The 2015 merger of health authorities in Nova Scotia was aggressive in pursuit of greater value. The goal was to create an integrated, accountable care network across the entire province. Years of pent-up frustration, death by a thousand cuts, declining service and growing expectations merged into a slow, insidious bleeding of support for change. The lessons learned from Nova Scotia are vital to achieving a value-based health system. The article describes some of the barriers to progress and the steps needed to achieve the goal of a value-based healthcare system for Canadians.
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http://dx.doi.org/10.12927/hcpap.2020.26153 | DOI Listing |
CJC Open
January 2025
Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Background: Preventing postoperative atrial fibrillation (POAF) as one of the most significant complications of cardiovascular surgeries remains a major clinical challenge. We conducted a systematic review with network meta-analysis of randomized controlled trials, to identify the most effective and safe anti-inflammatory drugs to prevent new-onset POAF.
Methods: MEDLINE, Embase, Web of Science, and Cochrane Library were searched without language or publication-date restriction on August 8, 2022 (updated on August 8, 2023).
CJC Open
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is typically diagnosed following an arrhythmic event or during screening after a family member experiences sudden cardiac death. Implantation of a defibrillator (ICD) improves survival but can be associated with morbidity and risks, an important consideration within a shared decision-making context. This study examined patient decisional needs and preferences surrounding ARVC screening and prophylactic ICD implantation.
View Article and Find Full Text PDFCJC Open
January 2025
Division of Cardiology, Unity Health Toronto-St. Michael's Hospital, Toronto, Ontario, Canada.
Background: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.
View Article and Find Full Text PDFCan J Nurs Res
January 2025
School of Social Work, Faculty of Health, Dalhousie University, Nova Scotia, Canada.
Background: Ancestral Black Nova Scotian (ABNS) nurses are a culturally distinct group yet, little is known about their experiences. Available literature suggests that ABNS nurses are underrepresented in nursing and that they encounter discrimination throughout the health system. Understanding the experiences of ABNS nurses facilitates addressing antiBlack racism in nursing and healthcare.
View Article and Find Full Text PDFAllergy Asthma Clin Immunol
January 2025
Division of Allergy, IWK Health Centre, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
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