June 10, 2013


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Abstracts

CALL FOR PAPERS: 2013 Aging and Society: An Interdisciplinary Conference
8-9 Nov 2013 Chicago Il
DEADLINE: 11 June 2013

This knowledge community is brought together by a common concern for learning and an interest to explore issues of concern in the fields of aging and society, and in their social interconnections and implications.

CALL FOR PAPERS: 37th Annual Rural Health Conference
22-25 April 2014 Las Vegas NV
DEADLINE 3 Jan 2014

America’s largest rural health conference, created for all of those with an interest in rural health care, including rural health practitioners, hospital administrators, clinic directors and lay health workers, social workers, state and federal health employees, academics, community members, and all others interested in rural health care.

CALL FOR ABSTRACTS: Visiting Nurse Associations of America 32nd Annual Meeting
2-4 April 2014 Lake Las Vegas, Nevada
DEADLINE 16 Aug 2013

VNAA wants participants to leave the 2014 Annual Meeting invigorated, inspired and equipped with practical tools for incorporation into their agencies and communities. In addition to enjoying social and networking events, participants will learn the most up-to-date critical news and information needed to operate their agencies as efficiently and effectively as possible, gaining insight on solutions and practice patterns to ensure success in all aspects of their operations.

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Publications

KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Research Methodology
Health Care in Canada
Aging

KT

Policymakers’ and other stakeholders’ perceptions of key considerations for health system decisions and the presentation of evidence to inform those considerations: an international survey.
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Vogel JP, Oxman AD, Glenton C, Rosenbaum S, Lewin S, Gulmezoglu AM, et al.
Health research policy and systems 2013 May 24;11:19-4505-11-19

BACKGROUND: The DECIDE framework was developed to support evidence-informed health system decisions through evidence summaries tailored to health policymakers. The objective of this study was to determine policymakers’ perceptions regarding the criteria in the DECIDE framework and how best to summarise and present evidence to support health system decisions. METHODS: We conducted an online survey of a diverse group of stakeholders with health system decision experience from 15 countries and the World Health Organization. We asked about perceptions of criteria relevant to making health system decisions, use of evidence, grading systems, and evidence summaries. RESULTS: We received 112 responses (70% response rate). Most respondents had healthcare (85%) and research (79%) experience. They (99%) indicated that systematic consideration of the available evidence would help to improve health system decision-making processes and supported the use of evidence from other countries (94%) and grading systems (81%). All ten criteria in the DECIDE framework were rated as important in the decision-making process. Respondents had divergent views regarding whether the same (38%) or different (45%) grading systems should be used across different types of health decisions. All components of our evidence summary were rated as important by over 90% of respondents. CONCLUSIONS: Survey respondents were supportive of the DECIDE framework for health system decisions and the use of succinct summaries of the estimated size of effects and the quality of evidence. It is uncertain whether the findings of this survey represent the views of policymakers with little or no healthcare and research experience.

Implementing the best available evidence in early delirium identification in elderly hip surgery patients.
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Russell-Babin KA, Miley H.
International journal of evidence-based healthcare 2013 Mar;11(1):39-45

AIMS: Delirium is a frequent complication in the surgical experience of elderly hip surgery patients. Its impact can be severe and may even include death. Implementation of a delirium predictor tool might focus attention on early recognition of delirium, thereby potentially decreasing its impact. A related aim is to evaluate best practices in implementation strategies in this project. METHODS: After an exhaustive search of the literature, no consensus was found regarding delirium predictors for the elderly hip surgery patient. A local research study was implemented to determine factors that may predict delirium in this population. With evidence secured, a multidisciplinary implementation project augmented by ongoing audit was instituted. A variety of social diffusion and education tools were used. Implementation was guided by the use of the Promoting Action on Research Implementation in Health Services framework assessment tool and the Alberta Context Tool, as well as traditional performance improvement tools, such as fishbone charting. Audit identified the rate of use of the predictor tool and pre- and post-rates of delirium. This project was part of the Joanna Briggs Institute Signature Project, an implementation project consisting of six teams, each representing a different organisation. This overall project was supported by experts in the field of translation and implementation science internationally. RESULTS: Initial compliance to the use of the predictor tool was assessed at 54% within 3 months of implementation and increased to 56% in the ensuing months. Before the study use of the predictor tool, the delirium rate was 10.4% (12 of 115 patients). An interim analysis 4 months after implementation identified a 20% delirium rate (18 of 70 patients) and an updated analysis 8 months into the project showed a 16.3% delirium rate. Delirium predictor tool use was associated with a lower delirium rate (9/76, 11.84%) than no delirium predictor tool (13/60, 21.67%), but the difference was not statistically significant with a sample size of 133 (P = 0.122). CONCLUSIONS: The delirium predictor tool shows promise as a prompt for best practices in prevention of delirium. This study showed a change in delirium rates as a result of its use. Although the results were not statistically significant, they may be clinically meaningful. Comprehensive assessment and implementation planning by a multidisciplinary team contributed to only 56% compliance in use. Despite this low rate, delirium identification rates were higher. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

Implementing evidence in an onco-haematology nursing unit: a process of change using participatory action research
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Abad-Corpa E, Delgado-Hito P, Cabrero-Garcia J, Meseguer-Liza C, Zarate-Riscal CL, Carrillo-Alcaraz A, et al.
International journal of evidence-based healthcare 2013 Mar;11(1):46-55

AIM: To implement evidence in a nursing unit and to gain a better understanding of the experience of change within a participatory action research. METHODS: Study design of a participatory action research type was use from the constructivist paradigm. The analytical-methodological decisions were inspired by Checkland Flexible Systems for evidence implementation in the nursing unit. The study was carried out between March and November 2007 in the isolation unit section for onco-haematological patients in a tertiary level general university hospital in Spain. Accidental sampling was carried out with the participation of six nurses. Data were collected using five group meetings and individual reflections in participants’ dairies. The participant observation technique was also carried out by researchers. Data analysis was carried out by content analysis. The rigorous criteria were used: credibility, confirmability, dependence, transferability and reflexivity. RESULTS: A lack of use of evidence in clinical practice is the main problem. The factors involved were identified (training, values, beliefs, resources and professional autonomy). Their daily practice (complexity in taking decisions, variability, lack of professional autonomy and safety) was compared with an ideal situation (using evidence it will be possible to normalise practice and to work more effectively in teams by increasing safety and professional recognition). It was decided to create five working areas about several clinical topics (mucositis, pain, anxiety, satisfaction, nutritional assessment, nauseas and vomiting, pressure ulcers and catheter-related problems) and seven changes in clinical practice were agreed upon together with 11 implementation strategies. Some reflections were made about the features of the study: the changes produced; the strategies used and how to improve them; the nursing ‘subculture’; attitudes towards innovation; and the commitment as participants in the study and as healthcare professionals. CONCLUSIONS: The findings throw light on the process of change in the healthcare sector. The results are useful to modify nursing practice based on evidence. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

