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How do you care for the growing number of people living with chronic diseases? What actions can be taken to prevent suicide in Canada? How can we improve communications about end-of-life decision-making and care in Ontario? What can we do to increase leadership capacity within our health systems? All are pressing health questions facing policymakers, healthcare professionals, researchers and the general public. The McMaster Health Forum seeks to help all of these stakeholders learn more about, and do more to address, these pressing concerns, through stakeholder dialogues, citizen panels and rapid-response syntheses. To read about the Forum’s work on each of the following topics, visit our Products page.

Recent topics

  • Examining the Impact of Decriminalizing or Legalizing Cannabis for Recreational Use (Rapid response)
    With the potential for large policy changes in Canada regarding the use of cannabis, it is timely to take stock of what is known about the social impact and epidemiological consequences of decriminalizing or legalizing recreational cannabis.
  • Identifying the Impacts of Cannabis Legalization on Youth, and the Responses that can be Taken by Public Institutions (Rapid response)

    Following cannabis legalization in Canada, what are the important health and social outcomes and challenges Canadian youth will likely face, and what approaches to policy and practice should large, student-focused public institutions consider in determining their response to these challenges?


  • Identifying the Effects of Using Telecommunications Technology to Provide Clinical Care at a Distance (Rapid response)

    Prior to expanding the use of telecommunications technologies in the health system, it is important to take stock of what is known about these technologies today, and their capacity to have an impact on patient satisfaction, health outcomes and the cost of care.


  • Examining Capital Acquisition Models for Advanced Diagnostic Imaging (Rapid response)
    This challenge of acquiring, replacing and maintaining equipment is particularly acute in the area of diagnostic imaging, which has been subject to an increase in demand over the past decade, and has led to a focus by federal, provincial and territorial governments to reduce wait times in priority areas such as diagnostics. There is a need to determine the most efficient and effective mechanisms for managing the procurement and acquisition of medical imaging equipment.
  • Addressing Health-system Sustainability in Ontario (Stakeholder dialogues)
    Like many jurisdictions across Canada and internationally, healthcare spending in Ontario has increased significantly in the past decade and a half. In addition to this observed growth in expenditure, projections of future healthcare spending in the province have contributed to establishing a dominant and widely accepted narrative that the province is in a fiscal crisis, and that current trends are not sustainable. While budgetary challenges may have served as a central narrative and launching point for discussions about health-system sustainability in the province, they are only the symptom of a much more complex set of underlying challenges that need to be addressed. 
  • Using Non-Medical Home Services to Support Older Adults (Rapid response)

    What are the effects of providing a ‘basket’ of non-medical home-care services for older adults and frail older adults on their quality of life, ability to remain at home longer, reducing or delaying the use of acute services (e.g., use of emergency departments and hospitalization) and long-term residential care, and on health system costs?


  • Addressing Health-System Sustainability in Ontario (Citizen panels)
    In response to increasing health-system costs, the provincial government has made efforts to restrain public spending on healthcare. In response to increasing health-system costs, the provincial government has made efforts to restrain public spending on healthcare. To begin this discussion, citizen perspectives about how to address challenges related to health-system sustainability in Ontario are needed to inform the efforts of those who are able to champion changes in the system.
  • Enhancing Access to Patient-centred Primary Care in Ontario (Citizen panels)

    In December 2015, the Government of Ontario published a proposal for how to achieve its committment to transforming the health system into one that puts the needs of patients at its centre. Building on this, the province recently introduced Bill 41, which is called the Patients First Act. However, to support its implementation there is a need to identify patient expectations for patient-centred primary care in Ontario. This is important for ensuring that the changes made contribute to enhancing patient experience, improving the health of Ontarians and reducing costs.


  • Strengthening Care for Frail Older Adults in Canada (Stakeholder dialogues)
    As in many other jurisdictions around the world, Canada’s population is living longer than ever before. In 2015, for the first time there were more persons aged 65 years and older in Canada than children aged 0-14. As the population over 80 continues to steadily rise, the number of adults experiencing symptoms of frailty is also expected to grow from 1.1 million to more than 2 million in 2035. Given this, taking on the challenge of strengthening care for frail older adults in Canada provides an opportunity to address the needs of a priority population for many provincial governments (i.e., older adults), and to consider how to strengthen care more generally across all sectors in the health system, including home and community care, primary care, specialty care, rehabilitation, long-term care and public health.

  • Planning for the Future Health Workforce of Ontario (Stakeholder dialogues)
    The emphasis on system transformation in Ontario with the introduction of Patients First presents a window of opportunity for improving health workforce planning in the province. However, many challenges confront those engaged in health workforce planning, with the key dimensions of the problem being:
    • the healthcare and health promotion/disease prevention needs of Ontarians are constantly evolving, which makes future health workforce requirements uncertain;
    • current approaches to workforce planning do not reflect the realities of Ontario’s changing health system;
    • the way the health system is organized makes it difficult to plan for future health workforce needs; and
    • political factors also make it difficult to plan for the health workforce in the long term. 

  • Addressing Long-term Stays in Hospital for People with Mental Health and Addictions Concerns (Rapid response)

    As of last year, nearly two million Ontarians saw their family physicians for mental health and addictions concerns. These two conditions account for approximately 10% of the disease burden in Ontario.

    Psychiatric alternate level of care (ALC) days and long-stay days represent a significant portion of all inpatient resources. Approximately 40% of patients with complex mental health and addictions concerns currently in tertiary care could be treated in the community. Ontario continues to face challenges in planning for and providing community-based mental health and addictions services and other support services that meet the needs of patients with mental health and addictions concerns. 


  • Planning for the Future Health Workforce of Ontario (Citizen panels)

    The introduction of the Patients First initiative in Ontario aims to improve access to healthcare services, make services more connected and supportive, and protect the universal health system. In meeting the objectives of the Patients First initiative, the health system in Ontario needs the right mix, supply and distribution of health professionals to ensure that Ontarians get the most appropriate programs, services and drugs where and when they need them. 


