ResearchRapid Reviews
Rapid reviews are environmental scans or quick literature reviews on policy issues identified as urgent or emerging by NAO members.
Levers for high-performing health systems
This rapid review assesses the relevance of these levers when compared to modern frameworks, and to propose updated and modernized levers that reflect current thinking around how health systems provide high-quality and safe care.
Supporting the development of public health system performance indicators
This rapid review aims to compare international approaches to public health system performance measurement to inform efforts in Canada.
Supporting the equitable access to health and social services for people experiencing homelessness in Ontario
This rapid review highlights promising interventions to increase access to health and social services for PEH in Ontario. We synthesize the evidence about these interventions that seek to promote access to health and social services for homeless populations in the province, with attention to enablers and barriers to collaborative cross-sectoral approaches.
Impact of recession and inflation on health outcomes and health systems
This rapid review explores the relationships between health outcomes and macroeconomic conditions.
Publicly funded pneumococcal vaccine programs and monitoring vaccine coverage for Canadian adults
This rapid review documents and compares the eligibility of publicly funded adult pneumococcal vaccines, and how pneumococcal vaccine coverage is monitored and tracked across provinces and territories.
Community partnerships and COVID-19 vaccines
This rapid review captures a range of examples of partnerships between public health organizations and community-based organizations in Canada related to COVID-19 vaccine uptake
Policy options for emergency department diversion
This rapid review presents an overview of selected ED diversion initiatives in seven jurisdictions – Australia, Belgium, Denmark, Israel, the Netherlands, England, and Ontario (Canada).
Emergency care data to support learning health systems in Canada
This rapid review aims to identify and compare approaches taken in selected Canadian provinces (British Columbia, Alberta, Ontario, Quebec, and Nova Scotia) to enable the access and analysis of data relevant to EC and explore whether and how these data are used to inform policy and clinical practice.
Health systems adaptations to support drug decriminalization
This rapid review aims to uncover the types of health system adaptations, reforms, and policies that various jurisdictions have implemented at both national and sub-national levels to prepare their health systems to support the decriminalization of hard drugs.
Primary Care Governance and Financing: Models and Approaches
This rapid review examines and compares reforms to primary care models in relation to governance and financing in 11 jurisdictions within Canada and abroad.
Eligibility and Out-of-Pocket Costs for HPV Vaccines Across Canada
This rapid review compares population eligibility criteria for publicly funded HPV immunization programs across Canada and identify OOP costs of the HPV vaccine in each PT.
Improving access to high quality team-based primary care in rural/ remote/ northern Canada
Strong primary care systems can contribute to improved health outcomes, health equity, and more efficient health systems. This rapid review draws lessons from three promising models of team-based primary care in place in Canada—nurse practitioner-led clinics, community health centres, and collaborative emergency centres—that have the potential to improve access to care in rural, remote, and…
Delivering Primary Care in Non-Traditional Healthcare Settings to Individuals Experiencing Homelessness
People experiencing homelessness (PEH) face multiple barriers to accessing primary care, over and above the pervasive problems of stigma and exclusion. This rapid review describes approaches to provide PEH with primary care services outside the mainstream health system, highlighting key features of promising and emerging initiatives from several countries.
Governance of COVID-19 Vaccine Data in Federations
Federations face unique challenges when organizing public health data across national and sub-national jurisdictions. These challenges are especially acute during a public health crisis such as the ongoing COVID-19 pandemic. This rapid review aims to draw lessons for Canada from other federations and a quasi-federation on the governance of COVID-19 vaccine data.
Public Reporting of Healthcare-Associated Infections in Three Canadian Provinces
Healthcare-associated infections (HAIs) are a major challenge for health systems globally. This rapid review assesses the state of HAI surveillance, monitoring, and reporting in three Canadian provinces: British Columbia, Manitoba, and Nova Scotia.
An International Review of Emergency Care Clinical Networks
Clinical networks have become increasingly widespread to promote innovation, knowledge creation and exchange, and collaboration. Emergency care clinical networks (ECCNs) are specifically oriented to support emergency care providers working in emergency settings. This rapid review explores the prevalence and characteristics of 32 ECCNs worldwide to identify and share promising practices that may ultimately enhance the…
Coverage of Grey Area Services in Four Provincial/Territorial Health Insurance Programs
Provincial and territorial (PT) health systems in Canada provide comparable universal health coverage (UHC) for hospital, medical, diagnostic, and inpatient prescriptions to their populations. Some medical services fall on the boundary, however, in what could be called the “grey area” of UHC services. This rapid review describes how four PT governments—BC, NWT, ON, and PEI—provide…
Never Events in Acute Care: Policy Lessons from International Comparisons
Patient safety incidents are estimated to be the third-leading cause of death in Canada among the highest in the OECD. This rapid review describes and assesses the policy interventions aimed at reducing “retained foreign object” incidents and other never events in England, Ireland, and New Zealand to identify policy lessons of interest to Canadian decision…
Peer Supports for Caregivers in Canada
Caregivers are increasingly recognized as the backbone of healthcare systems, providing much of community-based chronic disease and long-term care – a demand that will continue to rise as populations age. In response limitations in healthcare and social care institutions, online peer-based caregiver support systems have emerged enabling caregivers to share information, skill development, emotional support, and…
COVID-19 Case and Contact Management Strategies in Canada
Case and contact management is an essential component of a comprehensive public health response strategy in response to the ongoing COVID-19 pandemic. This rapid review describes the case and contact management strategies that have been deployed in jurisdictions across Canada.
