Creating and Sustaining a Collaborative Model of Care
Bibliographic record
Abstract
For the past 3 years, Toronto East General Hospital staff and leadership have been involved in the design, implementation, and evaluation of a transformational change to the model of patient care. The purpose of the new model is to enhance quality, safety, and patient satisfaction through a redefinition of our approach to the patient experience. The evaluation framework for the coordinated care team (CCT) model of care addressed safety and quality outcomes, patient satisfaction, staff and physician satisfaction, and resource impact. Results of the evaluation suggest that the introduction of the CCT model using the patient care bundle can have a significant impact on the patient experience through enhanced access to bedside care as well as improved quality and safety outcomes. This article is a follow-up to the article on the development of the model published in Forum (Fall 2009). It extends upon the previous article through an overview of the model as it evolved, a discussion of the first-year evaluation for three pilot units, and lessons learned regarding the change process.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.051 | 0.049 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.013 | 0.018 |
| Scholarly communication | 0.021 | 0.017 |
| Open science | 0.006 | 0.024 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".