  • Strengthening Care for Frail Older Adults in Canada (Citizen panels)

    Provincial and territorial health systems in Canada are increasingly focusing on how to strengthen care for those with complex health needs. This includes frail older adults, people living with multiple chronic diseases, and/or people living with disabilities. To do this, many provincial health systems have been focusing on strengthening primary care (the first point of contact for care for most), and enhancing coordination between primary, acute, home and community care and public health. The goal is to enhance patient experience, improve health outcomes and keep costs manageable.


  • Defining the Mental Health and Addictions ‘Basket of Core Services’ to be Publicly Funded in Ontario (Citizen panels)

    There is high demand in Ontario for mental health and addictions services across a continuum of severity and duration. In 2015, nearly two million Ontarians saw their family physicians for mental health or addictions concerns. It is estimated that mental health and substance use problems together account for approximately 10% of the total disease burden in Ontario.

    The purpose of the panel was to guide the work of the Ontario Mental Health and Addictions Leadership Council in defining a basket of core mental health and addictions services for Ontario. 
  • Identifying the Effects of and Approaches to Integrating Oral-Health Services in Health Systems (Rapid response)
    Oral health is important for the overall well-being of children and adults, and poor oral health has been linked to other diseases and serious health conditions such as respiratory infections, cardiovascular diseases, diabetes and poor nutritional status.
  • Defining the Mental Health and Addictions ‘Basket of Core Services’ to be Publicly Funded in Ontario (Stakeholder dialogues)
    In 2015, nearly two million Ontarians saw their family physicians for mental health or substance use concerns. Together these two broad categories of conditions account for approximately 10% of the disease burden in Ontario. Across the province, family members, caregivers and health and social service providers work hard to support those with mental health and substance use problems, and individuals experiencing such problems work hard to recover and regain full mental wellness. However, with many different providers, entry points and financial arrangements, Ontario continues to face challenges in planning for and providing mental health and addictions services that meet the needs of the population. 
  • Examining the Impact of and Approaches to Addressing the Needs of People Living with Mental Health Issues (Rapid response)

    The overall economic impact of mental health is large and diverse, costing the Canadian economy in excess of $50 billion per year. Developing mental health strategies and other policies with an understanding of what the research evidence on the issue says will help strengthen the policy actions being taken in the area, and could lead to improved population mental health and better outcomes for people living with mental health issues.


  • Strengthening Care for People with Chronic Diseases in Ontario (Stakeholder dialogues)
    Substantial investments have resulted in progress towards strengthening care for chronic diseases in Ontario (e.g., through the implementation of Health Links), but many challenges still remain. Given the focus on putting patients first by making care in the province more patient-centred and strengthening care for people with chronic disease, there is a clear ‘window of opportunity’ for evidence-informed action.
  • Strengthening Care for People with Chronic Diseases in Ontario (Citizen panels)
    There is much attention being paid to how to strengthen patient-centred care in Ontario. Strengthening care for people with chronic diseases is critical for making progress towards the priority of patient-centred care because of: the growing burden of chronic disease in Ontario; the complexity of providing care for people with chronic conditions (particularly those living with multiple chronic conditions); and patients not always being put at the centre of care. As a starting point, developing and executing a plan requires identifying the types of action needed, making the best use of resources available to take these actions, and having data to support their implementation, monitoring and evaluation.
  • Examining the Impacts of Accountable Care Organizations on Patient Experience, Population Health and Costs (Rapid response)
    Accountable care organizations (ACOs) have been developed in the U.S. as a way to provide coordinated high quality care and keep costs manageable by replacing traditional fee-for-service payment models with pay-for-performance models that reward physicians, other healthcare providers, and hospitals for improved patient health outcomes. The Ontario Ministry of Health and Long-Term Care (MOHLTC) has included many of the features of ACOs in its design of Health Links, which seeks to meet the needs of the top 5% of health systems’ users. With the aim of informing the evaluation of the Health Links model, we reviewed studies comparing ACOs to traditional fee-for-service payment models.
  • Key Features and Effects of Educational Approaches to Improve Clinical Performance (Rapid response)
    There are currently numerous national and international evidence-based guidelines for cancer screening, primary treatment, follow-up and palliative care. The vast number of continuously revised guidelines, recommendations and decision-aids makes it difficult for physicians and other care providers to ensure they are always using current best practices. In response, there have been growing calls for the development of new quality-measurement approaches that include education, training and feedback opportunities to support care providers to deliver the highest quality cancer care. This rapid synthesis identifies the key features and effects of educational initiatives to enhance clinical performance, with a focus on colonoscopy, mammography and pathology.  
  • Building a Primary-Care ‘Home’ for Every Ontarian (Stakeholder dialogues)
    Substantial investments have been made to strengthen primary care in Ontario, but many challenges still remain for the effort to build a primary care ‘home’ for every Ontarian (i.e., an approach to primary care that offers accessible, comprehensive, coordinated and continuing care). 
  • Integrating Data Across Sectors for Public Service Improvement in Ontario (Citizen panels)

    Demand is growing for the development of policies that address citizens’ holistic and multifaceted needs, which require the input of multiple ministries and the broader public sector. To this end, integrating person-level data may: 1) provide a clearer picture of public service needs; 2) ensure public services are citizen-centred; 3) improve efficiency; 4) facilitate better coordination of public services; and 5) lead to informed decisions that can improve social outcomes. Exploring whether and how data integration could improve public services in Ontario and realize these benefits is viewed as an important step towards determining the most appropriate ways forward in the province.