Virtual Primary Care in Northern, Rural and Remote Canada
In Canada, the effective use of virtual care is perhaps nowhere more urgent than in northern, rural, and remote communities. While these jurisdictions have taken major steps to further develop and implement new virtual care services, our understanding of the key features involved in providing accessible, efficient, and satisfying virtual care is limited. This rapid…
COVID-19 Case and Contact Tracing: Policy Learning from International Comparisons
This rapid review surveys approaches taken by selected We sought to understand how six countries have been able to contain the COVID-19 pandemic and begin transitioning to more relaxed public health measures through the use of testing, case management, and contact tracing, with particular interest in the role of digital case and contact tracing tools.
Supporting Mental Health and Wellbeing Among Students in Higher Education
Young people in post-secondary institutions are actively expressing concern over their mental health and wellbeing, and increasingly seeking help. This rapid review describes current approaches and new initiatives in Canada and other OECD jurisdictions to support mental health in post-secondary settings, and identifies the role of governments in these efforts.
Public Management and Regulation of Contracted Health Services
Much debate surrounds the delivery of healthcare services in private, non-hospital settings centres around efficiency. This rapid review compares the experience of five provinces as they strive to enforce accountability between non-hospital facilities and provincial health insurance programs for the delivery of advanced diagnostic and surgical services.
Alternative Level of Care and Delayed Discharge: Lessons Learned from Abroad
The Canadian health system is struggling to find effective approaches to getting patients who no longer require acute treatment – which uses limited and expensive inpatient resources – out of the hospital. This rapid review profiles approaches by other countries to tackle unnecessary prolonged stays, highlighting those that have successfully transferred people out of hospitals…
Innovations in Service Delivery for Institutional Care in Practically Managing Responsive Behaviours
People living with dementia sometimes exhibit “responsive behaviors” – agitation, aggression (including violence), and disturbances in mood, perception, and behaviour. This rapid review surveys and assesses emerging trends in non-pharmacological approaches to reducing responsive behaviors among people living with dementia in long-term care settings.
Using Technology to Support Home and Community Care in Rural Areas
An early pioneer in telehealth, Canada has long sought to deliver health care services and information to its underserved rural populations using information and communication technologies where possible. This rapid review identifies some best practices for using such technologies to support health care in rural communities.
Patient Safety Mandatory Reporting Legislation and Outcomes
Mandatory reporting legislation is key to monitoring patient safety incidents. This rapid review highlights a gap between the gathering of patient safety data and the ability of regulators, professionals, and other stakeholders to learn from such data to prevent future harm.
Adopting EMRs and Information Technology in Primary Care
While Electronic Medical Records (EMRs) and related information technologies have become a large component of high-performing health care systems, there remains very little progress in the Canadian context. This rapid review seeks to understand the outcomes associated with EMR use, the barriers towards implementations, and strategies for encouraging adoption.
Hospitals-As-Hubs: Integrated Care for Patients
Integrated models of care intend to improve the care experiences of people and providers as well as the outcomes of care for populations across the care continuum. This rapid review aims to understand the role that hospitals can play as lead integrators of care delivery models that span multiple sectors.
Dental Care Coverage for Older Adults in Seven Jurisdictions
While Canadians enjoy financial protection against the cost of hospital and physician services, there are some notable gaps in coverage, such as for oral health care. This rapid review describes several approaches to dental care coverage, with a focus on older adults (individuals 65 years and older), in seven comparable jurisdictions: Canada (Alberta),Australia (New South…
Strengthening Home and Community Care Services for Rural Populations
This rapid review describes home and community care interventions being delivered to rural populations, report their associated outcomes, and to highlight evidence-informed “best practices” for delivering care to rural communities. We also looked to Sweden, Intermountain healthcare in the United States, and Australia to identify any unique approaches or lessons to be learned for implementing…
Health System Performance of Northern Canada
This review compares Yukon’s performance with other northern regions, including: Labrador, Saguenay (QC), Côte-Nord (QC), Nord (QC), Nunavik (QC), Baie-James (QC), Northwestern (ON), Porcupine (ON), Thunder Bay (ON), Northern (MB), Mamawetan (SK), Keewatin (SK), Athasbasca (SK), North Zone (AB), Northwest (BC), North-Interior (BC), Northeast (BC), the Northwest Territories, Nunavut, and Yukon.
