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  • 1
    Online Resource
    Online Resource
    From Measurement to Improvement in Ontario’s Cancer System: Analyzing the Performance of 28 Provincial Indicators Over 15 years
    Longwoods Publishing ; 2020
    In:  Healthcare Quarterly Vol. 23, No. 1 ( 2020-04-30), p. 53-59
    Details
    In: Healthcare Quarterly, Longwoods Publishing, Vol. 23, No. 1 ( 2020-04-30), p. 53-59
    Type of Medium: Online Resource
    ISSN: 1710-2774
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.12927/hcq.2020.26137
    DOI: 10.12927/hcq
    DOI: 10.12927/hcq.2020.26138
    Language: Unknown
    Publisher: Longwoods Publishing
    Publication Date: 2020
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  • 2
    Online Resource
    Online Resource
    What do end-users want to know about managing the performance of healthcare delivery systems? Co-designing a context-specific and practice-relevant research agenda
    Springer Science and Business Media LLC ; 2021
    In:  Health Research Policy and Systems Vol. 19, No. 1 ( 2021-10-11)
    Details
    In: Health Research Policy and Systems, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2021-10-11)
    Abstract: Despite increasing interest in joint research priority-setting, few studies engage end-user groups in setting research priorities at the intersection of the healthcare and management disciplines. With health systems increasingly establishing performance management programmes to account for and incentivize performance, it is important to conduct research that is actionable by the end-users involved with or impacted by these programmes. The aim of this study was to co-design a research agenda on healthcare performance management with and for end-users in a specific jurisdictional and policy context. Methods We undertook a rapid review of the literature on healthcare performance management ( n  = 115) and conducted end-user interviews ( n  = 156) that included a quantitative ranking exercise to prioritize five directions for future research. The quantitative rankings were analysed using four methods: mean, median, frequency ranked first or second, and frequency ranked fifth. The interview transcripts were coded inductively and analysed thematically to identify common patterns across participant responses. Results Seventy-three individual and group interviews were conducted with 156 end-users representing diverse end-user groups, including administrators, clinicians and patients, among others. End-user groups prioritized different research directions based on their experiences and information needs. Despite this variation, the research direction on motivating performance improvement had the highest overall mean ranking and was most often ranked first or second and least often ranked fifth. The research direction was modified based on end-user feedback to include an explicit behaviour change lens and stronger consideration for the influence of context. Conclusions Joint research priority-setting resulted in a practice-driven research agenda capable of generating results to inform policy and management practice in healthcare as well as contribute to the literature. The results suggest that end-users are keen to open the “black box” of performance management to explore more nuanced questions beyond “does performance management work?” End-users want to know how, when and why performance management contributes to behaviour change (or fails to) among front-line care providers.
    Type of Medium: Online Resource
    ISSN: 1478-4505
    URL: Article
    DOI: 10.1186/s12961-021-00779-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2101196-5
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  • 3
    Online Resource
    Online Resource
    Faster and better: Improving the diagnostic phase of lung cancer at a system level.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 8_suppl ( 2017-03-10), p. 115-115
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 8_suppl ( 2017-03-10), p. 115-115
    Abstract: 115 Background: For many patients going through diagnostic testing for cancer, the time from suspicion to diagnosis or rule-out, can be a confusing and anxious time. In 2007, Cancer Care Ontario began investing in the implementation of diagnostic assessment programs (DAPs) across Ontario, Canada to improve the quality of care during the diagnostic phase of lung cancer. DAPs consist of multidisciplinary healthcare teams that manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis. The objectives of the DAPs are to: 1) decrease time from suspicion to diagnosis or resolution; 2) optimize the patient’s experience during the diagnostic process; 3) optimize satisfaction and experience among primary care providers and specialists; and 4) provide a sustainable solution by offering good value for money. Today over 35,000 patients have been diagnosed in one of the 18 lung DAPs that exist across the province. Methods: The implementation of DAPs featured the introduction of a patient navigator to act as the primary point of contact for patients, improve the patient experience and ensure their patients were progressing through any required diagnostic imaging and consultations in a timely manner. Cancer Care Ontario also engaged with primary care providers to refer patients with findings suspicious for lung cancer to DAPs as early as possible to ensure they benefited from organized assessment. Cancer Care Ontario has collected patient level data to measure wait times and implemented a patient survey to assess patient experience. Results: In the past five years, the median wait time from referral to a lung DAP to diagnosis or rule out has decreased by 19% to 24 days and the 90th %tile has decreased by 28% to 51 days. The large majority of patients have had a positive experience with their DAPs, with 95% of patients scoring their experience in the diagnostic process as “good” or “excellent”. Conclusions: The implementation of DAPs across the province is seen as a valuable component of quality of care by improving the diagnostic phase of cancer. The sustainability of the DAP model is demonstrated by the continued improvements in access and maintained patient experience in spite of growing volumes (91% increase in the past five years).