  • Building a Primary-Care ‘Home’ for Every Ontarian (Citizen panels)
    The Government of Ontario has expressed its commitment to transforming the health system into one that puts the needs of patients at its centre.  A key part of the plan to achieve the government's latest action plan is to strengthen primary care. This includes ensuring patients have a family physician or nurse practitioner as their most responsible clinical provider of care, as well as access to teams of providers when needed.  The purpose of the panel was to guide the efforts of the Ontario College of Family Physicians to promote the implementation of the patient’s medical home model in Ontario.
  • Improving Pain and Symptom Management in Cancer Care in Ontario (Stakeholder dialogues)
    As the number of individuals diagnosed with cancer continues to rise in Ontario, advances in screening, detection and treatment have also increased the number of people living longer after a diagnosis. Many individuals living with cancer experience significant amounts of pain and other distressful symptoms that may negatively affect their lives, and the need for comprehensive, patient-centred and evidence-based pain and symptom management is emerging as a priority issue.
  • Addressing Overuse of Health Services in Canada (Stakeholder dialogues)
    Countries like Canada are facing the challenge of how to maximize value for money spent by maintaining or improving the quality and efficiency of healthcare in the face of shrinking or slow-growing budgets. Addressing the issue of overuse of health services that provide no added benefit, may cause harm, or are low-value, can result in improvements in patient safety and in appropriateness and quality of care, and in reduced waste in the system.
  • Improving Leadership Capacity in Community Care in Ontario (Stakeholder dialogues)
    Dialogue participants built on the insights developed in a previous dialogue focused on strengthening leadership capacity in primary and community care in Ontario. This dialogue focused more intently on which problems were most pressing in the context of community care.
  • Exploring Models for Pharmacist Prescribing in Ontario (Citizen panels)
    In recent years, we have seen efforts to allow pharmacists and other healthcare professionals to prescribe drugs. Bill 179 expanded the scope of practice of pharmacists and granted authority to prescribe certain drugs under specific conditions. With a recently elected majority government that has already signaled its intent to introduce nurse prescribing, it appears timely to explore whether the implementation of a new pharmacist-prescribing model could further help the province achieve its key health-system goals.
  • Improving Pain and Symptom Management in Cancer Care in Ontario (Citizen panels)
    As advances in cancer care continue to improve the chances of surviving with cancer, more people in Ontario and Canada will live with the disease and require pain and symptom management support. In Ontario, improving pain and symptom management is a challenge, given the widespread implementation of pain and symptom management guidelines has encountered difficulties such as the low use of guidelines among healthcare professionals, and health system arrangements that are not optimally suited to promote the use of guidelines in practice.
  • Identifying When, Why and How to Analyze and Learn from Deaths in Healthcare Settings (Rapid response)
    Each year more than 1,000 children and youth (0-19 years of age) die in Ontario, and some of these deaths offer opportunities to learn from the circumstances of the death. Understanding approaches and processes that could be used to enhance efforts to identify when, why and how to analyze and learn from child deaths is important for ensuring high-quality reviews of deaths.
  • Using Financial Incentives to Achieve Health-System Goals in Ontario (Stakeholder dialogues)
    Any form of financial arrangement will create a financial incentive of some form or other. Ontario uses a wide variety of financial incentives and the time is ripe to stand back and ask whether they are being used optimally to achieve health-system goals, and where – for which types of stakeholders, in what sectors and for which types of conditions – does additional effort need to be put into their design, execution and monitoring.
  • Examining the Impact of Drop-in Centres (Rapid response)
    Hard-to-reach communities face many barriers to accessing care and, as a result, can often be alienated from health and social services. One possible low-cost approach (among many) to overcoming these barriers is to provide drop-in centres, which typically provide immediate services, such as food, clothing, showers, laundry, transit fare, peer support and support groups, as well as longer-term services such as case management. However, to inform decisions in community-based organizations (where drop-in centres are often provided), there is a need to identify the best available research evidence regarding the impact of centres and/or their constituent components.
  • Engaging Communities in Setting Priorities for Home and Community Care in Northeastern Ontario (Citizen panels)
    Over the last year, significant effort has been put into understanding and improving the provision of home and community care across Ontario. The North East region faces some unique challenges, including the large geographic region, cultural and linguistic diversity, and a higher percentage of adults aged 65 or older compared to the provincial average.  For this project, three citizen  panels were convened for: 1) Aboriginal community members; 2) Francophone community members; and 3) mainstream community members.
  • Preventing Interpersonal and Self-directed Violence and Injuries in the Caribbean (Stakeholder dialogues)
    The issue of violence and injuries is clearly an established policy priority both internationally and in the Caribbean region. As efforts are underway to develop a plan of action in the region, this stakeholder dialogue aims to complement these efforts by drawing on the best available global and local evidence to help clarify some of the more pressing problems related to violence and injuries in the region (and in particular those for which the health sector is well-positioned to take a leadership role in addressing), frame options for addressing these problems, and identify implementation considerations.
  • Exploring Models for Pharmacist Prescribing in Primary and Community Care Settings in Ontario (Stakeholder dialogues)
    The province of Ontario took some initial steps in expanding the scope of practice of pharmacists in 2009. The Regulated Health Professions Statute Law Amendment Act (Bill 179), which came into effect in October 2012, expanded the scope of practice of pharmacists and granted prescriptive authority for certain drugs under select conditions. This authority includes adapting dose, regimen, route or formulation of prescriptions; renewing therapy for patients with chronic and stable conditions; initiating therapy for smoking cessation; and administering influenza vaccination for those who are five years of age or older. With a recently elected majority government that has already signaled its intent to introduce nurse prescribing, it appears timely to explore whether the implementation of a new pharmacist-prescribing model could further contribute to achieving the province’s key health-system goals.
  • Advancing the Development of National Childhood Cancer-care Strategies in Latin America (Stakeholder dialogues)
    The burden of cancer morbidity and mortality will fall most heavily on low- and middle-income countries (LMICs). The recent UN Political Declaration on non-communicable diseases (NCDs) calls on each Member State to incorporate NCDs – principally, diabetes, cardiovascular disease, lung disease and cancer – into their health plans and development agendas. Taking action on childhood cancer is also a key component to addressing several global strategic objectives, including the Millennium Development Goal (MDG) 4 (which calls for a two-thirds reduction in global child mortality by 2015), the UN Secretary-General’s Global Strategy for Women’s and Children’s Health, and the WHO-led Partnership for Maternal, Newborn and Child Health.
  • Comparing Multi-component Chronic-disease Programs to Disease-specific Programs (Rapid response)
    The provincial Chronic Disease Prevention and Management Strategy from 2008-12 (and then renewed until 2016) began with a focus on diabetes. The strategy had a stated intention to expand beyond diabetes to a broader chronic-disease management approach. This 30-day rapid synthesis summarized the research to review evidence that compares the effectiveness of general chronic-disease programs to disease-specific programs.
  • Changing Sexual Offender Behaviour and Assessing Risk for Reoffending (Rapid response)
    In December 2014, the Ontario Minister of Health appointed a task force “to review the Regulated Health Professions Act, 1991, which governs all regulated health professions in the province, to ensure it is effective in preventing and dealing with sexual abuse of patients by regulated health professionals.” This 30-day rapid synthesis summarized the research to identify: how current legislation can ensure that processes dealing with issues involving sexual abuse are sensitive, accessible and timely; best practices from jurisdictions around the world that are leaders in dealing with this issue.
