Healthcare Restructuring with a View to Equity and Efficiency: Reflections on Unintended Consequences

Lynam, M. Judith; Henderson, Angela; Browne, Annette J.; Smye, Vicki; Semeniuk, Pat; Blue, Connie; Singh, Savitri; Anderson, Joan M.

doi:10.12927/cjnl.2003.16236

Cited by 28 publications

(33 citation statements)

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“…Our findings are revealing that some of the assumptions underlying healthcare restructuring, are just that (see, for example, Lynam et al. 2003).…”

Section: Postcolonial Feminism: Exploring Intersections In Contextmentioning

confidence: 75%

Lessons from a postcolonial‐feminist perspective: Suffering and a path to healing

Anderson

2004

Nursing Inquiry

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Recent events around the globe reflect the tensions and ethical dilemmas of the postmodern, postcolonial and neocolonial world that have far reaching implications for health, well-being, and human suffering. As we consider what is at stake, and what this means for local lives and human relationships, we need to examine whether the theories we draw on are adequate to further our understanding of health, and the social and material conditions of human suffering. In this paper I begin to explore the question, "Can postcolonial feminist theories provide an inclusive scholarship that would further our understanding of human suffering and open up a path to healing?" At issue here is whether this scholarship adds another dimension to a praxis-oriented nursing science.

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“…Our findings are revealing that some of the assumptions underlying healthcare restructuring, are just that (see, for example, Lynam et al. 2003).…”

Section: Postcolonial Feminism: Exploring Intersections In Contextmentioning

confidence: 75%

Lessons from a postcolonial‐feminist perspective: Suffering and a path to healing

Anderson

2004

Nursing Inquiry

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“…In this case it is a ‘best practice approach’ intended to address inequities in child health. It is informed by insights from the foundational work on social paediatrics as articulated by Julien [16]; by related research and practice in community paediatrics [19-21] and by Lynam and colleagues’ programs of research with marginalized groups [22-25]. …”

Section: Introductionmentioning

confidence: 99%

“…Providers use interventions that work to strengthen the relationships with providers but also to build networks with people who offer a range and diversity of community-based resources for children and their families. The approach seeks to be responsive by tailoring interventions to be timely, supportive, and effective in working with the target population [24,25]. The RICHER initiative purposefully partnered with community-based organizations to foster access and extend the types of resources and supports available including access to resources to address social determinants of health; past work suggests that building relationships through intersectoral collaborations for a common goal can buffer the negative effects of material disadvantage [27-30].…”

Section: Introductionmentioning

confidence: 99%

The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families

et al. 2012

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BackgroundThe Responsive Interdisciplinary Child-Community Health Education and Research (RICHER) initiative is an intersectoral and interdisciplinary community outreach primary health care (PHC) model. It is being undertaken in partnership with community based organizations in order to address identified gaps in the continuum of health services delivery for ‘at risk’ children and their families. As part of a larger study, this paper reports on whether the RICHER initiative is associated with increased: 1) access to health care for children and families with multiple forms of disadvantage and 2) patient-reported empowerment. This study provides the first examination of a model of delivering PHC, using a Social Paediatrics approach.MethodsThis was a mixed-methods study, using quantitative and qualitative approaches; it was undertaken in partnership with the community, both organizations and individual providers. Descriptive statistics, including logistic regression of patient survey data (n=86) and thematic analyses of patient interview data (n=7) were analyzed to examine the association between patient experiences with the RICHER initiative and parent-reported empowerment.ResultsRespondents found communication with the provider clear, that the provider explained any test results in a way they could understand, and that the provider was compassionate and respectful. Analysis of the survey and in-depth interview data provide evidence that interpersonal communication, particularly the provider’s interpersonal style (e.g., being treated as an equal), was very important. Even after controlling for parents’ education and ethnicity, the provider’s interpersonal style remained positively associated with parent-reported empowerment (p<0.01).ConclusionsThis model of PHC delivery is unique in its purposeful and required partnerships between health care providers and community members. This study provides beginning evidence that RICHER can better meet the health and health care needs of people, especially those who are vulnerable due to multiple intersecting social determinants of health. Positive interpersonal communication from providers can play a key role in facilitating situations where individuals have an opportunity to experience success in managing their and their family’s health.

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“…2009). As well, restructuring associated with fiscal restraint has created a context for inequities in care delivery because resources cannot be effectively mobilized to meet patients’ needs (Lynam et al. 2003).…”

Section: Discussionmentioning

confidence: 99%

Workforce utilization of visible and linguistic minorities in Canadian nursing

Premji

Etowa

2012

J Nurs Manag

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Aim This study seeks to develop a diversity profile of the nursing workforce in Canada and its major cities. Background There is ample evidence of ethnic and linguistic segregation in the Canadian labour market. However, it is unknown if there is equitable representation of visible and linguistic minorities in nursing professions. Methods We cross‐tabulated aggregate data from Statistics Canada’s 2006 Census. Analyses examined the distribution of visible and linguistic minorities, including visible minority sub‐groups, among health managers, head nurses, registered nurses, licensed nurses and nurse aides for Canada and major cities as well as by gender. Results In Canada and its major cities, a pyramidal structure was found whereby visible and linguistic minorities, women in particular, were under‐represented in managerial positions and over‐represented in lower ranking positions. Blacks and Filipinos were generally well represented across nursing professions; however, other visible minority sub‐groups lacked representation. Conclusions Diversity initiatives at all levels can play a role in promoting better access to and quality of care for minority populations through the increased cultural and linguistic competence of care providers and organizations. Implications for Nursing Management Efforts to increase diversity in nursing need to be accompanied by commitment and resources to effectively manage diversity within organizations.

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Healthcare Restructuring with a View to Equity and Efficiency: Reflections on Unintended Consequences

Cited by 28 publications

References 0 publications

Lessons from a postcolonial‐feminist perspective: Suffering and a path to healing

Lessons from a postcolonial‐feminist perspective: Suffering and a path to healing

The social paediatrics initiative: a RICHER model of primary health care for at risk children and their families

Workforce utilization of visible and linguistic minorities in Canadian nursing

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