From a project to transformation: how "going against the flow" led to improved access and patient flow in an academic hospital.

A results-driven approach to optimizing patient flow, grounded on quality improvement, change management and organizational learning principles, is described. Tactics included collaborative governance, performance management, rapid process improvements and implementation toolkits. Results included an 83.

Canada's public health system: is the pace of progress sufficient?

Tilson and Berkowitz review the Institute of Medicine reports that catalyzed the serious re-examination of the United States public health enterprise. For Canada, a similar catalyst stemmed from the lessons learned during the 2003 severe acute respiratory syndrome outbreak. While strong policy statements of commitment to strengthen the public health system are a necessary first step to stewarding change, they are insufficient without defined accountabilities, operationalized relationships and supporting legislation.

Crossing the strategic synapse: aligning hospital strategy with shared system priorities in ontario, Canada.

The dominant system-level strategic priorities facing Ontario hospitals were elicited and validated. Researchers employed a multi-stage survey and focus group process to solicit the opinions of senior hospital managers and other healthcare stakeholders. Four shared, system-level priorities emerged: (i) improved clinical and staff recruitment; (ii) stronger inter-hospital partnership and vertical integration along the continuum of care; (iii) improved patient safety; and (iv) the implementation of decision support systems.

Acute care hospital strategic priorities: perceptions of challenges, control, competition and collaboration in Ontario's evolving healthcare system.

To explore the current and pending strategic agenda of Ontario hospitals (the largest consumers of the provincial healthcare budget), a survey of Ontario acute care hospital CEOs was conducted in January 2004. The survey, with an 82% response rate, identifies 29 strategic priorities under seven key strategic themes consistent across different hospital types. These themes include (1) human resources cultivation, (2) service integration and partnerships, (3) consumer engagement, (4) corporate governance and management, (5) organizational efficiency and redesign, (6) improved information use for decision-making, (7) patient care management.