  • Optimizing Clinical Practice in Ontario Based on Data, Evidence and Guidelines (Stakeholder dialogues)
    Optimizing clinical practice based on data, evidence and guidelines is a challenge faced in every health system around the world. The way the challenge manifests itself at the level of the patient has been remarkably consistent over time: tough decisions made at the intersection of clinical expertise, patient values and preferences, and the best available data, evidence and guidelines. It’s timely to ask what can be done to optimize clinical practice in Ontario based on data, evidence and guidelines as The Excellent Care for All Act has invigorated these discussions.
  • Identifying Risk and Protective Factors for Quality Clinical Practice (Rapid response)
    While most who access health services in Canada receive safe and high-quality care, there is increased attention on those providing low-quality or unsafe care. One possible response to this increased attention begins with regulatory colleges developing a better understanding of the factors that influence the quality and safety of physician practices. The first step in this response is to collect information from the literature about risk and protective factors for quality clinical practice and to identify strategies that can be used to support quality clinical practices.
  • Improving Leadership Capacity in Primary and Community Care in Ontario (Stakeholder dialogues)
    As Ontario’s primary- and community-care sectors are increasingly called upon to work within an integrated system that aims to achieve health-system goals related to access, quality, health outcomes and value for money, developing strong leadership in both sectors has become crucial. This project includes both an evidence brief and a stakeholder dialogue in response to question from the Government of Ontario about how to improve management, governance and leadership capacity in both sectors, in order to achieve these goals.
  • Addressing Nutritional Risk Among Older Adults in Ontario (Citizen panels)
    Thirty-four percent of Canadians aged 65 or older who live in private households are considered to be at high risk of inadequate nutrition, a serious health concern, especially for vulnerable older adults living in the community and those admitted to healthcare facilities. Given the growth in an aging population, the burden of malnutrition among older adults in Ontario can be expected to increase over the coming years. However, many cases of malnutrition can be prevented. This citizen panel, informed by a citizen brief, will convene a group of citizens to share their views about how the different parts of the health system can be mobilized to tackle this problem.
  • Identifying Optimal Ways to Collect, Distill and Provide Efficient Access to Personal Health Information in Emergency Situations (Rapid response)
    The Canadian Institute for Health Information (CIHI) indicates that there are more than 16 million visits annually to emergency departments (EDs) in Canada. Approximately 52% of these visits are classified as high acuity (either an immediate threat to life, potential threat to life or limb function, or a possibility of progressing to a serious problem requiring emergency intervention). In these situations, it is important to ensure that healthcare providers as well as patients and their informal caregivers have access to the health information they need to ensure fast and appropriate care can be provided.
  • Sharing Online Health Information with Older Adults in Canada (Citizen panels)
    As the number of older adults who consult the internet for health information grows, it becomes increasingly important to ensure they have easy access to the best available information. Key challenges to achieving this include the wide variety of online resources about health and aging, and a lack of programs and services to help older adults find and use reliable online resources. This panel will convene a group of citizens to examine options for helping older adults identify and use the best available online health information.
  • Improving Care and Support for Unpaid Caregivers in Ontario (Citizen panels)
    There are more than 8 million people in Canada who are providing care to a family member or friend with a long-term health condition or aging-related needs. Despite the crucial role of these unpaid caregivers, support for them is lacking, inconsistent across provinces, or does not meet their needs. This citizen panel will bring together residents from across Ontario to discuss the challenges faced by informal caregivers, and share their views about what types of support is needed.
  • Improving the Delivery of Complex Cancer Surgeries in Canada (the Charlottetown, Prince Edward Island panel) (Citizen panels)
    Certain types of cancer, including esophagus, lung, liver, ovarian and pancreatic, can result in complex and resource-intensive surgeries that are associated with high risk of complications and wide variations in survival. This project includes a series of three citizen panels – one in Ontario, one in Alberta and one in Prince Edward Island – where groups of 10-14 citizens review the evidence and share their views on finding ways to improve patients’ and families’ experience with this type of cancer care and how it is organized.
  • Improving the Delivery of Complex Cancer Surgeries in Canada (the Edmonton, Alberta panel) (Citizen panels)
    Certain types of cancer, including esophagus, lung, liver, ovarian and pancreatic, can result in complex and resource-intensive surgeries that are associated with high risk of complications and wide variations in survival. This project includes a series of three citizen panels – one in Ontario, one in Alberta and one in Prince Edward Island – where groups of 10-14 citizens review the evidence and share their views on finding ways to improve patients’ and families’ experience with this type of cancer care and how it is organized.
  • Improving the Delivery of Complex Cancer Surgeries in Canada (the Hamilton, Ontario panel) (Citizen panels)
    Certain types of cancer, including esophagus, lung, liver, ovarian and pancreatic, can result in complex and resource-intensive surgeries that are associated with high risk of complications and wide variations in survival. This project includes a series of three citizen panels – one in Ontario, one in Alberta and one in Prince Edward Island – where groups of 10-14 citizens review the evidence and share their views on finding ways to improve patients’ and families’ experience with this type of cancer care and how it is organized.
  • Strengthening Public and Patient Engagement in Health Technology Assessment in Ontario (Stakeholder dialogues)
    Governments are increasingly relying on health technology assessments (HTAs) to make complex, and potentially contentious, coverage decisions about health technologies. In recent years, HTA agencies have given serious consideration to engaging the public and patients in their work, but they have been grappling with the best ways to do this. The evidence brief being developed as part of this project details the key challenges, examines the available research on the subject, and describes three elements of a potentially comprehensive approach to guide the actions of those involved in strengthening public and patient engagement in HTA in Ontario.
  • Engaging in Priority Setting about Primary and Integrated Healthcare Innovations in Canada (Rapid response)
    Ministries of health across Canada have made significant investments in primary healthcare reform over recent years to improve access, quality, continuity of care, cost, satisfaction and health outcomes, yet the current health system remains fragmented and uncoordinated. This 30-day rapid synthesis summarized the research on priority-setting mechanisms for research investments involving multiple partners, and on the gaps in research related to primary and integrated healthcare innovations, to help support change towards integrated healthcare delivery models that will provide better care to those with complex needs.
  • Developing a Rapid-response Program for Health System Decision-makers in Canada (Stakeholder dialogues)
    ‘Rapid-response’ programs have been identified as a key mechanism to support the use of research evidence by health system decision-makers by filling the gap that exists between ‘self-serve’ approaches (e.g., one-stop-shops for research evidence) and ‘full-serve’ approaches (e.g., preparing evidence briefs and convening stakeholder dialogues). This project included development of an issue brief that examined whether and how to develop a rapid-response program that could fill this gap for health system decision-makers in Canada. The brief informed discussions at a half-day stakeholder dialogue that included participants from a number of national and provincial governments and agencies.
  • Fostering Leadership for Health System Redesign in Canada (Stakeholder dialogues)
    Redesigning health systems in Canada has been a significant focus for some time, yet little progress has been made in bringing about change. Insufficient leadership capacity in Canada has garnered increasing attention in recent years as one potentially critical factor in this challenge. This project involved development of an issue brief that identified relevant research evidence and presented options for pan-Canadian approaches to foster leadership for health-system redesign in Canada. The brief informed discussions at a stakeholder dialogue that drew health system leaders and researchers from across the country.