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.8_suppl.115
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 4
    Online Resource
    Online Resource
    Delivery of Cancer Care in Ontario, Canada, During the First Year of the COVID-19 Pandemic
    American Medical Association (AMA) ; 2022
    In:  JAMA Network Open Vol. 5, No. 4 ( 2022-04-25), p. e228855-
    Details
    In: JAMA Network Open, American Medical Association (AMA), Vol. 5, No. 4 ( 2022-04-25), p. e228855-
    Type of Medium: Online Resource
    ISSN: 2574-3805
    URL: Article
    DOI: 10.1001/jamanetworkopen.2022.8855
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2931249-8
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  • 5
    Online Resource
    Online Resource
    Driving quality improvements of radiation treatment services through a centralized performance management approach.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 8_suppl ( 2017-03-10), p. 188-188
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 8_suppl ( 2017-03-10), p. 188-188
    Abstract: 188 Background: Radiation treatment services are delivered in 16 facilities spread across the province of Ontario, centralized through Cancer Care Ontario’s oversight of quality of care, equipment, hospital funding, clinical and technical guidelines. Methods: In order to ensure high quality care, Cancer Care Ontario employs a systematic approach performance management, whereby facilities are held accountable to achieving provincial quality targets. For radiation treatment, the quality improvement priorities that have leveraged this approach over the last 10 years have included: reduction of wait times to consultation; reduction of wait times to start of treatment; adoption of Intensity Modulated Radiation Therapy (IMRT) where appropriate; and implementation of peer review for treatment plans. In each case, key performance indicators were developed for use in provincial scorecards designed to focus the attention of local clinical and administrative leadership. Regular performance discussions with senior leaders took place throughout implementation, and targeted intervention occurred with facilities that were lagging behind their peers. Results: See table. Conclusions: The ability to centrally monitor the implementation of quality improvement initiatives across a large jurisdiction, and to hold the leadership of each facility accountable to provincial targets through regular feedback and escalation, has been a key component of highly successful change management initiatives in radiation treatment in Ontario. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.8_suppl.188
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 6
    Online Resource
    Online Resource
    Expansion of high-quality specialized services: The gynecologic oncology experience in Ontario hospitals.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 30_suppl ( 2018-10-20), p. 39-39
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 30_suppl ( 2018-10-20), p. 39-39
    Abstract: 39 Background: In Ontario’s publicly funded cancer system, patient access to Gynecological Oncology (GyneOnc) care is threatened by growing demand, waiting times and need for lengthy patient travel. Cancer Care Ontario has published organizational standards that lay out the minimum clinical elements and infrastructure needed for a high quality program. Capacity planning and readiness assessments were used to guide GyneOnc expansion into non-academic regional cancer centres to alleviate system pressure. We evaluated early expansion activities to learn about critical factors and generate recommendations for future growth of this specialized oncology service. Methods: Capacity planning for new centres factored health human resources (HHR), patient volume and travel distances, ensuring that existing programs maintain critical mass. Evaluation included review of documents and readiness assessments related to the expansion projects undertaken to date. Interviews were done with GyneOncologists and administrators working at local and provincial levels to discover areas of risk, key factors for success, and recommended strategies for future expansion. Results: Gyne Onc programs need adequate resourcing (minimum 3 GyneOncs) to meet patient demand, support on-call and offer resilience to parental/medical leaves. Programs need engagement from other surgical and medical subspecialties, and clinical services (e.g. pathology, diagnostic imaging) for integrated, multidisciplinary care. Academic appointments, residencies, fellowships, and support for research provide links with universities, important for credibility. Endorsement by senior leadership - both management and clinical - is crucial. Organizational standards need specificity around the infrastructure and multidisciplinary environment needed for program success. Conclusions: HHR planning and readiness assessment are critical enablers in the expansion of specialized services like GyneOnc beyond academic centres. New programs need to consider the adequacy and appropriateness of staffing models, broad engagement of the clinical team, and linkages to academia, in order to ensure program sustainability and acceptability.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.30_suppl.39
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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  • 7
    Online Resource
    Online Resource
    What do Practitioners Want to Know about Managing the Performance of Healthcare Delivery Systems?
    Academy of Management ; 2021
    In:  Academy of Management Proceedings Vol. 2021, No. 1 ( 2021-08), p. 10851-
    Details
    In: Academy of Management Proceedings, Academy of Management, Vol. 2021, No. 1 ( 2021-08), p. 10851-
    Type of Medium: Online Resource
    ISSN: 0065-0668 , 2151-6561
    URL: Article
    DOI: 10.5465/AMBPP.2021.10851abstract
    Language: English
    Publisher: Academy of Management
    Publication Date: 2021
    detail.hit.zdb_id: 2069299-7
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  • 8
    Online Resource
    Online Resource
    Reducing the impact of distance on hematopoietic cell therapy patients.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 30_suppl ( 2018-10-20), p. 74-74
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 30_suppl ( 2018-10-20), p. 74-74
    Abstract: 74 Background: Hematopoietic Cell Therapy (HCT) patients experience unique travel challenges and high out-of-pocket costs due to the highly specialized care required. We conducted a mixed methods study to understand current patient support programs in Ontario and other jurisdictions and a cost analysis to inform the development of recommendations to reduce the impact of remoteness on HCT patients and caregivers. Methods: Qualitative information on patient transportation and accommodation supports was gathered through informal and structured input from fourteen Ontario Regional Cancer Program Directors, Hematologists, Patient and Family Advisory Council and Aboriginal Navigators. An environmental scan of medical travel assistance programs within Ontario and in other jurisdictions was performed. A scoping literature review was conducted of published studies focused on inequities in receipt of cancer care in countries with Universal Health care. HCT patient travel patterns to each of the transplant facilities in Ontario were obtained from analysis of Cancer Care Ontario data holdings. Results: We concluded that travel assistance for cancer patients in Ontario varies considerably across the province, and that Ontario lags behind other jurisdictions in Canada and internationally. The scoping literature review revealed that patients who live far from specialist centres, for some diseases, have later stage at diagnosis, less timely access to specialist care, poorer outcomes, lower patient experience scores, and make treatment decisions based on distance. From the analysis of travel patterns for HCT patients, provincially 4 – 79% of patients travel for HCT based on their location (see table below). Conclusions: This study highlights the need to better support HCT patients in Ontario. As a result, a proposal to support accommodations for HCT patients was developed and approved by the Ontario government for implementation in 2018/19.[Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.30_suppl.74
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
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