Care Closer to Home: Elements of High Performing Home and Community Healthcare Services
This rapid review summarises and assesses the review literature to identify key attributes that are associated with high-performing care provided closer to home.
Accountable Care Organizations: Success Factors, Provider Perspectives and an Appraisal of the Evidence
This rapid review updates the previous rapid review (no. 9) and sets out to address three broad objectives: To identify the key factors and mechanisms involved in ACOs that have demonstrated success.To consider lessons learned from the perspectives of providers working in ACOs.To conduct an appraisal of the evaluative literature. The report concludes with discussing…
Waivers to Enable Innovation
This report examines the experiences of the U.S., U.K., and France with respect to the use of regulatory waivers or administrative agreements. This report summarizes the experience of regulatory permissiveness as a way to offer time-limited leniency from statutory or regulatory requirements to implement innovative programs and delivery models. It concludes with lessons learned for…
Province-Wide Services
This rapid review describes the current landscape of province-wide services in Canada, including the following two, often distinct, categories of services: 1) health and clinical services; and (2) shared back-office administrative services, including information technology, payroll and some human resources (HR) functions. We aim to shed light on the approaches provincial governments have taken to…
Accountable Care Organizations and the Canadian Context
This rapid review intended to address three broad objectives: To characterize public ACOs, in particular their approach to shared savings and financial risk, accountability and monitoring, as well as funding and incentive mechanismsTo synthesize the results of evaluations of ACOs conducted between 2015-2018 in the USTo explore initiatives across Canada with respect to implementing ACO-like…
Assistive Devices Regulation and Coverage in Five European Countries
Assistive technologies or devices have been defined as any piece of equipment or products that are used to maintain or improve an individual’s functional capabilities. Coverage of assistive technologies (ATs) has been shaped by two different policy regimes—disability policy and health policy. However, high-income jurisdictions have varying approaches to coverage for assistive technologies with differences…
Assistive Devices: Regulation and Coverage in New Zealand
Assistive technologies or devices have been defined as any piece of equipment or products that are used to maintain or improve an individual’s functional capabilities. Coverage of assistive technologies (ATs) has been shaped by two different policy regimes—disability policy and health policy. However, high-income jurisdictions have varying approaches to coverage for assistive technologies with differences…
Assistive Devices: Regulation and Coverage in Australia
Assistive technologies or devices have been defined as any piece of equipment or products that are used to maintain or improve an individual’s functional capabilities. Coverage of assistive technologies (ATs) has been shaped by two different policy regimes—disability policy and health policy. However, high-income jurisdictions have varying approaches to coverage for assistive technologies with differences…
Assistive Devices Coverage: Ontario Compared to Other High-Income Jurisdictions
Assistive technologies or devices have been defined as any piece of equipment or products that are used to maintain or improve an individual’s functional capabilities. Coverage of assistive technologies (ATs) has been shaped by two different policy regimes—disability policy and health policy. However, high-income jurisdictions have varying approaches to coverage for assistive technologies with differences…
Assistive Devices: Regulation and Coverage in Canada
Assistive devices aim to provide individuals with tools that can support the management of their health and social needs. These devices are often used to support hospital discharge, maintain independence in the home, and to support active participation at home, work, and in the community. Given that the proportion of older adults in Canada is…
Healthcare Quality Councils: A Pan-Canadian Scan
The public sector in Canada arrived late to the quality improvement (QI) movement compared to the United States and United Kingdom. In 2002, both the Kirby and Romanow Reports called for greater accountability for quality of care. following the Romanow Report’s recommendation for a pan-Canadian council to regularly assess health system performance, including QI, the…
Primary Care Reforms in Ontario, Manitoba, Alberta, and the Northwest Territories
A previous rapid review of all 13 provincial/territorial jurisdictions in Canada identified Ontario, Manitoba, Alberta, and the Northwest Territories as being the most innovative in pursuing primary care reform over the last decade (Peckham, Ho, & Marchildon, 2018). The purpose of the present rapid review was to explore these jurisdictions in greater depth. We rely…
Policy innovations in primary care across Canada
This review explores the state of primary care reform across Canada with an aim to elicit jurisdictions that have progressed primary care most innovatively through the last decade. To do this we use six criteria that are identified as necessary components for more effective and efficient primary care systems: Development of new models of primary…