Resilience among family physicians during the COVID-19 pandemic in Canada.

The purpose of this study was to investigate how the COVID-19 pandemic's inaugural wave impacted the professional autonomy of family physicians in Canada. This study highlights how family physician's resilience enabled them to overcome the many challenges they faced to provide health services to patients and has enabled them to rebuild their sense of purpose and duty of care. Four themes were found to summarize physician experiences: (1) loss of clinical autonomy and control; (2) abandonment and neglect by the health system; (3) a fear of patients "falling through the cracks" and moral injury; and (4) building resilience to support duty of care in family practice.

Digital Maturity as a Predictor of Quality and Safety Outcomes in US Hospitals: Cross-Sectional Observational Study.

Background: This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes.

Digital Maturity as a Strategy for Advancing Patient Experience in US Hospitals.

Patient experience is globally recognized as an important indicator of health system performance, linked to health system quality and improving patient outcomes. Post COVID-19, health systems have embraced digital health and advanced digital transformation efforts; however, the relationship between digital health and patient experience outcomes is not well-documented. Using HCAHPS hospital survey data to measure patient experience, and HIMSS EMRAM Maturity Model data to measure digital maturity, a cross-sectional design using multivariate analyses examined the impact of digital maturity on patient experience in US hospitals.

The necessity of healthcare supply chain resilience for crisis preparedness.

Prior to and during the COVID-19 pandemic, Canadian provincial health systems and governments did not sufficiently consider healthcare supply chain in their crisis preparedness plans, leading to an exposed and vulnerable healthcare system. There have been many opportunities to learn from past Canadian and global crises, which have emphasized the importance of healthcare supply chain resilience in providing essential care to patients; however, considerations of healthcare supply chain resilience remain a significant gap in preparedness planning. Illustrated through the Canadian response to COVID-19 pandemic, this article will explore how healthcare supply chain resilience should be a necessary consideration in any crisis preparedness plans.

Surface properties influence marine biofilm rheology, with implications for ship drag.

Marine biofilms on ship hulls increase frictional drag, which has economic and environmental consequences. It is hypothesised that biofilm mechanics, such as viscoelasticity, play a critical role in biofilm-associated drag, yet is a poorly studied area. The current study aimed to rheologically characterise ship-relevant marine biofilms.

The Emerging Features of Healthcare Supply Chain Resilience: Learning from a Pandemic.

The COVID-19 pandemic exposed significant fragilities in the configuration of global healthcare supply chains. This was felt acutely by citizens, patients and healthcare workers across Canada. As demand for critical medical products surged in Canada, and globally, provincial healthcare supply chain teams worked to rapidly stabilize their supply chains.

Learning models for forecasting hospital resource utilization for COVID-19 patients in Canada.

Hospitals in Canada are facing a crisis-level shortage of critical supplies and equipment during the COVID-19 pandemic. This motivates us to create predictive models that can use Canada COVID-19 data and pandemic-related factors to accurately forecast 5 quantities-three related to hospital resource utilization (i.e.

Digitally enabled supply chain as a strategic asset for the COVID-19 response in Alberta.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Alberta. With a history of emergency preparedness, Alberta's unique context, one that includes having an already established, centralized, and digital healthcare supply chain strategy, sets this case apart from the others in terms of pandemic responses. A key challenge navigated by Alberta was the inadequacies of traditional sourcing and procurement approaches to meet surges in product demand, which was overcome by the implementation of unique procurement strategies.

Supply chain capacity to respond to the COVID-19 pandemic in Ontario: Challenges faced by a health system in transition.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Ontario. The context of significant restructuring of health organizations and regions in Ontario challenged the province's capacity to respond to COVID-19. A complex leadership structure, led by political leaders, with limited healthcare supply chain expertise at decision-making tables and a prioritization of "hospitals first" early in the first wave were described as challenges Ontario faced in managing the pandemic.

