ABSTRACT
Amol Verma and Sacha Bhatia's (2016) paper presents policy recommendations that merit serious consideration on a system-wide level. While they make compelling arguments about why provincial governments are ideally suited to adapt Triple Aim innovation, we are concerned that the current health system climate limits this possibility. In our commentary, we present our thoughts about the authors' admittedly aspirational goals and the realities of the pan-Canadian healthcare system. We commence our commentary by confirming our agreement about the potential inherent within the Triple Aim framework. Second, we argue how important progress can take place that may not reflect a provincial-wide system. Next, we maintain that a learning health system is an essential ingredient to advancing Triple Aim and other health system-wide improvements. Third, we wonder whether the stewardship role of government is real and possible. Finally, we question the concept of our current health system's readiness for system change. While we have raised some questions about Verma and Bhatia's thinking around provincial adoption of the Triple Aim, we applaud their ideas. We believe that transformation in provincial health systems requires bold thinking.
Subject(s)
Delivery of Health Care , Policy , Canada , Government ProgramsABSTRACT
Healthcare organizations the world over are faced with having to set priorities and allocate resources within the constraint of a fixed envelope of funding. Drawing on economic principles of value for money and ethical principles of fair process, a priority setting framework was developed for Ontario's local health integration networks (LHINs) in late 2007 and early 2008. Subsequently, over an 18-month period, the framework was piloted in three LHINs. In this article, the framework and pilot implementations are described, results from a formal evaluation are outlined and recommendations for future use are highlighted.
Subject(s)
Community Networks , Health Priorities , Community Networks/economics , Community Networks/ethics , Community Networks/organization & administration , Health Priorities/economics , Health Priorities/ethics , Health Priorities/organization & administration , Humans , Models, Organizational , Ontario , Policy Making , Program Development , Program EvaluationABSTRACT
In 2009, the North West Local Health Integration Network hosted Share Your Story, Shape Your Care, an innovative community engagement initiative. Over 800 residents and health service providers in Northwestern Ontario participated and identified healthcare priorities, reacted to proposed strategies and shared ideas and stories. Primarily web-based (with a Choicebook, message board, blog and YouTube video), paper copies and conversation guides supported informed and reflective participation. This project enabled community-level participation in healthcare, supporting local planning and decision-making, and was awarded the inaugural Innovation Using Technology Award by the International Association for Public Participation.
Subject(s)
Health Priorities , Information Dissemination , Patient Participation , Policy Making , Anecdotes as Topic , Delivery of Health Care , Humans , Internet , Interviews as Topic , National Health Programs , OntarioABSTRACT
Ontario's 14 Local Health Integration Networks (LHINs) produced their first major deliverable when they issued their integrated health service plans in October 2006. This article reviews the experience of LHINs in meeting this challenge, outlines the process and outcome dimensions of the plans and discusses eight opportunities for LHINs as they act on the basis of their plans.
