RESUMEN
The coronavirus 2019 (COVID-19) pandemic allowed for exceptional decision-making power to be placed in the hands of public health departments. Data and information were widely disseminated in the media and on websites. While the improvement of pandemic management is still a learning curve, the ecosystem perspective - that is, the interconnection of academic health research systems and decision-making spaces - has received little attention. In this commentary, we look at the mechanisms in place, or not, in Canada for ensuring decision-making spheres can "speak" to academic research systems. We look at the thick walls that are still in place between health research systems and decision-making spaces. More precisely, we discuss three organizational flaws that we identified in the evidence-informed decision-making ecosystem of Québec and, more broadly, Canada. We introduce some inspiring measures that other countries have implemented to better link evidence and public health decision-making during health crises. The observed flaws and options are related to the vitality of early information sharing relays, the cross-sectional capacity to issue opinions, and the collection and integration of hard and soft data.
Asunto(s)
COVID-19 , Pandemias , Humanos , Canadá , Estudios Transversales , QuebecRESUMEN
Many healthcare systems are struggling with the issue of providing high-quality care to high-needs patients at lower costs. Our comments in this paper draw on insights that we have gained from the development and implementation of integrated models of care in Québec. This experience highlights the importance of developing a clear clinical approach to the delivery and coordination of care and to support providers in new roles. Our second insight is that system-level policy guidelines may help to focus the attention of organizations and providers on key priorities, but they need to take into account differing needs in various contexts. Third, a crucial factor for success over the longer term is the ability of local networks to reshape the allocation and use of resources to bring about change in day-to-day operations. We conclude by highlighting key characteristics of high-performing health systems and with the final observation that politicians and policymakers need to allow enough time to harness the full benefit of change initiatives.