Assignment: Drivers of High Performance Healthcare Systems

Assignment: Drivers of High Performance Healthcare Systems

ORDER NOW FOR AN ORIGINAL PAPERAssignment: Assignment: Drivers of High Performance Healthcare Systems

Select two drivers (for example quality, cost, and access) of high performance healthcare systems and apply it to your current work situation. The application could demonstrate the presence of the driver in a positive manner or it could acknowledge the presence of a concern.

High-Performance Healthcare: Access and Quality
Jennifer Zelmer, BSc, MA, PhD, Editor-in-chief
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Cet article est disponible en français. Voyez “Services de santé de rendement supérieur : accès et qualité”.

Volumes have been written about the importance of access to high-quality healthcare, and hundreds – perhaps thousands – of speeches have been made on the topic. Access is also one of the key drivers of health reform efforts in Canada and around the world, but the term means different things to different people. As the debates currently underway in the United States clearly show, not everyone places the same value on different dimensions of access.

This issue of Healthcare Policy/Politiques de Santé features a number of papers that touch on different aspects of access to healthcare. Graham J. Reid and colleagues measure the proportion of people living in southwestern Ontario who do not have a regular family physician, and explore where these people tend to seek care when they need it. For those who do have a family doctor, Michelle Howard and Glen E. Randall examine access to care outside regular office hours – specifically, the instructions that patients receive when they telephone their family physician’s practice after hours.

Whether you have a regular family physician or not, socio-cultural, financial and other aspects of access to healthcare are also important. For example, Alice W. Chen and her co-authors identify access to care as one factor that may drive differences in mental health diagnoses between recent Chinese immigrants and others in British Columbia. Likewise, Irfan A. Dhalla and colleagues investigate the potential effects of removing financial barriers to accessing medications after a hospital stay for a myocardial infarction.

Furthermore, the quality of care that you access matters, as several papers in this issue point out. For instance, Elizabeth F. Wenghofer and her colleagues explore the extent to which different factors affect the quality of care provided by family physicians, as measured through peer assessments conducted by their professional regulatory body. They find that the personal and professional characteristics of physicians are associated with quality, as are organizational and systemic factors. Moira Stewart and her co-authors take a different approach. Their paper focuses on the potential to use electronic medical records as a tool for improving practice, policy and research in primary healthcare, as well as the practical realities of establishing this infrastructure. Other papers in the journal profile lessons learned from efforts to promote action on women’s health in Ontario’s health sector through performance measurement, public reporting of data on nursing home quality of care in the United States, and a collaborative education initiative related to dementia care and challenging behaviours in nursing homes.

In an odd coincidence of timing, I found myself re-reading the papers in this issue at the same time as I was myself accessing health services in a new way. I will shortly be travelling to Colombia and needed to check on vaccination requirements. Rather than going to my doctor’s office, I initiated my first e-consult by sending my doctor information about my upcoming trip and previous vaccinations through a secure electronic portal. The message that I sent Sunday night was answered by 9:30 a.m. on Monday. Change to my current or future health status from the speed of the response: nil. Quality of the patient experience: superb. The fact that I needed no new shots: priceless.

I hope that the papers in this issue whet your appetite for more. Future issues of the journal will feature further insights into opportunities to improve access to care, its appropriateness and effectiveness, the patient experience and other dimensions of a high-performance health system. As in this issue, upcoming papers also explore how best to identify and spread such innovations throughout the health system. As President Obama said in his recent speech to the joint session of Congress, “I still believe we can act even when it’s hard.”1 By building the evidence base about what works, why, and how, hopefully we can collectively make the path to change and improvement a little less steep. Watch this space.

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