Structure of health-care dyad leadership: an organization's experience.

Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys. In addition, five senior leaders were interviewed.

A Matter of Balance: Sharing Front-Line Ownership for Quality and Safety with Patients and Families - Scaling and Spreading Local Improvements for Broader Impact.

The approach to front-line ownership proposed by Gardam et al. (2017) consists of many elements integral to most approaches to quality improvement. The mix of these elements may need to be modified in circumstances that have the most impact on patient safety, where a higher level of standardization may be essential and a more directive approach may be needed.

Finding economies of scale and coordination of care along the continuum to achieve true system integration.

Is it time to reduce hospitals and replace them with digitally enabled distributed specialty service delivery channels that focus on ambulatory care, urgent care, and patient reactivation? Is delivery system integration immaterial if care is standardized and supported by integrated information systems? Maybe Lean methodology needs to be applied across the entire delivery systems, not just within its component functions and processes. Comments are offered on each of these perspectives.

Thoughts on "looking back on 50 years in hospital administration" from the perspectives of quality and safety.

The healthcare landscape has changed considerably over the past 50 years, with far greater emphasis on the quality of care. Although much progress has been made, there are many opportunities to improve quality and safety of care across Canada. The new Saskatchewan healthcare management system represents one whole-system approach to achieving better health, better care, better value and better teams, using a Lean-based approach that reflects the dominant issues identified 50 years ago.

Building a culture of ethics: the Capital Health Ethics Support model.

This article describes a new model for ethics support for Capital Health (a health region in Nova Scotia). With its emphasis on building a culture of ethics, many innovative elements are integral to this model and its future success. Particular emphasis is on organizational healthcare ethics and meaningful participation.