February 9, 2015


Abstracts
Grants & Awards
Publications
Events
Courses
News
Resources
Opportunities

Abstracts

CALL FOR ABSTRACTS:
Canadian Knowledge Mobilization Forum 2015
14-15 May Montreal
DEADLINE 13 March

The Canadian Knowledge Mobilization Forum was created in 2012 as a professional development forum for practitioners and professionals working in knowledge mobilization across fields and sectors. It has become recognized as a premier learning and networking event in Canada – friendly, open, limited in size to 200 attendees, and creative.

CALL FOR CONFERENCE PRESENTATION and PRE-CONFERENCE WORKSHOP PROPOSALS:
International Evaluation Conference
5-9 September Melbourne Australia
DEADLINE 6 March

Whatever your role, interest and experience in evaluation we invite you to submit a proposal for a conference presentation or pre-conference workshop and join us in Melbourne to debate, discuss, share knowledge and experiences, network and learn about what is happening in evaluation, and evaluation-related fields, in the Australasian region and across the world.

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Grants & Awards

TVN 2015 Summer Student Awards Program.
Up to 10 awards of a maximum of $4,500 each are available from TVN
DEADLINE Indication of intent 27 February, Full application 9 March

TVN’s Interdisciplinary Training Program is unique in going beyond traditional academic and clinical training opportunities within disciplines, offering enriched experiential learning based on the concept of interdisciplinary collaboration. This program has been designed to provide students with an interdisciplinary summer experience, which will develop a frame of reference for participants in examining health care for Canada’s seriously ill, frail elderly.

IHSPR Article of the Year Award 2014-15
$10 000
DEADLINE Friday 13 February

This award is intended to recognize published research in a peer-reviewed journal that has significantly contributed to the advancement of the field of health services and policy research in Canada. IHSPR will consider articles related to:
-Research that demonstrates a clear impact or potential impact on policy, practice, or health outcomes (e.g., decision maker uptake, change management for improved practice);
OR
-Research that breaks ground in the way health services or policy research is conducted (e.g., innovations in methodology, novel theory or application of theory, new approaches to existing problems).

IHSPR Rising Star Award 2014-2015
$1000
DEADLINE Friday 13 February

The CIHR Institute of Health Services and Policy Research (IHSPR) is dedicated to supporting graduate students and post-doctoral Fellows and to recognizing the research excellence and knowledge translation initiatives of these emerging health services and policy researchers at an early stage in their career.
Objectives
-To recognize the excellence of Canadian research and innovative knowledge translation (KT) initiatives of graduate students (e.g. M.D., M.A., M.Sc. and PhD) and post-doctoral fellows studying health services and policy research;
-To recognize research and/or KT contributions for which a graduate student or post-doctoral fellow has had primary responsibility;
-To promote careers in health services and policy research

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Publications

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

KT

Adoption factors associated with electronic health record among long-term care facilities: a systematic review
Non UofA Access
Kruse CS, Mileski M, Alaytsev V, Carol E, Williams A.
BMJ open 2015 Jan 28;5(1):e006615-2014-006615

The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. SETTING: We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. PARTICIPANTS: Search results were filtered by date range, full text, English language and academic journals (n=22). INTERVENTIONS: Multiple members of the research team read each article to confirm applicability and study conclusions. PRIMARY AND SECONDARY OUTCOME MEASURES: Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. RESULTS: Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. CONCLUSIONS: Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs.

A strategy for translating evidence into policy and practice to close the gap – developing essential service standards for aboriginal and torres strait islander cardiovascular care.
Non UofA Access
Brown A, O’Shea RL, Mott K, McBride KF, Lawson T, Jennings GL, et al.
Heart, lung & circulation 2015 Feb;24(2):119-125

The development and application of essential standards for cardiovascular care for Aboriginal and Torres Strait Islander people creates a strategic platform on which to systematically close the gap in the health outcomes and life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous people in Australia. We outline six developmental stages that can be used to enhance the effective translation of evidence into practice that reduces life expectancy differentials. Focussing efforts where the biggest gain can be made; considering how to make a policy-relevant difference with an emphasis on translation into policy and practice; establishing a foundation for action by engaging with stakeholders throughout the process; developing a framework to guide action; drafting policy-relevant and framework-appropriate essential service standards; and defining standards that help policy decision makers achieve current priority policy targets. Copyright © 2014

Antecedents of Knowledge Sharing Behavior among Nurses: Towards Research Agenda
Non UofA Access
Shaari R, Bakri N, Rahman AA.
Procedia 2015 /1/16/;171(0):635-641

This paper attempts to propose presenteeism, altruism and virtual communities of practices (CoP) as the main antecedents to facilitate knowledge sharing behavior (KSB) among nurses. A systematic review technique is adopted to formulate a conceptual framework that integrates the Social Cognitive theory, Social Capital theory and Theory of Planned Behavior. This paper suggests the importance of KSB and its antecedents from the perspective of nursing. Presenteeism in this study is generated by positive attitude to implement tasks by nurses. Indeed, their essence of knowledge and caring has led this study to propose altruism and informal communication tool (facebook) as factors that can influence KSB.