Factors influencing rural and urban emergency clinicians’ participation in an online knowledge exchange intervention.
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Curran JA, Murphy AL, Sinclair D, McGrath P.
Rural and remote health 2013 Jan;13(1):2175

INTRODUCTION: Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians’ participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician’s decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians’ perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? METHODS: A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. RESULTS: The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual involvement in research activities (χ(2)=5.23, p=0.019), consultation with colleagues from other EDs (χ(2)=6.37, p=0.01) and perception of organizational expectations to use research evidence to guide practice (χ(2)=5.52, p=0.015). Most clinicians (95/105 or 92%) reported relying on colleagues from their own ED as a primary knowledge source. Urban clinicians were more likely than their rural counterparts to perceive that use of research evidence to guide practice was an expectation. Rural clinicians were more likely to rely on physicians from their own ED as a preferred knowledge source. CONCLUSIONS: The decision made by emergency clinicians to participate in a Web-based knowledge exchange intervention was influenced by a number of individual and contextual factors. Differences in these factors and preferences for knowledge sources require further characterization to enhance engagement of rural ED clinicians in online knowledge exchange interventions.

The applicability and transferability of public health research from one setting to another: a survey of maternal health researchers.
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Burchett HE, Dobrow MJ, Lavis JN, Mayhew SH.
Global health promotion 2013 Mar;20(1):16-24

BACKGROUND: Little is known about the process of assessing whether research conducted in one setting is applicable (i.e. implementable) and transferable (i.e. as effective) to another, despite its importance for health policy and practice. Applicability/transferability differs from external validity; the former focuses on potential utility in another specific setting, whilst the latter is more general. This study explored perceptions of applicability/transferability among maternal health researchers. METHODS: Published maternal public health researchers in low- or middle-income countries were invited to complete an online questionnaire. They were shown four summaries of maternal public health intervention evaluations and asked which they felt were the most and least applicable/transferable to their own setting and why. RESULTS: 283 valid questionnaires were received (41% response rate). Applicability/transferability decisions frequently depended on the pertinence of the problem addressed by the intervention or the intervention’s characteristics. Less common were comparison of the respondents’ setting with the study setting, or consideration of the study’s effectiveness. CONCLUSIONS: The factors affecting perceptions of applicability/transferability are broader than those associated with external validity. Improving the reporting of intervention characteristics and implementation is particularly important for applicability/transferability assessments and could increase the appropriate use of public health research in policy and practice.

Did you have an impact? A theory-based method for planning and evaluating knowledge-transfer and exchange activities in occupational health and safety.
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Kramer DM, Wells RP, Carlan N, Aversa T, Bigelow PP, Dixon SM, et al.
International journal of occupational safety and ergonomics 2013;19(1):41-62

Few evaluation tools are available to assess knowledge-transfer and exchange interventions. The objective of this paper is to develop and demonstrate a theory-based knowledge-transfer and exchange method of evaluation (KEME) that synthesizes 3 theoretical frameworks: the promoting action on research implementation of health services (PARiHS) model, the transtheoretical model of change, and a model of knowledge use. It proposes a new term, keme, to mean a unit of evidence-based transferable knowledge. The usefulness of the evaluation method is demonstrated with 4 occupational health and safety knowledge transfer and exchange (KTE) implementation case studies that are based upon the analysis of over 50 pre-existing interviews. The usefulness of the evaluation model has enabled us to better understand stakeholder feedback, frame our interpretation, and perform a more comprehensive evaluation of the knowledge use outcomes of our KTE efforts.

What does it mean to be pragmatic? Pragmatic methods, measures, and models to facilitate research translation
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Glasgow RE.
Health education & behavior 2013 Jun;40(3):257-265

Background. One of the reasons for the slow and uncertain translation of research into practice is likely due to the emphasis in science on explanatory models and efficacy designs rather than more pragmatic approaches. Methods. Following a brief definition of what constitutes a pragmatic approach, I provide examples of pragmatic methods, measures, and models and how they have been applied. Results. Descriptions are provided of pragmatic trials and related designs, practical measures including patient-reported items for the electronic health record, and the Evidence Integration Triangle and RE-AIM practical models, each of which can help increase the relevance of research to policy makers, practitioners, and patients/consumers. Conclusions. By focusing on the perspective of stakeholders and the context for application of scientific findings, pragmatic approaches can accelerate the integration of research, policy, and practice. Progress has been made, especially in pragmatic trials but even more opportunities remain.

Evidence based practice in long term care settings.
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Specht JK.
Journal of Korean Academy of Nursing 2013 Apr;43(2):145-153

PURPOSE: The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. METHODS: Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. RESULTS: Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff’s perception of the leadership. CONCLUSION: There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

Applying the principles of knowledge translation and exchange to inform dissemination of HIV survey results to adolescent participants in South Africa.
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Nixon SA, Casale M, Flicker S, Rogan M.
Health promotion international 2013 Jun;28(2):233-243

It is widely accepted that researchers have an obligation to inform survey participants of research results. However, there is little evidence on the effectiveness of various dissemination strategies. The emerging field of knowledge transfer and exchange (KTE) may offer insight given its focus on techniques to enhance the effectiveness of communicating evidence-based information. To date, KTE has focused primarily on information exchange between researchers and policy-makers as opposed to study participants; however, there are principles that may be relevant in this new context. This gap in the literature becomes even more salient in the context of public health research where research results can reveal particular misunderstandings or shortcomings in knowledge that threaten to severely compromise participants’ health. The objective of this article is to describe how KTE principles were used to inform dissemination of results of a self-administered sexual health survey to adolescent study participants in a resource-deprived, peri-urban area of South Africa. Strategies for enhancing two-way information exchange included constructing interactive dissemination sessions led by young, isiZulufieldworkers. We also employed techniques to create a safe space for dialogue, encouraged the shared ownership of results and crafted targeted messages. Particularly noteworthy was the benefit accrued by the research team through this process of exchange, including novel explanations for study findings and new ideas for future research.

Towards a new paradigm in health research and practice?: Collaborations for Leadership in Applied Health Research and Care
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Martin GP, McNicol S, Chew S.
Journal of Health, Organisation and Management 2013;27(2):193-208

Purpose: Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are a new UK initiative to promote collaboration between universities and healthcare organisations in carrying out and applying the findings of applied health research. But they face significant, institutionalised barriers to their success. This paper seeks to analyse these challenges and discuss prospects for overcoming them. Design/methodology/approach: The paper draws on in-depth qualitative interview data from the first round of an ongoing evaluation of one CLAHRC to understand the views of different stakeholders on its progress so far, challenges faced, and emergent solutions. Findings: The breadth of CLAHRCs’ missions seems crucial to mobilise the diverse stakeholders needed to succeed, but also produces disagreement about what the prime goal of the Collaborations should be. A process of consensus building is necessary to instil a common vision among CLAHRC members, but deep-seated institutional divisions continue to orient them in divergent directions, which may need to be overcome through other means. Originality/value: This analysis suggests some of the key means by which those involved in joint enterprises such as CLAHRCs can achieve consensus and action towards a current goal, and offers recommendations for those involved in their design, commissioning and performance management. © Emerald Group Publishing Limited.

