Although national spending on healthcare has progressed on an upward trend over several decades, issues regarding performance remain. Challenges such as access to specialist care and maternal and infant mortality rates contributed to Canada’s recent ranking of ninth among 11 Organisation for Economic Co-operation and Development countries for overall health system performance. Although disruptive transformation is required to resolve our chronic performance issues, effective change cannot be realized without addressing the foundational elements of patient-centred care, interprofessional care, and system integration. Inspired by examples of innovative disruption in other jurisdictions and industries, these three concepts are outlined as the core ingredients for healthcare transformation and describe how they currently function in a paradoxical manner—as self-contradictory statements which in reality are not executed to their true meaning. This article illustrates how improvements in health system performance are hinged to the need to rectify and fuse these three mutually inclusive and inseparable concepts.
This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/acm2.13846.
Nuclear engineers commonly work in the disciplines of NE, nuclear security, and nuclear criticality safety, as defined later. NE has significant overlap with health physics and medical physics (described in Chapters 2 and 3, respectively) and is also closely allied with mechanical engineering, materials science and engineering, and accelerator physics.
The professional radiation workforce in the United StatesA radiation workforce of sufficient size and capacity is necessary to meet our nation's current and future needs for energy production, health care, and other vital areas. Over the long term, workforce shortages have the potential to compromise our nation's capabilities in these strategic sectors and, if sustained, would result in degradation of economic competitiveness and national security. In 2015, a multidisciplinary team began reviewing a selection of professional radiation workforces in the United States with the goal of developing a resource that would contain information of relevance to employers, policy makers, educational institutions, students contemplating radiation-related careers, and the public. This approach was taken because ionizing radiation is used for a wide array of applications, and these frequently involve multidisciplinary teams. Indeed, the various radiation disciplines comprise a synergistic ecosystem, with many interdependencies, and this motivated us to review disciplines individually, as well as in the context of the larger multidisciplinary ecosystem.The team members were drawn from those professions that are chiefly responsible for the radiation protection of workers, patients, and the public: health physics, medical physics, medicine (including diagnostic radiology, interventional radiology, nuclear medicine, and radiation oncology), nuclear engineering, radiation biology, and radiochemistry and nuclear chemistry. Due to practical considerations, this selection was limited; nonetheless, the authors emphasize the importance of other worker cohorts, including technologists who work in medical radiation therapy and imaging, and radiation epidemiologists and ecologists, who draw on the basic sciences of physics, chemistry, mathematics, and biology and play a significant role in radiation protection. It is hoped that these and other groups will be considered in future works.The methods used to prepare this review included surveying relevant information on each workforce, using data from the literature and other resources, such as information from professional societies. All data were evaluated by teams of subject matter experts, comprised of leaders in each of the respective professions. However, it must be emphasized that some of the professions have few to no means of surveilling theirThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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