Team-based delivery of family doctor services is associated with improved patient experiences, better health outcomes, and more efficient healthcare utilization. Team effectiveness is related to the team's output, and family doctor team effectiveness (FDTE) directly impacts the quality and efficiency of contracted family doctor services. We aimed to explore the path and mechanisms influencing family doctor team effectiveness, propose strategies for improvement, and enhance both team effectiveness and service quality.

To determine methods of FOBT de-implementation in acute care practice while summarizing the reasons and contraindications for inappropriate FOBT in acute care settings. Fecal occult blood testing is valuable for colorectal cancer screening in ambulatory settings but is not valuable for diagnostics in acute care with consistent indications for discontinuation as a tradition-based practice.

Healthcare quality has long been defined and assessed using different theories that outline care delivery as a product of two factors; one being the clinical aspect symbolizing the science of care and the other being the non-clinical aspect symbolizing non-medicinal aspect of care delivery. To the best of our knowledge, the joint effect of the clinical, social and technological aspects of care on outcome quality has not been investigated in the literature. The current study empirically investigates the joint effect of the clinical, social and technological care quality dimensions on mortality rates through analyzing longitudinal data from 3081 US hospitals.

Giant cell arteritis (GCA) can present diagnostic challenges and early diagnosis is crucial due to potential ischemic complications. Recent guidelines suggest that a suspected diagnosis should be confirmed with temporal artery biopsy or imaging, including ultrasound (US). In our Canadian setting, point-of-care temporal artery US was near unavailable, and biopsy remains the standard of care. We hypothesize that launching a fast-track US clinic by rheumatologists may spare the need for a temporal artery biopsy. Therefore, this study aimed to assess the diagnostic performance of US in this newly launched fast-track clinic.

Benchmarks are an important aspect of quality measurement and evaluation of long-term care services (LTCS) performance. In this study, we aimed to estimate achievable benchmarks of care (ABC©) for 12 quality indicators used to monitor quality of care in Australian LTCS and to identify LTCS characteristics associated with attaining the estimated ABC.

Safety culture development is essential for patient safety in healthcare institution. Perceptions of patient safety and cultural changes are shown up in patient safety reports, however, were rarely investigated. The aim of this study was to investigate the perception of physicians and to explore the development of safety culture using quantitative content analysis for patient safety reports.

The Finnish public healthcare system aims to ensure equal access to health services for all but faces challenges in meeting the demand for specialized care, such as neurosurgery, due to resource constraints. This study investigates interventions to increase resources at a neurosurgery outpatient clinic to improve patient care without compromising waiting times for diagnoses and treatments, leveraging Finland's unique healthcare landscape.

Iron deficiency is the leading cause of anaemia worldwide and is increasingly treated with intravenous (IV) iron therapy. Staining from IV iron therapy is a rare but significant and preventable adverse event. To mitigate patient harm, a health-service-wide quality improvement project was implemented. This study aimed to determine the real-world impact of a quality improvement project on IV iron staining incidents and preventability.

Integrated care can be broadly defined as the delivery of high-quality and safe care for patients as they cross organizational boundaries or when care is delivered with multiple health care teams, professions, or organizations. Successful integration of care services is contingent on multiple and complex factors across macro, meso, and micro levels of health and social care systems in lower-, middle-, and higher-income countries. Previous priorities for the future development of integrated care have focused on designing and implementing models or approaches to integrated care rather than establishing the research needed to underpin them. This study aimed to address this evidence gap by developing a consensus on international research priorities related to integration of care and cross-boundary working.

High-quality discharge information is important to promote patient safety when patients are transferred from hospital to primary care. Patients with multiple long-term conditions are especially vulnerable to insufficient transfer of medication information, as they use many medications and have complex interactions with the healthcare services. The aim of this study was to investigate the effect of integrated medicines management provided to hospitalized multimorbid patients on the quality of the discharge medication information.