Factors influencing evidence-based practice by Iranian general practitioners
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Olfati N, Dastgiri S, Hajebrahimi S, Jahanbin H.
International journal of health care quality assurance 2013;26(4):360-374

Purpose: This study aims to fill the knowledge gap regarding general practitioners’ (GPs) research utilization (RU) behavior in Iran. It also aims to find possible barriers to research use among GPs to inform organizational change processes. Design/methodology/approach: The authors modified the research utilization questionnaire developed by Estabrooks et al., to address physicians’ views. The questionnaire was piloted and its validity and reliability was assessed before being sent to GPs. A 77 percent response rate was eventually achieved. Findings: Respondents were generally positive concerning research evidence use. Respondents’ mean attitude score was 25.3 (SD=5.6, min. 13, max. 37). However, less than 25 percent of the GPs practiced any form of RU in the last year. Absent facilities and resources, little authority to change practices, expected increases in patient visit durations and the poor access to research information were found to be the main RU barriers for GPs. Practical implications: The borderline 77 percent response rate was reached despite sending questionnaires to non-responders two times. Considering the non-probability sampling used in this study, generalizing the results should be considered cautiously. Originality/value: Research utilization programs are new in Iran and there is little evidence to inform policies. This study focused attitudes concerning RU and GPs’ knowledge concerning novel research and skills, and to some extent, GPs’ behaviors toward RU. © Emerald Group Publishing Limited.

Fading vision: knowledge translation in the implementation of a public health policy intervention.
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Tomm-Bonde L, Schreiber RS, Allan DE, Macdonald M, Pauly B, Hancock T.
Implementation science 2013 Jun 4;8(1):59

BACKGROUND: In response to several high profile public health crises, public health renewal is underway in Canada. In the province of British Columbia, the Ministry of Health initiated a collaborative evidence-informed process involving a steering committee of representatives from the six health authorities. A Core Functions (CF) Framework was developed, identifying 21 core public health programs. For each core program, an evidence review was conducted and a model core program paper developed. These documents were distributed to health authorities to guide development of their own renewed public health services. The CF implementation was conceptualized as an embedded knowledge translation process. A CF coordinator in each health authority was to facilitate a gap analysis and development of a performance improvement plan for each core program, and post these publically on the health authority website. METHODS: Interviews (n = 19) and focus groups (n = 8) were conducted with a total of 56 managers and front line staff from five health authorities working in the Healthy Living and Sexually Transmitted Infection Prevention core programs. All interviews and focus groups were digitally recorded, transcribed and verified by the project coordinator. Five members of the research team used NVivo 9 to manage data and conducted a thematic analysis. RESULTS: Four main themes emerged concerning implementation of the CF Framework generally, and the two programs specifically. The themes were: ‘you’ve told me what, now tell me how’; ‘the double bind’; ‘but we already do that’; and the ‘selling game.’ Findings demonstrate the original vision of the CF process was lost in the implementation process and many participants were unaware of the CF framework or process. CONCLUSIONS: Results are discussed with respect to a well-known framework on the adoption, assimilation, and implementation of innovations in health services organizations. Despite attempts of the Ministry of Health and the Steering Committee to develop and implement a collaborative, evidence-informed policy intervention, there were several barriers to the realization of the vision for core public health functions implementation, at least in the early stages. In neglecting the implementation process, it seems unlikely that the expected benefits of the public health renewal process will be realized.

How to Summarize a 6,000-Word Paper in a Six-Minute Video Clip
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Pascale Lehoux, Patrick Vachon, Genevieve Daudelin and,Myriam Hivon.
Healthcare Policy 2013 05/31;8(4):19-26

As part of our research team’s knowledge transfer and exchange (KTE) efforts, we created a six-minute video clip that summarizes, in plain language, a scientific paper that describes why and how three teams of academic entrepreneurs developed new health technologies. Recognizing that video-based KTE strategies can be a valuable tool for health services and policy researchers, this paper explains the constraints and sources of inspiration that shaped our video production process. Aiming to provide practical guidance, we describe the steps and tools that we used to identify, refine and package the key content of the scientific paper into an original video format.

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Health Care Administration and Organization

Leadership training to improve nurse retention.
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Wallis A, Kennedy KI.
Journal of nursing management 2013 May;21(4):624-632

Aim  This paper discusses findings from an evaluation of a training programme designed to promote collaborative, team-based approaches to improve nurse retention within health care organizations. Background  A year-long leadership training programme was designed and implemented to develop effective teams that could address retention challenges in a diverse set of organizations in Colorado ranging from public, private to non-profit. Evaluation  An evaluation, based on a combination of participant observation, group interviews, and the use of standardized tests measuring individual emotional intelligence and team dynamics was conducted to assess the effectiveness of the training programme. Key issues  What role do the emotional intelligence of individual members and organizational culture play in team effectiveness? Conclusions  Out of five teams participating in the training programme, two performed exceptionally well, one experienced moderate success and two encountered significant problems. Team dynamics were significantly affected by the emotional intelligence of key members holding supervisory positions and by the existing culture and structure of the participating organizations. Implications for nursing management  Team approaches to retention hold promise but require careful development and are most likely to work where organizations have a collaborative problem-solving environment.
© 2012 Blackwell Publishing Ltd.

Changing our lens: seeing the chaos of professional practice as complexity.
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Kramer M, Brewer BB, Halfer D, Maguire P, Beausoleil S, Claman K, et al.
Journal of nursing management 2013 May;21(4):690-704

AIM: The purpose of this evidence-based management practice project was to analyse dimensions of the Getting my Work Done issue, the only one of seven issues of highest concern for which 907 nurse interviewees were unable to identify effective strategies, formulate a ‘best management practice’, integrate the practice into clinical settings and evaluate results. METHOD/PROCESS: The evidence-based management practice process was used to identify the major impediment to Getting Work Done-assignment to multiple patients with simultaneous complex needs. Best management practice consisted of class presentation of a clinical-management problem scenario to 144 residents in nine Magnet hospitals, a private action commitment, class discussion and terminal action commitments. RESULTS: Responses indicated that this ‘best management practice’ was effective in helping newly licensed registered nurses manage and handle multiple patients with simultaneous complex needs. A major avenue of resolution was perception of professional practice responsibilities as a series of complex, interrelated, adaptive systems. CONCLUSIONS/IMPLICATIONS FOR NURSING MANAGEMENT: Perception and use of the principles of complexity science assists newly licensed registered nurses in mastering management dilemmas that inhibit professional practice. In many participating hospitals, plans are underway to expand this best practice to include input and perception exchange among experienced nurses, managers and physicians. © 2013 Blackwell Publishing Ltd.