Supply chain integration as a strategy to strengthen pandemic responsiveness in Nova Scotia.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Nova Scotia. During the first wave of the pandemic, Nova Scotia faced the massive destabilization of its traditional supply channels and had to grapple with role clarity and communication in its emergency response structure. Nova Scotia was able to centralize its pandemic sourcing, procurement, and management efforts to its provincial health authority.

Supply chain capacity to respond to COVID-19 in Newfoundland and Labrador: An integrated leadership strategy.

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Newfoundland and Labrador (NL). Faced with the destabilization of its traditional supply chain, NL leveraged an existing centralized healthcare supply chain structure to organize its supply chain response to the pandemic. To overcome product shortages, health leaders collaborated with their local business community and industries to source and procure personal protective equipment and create domestic manufacturing capacity for critical supplies.

COVID-19, Workforce Autonomy and the Health Supply Chain.

During the COVID-19 pandemic, the rapid surge in demand for critical supplies and public health efforts needed to guard against virus transmission have placed enormous pressure on health systems worldwide. These pressures and the uncertainty they have created have impacted the health workforce in a substantial way. This paper examines the relationship between health supply chain capacity and the impact of the COVID-19 pandemic on Canada's health workforce.

Key Characteristics of a Fragile Healthcare Supply Chain: Learning from a Pandemic.

The COVID-19 pandemic has highlighted the many challenges that provincial health systems have experienced while scaling health services to protect Canadians from viral transmission and support care for those who get infected. Supply chain capacity makes it possible for health systems to deliver care and implement public health initiatives safely. In this paper, we present emerging findings from a national research study that documents the key features of the fragility of the health supply chain evident across the seven Canadian provinces.

An Evidence-Based Strategy to Scale Vaccination in Canada.

Provincial health systems have been challenged by the surge in healthcare demands caused by the COVID-19 pandemic; the COVID-19 vaccine rollout across the country has further added to these challenges. A successful vaccination campaign is widely viewed as the only way to overcome the COVID-19 pandemic, placing greater urgency on the need for a rapid vaccination strategy. In this paper, we present emerging findings, from a national research study, that document the key challenges faced by current vaccine rollout strategies, which include procurement and leadership strategies, citizen engagement and limitations in supply chain capacity.

"Flying Blind": Canada's Supply Chain Infrastructure and the COVID-19 Pandemic.

Canada's COVID-19 response has been described as slow, with reactive decision making that has left the most vulnerable populations at risk of infection and death from the virus. Yet, within and across the provincial health systems, the supply chain processes and data infrastructure needed to generate the relevant data for, and evidence of, the spread of COVID-19 and the health system's capacity to respond to the pandemic are non-existent in Canada. Emerging evidence from a national research study highlights the significance of supply chain data infrastructure and processes that offer transparent, real-time data to inform decisions that support a coordinated, evidence-informed pandemic strategy that is proactive and capable of protecting the health of every Canadian.

A Patient's Perspective: Bridging the Transition Following Radiation Therapy for Patients with Breast Cancer.

Introduction: As the number of women surviving breast cancer grows, it becomes increasingly important to investigate their unique psychosocial and physical needs in the post-treatment period. The period of transition from patient to survivor is a time fraught with physical and emotional challenges. This qualitative study was conducted to gain insight into the perspective of breast cancer patients transitioning to survivorship after receiving RT in Alberta.

Case Study: Innovation Procurement for a Patient and Caregiver Support Solution in the Home.

This case describes an innovation partnership procurement strategy by a community care health organization to procure a digital solution able to support both caregivers and older adults receiving homecare services. Vendor submissions proposed both existing technologies and new solutions that were challenging to evaluate. An existing technology was procured and first pilot tested in a laboratory setting prior to a field trial with seniors and their caregivers in the home.

Case Study: Innovation Procurement for a "Smart" Privacy Solution.