Past topics

  • Meeting the Future Home and Community Care Needs of Older Adults in Ontario (Citizen panels)
    Helping older adults be healthy and live at home and in their communities for as long as possible is a top priority for the Ontario health system. This project was organized to gather input from a group of 10-14 citizens from across the province on how to transform the health system in order to meet the future care needs of an aging and increasingly diverse population.
  • Identifying Effective Suicide Prevention Interventions (Rapid response)
    Building on the work of an earlier stakeholder dialogue and evidence brief on suicide prevention, this rapid synthesis focused specifically on identifying effective strategies to prevent suicide. The synthesis described the key findings from 95 systematic reviews that covered topics related to suicide-prevention efforts.
  • Improving Care and Support for People with Multiple Chronic Health Conditions in Ontario (Citizen panels)
    People who have multiple chronic conditions have complex needs, but they often receive care that is fragmented and ineffective. This project convened a panel of Hamilton-area citizens to discuss the challenges faced by those with multiple chronic health conditions, and potential options for improving the situation. Options considered by the panel included changing the way care is organized and delivered for people with multiple chronic health conditions, supporting them to engage in shared decision-making with their healthcare providers, and supporting them to better manage their own care.
  • Improving End-of-life Communication and Decision-making in Ontario (Citizen panels)
    Also part of the overall project on end-of-life issues, this panel consisted of citizens from throughout the province of Ontario sharing their views about and experiences with improving end-of-life communication and decision-making. The panel considered efforts to raise public awareness about this topic, help society in general feel more comfortable talking openly about end-of-life, and the supports needed to engage more people in advance care planning.
  • Improving Access to Palliative Care in Ontario (Citizen panels)
    This citizen panel was part of the Forum’s overall project on end-of-life communication, decision-making and care. The panel brought together citizens from Hamilton and area, representing a broad range of ages and walks of life, to share their views and experiences about access to palliative care. The panel focused on options to improve public awareness, help patients and families navigate the system, and engage the public in developing a provincial strategy on palliative care.
  • Strengthening National Health Systems' Capacity to Respond to Future Pandemics (Stakeholder dialogues)
    The need for countries like Canada, the U.S. and Mexico to be adequately prepared to respond quickly and effectively to future pandemics is more important than ever, as factors such as urbanization, global travel, trans-border trade and changes to the environment and food systems increase. Countries can face catastrophic consequences to populations and economies if their governments are not able to stop the rapid spread of infectious diseases. This project includes the development of an issue brief that identifies and defines the breadth of challenges associated with pandemic management, and present available health systems evidence that can help strengthen national responses. A stakeholder dialogue uses this issue brief as the basis for deliberations regarding the resources and information required to fuel coordinated and collaborative efforts to respond effectively and efficiently to pandemics.
  • Designing Integrated Approaches to Support People with Multimorbidity in Ontario (Stakeholder dialogues)
    The challenges related to caring for patients who have multiple chronic health conditions (multimorbidity) are examined in this project, which started with the development of a knowledge synthesis that summarizes the best available global, national and provincial research evidence on issues related to the delivery of healthcare to this population. Multimorbidity is faced by a growing number of citizens, and has a significant impact on healthcare utilization and costs. It also affects quality of life, ability to work, employability and mortality. The knowledge synthesis informed the preparation of an issue brief that informed discussions at a stakeholder held in the fall of 2013.
  • Supporting Optimal Screening Approaches in Canada (Stakeholder dialogues)
    Screening the public for various health-related conditions is an important component of health systems across Canada. While well-established screening approaches are available for various diseases such as some types of cancers or genetic conditions, there is growing awareness of the need for a more coordinated approach to screening policy, programs and practice within and across Canadian provinces and territories. The evidence brief and stakeholder dialogue that are part of this project will marshal the best available evidence on challenges related to screening, focus attention on the governance, financial and delivery of screening services, and prompt consideration of what citizens want and what is recommended or deemed appropriate by providers and policymakers. (Dialogue held October 17, 2013)
  • Examining the Effectiveness and Cost-effectiveness of Rehabilitation-care Models for Frail Seniors (Rapid response)
    The health of seniors has been identified as a high priority for the province of Ontario. Functional difficulties among older adults can significantly compromise quality of life and are associated with depression, increased frailty, long-term care home placement, and mortality. This 10-day rapid synthesis summarizes research evidence about the effectiveness and cost-effectiveness of different models of rehabilitation for frail seniors, to support efforts by the ministry and others to improve the value and quality of rehabilitation care for frail seniors.
  • Improving End-of-life Communication, Decision-making and Care in Ontario (Stakeholder dialogues)
    Improving end-of-life communication, decision-making and care has been identified as a pressing health issue in Ontario, as the increasingly aging and culturally diverse population experiences a growing burden of chronic conditions and complex care needs. This project is designed to inform the development of a comprehensive strategy for end-of-life care that supports communication and decision-making, and improves access to quality palliative care. The evidence brief, the stakeholder dialogue held in September, and the convening of two citizen panels in November will help ensure that healthy individuals plan now so they have a say in their own end-of-life care, and they receive the care that’s right for them.