Relational leadership, decision-making and the messiness of context in healthcare
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Fulop L, Mark A.
Leadership 2013;9(2):254-277

Decision-making is a neglected area in the leadership literature and in healthcare in particular. This paper draws on the Cynefin framework, which is a practice-based approach to decision-making, to theorize about leadership in healthcare. The framework uses a multi-ontology cognitive-based sense-making perspective to identify five domains of decision-making that are linked to individual leadership styles and given contexts. It is markedly different from other complexity approaches by the inclusion of the central domain of Disorder. While this inclusion is vitally important, the leadership implications of the approach are under-theorized. Focusing on the idea of Disorder, we argue alternatively that a relational leadership approach is needed to understand decision-making as a multi-ontology sensemaking approach and this also necessitates accounting for professional sensemaking in healthcare settings. The relational approach adopted here is based on Dian Hosking’s work and views decision-making as a task that is undertaken through organizing processes that are cognitive but also social/cultural, political and emotional, and in which the social construction of leadership and context are inseparable individual and collective undertakings. When skilful relating is a part of leadership practice then multi-ontology sensemaking is a possibility in decision-making tasks. We support our arguments with illustrative examples to put forward a relational approach to leadership in healthcare. © The Author(s).

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Health Care Innovation and Quality Assurance

Safety climate and its association with office type and team involvement in primary care.
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Gehring K, Schwappach DL, Battaglia M, Buff R, Huber F, Sauter P, et al.
International journal for quality in health care 2013 May 10

OBJECTIVE: To assess differences in safety climate perceptions between occupational groups and types of office organization in primary care. METHODS: Primary care physicians and nurses working in outpatient offices were surveyed about safety climate. Explorative factor analysis was performed to determine the factorial structure. Differences in mean climate scores between staff groups and types of office were tested. Logistic regression analysis was conducted to determine predictors for a ‘favorable’ safety climate. RESULTS: 630 individuals returned the survey (response rate, 50%). Differences between occupational groups were observed in the means of the ‘team-based error prevention’-scale (physician 4.0 vs. nurse 3.8, P < 0.001). Medical centers scored higher compared with single-handed offices and joint practices on the ‘team-based error prevention’-scale (4.3 vs. 3.8 vs. 3.9, P < 0.001) but less favorable on the ‘rules and risks’-scale (3.5 vs. 3.9 vs. 3.7, P < 0.001). Characteristics on the individual and office level predicted favorable ‘team-based error prevention’-scores. Physicians (OR = 0.4, P = 0.01) and less experienced staff (OR 0.52, P = 0.04) were less likely to provide favorable scores. Individuals working at medical centers were more likely to provide positive scores compared with single-handed offices (OR 3.33, P = 0.001). The largest positive effect was associated with at least monthly team meetings (OR 6.2, P < 0.001) and participation in quality circles (OR 4.49, P < 0.001). CONCLUSIONS: Results indicate that frequent quality circle participation and team meetings involving all team members are effective ways to strengthen safety climate in terms of team-based strategies and activities in error prevention.

Do team processes really have an effect on clinical performance? A systematic literature review.
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Schmutz J, Manser T.
British journal of anaesthesia 2013 Apr;110(4):529-544

There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine the impact of team process behaviours on clinical performance. We conducted a literature search in five major databases. Inclusion criteria were: English peer-reviewed papers published between January 2001 and May 2012, which showed or tried to show (i) a statistical relationship of a team process variable and clinical performance or (ii) an improvement of a performance variable through a team process intervention. Study quality was assessed using predefined quality indicators. For every study, we calculated the relevant effect sizes. We included 28 studies in the review, seven of which were intervention studies. Every study reported at least one significant relationship between team processes or an intervention and performance. Also, some non-significant effects were reported. Most of the reported effect sizes were large or medium. The study quality ranged from medium to high. The studies are highly diverse regarding the specific team process behaviours investigated and also regarding the methods used. However, they suggest that team process behaviours do influence clinical performance and that training results in increased performance. Future research should rely on existing theoretical frameworks, valid, and reliable methods to assess processes such as teamwork or coordination and focus on the development of adequate tools to assess process performance, linking them with outcomes in the clinical setting.

Quality of Hospice Care for Individuals with Dementia.
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Albrecht JS, Gruber-Baldini AL, Fromme EK, McGregor JC, Lee DS, Furuno JP.
Journal of the American Geriatrics Society 2013 May 27

BACKGROUND: Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. DESIGN: Cross-sectional analysis of data. SETTING: 2007 National Home and Hospice Care Survey. PARTICIPANTS: Four thousand seven hundred eleven discharges from hospice care. MEASUREMENTS: A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. RESULTS: Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). CONCLUSIONS: The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Exploring the feasibility of Conjoint Analysis as a tool for prioritizing innovations for implementation.
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Farley K, Thompson C, Hanbury A, Chambers D.
Implementation science 2013 May 29;8:56-5908-8-56

BACKGROUND: In an era of scarce and competing priorities for implementation, choosing what to implement is a key decision point for many behavioural change projects. The values and attitudes of the professionals and managers involved inevitably impact the priority attached to decision options. Reliably capturing such values is challenging. METHODS: This paper presents an approach for capturing and incorporating professional values into the prioritization of healthcare innovations being considered for adoption. Conjoint Analysis (CA) was used in a single UK Primary Care Trust to measure the priorities of healthcare professionals working with women with postnatal depression. Rating-based CA data was gathered using a questionnaire and then mapped onto 12 interventions being considered as a means of improving the management of postnatal depression. RESULTS: The ‘impact on patient care’ and the ‘quality of supporting evidence’ associated with the potential innovations were the most influential in shaping priorities. Professionals were least influenced by whether an innovation was an existing national or local priority, or whether current practice in the Trust was meeting minimum standards. Ranking the 12 innovations by the preferences of potential adopters revealed ‘guided self help’ was the top priority for implementation and ‘screening questions for post natal depression’ the least. When other factors were considered (such as the presence of routine data or planned implementation activity elsewhere in the Trust), the project team chose to combine the eight related treatments and implement these as a single innovation referred to as ‘psychological therapies’. CONCLUSIONS: Using Conjoint Analysis to prioritise potential innovation implementation options is a feasible means of capturing the utility of stakeholders and thus increasing the chances of an innovation being adopted. There are some practical barriers to overcome such as increasing response rates to conjoint surveys before routine and unevaluated use of this technique should be considered.

