PubMed · 14199102
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S HIERONS. 1964. VARIABLE UTILIZATION FEE IN OPERATION.. https://pubmed.ncbi.nlm.nih.gov/14199102/
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BACKGROUND: Health systems worldwide face persistent health workers challenges including nursing shortages, workforce strain, and inequities. In Canada, these challenges have prompted renewed national and provincial reforms to strengthen recruitment, retention, leadership, and sustainability. This paper compares nursing workforce policy directions across Canada, and international jurisdictions to inform policy and planning. METHODS: A cross-country comparative analysis of policies building on a comprehensive national funded review that included an umbrella review of 69 systematic reviews, a comparative policy review of nursing workforce strategies in five jurisdictions, and validation through national horizon-scanning and policy dialogues (n >100). Evidence was analyzed across system, organizational, and individual levels. RESULTS: At the system level, international jurisdictions demonstrate comprehensive, legislated approaches integrating data, governance, and multi-year funding have advanced key nursing strategies. In Canada, the advances show the importance of strategies to have national and provincial/territorial alignment emphasizing leadership, flexibility, and inclusion as key levers. Organizational and individual-level reforms such as mentorship, leadership development, and wellness initiatives are expanding but remain variably evaluated. Experts identified national workforce data strategies and policy integration with embedded evaluation as key enablers to inform scalability and sustainability of implemented strategies. CONCLUSIONS: Canada's nursing workforce reforms are advancing toward coordinated, equity-driven, and evidence-informed strategies. Continued investment in evaluation, leadership, and national integrated data systems along with integrating nursing workforce planning within broader intersectoral planning will consolidate these gains and position Canada as an international leader in sustainable nursing workforce policy.
Proving the efficacy of thrombolysis in improving outcome from stroke has put time to assessment of patients at the forefront for healthcare providers when organizing stroke care. The chain of recovery begins with the patient. Efforts are being made to improve the general public's understanding of stroke. However, it appears at the moment that a greater effect in reducing the delay to initial medical assessment and treatment decision is to be gained through streamlining care as soon as 911 has been called. Emergency medical services dispatchers and technicians play a key role in recognizing that a patient is having a stroke and prioritizing the transport of the patient to an appropriate facility. Emergency departments need to have clear protocols in place to ensure that physicians can make prompt treatment decisions after having fully assessed and investigated the patient. Only with all these pieces in place is the initial phase of the chain of recovery complete, with the end result that more patients have the chance to have an improved outcome from stroke.