Exploring System Resilience within the North York Toronto Health Partners North York Community Access to Resources Enabling Support Program (NYCARES): A Pragmatic Case Study
Bibliographic record
Abstract
Ontario Health Teams (OHTs) were implemented in 2019 as a model of health system organization to improve integration of care across Ontario. Health system integration and health system resilience are closely intertwined. North York CARES (NYCARES) is an OHT program developed to support patients with complex care needs transitioning from hospital to home. This thesis used NYCARES to study the OHT model’s integrative characteristics in practice, and its ability to respond to large scale crises, using the COVID-19 pandemic as a natural experiment. An interpretive qualitative approach was used to explore program partners’ individual and collective program experiences. The results of this thesis highlight the complexity of Ontario’s healthcare systems and the necessity of approaching healthcare programs with a Complex Adaptive Systems (CAS) lens. Further research must be done to extend the application of CAS theory to healthcare contexts, with both system integration and system resilience in mind.
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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 | 0.007 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.020 | 0.012 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".