RWJF: Achieving the Potential of Health Care Performance Measures Timely Analysis of Immediate Health Policy issues
May 2013

This report provides an overview of performance measurement in U.S. health care, and includes policy recommendations aimed at improving the performance measurement enterprise. Specifically, they recommend how to develop better measures; when and how to use measures; and how to ensure the validity and comparability of publicly-reported performance measure data.

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Research Methodology

Are systematic reviews up-to-date at the time of publication?
Non UofA Access
Beller EM, Chen JK, Wang UL, Glasziou PP.
Systematic reviews 2013 May 28;2(1):36

BACKGROUND: Systematic reviews provide a synthesis of evidence for practitioners, for clinical practice guideline developers, and for those designing and justifying primary research. Having an up-to-date and comprehensive review is therefore important. Our main objective was to determine the recency of systematic reviews at the time of their publication, as measured by the time from last search date to publication. We also wanted to study the time from search date to acceptance, and from acceptance to publication, and measure the proportion of systematic reviews with recorded information on search dates and information sources in the abstract and full text of the review. METHODS: A descriptive analysis of published systematic reviews indexed in Medline in 2009, 2010 and 2011 by three reviewers, independently extracting data. RESULTS: Of the 300 systematic reviews included, 271 (90%) provided the date of search in the full-text article, but only 141 (47%) stated this in the abstract. The median (standard error; minimum to maximum) survival time from last search to acceptance was 5.1 (0.58; 0 to 43.8) months (95% confidence interval = 3.9 to 6.2) and from last search to first publication time was 8.0 (0.35; 0 to 46.7) months (95% confidence interval = 7.3 to 8.7), respectively. Of the 300 reviews, 295 (98%) stated which databases had been searched, but only 181 (60%) stated the databases in the abstract. Most researchers searched three (35%) or four (21%) databases. The top-three most used databases were MEDLINE (79%), Cochrane library (76%), and EMBASE (64%). CONCLUSIONS: Being able to identify comprehensive, up-to-date reviews is important to clinicians, guideline groups, and those designing clinical trials. This study demonstrates that some reviews have a considerable delay between search and publication, but only 47% of systematic review abstracts stated the last search date and 60% stated the databases that had been searched. Improvements in the quality of abstracts of systematic reviews and ways to shorten the review and revision processes to make review publication more rapid are needed.

“Let’s get the best quality research we can”: public awareness and acceptance of consent to use existing data in health research: a systematic review and qualitative study.
Non UofA Access
Hill EM, Turner EL, Martin RM, Donovan JL.
BMC medical research methodology 2013 Jun 4;13(1):72

BACKGROUND: Opt-in consent is usually required for research, but is known to introduce selection bias. This is a particular problem for large scale epidemiological studies using only pre-collected health data. Most previous studies have shown that members of the public value opt-in consent and can perceive research without consent as an invasion of privacy. Past research has suggested that people are generally unaware of research processes and existing safeguards, and that education may increase the acceptability of research without prior informed consent, but this recommendation has not been formally evaluated. Our objectives were to determine the range of public opinion about the use of existing medical data for research and to explore views about consent to a secondary review of medical records for research. We also investigated the effect of the provision of detailed information about the potential effect of selection bias on public acceptability of the use of data for research. METHODS: We carried out a systematic review of existing literature on public attitudes to secondary use of existing health records identified by searching PubMed (1966-present), Embase (1974-present) and reference lists of identified studies to provide a general overview, followed by a qualitative focus group study with 19 older men recruited from rural and suburban primary care practices in the UK to explore key issues in detail. RESULTS: The systematic review identified twenty-seven relevant papers and the findings suggested that males and older people were more likely to consent to a review of their medical data. Many studies noted participants’ lack of knowledge about research processes and existing safeguards and this was reflected in the focus groups. Focus group participants became more accepting of the use of pre-collected medical data without consent after being given information about selection bias and research processes. All participants were keen to contribute to NHS-related research but some were concerned about data-sharing for commercial gain and the potential misuse of information. CONCLUSIONS: Increasing public education about research and specific targeted information provision could promote trust in research processes and safeguards, which in turn could increase the acceptability of research without specific consent where the need for consent would lead to biased findings and impede research necessary to improve public health.

CHSPR: Measuring Patient Experiences in Primary Health Care A review and classification of items and scales used in publicly-available questionnaires
May 2013

The purpose of this review was to identify items and scales to inform the composition of a core Patient Experience Survey for use across Canada. This scoping review provides an up-to-date review of the publicly available instruments that purport to measure patients’ experiences in Primary Health Care.

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Bibliometrics

How does investment in research training affect the development of research networks and collaborations?
Non UofA Access
Paina L, Ssengooba F, Waswa D, M’imunya JM, Bennett S.
Health research policy and systems / BioMed Central 2013 May 20;11:18-4505-11-18

BACKGROUND: Whether and how research training programs contribute to research network development is underexplored. The Fogarty International Center (FIC) has supported overseas research training programs for over two decades. FIC programs could provide an entry point in the development of research networks and collaborations. We examine whether FIC’s investment in research training contributed to the development of networks and collaborations in two countries with longstanding FIC investments – Uganda and Kenya – and the factors which facilitated this process. METHODS: As part of two case studies at Uganda’s Makerere University and Kenya’s University of Nairobi, we conducted 53 semi-structured in-depth interviews and nine focus group discussions. To expand on our case study findings, we conducted a focused bibliometric analysis on two purposively selected topic areas to examine scientific productivity and used online network illustration tools to examine the resulting network structures. RESULTS: FIC support made important contributions to network development. Respondents from both Uganda and Kenya confirmed that FIC programs consistently provided trainees with networking skills and exposure to research collaborations, primarily within the institutions implementing FIC programs. In both countries, networks struggled with inclusiveness, particularly in HIV/AIDS research. Ugandan respondents perceived their networks to be more cohesive than Kenyan respondents did. Network cohesiveness was positively correlated with the magnitude and longevity of FIC’s programs. Support from FIC grants to local and regional research network development and networking opportunities, such as conferences, was rare. Synergies between FIC programs and research grants helped to solidify and maintain research collaborations. CONCLUSIONS: Networks developed where FIC’s programs focused on a particular institution, there was a critical mass of trainees with similar interests, and investments for network development were available from early implementation. Networks were less likely to emerge where FIC efforts were thinly scattered across multiple institutions. The availability of complementary research grants created opportunities for researchers to collaborate in grant writing, research implementation, and publications. FIC experiences in Uganda and Kenya showcase the important role of research training programs in creating and sustaining research networks. FIC programs should consider including support to research networks more systematically in their capacity development agenda.

