We need to work differently in a crisis: peer-professional leadership to redesign physicians' work.

Background: Understanding physician leadership is critical during pandemics and other health crises when formal organisational leaders may be unable to respond expeditiously. This study examined how physician leaders managed to quickly design a new model for acute-care physicians' work, adopted across four large hospitals in a public health authority in Canada during the COVID-19 pandemic.

Methods: The research employed a qualitative case study methodology, with inductive analysis of interview transcripts and documents.

Perspectives on primary care management of obstructive sleep apnea: a qualitative study of patients and health care providers.

Study Objectives: Difficulties in providing timely access to care have prompted interest in primary care delivery models for obstructive sleep apnea (OSA). Sustainable implementation of such models requires codesign with input from key stakeholders. The purpose of this study was to identify patient and provider perspectives on barriers and facilitators to optimal, patient-centered management of OSA in a primary care setting.

Disrupting activities in quality improvement initiatives: a qualitative case study of the QuICR Door-To-Needle initiative.

Background: Healthcare quality improvement (QI) efforts are ongoing but often create modest improvement. While knowledge about factors, tools and processes that encourage QI is growing, research has not attended to the need to disrupt established ways of working to facilitate QI efforts.

Objective: To examine how a QI initiative can disrupt professionals' established way of working through a study of the Alberta Stroke Quality Improvement and Clinical Research (QuICR) Door-to-Needle Initiative.

Integrated versus fragmented implementation of complex innovations in acute health care.

Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations-those that require coordinated use across the adopting organization to have the intended benefits.

Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so.