HealthcarePapers
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Solving the obesity crisis has less to do with post-partisanship and more to do with increasing public support for strong public policy initiatives that will make the healthy choice the easy choice. The government has an important role in mitigating the toxic food environment created by food manufacturers and restaurant chains. Progress to date has occurred on the state level. With greater public support in a new political environment, national progress may be possible in the foreseeable future.
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Following decades of stagnation, potentially transformative changes in primary healthcare are proceeding in several Canadian provinces. These changes - primarily collaborative and interdisciplinary models of care delivery and quality improvement programs - have been impelled by an improved fiscal climate, increased federal transfers (some earmarked for primary healthcare), pressure generated by the recommendations of the Romanow Commission and the Kirby Committee and growing political and public concern about healthcare access and quality. ⋯ Processes are needed at the regional and provincial levels to collectively engage the full range of key stakeholders in providing policy advice and informing the articulation of clear policy direction for primary healthcare. Critical areas for investment include integrated health information systems, quality improvement processes, interdisciplinary primary healthcare teams and group practices, and systematic evaluation of primary healthcare innovations and ongoing system performance.
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The outbreak of severe acute respiratory syndrome (SARS) in 2003 provided valuable lessons for protecting health workers during an influenza pandemic or other public health crisis. In its final report, the SARS Commission concluded that a key lesson in worker safety was the precautionary principle. It stated that reasonable actions to reduce risk should not await scientific certainty. ⋯ Absent such an approach, the SARS Commission said worker safety may focus solely on a particular piece of personal protective equipment, such as an N95 respirator (important as it may be), or on specific policies and procedures, such as fit testing the N95 respirator to the wearer (significant as it may be). In worker safety, said the commission, the integrated whole is greater than the uncoordinated parts. The third and final worker safety lesson of SARS is the importance of having a robust safety culture in the workplace in which workers play an integral role in promoting a safe workplace.
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The two lead articles for this issue by Shamian and El-Jardali and by Clements, Dault and Priest provide an opportunity to consider how two agendas - teamwork in healthcare and the healthy workplace - can be strengthened to gain mutual advancement. Both agendas are in the pan-Canadian Health Human Resource (HHR) strategic plan in Canada and were also identified within the Health Council of Canada's 2005 Annual Report. Strong links have yet to be made related to the teamwork in healthcare agenda and its relationship with the workplace environment. ⋯ It is recommended that those engaged in the research in these two domains dialogue with each other and collectively consider ways in which they could advance the policy directions required to enhance both patient and provider satisfaction in our healthcare system. The teamwork and healthy workplace agendas require thoughtful deliberation between researchers and policy-makers to inform action. This commentary provides an example of how the Ontario government has been able to engage within an evidence-informed process to develop inter-professional care that may ultimately positively impact the teamwork in healthcare agenda and the healthy workplace agenda in the future.