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Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.

A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.

This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.

This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.

Sexual and reproductive health (SRH) interventions demand diverse services, encompassing medical, social and psychological care to ensure the overall wellbeing of service users. In the absence of multidisciplinary response to SRH interventions, service users could be deprived of crucial SRH services, which could undermine their safety and wellbeing. Based on this knowledge, our study was designed to map the interprofessional space in primary healthcare (PHC) facilities in Ebonyi State, Nigeria that deliver SRH services.

Interviews with 20 health workers and group discussions with 72 young people aged 15–24 years provided the data for the study. We analyzed data deductively, focusing on the assessments of the presence or absence of specific professionals that are typically expected to provide different aspects of SRH services.

We found conspicuous absence of laboratory diagnostic, social care, psycho-cognitive and some medical services expected of primary care. These absences necessitated unnecessary referrals, encouraged breaches in confidentiality, undermined social care and justice, increased cost of care and discouraged young clients from utilizing SRH services provided in PHCs. Our study, therefore, emphasizes the need for integrated care in the delivery of SRH services, which would involve relevant diverse professionals contributing their expertise toward comprehensive care for SRH service users.

The study provides human resource insights toward strengthening primary healthcare in Nigeria vis-à-vis efficient delivery of SRH services to guarantee the health security of service users.

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

This paper aims to explore the intricate relationship between artificial intelligence (AI) and health information literacy (HIL), examining the rise of AI in health care, the intersection of AI and HIL and the imperative for promoting AI literacy and integrating it with HIL. By fostering collaboration, education and innovation, stakeholders can navigate the evolving health-care ecosystem with confidence and agency, ultimately improving health-care delivery and outcomes for all.

This paper adopts a conceptual approach to explore the intricate relationship between AI and HIL, aiming to provide guidance for health-care professionals navigating the evolving landscape of AI-driven health-care delivery. The methodology used in this paper involves a synthesis of existing literature, theoretical analysis and conceptual modeling to develop insights and recommendations regarding the integration of AI literacy with HIL.

Impact of AI on health-care delivery: The integration of AI technologies in health-care is reshaping the industry, offering unparalleled opportunities for improving patient care, optimizing clinical workflows and advancing medical research. Significance of HIL: HIL, encompassing the ability to access, understand and critically evaluate health information, is crucial in the context of AI-driven health-care delivery. It empowers health-care professionals, patients and the broader community to make informed decisions about their health and well-being. Intersection of AI and HIL: The convergence of AI and HIL represents a critical juncture, where technological innovation intersects with human cognition. AI technologies have the potential to revolutionize how health information is generated, disseminated and interpreted, necessitating a deeper understanding of their implications for HIL. Challenges and opportunities: While AI holds tremendous promise for enhancing health-care outcomes, it also introduces new challenges and complexities for individuals navigating the vast landscape of health information. Issues such as algorithmic bias, transparency and accountability pose ethical dilemmas that impact individuals’ ability to critically evaluate and interpret AI-generated health information. Recommendations for health-care professionals: Health-care professionals are encouraged to adopt strategies such as staying informed about developments in AI, continuous education and training in AI literacy, fostering interdisciplinary collaboration and advocating for policies that promote ethical AI practices.

To enhance AI literacy and integrate it with HIL, health-care professionals are encouraged to adopt several key strategies. First, staying abreast of developments in AI technologies and their applications in health care is essential. This entails actively engaging with conferences, workshops and publications focused on AI in health care and participating in professional networks dedicated to AI and health-care innovation. Second, continuous education and training are paramount for developing critical thinking skills and ethical awareness in evaluating AI-driven health information (Alowais et al., 2023). Health-care organizations should provide opportunities for ongoing professional development in AI literacy, including workshops, online courses and simulation exercises focused on AI applications in clinical practice and research.

This paper lies in its exploration of the intersection between AI and HIL, offering insights into the evolving health-care landscape. It innovatively synthesizes existing literature, proposes strategies for integrating AI literacy with HIL and provides guidance for health-care professionals to navigate the complexities of AI-driven health-care delivery. By addressing the transformative potential of AI while emphasizing the importance of promoting critical thinking skills and ethical awareness, this paper contributes to advancing understanding in the field and promoting informed decision-making in an increasingly digital health-care environment.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across different health and social care organizations can support enhanced care for older adults living in rural regions. However, IHSC is not well understood within a rural Canadian context.

A case study of a Canadian IHSC initiative, Geriatric Assessment Program Collaboratory (GAPC), in northern Alberta was undertaken to understand how successful IHSC can occur in an urban/rural region. The study used key informant interviews and a focus group of representatives from the GAPC organizations.

Nine factors were identified that support GAPC: communications, information sharing, shared vision and goals, inter-organizational culture, diffused leadership, team-based approaches, dedicated resources, role clarity, champions and pre-existing relationships. Eight external influence factors were identified as influencing partnership including geography, strong sense of community, inter-sectoral work, public policy, governance authorities and structures, funding models, aging communities and operating within a not-for-profit (NFP) setting.

The study reveals insights into how IHSC can occur within a rural Canadian context. This study demonstrates that IHSC occurs at the local level and that primary care providers can drive IHSC successfully.