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Health Care in Canada

Wait Time from Primary to Specialty Care: A Trend Analysis from Edmonton, Canada
Non UofA Access
Thanh NX.
Healthcare Policy 2013 05/31;8(4):35-44

Medical wait time is a top health policy issue in Canada. Reliable data on the referral wait time from primary to specialty care are limited. Existing data on referral wait times are generally self-reported by specialists. In 2008, the Edmonton North Primary Care Network (PCN) developed a Centralized Referral Program, including a specialist database that contains information on specialists’ referral requirements, forms and protocols, and has the capability of tracking referrals that the PCN makes on behalf of its family physicians to specialty care. We performed a trend analysis of the referral wait time (defined as the time from referral by a family physician to an appointment date with a specialist) from 2009 to 2011 using the program database (n=33,281 referrals). The study provided a unique and comprehensive picture of wait times for 22 specialties. We identified a decrease in the overall wait time year over year, and improvement in the number of referrals that are accepted the first time. Additionally, specific opportunities for further improvement in referral wait time were noted.

Health Council of Canada: Progress Report 2013: Health care renewal in Canada
May 2013

In Progress Report 2013: Health care renewal in Canada, the Health Council reports on the progress made by jurisdictions in five priority areas of the health accords:
access and wait times;
primary health care reform and electronic health records;
pharmaceuticals management;
disease prevention, health promotion and public health; and
Aboriginal health.

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Aging

Examining markers of safety in homecare using the international classification for patient safety.
Non UofA Access
Macdonald MT, Lang A, Storch J, Stevenson L, Barber T, Iaboni K, et al.
BMC health services research 2013 May 24;13:191-6963-13-191

BACKGROUND: Homecare is a growth enterprise. The nature of the care provided in the home is growing in complexity. This growth has necessitated both examination and generation of evidence around patient safety in homecare. The purpose of this paper is to examine the findings of a recent scoping review of the homecare literature 2004-2011 using the World Health Organization International Classification for Patient Safety (ICPS), which was developed for use across all care settings, and discuss the utility of the ICPS in the home setting. The scoping review focused on Chronic Obstructive Pulmonary Disease (COPD), and Congestive Heart Failure (CHF); two chronic illnesses commonly managed at home and that represent frequent hospital readmissions. The scoping review identified seven safety markers for homecare: Medication mania; Home alone; A fixed agenda in a foreign language; Strangers in the home; The butcher, the baker, the candlestick maker; Out of pocket: the cost of caring at home; and My health for yours: declining caregiver health. METHODS: The safety markers from the scoping review were mapped to the 10 ICPS high-level classes that comprise 48 concepts and address the continuum of health care: Incident Type, Patient Outcomes, Patient Characteristics, Incident Characteristics, Contributing Factors/Hazards, Organizational Outcomes, Detection, Mitigating Factors, Ameliorating Actions, and Actions Taken to Reduce Risk. RESULTS: Safety markers identified in the scoping review of the homecare literature mapped to three of the ten ICPS classes: Incident Characteristics, Contributing Factors, and Patient Outcomes. CONCLUSION: The ICPS does have applicability to the homecare setting, however there were aspects of safety that were overlooked. A notable example is that the health of the caregiver is inextricably linked to the wellbeing of the patient within the homecare setting. The current concepts within the ICPS classes do not capture this, nor do they capture how care responsibilities are shared among patients, caregivers, and providers.

A cross-sectional study to compare care needs of individuals with and without dementia in residential homes in the Netherlands.
Non UofA Access
van der Ploeg ES, Bax D, Boorsma M, Nijpels G, van Hout HP.
BMC geriatrics 2013 May 24;13(1):51

BACKGROUND: Little is known about met and unmet needs of individuals in residential care, many of whom suffer from dementia. Unmet needs are associated with a decreased quality of life, worse mental health, dissatisfaction with services, and increased costs of care. The aim of this study was to compare the number and type of (unmet) needs of people with and without dementia in residential care in the Netherlands. METHODS: 187 individuals in residents care or their relatives were interviewed to identify their care needs on 24 topics using the Camberwell Assessment of Needs for the Elderly (CANE) interview. RESULTS: Individuals diagnosed with probable dementia reported more needs in total and more unmet needs in comparison with individuals without this diagnosis. More specifically, differences were found for the topics “accommodation”, “money”, “benefits”, “medication management”, “incontinence”, “memory problems”, “inadvertent self-harm”, “company” and “daytime activities”. CONCLUSIONS: It seems that the differences in care needs between individuals with and without dementia can be attributed to actual differences in physical and cognitive functioning. Residents with dementia reported more often unmet needs which might imply that care for people with dementia can still be better attuned to their needs.

Is geriatric care associated with less emergency department use?
Non UofA Access
D’Arcy LP, Stearns SC, Domino ME, Hanson LC, Weinberger M.
Journal of the American Geriatrics Society 2013 Jan;61(1):4-11

OBJECTIVES: To determine whether community-dwelling individuals and nursing home (NH) residents treated by a geriatrician were less likely to use the emergency department (ED) than individuals treated by other physicians. DESIGN: Retrospective cohort study using data from a national sample of older adults with a history of cardiovascular disease. SETTING: Ambulatory care or NH. PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 66 and older diagnosed with one or more geriatric conditions from 2004 to 2007 and followed for up to 3 years. MEASUREMENTS: Emergency department use was measured in Medicare inpatient and outpatient claims; geriatric care was measured as geriatrician visits in ambulatory or NH settings coded in physician claims. RESULTS: Multivariable analyses controlled for observed and unobserved subject characteristics that were constant during the study period. For community-dwelling participants, one or more nonhospital geriatrician visits in a 6-month period were associated with 11.3% lower ED use the following month (95% confidence interval (CI) = 7.5-15.0, N = 287,259). Participants who received primary care from geriatricians were less likely to have ED use than those who had traditional primary care. Results for participants who received consultative care from geriatricians were similar to those for participants who received primary care from geriatricians. Results for NH residents (N = 66,551) were similar to those for community-dwelling participants. CONCLUSION: Geriatric care was associated with an estimated 108 fewer ED visits per 1,000 community-dwelling residents and 133 fewer ED visits per 1,000 NH residents per year. Geriatric consultative care in collaboration with primary care providers may be as effective in reducing ED use as geriatric primary care. Increased provision of collaborative care could allow the existing supply of geriatricians to reach a larger number of individuals. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

The effects of dementia care mapping on nursing home residents’ quality of life and staff attitudes: design of the quasi-experimental study Leben-QD II.
Non UofA Access
Halek M, Dichter MN, Quasdorf T, Riesner C, Bartholomeyczik S.
BMC geriatrics 2013 Jun 1;13(1):53