  • Creating Community-based Specialty Clinics in Ontario (Stakeholder dialogues)
    This project was initiated to assist the Ontario Ministry of Health and Long-Term Care as it considers how to support the creation and growth of not-for-profit, community-based specialty clinics that offer a variety of procedures, tests and assessments that have historically been offered in hospital settings. Surgical procedures such as cataract surgery, diagnostic tests such as colonoscopies, and a wide range of clinical assessments, are among the services that could be offered at these clinics. An evidence brief to inform deliberations at a stakeholder dialogue provides relevant research evidence and addresses issues such as how to determine which services should be offered in specialty clinics, and how to commission, fund and govern such clinics. (Dialogue held May 22, 2013)
  • Addressing Student Mental Health Needs at McMaster University (Stakeholder dialogues)
    The prevalence of mental health concerns in the student population and how to address the growing need for mental health services on the McMaster campus is the focus of this project, which included the Forum’s first student-led dialogue. The issue brief developed to inform discussions at the dialogue examined the factors contributing to the increased demand for services, how existing services are provided and utilized, and options for engaging students and administrators to ensure the need for appropriate and sustainable programs and resources is creatively addressed by all campus stakeholders. (Dialogue held April 10, 2013)
  • Identifying Optimal Treatment Approaches for People with Multimorbidity in Ontario (Rapid response)
    Multimorbidity is faced by a growing number of citizens, and has a significant impact on healthcare utilization and costs. It also affects quality of life, ability to work, employability and mortality. The challenges related to caring for patients who have multiple chronic health conditions (multimorbidity) are examined in this knowledge synthesis that summarizes the best available global, national and provincial research evidence on issues related to the delivery of healthcare to this population.
  • Building Momentum in Using Avoidable Mortality Indicators in Canada (Stakeholder dialogues)
    Over the past three decades, Canada has made substantial progress in reducing the national rate of 'avoidable' deaths – those that could potentially have been avoided through disease prevention or healthcare services. Despite the progress made in this area, there are still variations in rates across the provinces, territories and various population groups. As well, the focus on reporting, monitoring and making decisions related to avoidable mortality rates has been primarily in the academic community. An issue brief and stakeholder dialogue are being undertaken to explore what is known about the limited use of the avoidable mortality indicator in Canada, and to consider approaches to support the use of the indicator. (Dialogue held February 15, 2013)
  • Preventing Suicide in Canada (Stakeholder dialogues)
    Suicide is consistently among the top five to 10 causes of death in North America annually, yet it lacks the level of attention often given to other public health problems that result in fewer deaths. In Canada, there is no coordinated national strategy that provides a clear picture of the magnitude of the problem, identifies those most affected by suicide, and presents the complex array of risk factors in order to address gaps in programs and services. In this project, an evidence brief was prepared to identify ways to facilitate the coordination and integration of strategies aimed at preventing suicide in Canada. The brief informed discussions at a stakeholder dialogue planned for the fall. (Dialogue held November 9, 2012)
  • Promoting Healthy Weights Using Population-based Interventions in Canada (Stakeholder dialogues)
    The growing number of Canadians who are overweight or obese is both a health and economic burden for the country. Recent data show one in four adults in Canada is overweight or obese, and an array of health-related problems such as diabetes, cardiovascular disease, respiratory and mental health issues, and some types of cancer have been demonstrated to be associated with being overweight. This project involves preparing an evidence brief that examines the problem and the related evidence, and offers options to be considered by stakeholders who took part in a dialogue to consider how best to identify ways to promote healthy weights using population-based interventions. (Dialogue held September 17, 2012)
  • Coordinating the Use of Genetic Tests and Related Services in British Columbia (Stakeholder dialogues)
    Coordinating the present and future use of genetic tests and related services has been identified as an important policy issue in many provincial jurisdictions. However, there are many challenges inherent in addressing the issue, including scarce resources, relatively fixed infrastructure, a constantly evolving landscape with new and emerging genetic and genomic technologies, and increased demands for genetic testing. This project focused specifically on the province of British Columbia’s ongoing planning, funding, delivery and evaluation of genetic tests and related services. An evidence brief examining the challenges faced by the province, describing possible options for addressing them, and highlighting research related to the subject, was prepared to inform discussions at a stakeholder dialogue convened in Vancouver. (Dialogue held June 19, 2012)
  • Expanding Uptake of Hospital-based Tobacco-use Cessation Supports Across Ontario (Stakeholder dialogues)
    While tobacco use remains the number one preventable cause of death and disease in Canada, kills more than 16,000 Ontario residents each year, and is a key driver of healthcare costs, Ontario hospitals lack a common, feasible, cost-effective and sustainable approach to delivering tobacco-use cessation supports. Since tobacco-related illness can boost a user’s motivation to quit, and brings them into healthcare settings where providers have an opportunity to encourage and enable tobacco cession, hospitals are in a unique position to identify tobacco users, initiate cessation supports, and facilitate appropriate follow-up. This project included an evidence brief that examined the need for, existence of, and potential to improve, hospital-based tobacco-cessation supports, which was the focus of deliberations at a stakeholder dialogue. (Dialogue held January 18, 2012)
  • Organizing a Care System for Older Adults in Ontario (Stakeholder dialogues)
