Enhancing lives together: reviewing the process of an organizational amalgamation.

The amalgamation between two hospitals creates a transition period of significant change, uncertainty and complexity. It is a challenging time within an organization that needs to be managed effectively. This article outlines the integration process and eight-step framework used during an amalgamation of an acute hospital organization and a post-acute hospital. The initial process evaluation and lessons learned are also presented.

Leveraging our collective investment in Canada's Healthcare System.

The pursuit of tangible mechanisms and measures to quantify the value-for-money proposition within Canada's healthcare system has become healthcare's own Holy Grail. A critical assessment and analysis of this age-old conundrum, as explored in the lead paper of this issue, forms the basis of this commentary which goes on to challenge readers to consider how healthcare providers can collectively act on the information and research available and begin to leverage investments already made with the goal of affecting real change across the system.

A visit down under: our journey to improve Canada's healthcare system.

Good health is a journey. It cannot be achieved overnight, in a month or even a year. Good health is perhaps best viewed as a quest - an evolution that takes ongoing commitment and often requires compromise, sacrifice and a lot of simple hard work. Indeed, the creation of a reliable and accessible healthcare system is no different. Few countries have adopted the same approach to delivering healthcare and each approach comes with its own unique rationale and lengthy list of pros and cons. In the end, the perfect system is elusive; however, for those of us who work within these systems, the quest for perfection is ongoing. There is a constant need and drive to make improvements and innovations to design a system that meets the needs of patients and providers without leaving behind a wake of frustration and financial burden.

Powering the future: how Hamilton Health Sciences put cogeneration to work for healthcare.

The absolute necessity of a stable and uninterrupted power supply within hospitals makes many of these facilities uniquely suited to cogeneration plants. Hamilton Health Sciences recently completed the largest hospital cogeneration project ever undertaken in the country. Spanning three acute care hospitals and generating a combined total of 22.75 megawatts of electricity, Hamilton Health Sciences' cogeneration plants address energy supply issues by offering a clean and reliable power source completely within the hospital's control, and provide the organization with the potential to generate its own revenue into the future by selling excess electricity back to the province. The following article highlights Hamilton Health Sciences' approach to the project, including some important lessons learned, and may serve as an example for other publicly funded institutions interested in implementing similar projects.

Integration of cancer services in Ontario: the story of getting it done.

Leaders in healthcare have known for years that integrating service delivery makes sense, yet paradoxically across Canada, despite major system restructuring, cancer care has remained the exception. In Ontario it was recognized that this was an area both ripe for and in need of change. The economic impact associated with the growing burden of cancer in Ontario has been well documented. Also well documented are the potential solutions for how cancer services could be better integrated and organized to improve efficiency and quality of care. Until recently, however, little action was taken. Traditional biases, turf protection, political minefields and perhaps even restructuring fatigue have been excuses to stand still.