Healthcare quarterly (Toronto, Ont.)
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In April 2012, the Ontario government introduced Health System Funding Reform (HSFR), a transformational shift in how hospitals are funded. Mount Sinai Hospital recognized that moving from global funding to a "patient-based" model would have substantial operational and clinical implications. Adjusting to the new funding environment was set as a top corporate priority, serving as the strategic basis for re-examining and redesigning operations to further improve both quality and efficiency. Two years into HSFR, this article outlines Mount Sinai Hospital's approach and highlights key lessons learned.
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Since the release of the seminal work To Err Is Human in 1999, there has been widespread acknowledgement of the need to change our approach to patient safety in North America. Specifically, healthcare organizations must adopt a systems approach to patient safety, in which organizations take a comprehensive approach aimed at building resilient barriers and ensuring a culture of open communication and learning. ⋯ Baker et al. (2004) argued for the need to modify the work environment of healthcare professionals to better ensure barriers were in place, as well as the need to improve communication and coordination among healthcare providers. The changes proposed a decade ago required greater healthcare worker engagement in patient safety and the creation of a culture of patient safety.
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The deinstitutionalization movement in Canada began in the 1960s. It is defined as the process of discharging chronic mental health patients into the community in order for them to receive care from community mental health services. The deinstitutionalization movement is failing in Canada at this time for two main reasons: (1) the provinces' community mental health programs lack integration; and (2) the negative stigma attached to mental illness is still present in the community. This article will discuss ways to ensure the integration of first-line mental health services and the elimination of stigma through organizational and systemic changes in Canada.