    The health of the aging population has been identified as a high priority for the province of Ontario, and is one of the province’s most pressing health and social policy issues. As the number of residents aged 65 and older continues to grow, the challenges that Ontario faces in supporting the health and social care needs of this population will intensify significantly. A critical part of the continuum of care for seniors requires planning to support aging in the community in the long-term. In this project, an evidence brief was prepared to inform a stakeholder dialogue that focused on options for organizing a care system for older adults in Ontario. (Dialogue held November 14, 2011)
  • Measuring Health System Efficiency in Canada (Stakeholder dialogues)
    Canada’s ability to measure health system efficiency in order to better understand how to maximize what the health system can effectively do with a given level of resources, is hampered by a variety of challenges. These include a lack of consensus about how to define the objectives, inputs and outputs of the health system, lack of availability of necessary data, and no agreed-upon methods to measure inputs and outputs. This project was designed to feed into a report and analysis framework on health system efficiency by the Canadian Institute for Health Information, which is an organization uniquely positioned to measure health system efficiency in Canada. (Dialogue held November 7, 2011)
  • Supporting Neighbourhood-based Approaches to Addressing Poverty Concentration and its Impacts on Health in Hamilton (Stakeholder dialogues)
    Evidence shows that living in poverty is a cause of poor health, and in the City of Hamilton, dramatic inequalities in health between neighbourhoods correspond closely with long-standing patterns of neighbourhood concentrations of poverty. However, these inequalities are avoidable and more can be done to redress inequities between neighbourhoods. This project involved developing an evidence-informed issue brief and bringing together a broad range of high-level representatives from Hamilton’s anchor institutions to develop collaborative, action-oriented approaches to address poverty concentration and its impact on health. (Dialogue held October 6, 2011)
  • Addressing the Integration of Clinical Nurse Specialists and Nurse Practitioners in Acute Healthcare Settings in Canada (Stakeholder dialogues)
    The skills that advanced practice nurses can contribute to the breadth and quality of healthcare are not being adequately utilized across Canada, due to a lack of full integration of these professionals in primary and acute healthcare settings. With the growing burden of chronic disease, the increased complexity of healthcare needs, and the need to improve the delivery of effective programs and services to patients who need them, it is crucial that health systems better incorporate the role of nurse practitioners and clinical nurse specialists. This project involved two stakeholder dialogues, informed by individual issue briefs that examined the scope of the challenge in each of the primary healthcare and acute healthcare setting, respectively, and offered options to address the various issues in order to move towards fuller integration of these professions in the delivery of healthcare. (Dialogues held July 6 and 7, 2011)
  • Addressing the Integration of Nurse Practitioners in Primary Healthcare Settings in Canada (Stakeholder dialogues)
    The skills that advanced practice nurses can contribute to the breadth and quality of healthcare are not being adequately utilized across Canada, due to a lack of full integration of these professionals in primary and acute healthcare settings. With the growing burden of chronic disease, the increased complexity of healthcare needs, and the need to improve the delivery of effective programs and services to patients who need them, it is crucial that health systems better incorporate the role of nurse practitioners and clinical nurse specialists. This project involved two stakeholder dialogues, informed by individual issue briefs that examined the scope of the challenge in each of the primary healthcare and acute healthcare setting, respectively, and offered options to address the various issues in order to move towards fuller integration of these professions in the delivery of healthcare. (Dialogues held July 6 and 7, 2011)
  • Addressing Health and Emerging Global Issues in Canada (Stakeholder dialogues)
    As globalization erodes the protective effect that national borders once offered to the health of Canadians, it's becoming increasingly important for countries to look at new ways to protect their citizens. In Canada, responses to these erosions have not always been commensurate with current and possible future challenges. This project involved preparing an issue brief and convening a dialogue at which participants deliberated on the interdependence among emerging global issues, the need to improve collaboration across traditional divides to identify and address such issues, and the value in engaging the appropriate stakeholders to develop agendas and take well-considered actions to better protect Canadians from current and emerging global issues that could threaten their health. (Dialogue held May 12, 2011)
  • Engaging Health System Decision-makers in Supporting Comprehensive Chronic Pain Management in Provincial and Territorial Healthcare Systems in Canada (Stakeholder dialogues)
    Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of healthcare services by people living with chronic pain. Overall, provincial and territorial health systems do not adequately support the management of chronic pain. An evidence brief and a stakeholder dialogue involving participants drawn from across Canada, examined the problem in order to develop creative, sustainable ways to support those with chronic pain. A second dialogue and issue brief focused on engaging health system decision-makers in supporting comprehensive pain management. (Dialogues held December 9, 2009 and April 11, 2011)
  • Enhancing Patient Transitions from Treatment in a Regional Cancer Centre to Survivorship in the Community (Stakeholder dialogues)
    As cancer cases continue to rise across Canada, and improvements in treatment and care result in longer survival times for patients, it is increasingly important to find ways to improve how patients transition from being treated in a regional cancer centre to surviving in the community. This project involved preparing an evidence brief and convening a stakeholder dialogue to identify opportunities for improvement in the current care, financial and organizational arrangements between cancer centres and community programs in the Hamilton region. It is hoped the lessons learned from this demonstration area can inform developments both at the provincial level and in other regions across the province. (Dialogue held April 5, 2011)
