Can leadership make a difference?

Strong leadership is needed to reform the healthcare system in an accountable and transparent manner. This article examines the context of leadership development programs and the conditions that lead to their success as measured by effective outcomes. The article includes a discussion of evaluating leadership performance in the context of 360-degree feedback.

National guidelines for rehabilitation staffing levels: a literature review.

Canadian rehabilitation staffing guidelines do not exist; consequently, significant service-level differences are found. This article reviews methods of determining rehabilitation staffing and presents factors to consider in developing staffing guidelines. Skill mix, service intensity, patient diagnosis and cost of care should drive staffing benchmarks.

Strategic relevance and accountability expectations: new perspectives for health care information technology design.

In this article, we discuss the traditional systems analysis perspective on end-user information requirements analysis and extend it to merge with the new accountability expectations perspective to guide the future planning and design of health organization information systems. Underlying the strategic relevance of health care information technology (HCIT) are three critical questions: (1) What is the ideal HCIT model for the health organization in terms of achieving strategic expertise and competitive advantage? Specifically, how does this model link industry performance standards with organizational performance and accountability expectations? (2) How should the limitations of past HCIT models be reconciled to the benefits presented by the superior arrangement of the ideal model in the context of changing accountability expectations? (3) How should alternative HCIT solutions be evaluated in light of evidence-based accountability and organizational performance benchmarking? Insights into these questions will ensure that health care managers, HCIT practitioners and researchers can continue to focus on the most critical issues in harnessing today's fast-paced changing technologies for evolving strategically relevant, performance-based health organization systems.

Surgical waiting lists I: Definition, desired characteristics and uses.

In the first of this two-part series, the authors define waiting lists, review the waiting list situation in Canada, discuss factors affecting such lists, outline their desired characteristics and describe the analysis and use of waiting list data. The manner in which lists are compiled results in significant differences which makes the meaning of waiting lists difficult to determine. From the literature reviewed and interviews with various health service executives, the authors show that waiting lists, as compiled today, are not a valid and reliable measure of the extent of unmet demands for hospital care.