a daily basis. It considers not only geographical or physical access but also culturally safe access to healthcare. ⋯ Cultural safety training is recommended, as well as recruitment and retention of Indigenous health professionals. Several recommendations to address physical and geographical access are also recommended, including self-governance and capacity building; enhanced partnerships and collaboration to address jurisdictional issues, particularly for First Nations communities, and a national strategy for access to healthy and affordable food in northern, remote and rural communities.
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An organization can drive quality only through its people. Too often, we relegate quality to a single department or a small group of evangelical leaders but fail to make it everyone's business. Accountability has become a buzzword, and we have translated it into huge agreements with myriads of measures and indicators, all purporting to have something to do with quality. ⋯ As I have said repeatedly, it is as simple as choosing a measure, planning to implement some changes and re-measuring to see if your changes have had any impact. You don't need a national council, or even a provincial one, to make quality happen in the day-to-day operations of every healthcare organization in the country. Rather, you just need to get started.
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Canada's health and social care system is paralyzed by our decentralized federalist governing structure. Public policy change, such as that suggested by Chappell and Hollander, will require a new political paradigm that recognizes the need for a multi-sectoral, co-operative approach to integrated systems of care delivery. The federal government must provide the necessary leadership, and the provinces and territories must show the political will to co-operate if Canada is to embrace the challenges of an aging population.
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This commentary provides perspectives from the nursing profession on the lead article that address professional and regulatory issues and shares insights derived from many years of leading quality enhancement initiatives at policy and clinical levels. The commentary calls attention to a number of successful national and provincial approaches founded on strong leadership, collaboration and consensus building. It also underscores the idea that professional organizations and individual health professionals are important drivers of quality initiatives at the point of care and when overseeing adherence to standards and successful program implementation.
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This commentary by Victorian Order of Nurses Canada, written in response to "Getting What We Pay For? The Value-for-Money Challenge," by McGrail, Zierler and Ip, answers four key questions about Canada's home and community care sector: (1) What are our objectives? (2) Where do we achieve good value now? (3) Where and why are we failing? and (4) What will help us do better? We conclude that although the home and community care sector offers great promise in meeting the evolving health and social needs of Canadians, it is not living up to its potential. We propose the development of a national, integrated approach to home and community care to help Canadians remain healthy and independent in their homes. This would represent a wise financial investment for governments and would contribute to the long-term health of Canadians.