The health system is on fire — and it was predictable

Aerde, Johny Van

doi:10.37964/cr24727

Cited by 6 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An orientation to possibility and renewal. Grounded in the panarchy cycle (exploitation, conservation, release, and reorganization in systems), 8 Context is always the moderating variable in social systems. With the changes that have occurred and continue to occur, leaders could benefit from practical social system leadership strategies.…”

Section: Recommendations For Health Leaders When Addressing Future Le...mentioning

confidence: 99%

“…An orientation to possibility and renewal. Grounded in the panarchy cycle (exploitation, conservation, release, and reorganization in systems), 8 this topic could help set the stage for course content by exploring how health leaders can help avoid the “rigidity trap” 8 in the Canadian health system.2. Emerging issues in strategic HR planning .…”

Section: Recommendations For Health Leaders When Addressing Future Le...mentioning

confidence: 99%

See 1 more Smart Citation

Strengthening health system leadership in practice

Cady,

Heykoop

2023

Healthc Manage Forum

View full text Add to dashboard Cite

The field of health leadership is shifting rapidly, and there is an opportunity to learn with health leaders about what is needed to support health leadership education, research, and practice. In 2022, to augment student feedback and faculty praxis, Royal Roads University (RRU) conducted 12 virtual interviews with senior health system leaders across various settings to learn how health leaders can better respond to emerging and future leadership needs and priorities facing health systems. Findings from this study informed the development of a health-specific elective for the MAL-H program entitled Considerations for Health Systems Renewal. This elective explores the following topics that emerged from this research study: (1) an orientation to possibility; (2) emerging strategic HR concerns; (3) healthcare innovation; (4) relational and social systems leadership; (5) polarity thinking; (6) trauma-informed leadership; and (7) Canadian healthcare networks. In this article, we share our research process and findings to arrive at these recommendations.

show abstract

Section: Recommendations For Health Leaders When Addressing Future Le...mentioning

confidence: 99%

Section: Recommendations For Health Leaders When Addressing Future Le...mentioning

confidence: 99%

Strengthening health system leadership in practice

Cady,

Heykoop

2023

Healthc Manage Forum

View full text Add to dashboard Cite

show abstract

“…However, the determinants of health and management of disease are multilayered and interdependent subsystems that continuously interact and influence each other. 8 The boundaries of these systems are semipermeable. Their interconnectedness was demonstrated during the COVID syndemic as biologic and social conditions and states interacted to increase a person’s susceptibility to harm or worsen their health outcomes.…”

Section: What Are Complex Adaptive Systems and Why Are They Important...mentioning

confidence: 99%

Complex adaptive systems in CanMEDS 2025

et al. 2022

View full text Add to dashboard Cite

“…The coalition’s mandate is to support physician QI leadership and participation to improve clinical processes and outcomes. Physician QI leadership is defined ‘as the active/willing participation of physicians in QI projects that develop a strategic partnership with healthcare operations to improve healthcare delivery’ 16 . p.6 One coalition priority was laboratory test overuse, specifically repetitive ‘daily’ ordering and BUN testing.…”

Section: Introductionmentioning

confidence: 99%

Factors of a physician quality improvement leadership coalition that influence physician behaviour: a mixed methods study

et al. 2023

View full text Add to dashboard Cite

BackgroundA coalition (Strategic Clinical Improvement Committee), with a mandate to promote physician quality improvement (QI) involvement, identified hospital laboratory test overuse as a priority. The coalition developed and supported the spread of a multicomponent initiative about reducing repetitive laboratory testing and blood urea nitrogen (BUN) ordering across one Canadian province. This study’s purpose was to identify coalition factors enabling medicine and emergency department (ED) physicians to lead, participate and influence appropriate BUN test ordering.MethodsUsing sequential explanatory mixed methods, intervention components were grouped as person focused or system focused. Quantitative phase/analyses included: monthly total and average of the BUN test for six hospitals (medicine programme and two EDs) were compared pre initiative and post initiative; a cost avoidance calculation and an interrupted time series analysis were performed (participants were divided into two groups: high (>50%) and low (<50%) BUN test reduction based on these findings). Qualitative phase/analyses included: structured virtual interviews with 12 physicians/participants; a content analysis aligned to the Theoretical Domains Framework and the Behaviour Change Wheel. Quotes from participants representing high and low groups were integrated into a joint display.ResultsMonthly BUN test ordering was significantly reduced in 5 of 6 participating hospital medicine programmes and in both EDs (33% to 76%), resulting in monthly cost avoidance (CAN$900–CAN$7285). Physicians had similar perceptions of the coalition’s characteristics enabling their QI involvement and the factors influencing BUN test reduction.ConclusionsTo enable physician confidence to lead and participate, the coalition used the following: a simply designed QI initiative, partnership with a coalition physician leader and/or member; credibility and mentorship; support personnel; QI education and hands-on training; minimal physician effort; and no clinical workflow disruption. Implementing person-focused and system-focused intervention components, and communication from a trusted local physician—who shared data, physician QI initiative role/contribution and responsibility, best practices, and past project successes—were factors influencing appropriate BUN test ordering.

show abstract

The health system is on fire — and it was predictable

Cited by 6 publications

References 0 publications

Strengthening health system leadership in practice

Strengthening health system leadership in practice

Complex adaptive systems in CanMEDS 2025

Factors of a physician quality improvement leadership coalition that influence physician behaviour: a mixed methods study

Contact Info

Product

Resources

About