  • Supporting Quality Improvement in Primary Healthcare in Ontario (Stakeholder dialogues)
    An evidence brief drawing on the best available research evidence about primary healthcare strengthening, an issue brief drawing on more than 40 key informant interviews, an issue brief that focused on the sub-topic of quality improvement, and a series of three stakeholder dialogues aimed to improve access to and the quality of primary healthcare across the country. This work addressed the overarching problem of limited or inequitable access to sustainable, high-quality community-based primary healthcare in federal, provincial and territorial publicly-funded health systems. (Dialogues held May 11, 2009, January 8, 2010 and June 21, 2010)
  • Developing a Rural Health Strategy in Saskatchewan (Stakeholder dialogues)
    Although all people living in Saskatchewan should have equal access to publicly insured healthcare programs and services, those living in rural areas may not be receiving the healthcare they need. With more than one third of the province's population living in rural areas, geographic location can be an important factor affecting health, healthcare and quality of healthcare, yet Saskatchewan does not have an integrated approach to addressing the healthcare challenges in these areas. An evidence brief and stakeholder dialogue were undertaken to help the province with its strategic planning process, and specifically to create a framework to address the problems underlying the current organization of rural healthcare in Saskatchewan. (Dialogue held June 17, 2010)
  • Addressing Housing Challenges Faced by People with HIV in Ontario (Stakeholder dialogues)
    Many Ontarians with HIV struggle to find and maintain appropriate, stable housing, which affects their health and well-being as well as their access to health services. The purpose of this issue brief and stakeholder dialogue was to identify ways to address several fundamental problems, such as existing housing and housing-related services not meeting the needs of people with HIV, delivery methods for housing and HIV services that complicate access to these services, and funding arrangements and jurisdictional issues that make it more difficult to provide services that meet the housing and health needs of these individuals. (Dialogue held June 1, 2010)
  • Strengthening Primary Healthcare in Canada - 2 (Stakeholder dialogues)
    An evidence brief drawing on the best available research evidence about primary healthcare strengthening, an issue brief drawing on more than 40 key informant interviews, an issue brief that focused on the sub-topic of quality improvement, and a series of three stakeholder dialogues aimed to improve access to and the quality of primary healthcare across the country. This work addressed the overarching problem of limited or inequitable access to sustainable, high-quality community-based primary healthcare in federal, provincial and territorial publicly-funded health systems. (Dialogues held May 11, 2009, January 8, 2010 and June 21, 2010)
  • Supporting Chronic Pain Management across Provincial and Territorial Health Systems in Canada (Stakeholder dialogues)
    Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of healthcare services by people living with chronic pain. Overall, provincial and territorial health systems do not adequately support the management of chronic pain. An evidence brief and a stakeholder dialogue involving participants drawn from across Canada, examined the problem in order to develop creative, sustainable ways to support those with chronic pain. A second dialogue and issue brief focused on engaging health system decision-makers in supporting comprehensive pain management. (Dialogues held December 9, 2009 and April 11, 2011)
  • Engaging Civil Society in Supporting Research Use in Health Systems (Stakeholder dialogues)
    The lack of civil society engagement in supporting research use was the focus of an issue brief and a stakeholder dialogue that convened participants from more than a dozen countries. Civil society can be considered to be any voluntary organization apart from those under the direct control of governments or for-profit firms. Dialogue participants noted that typically civil society is not engaged in supporting research use in health systems, and there are few enablers to promote such engagement. However, they identified a number of promising ways forward. (Dialogue held November 23, 2009)
  • Optimizing Diabetes Management in Ontario (Stakeholder dialogues)
    The burden of diagnosed diabetes in Ontario continues to grow, yet components of comprehensive diabetes management programs are not available or accessible to all Ontarians. Both an evidence brief and stakeholder dialogue addressed the need for greater co-ordination and integration within and across the many services, programs and initiatives that can support optimal diabetes management in Ontario. Stakeholders suggested one possible next step being the provincial government developing a comprehensive policy framework for enhancing and coordinating the key features of a diabetes-management system. (Dialogue held November 5, 2009)
  • Strengthening Chronic Disease Management in Ontario (Stakeholder dialogues)
    Chronic diseases are a significant and growing challenge in the province of Ontario. A stakeholder dialogue, and the evidence brief prepared to inform it, aimed to address the lack of coordinated and proactive chronic disease management in the province by working through the underlying problem, options for addressing it and key implementation considerations. One key challenge identified by dialogue participants lies in supporting people to live well with their chronic conditions. (Dialogue held October 19, 2009)
  • Strengthening Primary Healthcare in Canada - 1 (Stakeholder dialogues)
    An evidence brief drawing on the best available research evidence about primary healthcare strengthening, an issue brief drawing on more than 40 key informant interviews, an issue brief that focused on the sub-topic of quality improvement, and a series of three stakeholder dialogues aimed to improve access to and the quality of primary healthcare across the country. This work addressed the overarching problem of limited or inequitable access to sustainable, high-quality community-based primary healthcare in federal, provincial and territorial publicly-funded health systems. (Dialogues held May 11, 2009, January 8, 2010 and June 21, 2010)

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