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The rate of starting buprenorphine maintenance increased from 10% (30 of 305 eligible patients) to 24% (64 of 270 eligible patients) after the intervention, with interrupted time series analysis showing a significant increase in rate (14.4%; 95% CI, 3.6%-25.3%; P = .02). Engagement in treatment after discharge was unchanged (40%-46% engaged 30 days after discharge). Of 156 internal medicine residents, 89 (57%) completed the baseline survey and 66 (42%) completed the follow-up survey. FIN56 order Responses demonstrated improved resident knowledge and comfort with buprenorphine.

Internal medicine resident teams were more likely to start patients on buprenorphine maintenance after clinician education and implementation of a Buprenorphine Bridge Team.
Internal medicine resident teams were more likely to start patients on buprenorphine maintenance after clinician education and implementation of a Buprenorphine Bridge Team.
Many initiatives seek to increase the number of morning hospital discharges to improve patient flow, but little evidence supports this practice.

To determine the association between the number of morning discharges and emergency department (ED) length of stay (LOS) and hospital LOS in general internal medicine (GIM).

Multicenter retrospective cohort study involving all GIM patients discharged between April 1, 2010, and October 31, 2017, at seven hospitals in Ontario, Canada.

The primary outcomes were ED LOS and hospital LOS, and secondary outcomes were 30-day readmission and in-hospital mortality. The number of morning GIM discharges (defined as the number of patients discharged alive between 800 AM and 1200 PM) on the day of each hospital admission was the primary exposure. Multivariable regression models were fit to control for patient characteristics and situational factors, including GIM census.

The sample included 189,781 patient admissions. In total, 36,043 (19.0%) discharges occurred between M. Our findings suggest that increasing the number of morning discharges alone is unlikely to substantially improve patient throughput in GIM, but further research is needed to determine the effectiveness of specific interventions.
The number of morning discharges was not significantly associated with shorter ED LOS or hospital LOS in GIM. Our findings suggest that increasing the number of morning discharges alone is unlikely to substantially improve patient throughput in GIM, but further research is needed to determine the effectiveness of specific interventions.Time-driven activity-based costing (TDABC) has received considerable attention globally as a way to measure value in healthcare systems. This study aimed to apply TDABC for cataract surgery at the Kensington Eye Institute (KEI). During a field evaluation, a detailed process map was created for cataract surgery at KEI. The amount of resource use in terms of providers, equipment, space and consumables was calculated to determine the total costs of care. The average patient journey lasted 76 minutes, with 13 minutes of the surgical procedure occurring in the operating room (OR). The average procedure's cost per case was $545.28, which included consumables (34.40%), space and equipment (23.702%), personnel (11.69%), overhead (30.27%) and OR (57%). KEI cataract operation was at approximately 50% capacity due to funding limits. The TDABC process map and costing allow centres to have data-driven support tools for care redesign and optimization.Language barriers can reduce access to medical and virtual care. Although the topic of healthcare professionals and linguistic minorities has been studied in Canada, it has mainly been done for official languages (i.e., English and French). Non-official languages (NOLs) have not been explored previously in the healthcare system at the pan-Canadian level. The objective of this study is to determine to what extent NOLs spoken by physicians relate to those of Canadian ethnic groups and are an enabler of access to care. Using data from the Canadian Institute for Health Information (CIHI) and Statistics Canada, we found an imbalance in the physician-to-population NOL ratios in Montreal and, to a lesser extent, Vancouver.
This paper reports the quantitative component of a mixed-methods study of patient flow in the 10 urban health regions/zones of Western Canada. We assessed whether jurisdictions differed meaningfully in their emergency flow performance, defined as mean emergency department length of stay (ED LOS).

We used hierarchical linear modelling to compare ED LOS across jurisdictions, based on nationally reported data for 2017 to 2018. We also explored 36-month performance trends. Admitted and discharged patients were analyzed separately.

With the exception of one high performer, no region's performance differed significantly from average for both admitted and discharged patients. The regions' levels of performance remained largely static throughout the study period.

Results precluded any mixed-methods comparison of high- and low-performing regions. However, they converged with our qualitative findings, which suggested that most regions were pursuing similar flow-improvement strategies with limited effectiveness. Deeper changes may be required to address persistent misalignment between capacity and demand.
Results precluded any mixed-methods comparison of high- and low-performing regions. However, they converged with our qualitative findings, which suggested that most regions were pursuing similar flow-improvement strategies with limited effectiveness. Deeper changes may be required to address persistent misalignment between capacity and demand.Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.
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