BACKGROUND: The main objective of care for people with dementia is the maintenance and promotion of quality of life (Qol). Most of the residents in nursing homes have challenging behaviors that strongly affect their Qol. Person-centered care (PCC) is an approach that aims to achieve the best possible Qol and to reduce challenging behaviors. Dementia Care Mapping (DCM) is a method of implementing PCC that has been used in Germany for several years. However, there are no data on the effectiveness of DCM or the challenges of implementation of DCM in German nursing homes.Methods/design: In this quasi-experimental non-randomized cluster-controlled study, the effects of DCM will be compared to 2 comparison groups. 9 nursing homes will take part: 3 will implement DCM, 3 will implement a comparison intervention using an alternative Qol assessment, and 3 have already implemented DCM. The main effect outcomes are Qol, challenging behaviors, staff attitudes toward dementia, job satisfaction and burnout of caregivers. These outcomes will be measured on 3 data points. Different quantitative and qualitative data sources will be collected through the course of the study to investigate the degree of implementation as well as facilitators of and barriers to the implementation process. DISCUSSION: This study will provide new information about the effectiveness of DCM and the implementation process of DCM in German nursing homes. The study results will provide important information to guide the national discussion about the improvement of dementia-specific Qol, quality of care in nursing homes and allocation of resources. In addition, the study results will provide information for decision-making and implementation of complex psychosocial interventions such as DCM. The findings will also be important for the design of a subsequent randomized controlled trial (e.g. appropriateness of outcomes and measurements, inclusion criteria for participating nursing homes) and the development of a successful implementation strategy.Trial registration: Current Controlled Trials ISRCTN43916381.

Convoys of care: theorizing intersections of formal and informal care.
Non UofA Access
Kemp CL, Ball MM, Perkins MM.
Journal of aging studies 2013 Jan;27(1):15-29

Although most care to frail elders is provided informally, much of this care is paired with formal care services. Yet, common approaches to conceptualizing the formal-informal intersection often are static, do not consider self-care, and typically do not account for multi-level influences. In response, we introduce the “convoy of care” model as an alternative way to conceptualize the intersection and to theorize connections between care convoy properties and caregiver and recipient outcomes. The model draws on Kahn and Antonucci’s (1980) convoy model of social relations, expanding it to include both formal and informal care providers and also incorporates theoretical and conceptual threads from life course, feminist gerontology, social ecology, and symbolic interactionist perspectives. This article synthesizes theoretical and empirical knowledge and demonstrates the convoy of care model in an increasingly popular long-term care setting, assisted living. We conceptualize care convoys as dynamic, evolving, person- and family-specific, and influenced by a host of multi-level factors. Care convoys have implications for older adults’ quality of care and ability to age in place, for job satisfaction and retention among formal caregivers, and for informal caregiver burden. The model moves beyond existing conceptual work to provide a comprehensive, multi-level, multi-factor framework that can be used to inform future research, including research in other care settings, and to spark further theoretical development. Copyright © 2012 Elsevier Inc. All rights reserved.

United Health Foundation: 2013 Senior Report (US)
2013

America’s Health Rankings Senior Report compares the health of all 50 states to each other using 34 different measures of health ranging from smoking and obesity to ICU usage.

 

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Events

Non UofA

InspireNet’s Fall 2013 Conference
Vancouver BC 16 September 2013

Connect 2013 is the fourth annual InspireNet conference. New and returning members can continue the journey to learn about nursing health services research and application in the practice setting.

CFHI presents IHI’s Driving Quality, Lowering Costs: A Two-day Improvement Workshop
24-25 October 2013 Ottawa ON

CFHI is proud to host the Institute for Healthcare Improvement’s (IHI) Driving Quality, Lowering Costs. This two-day improvement workshop is designed for clinical quality teams and finance leaders to improve their knowledge, skills, and strategies to implement measurable cost reductions while improving quality of care. CFHI and IHI have adapted this highly praised workshop for the Canadian context with the help of Canadian healthcare improvement experts.

Online

CAG: Sustaining Age-Friendly Communities (AFC): A focus on “Champions”
Tuesday 18 June 2013 11:00-12:30 MT

The webinar will be moderated by Cathy Bennett, Manager, Healthy Communities Unit, Population Health Promotion and Innovation Division, Public Health Agency of Canada.
It will feature presentations by and discussion with:
• Leo Bonnell, Chair of the Provincial Advisory Council on Aging & Seniors for the Province of Newfoundland and Labrador
• Sheila Hallett, Executive Director, Edmonton Seniors Coordinating Council, Edmonton, Alberta
• Judy Brownoff, Councillor and Director, Capital Regional District, District of Saanich, B.C.

BC Patient Safety & Quality Council: Listening to our Patients’ Voices: Experience of Care in the Acute IP Sector
Monday 17 July 2013 13:00-14:00 MT

Do you conduct patient experience surveys but struggle with translating your results into action?Between October 2011 and March 2012, all of BC’s 80 acute care hospitals participated in the province`s third province-wide, coordinated survey of patient experience and satisfaction of quality of care. Respondents receiving maternity, paediatrics, medical and surgical care as well as rehabilitation services provided feedback.

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Courses

Centre for Clinical Epidemiology and Evaluation: Introduction to Systematic Reviews
Tuesday 18 June 2013 Vancouver BC Registration Deadline June 20, 2013

This course is intended to provide participants with an understanding of systematic review methodology and what is entailed in completing such a task.

Online

Canadian Cochrane Centre: The Steps of a Cochrane Review: An Overview
Thursday 13 June 2013 10:00-11:00 MT

What makes Cochrane Reviews different from other systematic reviews? Who – and what – is involved in the process? We will introduce you to the steps of a Cochrane Review and give you some practical tips for getting a review underway.

Canadian Cochrane Centre: The Steps of a Cochrane Review: Let’s Start at the Very Beginning: Getting the Question Right for Your Cochrane Review
Thursday 20 June 2013 10:00-11:00 MT

A strong, clear question gives your Cochrane Review the foundation it needs: it informs your search strategy, narrows your focus, and provides the framework for your team’s work. Join us to learn what sort of questions are answered in Cochrane Reviews. We’ll cover the key components of a good research question and we’ll work through sample questions: you’re invited to share your research topic as an example!

Stanford University: Statistics in Medicine
June 11- Aug 2013

This course aims to provide a firm grounding in the foundations of probability and statistics. Specific topics include:
1. Describing data (types of data, data visualization, descriptive statistics)
2. Statistical inference (probability, probability distributions, sampling theory, hypothesis testing, confidence intervals, pitfalls of p-values)
3. Specific statistical tests (ttest, ANOVA, linear correlation, non-parametric tests, relative risks, Chi-square test, exact tests, linear regression, logistic regression, survival analysis; how to choose the right statistical test)
The course focuses on real examples from the medical literature and popular press.

University of Oxford: Introduction to Statistics for Health Care Research
24 June-30 Aug 2013 £1500.00

his online statistics course is designed for busy health and social care professionals who need to understand the basics of health statistics without becoming statisticians. Students can study at the time of day and week that is best for them. Online discussion forums enable students to communicate with each other and with the tutor to analyse and understand real-life scenarios.