The closure of a pharmacy-led anticoagulation clinic, which provided point-of-care (POC) international normalized ratio (INR) testing and face-to-face visits, coupled with the transition to an academic physician-led clinic without POC INR testing and reliance on telephone communication, created significant challenges for warfarin management during the Coronavirus disease 2019 pandemic. The aim of this quality control project was to increase the percentage of patients on warfarin within the optimal time in therapeutic range (TTR) from 52.30% to 65.00%, sustain baseline quarterly cumulative percentage TTR to 59.00%, and transition 20% of eligible patients from warfarin to dual oral anticoagulation (DOAC) within 12 months.

Health inequity between Indigenous (First Nations, Inuit, and Métis) peoples and other citizens is an important policy concern in Canada, as in other colonial countries. Racism in healthcare has been identified as contributing to poorer care and to worse outcomes. Despite a large literature regarding racism in other healthcare contexts, the dimensions of the existing literature on anti-Indigenous racism in Canadian healthcare are unclear. A scoping review examined the evidence of anti-Indigenous racist experiences in healthcare in the research literature, including the types of racist behaviours identified, settings studied, and Indigenous populations and geographic regions included. We identified English and French language journal articles on anti-Indigenous racism in Canadian healthcare settings in Scopus, PubMed, CINAHL, and the Bibliography of Indigenous Peoples in North America, and grey literature reports. A total of 2250 journal articles and 9 grey literature reports published since 2000 were included in screening, and 66 studies were included in the final review. Most used qualitative interviews with patients, but a large proportion included healthcare providers. Most were conducted in urban settings, a majority in Ontario or British Columbia, with mixed Indigenous populations. The largest proportion focussed on patient experiences with healthcare in general, rather than specific clinical contexts. Most racist experiences identified were 'covert' racism, including patients feeling treated differently from non-Indigenous patients, being ignored, treated more slowly, or not believed. Stereotyping of Indigenous peoples as substance users, poor patients, or poor parents was also commonly reported. 'Overt racism', including the use of racist slurs, was not widely found. Some quantitative studies did use standardized or validated instruments to capture racist experiences, but most did not result in generalizable estimates of their prevalence. The few studies linking racism to health outcomes found that experiencing racism was related to reluctance to seek healthcare, potentially leading to higher unmet healthcare needs. Gender was the intersecting dimension most identified as shaping healthcare experiences, with Indigenous women and girls at risk to specific stereotypes. Some papers suggested that socio-economically disadvantaged Indigenous people were at the highest risk to experiencing racism. Types of anti-Indigenous racism identified in Canadian healthcare appear similar to those reported in other jurisdictions. Indigenous peoples facing multiple dimensions of disadvantage, especially gender and social class, may be the most likely to experience racism. It is likely that the experience of racism in healthcare has implications for Indigenous peoples' health, mainly by reducing healthcare access.

Joint Commission International (JCI) accreditation is a recognized leader in healthcare accreditation worldwide. It aims to improve quality of care, patient safety, and organizational performance. Many hospitals do not apply for re-accreditation after JCI status expires. Understanding employees' perceptions of JCI accreditation would benefit hospital management. We aimed to examine whether re-accredited hospital employees perceived more significant benefits and were more likely to recommend JCI to other hospitals than ex-accredited employees. This is a prospective cross-sectional study with a comparison group design. Survey questionnaires, developed from a qualitative study, included perceptions of challenges, benefits, and overall rating of JCI accreditation. An electronic-based questionnaire was distributed to physicians, nurses, medical technicians, and administrative staff in five private Obstetrics and Gynecology hospitals in China, March-April 2023. Descriptive and linear regression analyses were performed. The statistically significant level is P-value <.05. Of 2326 employees, 1854 (79.7%) were included in the study after exclusions, 1195 were re-accredited, and 659 were ex-accredited. Perceptions of JCI accreditation were positive, as both groups reported a mean score >4.0 regarding the overall benefits. Adjusted for covariates, re-accredited employees were more willing to recommend JCI accreditation to other hospitals than ex-accredited employees. Re-accredited employees perceived greater benefits of JCI accreditation and were more willing to recommend it to other hospitals, suggesting that perceived benefits contribute to a desire to maintain and sustain JCI accreditation. Employee participation is vital for its effective implementation. Employees' perceived challenges and benefits may provide insights for healthcare leaders considering pursuing and reapplying for JCI accreditation.