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This paper provides insights into the use of performance data by middle managerial staff in Ontario hospitals in 2019 and compares the results to a study conducted in Europe in the same year. A total of 236 managers working in 61 hospitals across Ontario provided responses to the survey. Compared to their European colleagues, Ontario respondents self-assessed using significantly more performance data for managerial decision making. The use of performance data in Ontario was mostly motivated by external accountability requirements, followed by internal quality improvement efforts. Ontario managers also reported accessibility, appropriateness and timeliness of data and human resources and engagement as the biggest barriers to further performance data utilization. Comparative studies, such as the one this paper is based on, provide the foundation for drawing lessons across jurisdictions. This paper also affirms the importance of hospital middle management in moving from quality assurance to quality improvement efforts and developing sustainable learning healthcare organizations and systems.

This qualitative study examines the determinants of effective inter-organization information sharing in the Health Capital Planning process (the process), primarily in the final stage of the process which focuses on the review of final expenses and release of a holdback. Using thematic analysis and building off a scoping review that was conducted in preparation for this study, we provide a framework for effective information sharing during the process. We interviewed 17 leaders from the Government of Ontario and hospitals across the province. The results of the interviews indicate that the most essential determinants of effective inter-organization information sharing in the process: organizational characteristics; reducing complex bureaucracies; preserving human resources and expertise; clear and standardized information; reducing policy changes; networks; negotiation abilities; information technology; training; record retention; and early planning. This study confirmed the need for effective intra-organization and interpersonal information sharing to achieve successful inter-organization information sharing.

Background: In the manufacturing and service-sector industries, organizational characteristics associated with the use of innovation are well studied. This same study has not been applied to hospit...

Supplemental Material: The Determinants of Effective Inter-organization Information Sharing in the Health Capital Planning process - Methods

Supplemental Material for Determinants of Effective Information Sharing in Publicly Funded Infrastructure Projects: A Scoping Review by Rayeh Kashef Al-Ghetaa, James Shaw, Mostafa Alabousi, David Klein, Daniel Imtiaz, Bijan Teja, and Adalsteinn Brown in Public Works Management & Policy

KEY POINTS Concerns over the sustainability of Canada’s health care systems frequently lead to heated discussions about physician compensation, drug prices and wait times. In the current climate of an aging population, rising chronic disease and increasing demand for services, most discussions

PurposeHealth literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey.Design/methodology/approachThis survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed.FindingsThe participation rate of hospitals was 46 percent. Exploratory factor analysis demonstrated that there were five factors. The survey, and each of the five factors, had moderate to high levels of reliability.Research limitations/implicationsThere is a need to expand the focus of further research to examine the experiences of patients and families. Repeating this study with a larger sample would facilitate further survey development.Practical implicationsMeasuring health literate discharge practices with an organizational survey will help hospital managers to understand their performance and will help direct quality improvement efforts to improve patient care at hospital discharge and to decrease hospital readmission.Originality/valueThere has been little research into how patients are discharged from hospital. This study is the first to use an organizational survey tool to measure health literate discharge practices.

This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

Since 1998, most hospitals in Ontario have voluntarily participated in one of the largest and most ambitious publicly available performance-reporting initiatives in the world. This article describes the method used to select key financial indicators for inclusion in the report including the literature review, panel and survey approaches that were used. The results for five years of recent data for Ontario hospitals are also presented.

This article examines the characteristics associated with Alternate Level of Care (ALC) status in mental health in-patient units across Ontario. Using assessment information from the Resident Assessment Instrument–Mental Health, the prevalence of ALC episodes, resource utilization associated with ALC, and demographic and diagnostic characteristics of ALC patients are examined. The effective management of ALC patients should be an important priority for all stakeholders involved in mental health services delivery in Canada.

Objective Early abortions have been predominantly surgical for many years, but medical options with comparable efficacy and safety are now available. This study compares the costs of two medical options and two surgical options. Methods We used a clinical model to compare the costs in Ontario of four options for early abortion: medical abortion using either mifepristone or methotrexate, and surgical abortion by vacuum aspiration in either a hospital or a free-standing clinic. The cost analysis was conducted from the perspectives of society, the health care system, and the patient. Results From all perspectives, total costs were highest for hospital surgical abortion, followed by surgical abortion in a clinic. From the patient's perspective, total costs were higher for surgical abortion but direct costs (mainly for medications) were higher for medical abortion. The total cost of mifepristone and methotrexate abortion was equal if the price of mifepristone (200 mg) was $59.52. The model was robust but was sensitive to the price of mifepristone. Conclusion Early medical abortion costs less than early surgical abortion from the societal and health care system perspectives but more than surgical abortion from the patient's perspective. Surgical abortion costs more in hospitals than in free-standing clinics from the societal and health care system perspectives, but the costs are the same in both settings from the patient's perspective. No method for early abortion can be identified as best, and patients should be free to choose the option they prefer.

Since the inception of the Hospital Reports in 1998, researchers have focused on three separate but related problems--how to measure performance; how to evaluate performance; and how to transfer knowledge about excellent performance to the field. This article describes a method to address the second problem--how to evaluate performance by benchmarking two indicators of financial performance and condition through three years of recent data for Ontario hospitals.