CFHI: Palliative and Therapeutic Harmonization – Optimal care meets appropriate spending
Wednesday 12 June 2013 10:00-11:00 MT $99

Our June 12 session of On Call features the Palliative and Therapeutic Harmonization (PATH) model ─an innovative, award winning solution designed to improve appropriateness of care and use of resources across the healthcare continuum.

CONSORT Statement: guidance for reporting randomised trials
Monday 24 June 2013 08:00-09:00 MT

Presenter: Prof Doug Altman Director of the Centre for Statistics in Medicine in Oxford; senior statistics editor at the BMJ, co-editor-in-chief of Trials and Founder of the EQUATOR Network.

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News

Canadian Federation of Nurses Union: Canadians identify major gaps in long-term care in national survey

The national poll conducted by Praxis Analytics in May 2013 showed Canadians were particularly concerned by what they perceived as a shortage of long-term care spaces and lack of qualified staff working in long-term care settings.

Canadians eager for more virtual, mobile health care solutions

According to a new report from PwC Canada, almost half of Canadians believe that mobile health apps will make health care more convenient over the next three years.

Dutch district nurses rediscover ‘complete care’ role

The nurses work in teams of 10, each serving a neighbourhood of about 10,000 people. The teams run themselves – there are no managers. They are available round the clock and – working closely with GPs – they organise all the supporting care, drawing in families, friends, and volunteers.

Bed closures possible as Alberta health authority strives to trim $220 million

A three-year health plan by Alberta’s health authority that will focus more money on community care, emergency services and primary care teams could also mean the closure of hospital beds and elimination of underutilized programs.

With Money at Risk, Hospitals Push Staff to Wash Hands

At North Shore University Hospital on Long Island, motion sensors, like those used for burglar alarms, go off every time someone enters an intensive care room. The sensor triggers a video camera, which transmits its images halfway around the world to India, where workers are checking to see if doctors and nurses are performing a critical procedure: washing their hands.

Health Canada Launches Clinical Trial Database

Health Canada, through its Clinical Trials Database, is providing to the public a listing of specific information relating to phase I, II and III clinical trials in patients. The database is managed by Health Canada and provides a source of information about Canadian clinical trials involving human pharmaceutical and biological drugs.

Quebec proposes innovative insurance plan to deal with aging population

Faced with a population that is aging at a rate second only to that of Japan, Quebec is proposing to create an innovative insurance plan to offer the elderly less expensive long-term care services at home.

The Family Caregiver Turns Pro

The workers who take on home care represent a polyglot group. They work independently or through agencies; they are largely underpaid and lack benefits; they do a tough job and have high injury rates; they run the gamut from inadequately trained to professionally skilled. And already, we don’t have enough of them.

AHS contracts out home care to for-profit companies

In a remarkably offhand vote Thursday, Alberta Health Services awarded contracts worth up to $371 million to two Ontario-based, profit-making companies that provide home care to the sick, the frail, the elderly and the disabled.

Nation at crossroads in home care for elders

Article about the looming home care crisis.

Rise of ‘Altmetrics’ Revives Questions About How to Measure Impact of Research

Adding altmetrics to CVs and dossiers may not be common yet. But interest in altmetrics is growing fast, as scholars begin to realize that it’s possible to track and share evidence of online impact, and publishers and new start-up companies rush to develop altmetric services to help them document that impact.

Canadian Institutes of Health Research Institute of Aging 2013–18 Strategic Plan

With this strategic plan, the Institute has established five research priorities that underlie the following four major goals:
-to make researchers more aware of the challenges posed by older people’s health and wellness;
-to ensure that knowledge users and the general public participate in the research process from the very outset;
-to incorporate all aspects of the individual and society that contribute to health and wellness;
-and to draw inspiration from the traditional values of Aboriginal peoples that foster positive attitudes toward elders.

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Resources

Design Thinking for Educators

A creative process that helps you design meaningful solutions in the classroom, at your school, and in your community. The toolkit provides you with instructions to explore Design Thinking.

NCCMT: Videos from KT Workshop on Preventing Childhood Obesity

In January of this year, NCCMT hosted a one-day KT workshop entitled Preventing Childhood Obesity. People from a variety of fields joined us in Toronto to explore strategies and develop a work plan based on what we know works (or doesn’t work) in childhood obesity prevention.

NCCHPP: Overview : A knowledge synthesis method to effectively inform decision makers about public policies – Web Presentation

This 20-minute narrated presentation gives an overview of the method developed by the NCCHPP to synthesize knowledge about public policies. Besides giving an overview of the method, we also present different scenarios in which it could be usefully applied, and we refer to the different resources developed by the Centre around this method. This Web Presentation was developed by Florence Morestin and Julie Castonguay.

Quality Palliative Care in Long Term Care

The Quality Palliative Care in Long Term Care Alliance is comprised of 38 organizational partners and 27 researchers who will actively contribute their expertise to a five-year comparative case study research project, Improving Quality of Life for People Dying in Long Term Care Homes.

Coping With Alzheimer’s: A Mother and Daughter Portrait Of Long-Term Care

This online video is featured on the PBS Newshour site as part of a series on Alzheimers Disease. After being diagnosed with Alzheimer’s, professional artist Mary Wyant slowly lost her ability to paint and the ability to take care of herself. Ray Suarez examines the story of Mary and her daughter Rebecca, who is now her mother’s legal guardian and primary caretaker, about the daily struggles of long-term care.

Dying well at home: the case for integrated working

Dying well at home is a guide created by the Social Care Institute for Excellence that will provide guidance to health care professionals and managers supporting people with end of life care needs. In this case “home” can mean the place where the patient lives, an assisted living facility or any other type of accommodation that is not a long-term care home. The guide includes information on coordinating care; helping caregivers at home; accessing equipment and services and the costs of dying at home.

How to Restart Your Research This Summer

Some ideas on how to get excited about (or at least inspired enough to finish) a research project that’s been sitting on the back burner.

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Opportunities

BC Patient Safety & Quality Awards
DEADLINE: 12 July 2013 23:59 PT

Did your colleague or initiative improve health care quality? Join us in celebrating extraordinary work in our health system by nominating them for a 2014 BC Quality Award! Award categories represent the four areas of care, an individual who demonstrates outstanding leadership, and an Everyday Champion who will be chosen through online voting by everyone throughout British Columbia.

Research & KT Coordinator – Healthier Built Environments Ontario
Hamilton, ON
DEADLINE: 12 June 2013

The Collaboratory for Research on Urban Neighbourhoods, Community Health and Housing (CRUNCH) at McMaster University is engaged in planning, data collection, analysis, and KTE (Knowledge Translation & Exchange) activities. This position will be a temporary contract of 11 months, with hours of work between 25-35 hours per week.

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