This case describes an initiative to procure a "smart" privacy solution with machine learning capabilities that could eliminate false-positive alerts of privacy risks for an Ontario hospital. A competitive dialogue procurement strategy proceeded over a two-year period and involved two stages of competitive dialogue and a pilot phase to test the procured privacy solution. Discussions and sharing feedback on solutions with vendors, followed by dialogue on solution pricing and service offerings, resulted in a vendor contract that allowed other hospitals to benefit from the established agreement.

Case Study: Innovation Procurement for a Digital Services Platform.

This case describes a design contest strategy to procure a solution to coordination of care transitions across healthcare programs to strengthen patient outcomes. The fit of the vendors' approach with the organization and the potential for building a strong relationship with the vendor teams were evaluated. A consortium of small Canadian companies was selected to proceed to a proof-of-concept phase and full implementation of the digital solution across the region.

Case Study: Innovation Procurement for a Cardiac Program.

This case describes a competitive dialogue strategy to procure a cardiac program solution to strengthen performance, outcomes and value in an Ontario hospital. All major contracts for the cardiac program were expiring, offering a unique opportunity for procurement of innovation. Procurement was completed in two phases, with an additional request for proposals issued for the unique specialty products not included in the initial procurement.

Innovation Procurement in Health Systems: Exploring Practice and Lessons Learned.

As rising healthcare costs continue to challenge the sustainability of global health systems, there has been a strategic shift toward a focus on value, which considers the outcomes and value of healthcare delivery relative to the costs of care delivery. A unique feature of this focus on value has influenced a shift in procurement whereby health organizations are advancing the procurement of innovative solutions to achieve defined outcomes that overcome challenges such as the quality, safety and cost of care delivery. In this paper, we report on the implementation of three innovation procurement models in four Ontario healthcare organizations.

Case Study: Supply Chain Transformation in Alberta Health Services.

This case study provides empirical evidence of the effect of implementing an integrated supply chain strategy province-wide to improve the safety, quality and performance of Alberta Health Services (AHS). AHS implemented a transformational supply chain strategy, enabled by GS1 standards, to achieve traceability of all products, equipment and patient safety events across the health system. Key features of the AHS strategy include strong vision and leadership, price harmonization, a provincial item master and integrated data infrastructure and a centralized warehouse and distribution strategy.

Case Study: Supply Chain Transformation in the Mercy Health System.

The Mercy case study documents evidence of a clinically integrated supply chain strategy implemented in the peri-operative programs in three of the 46 hospitals in the Mercy system. Mercy became the first US health system to achieve "the perfect order," a supply chain industry standard with end-to-end integration of supply chain best practice in the Mercy system. To date, the Mercy strategy has demonstrated revenue growth of $8 billion, a 70% reduction in Never Events, a 33.

Case Study: Supply Chain Transformation in the UK National Health Service.

This case study provides evidence of the impact of the Scan4Safety program demonstrated in six National Health Service (NHS) Trusts, funded to achieve supply chain transformation to improve safety, quality and performance in the NHS in England. All 154 Trusts were mandated to adopt GS1 global standards for supply chain processes and Pan-European Public Procurement On-Line standards in 2014 to enable digital transactions across the NHS. The outcomes of this case reflect the early implementation of the program infrastructure in surgical theatre and cardiac programs.

Clinically Integrated Supply Chain Infrastructure in Health Systems: The Opportunity to Improve Quality and Safety.

Health systems worldwide are challenged by the growing costs and demands of delivering high-quality healthcare services that are safe and cost-effective to support health and wellness for populations. This paper proposes a system-level transformation of clinical environment infrastructure to advance quality and strengthen patient safety at sustainable costs. Evidence of the impact and value of the clinically integrated supply chain strategy is emerging in three global health systems: Alberta Health Services (Canada), Mercy (US) and the National Health Service (UK) to inform a strategic roadmap for health system leaders to leverage supply chain infrastructure in clinical environments as a strategic asset to strengthen quality, safety and cost.