The importance of context in implementation research.
Non UofA Access
Edwards N, Barker PM.
Journal of acquired immune deficiency syndromes (1999) 2014 Nov 1;67 Suppl 2:S157-62

This article describes the pertinence of context in HIV/AIDS implementation research. Without attending to context and how it interacts with interventions, national protocols for HIV/AIDS interventions are likely to fail or underperform. With its focus on what works, for whom, under what contextual circumstances, and whether interventions are scalable, implementation research yields context-sensitive designs and enhances the likelihood of scale-up for equitable outcomes. A framework for implementation science is presented alongside a review of published HIV/AIDS protocols for complex interventions. A case study of the South African Prevention of Mother-to-Child Transmission of HIV program highlights the application of complex system improvement principles in developing adaptive and context-sensitive scale-up designs. Preliminary recommendations are provided that can be used to characterize context when reporting interventions and describing how context can be accounted for in implementation strategies.

A call for a backward design to knowledge translation.
Non UofA Access
El-Jardali F, Fadlallah R.
International journal of health policy and management 2015 Jan 1;4(1):1-5

Despite several calls to support evidence-informed policy-making, variations in uptake of evidence into policy persist. This editorial brings together and builds on previous Knowledge Translation (KT) frameworks and theories to present a simple, yet, holistic approach for promoting evidence-informed policies. The proposed conceptual framework is characterized by its impact-oriented approach and its view of KT as a continuum from the evidence synthesis stage to uptake and evaluation, while highlighting capacity and resource requirement at every step. A practical example is given to guide readers through the different steps of the framework. With a growing interest in strengthening evidence-informed policy-making, there is a need to continuously develop theories to understand and improve the science of KT and its implementation within the field of policy-making.

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Health Care Administration and Organization

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.
Non UofA Access
Hakanson C, Cronfalk BS, Henriksen E, Norberg A, Ternestedt BM, Sandberg J.
The open nursing journal 2015 Jan 22;8:71-78

The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

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Health Care Innovation and Quality Assurance

Demystifying theory and its use in improvement.
Non UofA Access
Davidoff F, Dixon-Woods M, Leviton L, Michie S.
BMJ quality & safety 2015 Jan 23

The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes and facilitate the evaluation of their effectiveness. Many professionals, including improvement practitioners, are unfortunately mystified-and alienated-by theory, which discourages them from using it in their work. In an effort to demystify theory we make the point in this paper that, far from being discretionary or superfluous, theory (‘reason-giving’), both informal and formal, is intimately woven into virtually all human endeavour. We explore the special characteristics of grand, mid-range and programme theory; consider the consequences of misusing theory or failing to use it; review the process of developing and applying programme theory; examine some emerging criteria of ‘good’ theory; and emphasise the value, as well as the challenge, of combining informal experience-based theory with formal, publicly developed theory. We conclude that although informal theory is always at work in improvement, practitioners are often not aware of it or do not make it explicit. The germane issue for improvement practitioners, therefore, is not whether they use theory but whether they make explicit the particular theory or theories, informal and formal, they actually use.

Exploring nursing assistants’ roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.
Non UofA Access
Liu JY.
Journal of advanced nursing 2014 May;70(5):1065-1077

To explore nursing assistants’ roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. BACKGROUND: Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents’ pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants’ functions in pain management. DESIGN: This is a descriptive, exploratory qualitative study. METHODS: Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. RESULTS: Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. CONCLUSIONS: This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants’ scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.
Non UofA Access
Martsolf GR, Auerbach D, Benevent R, Stocks C, Jiang HJ, Pearson ML, et al.
Medical care 2014 Nov;52(11):982-988

Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. OBJECTIVE: To assess the effect of nurse staffing on quality of care and inpatient care costs. DESIGN: Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. SUBJECTS: Hospital discharges from California, Nevada, and Maryland (n=18,474,860). METHODS: A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. RESULTS: Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. CONCLUSIONS: The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost.

A value-added benefit of nurse practitioners in long-term care settings: increased nursing staff’s ability to care for residents. Canada-flat-icon
Non UofA Access
Sangster-Gormley E, Carter N, Donald F, Misener RM, Ploeg J, Kaasalainen S, et al.
Nursing leadership (Toronto, Ont.) 2013 Sep;26(3):24-37

The number of people living longer is increasing, and those with physical or cognitive impairments may need admission into long-term care settings. In long-term care there is a need to increase nursing staff’s capacity to meet the care needs of residents, develop a team approach to providing care and provide opportunities for staff to improve their knowledge and skills. One approach to meet these needs has been to employ a nurse practitioner (NP). The purpose of this paper is to examine nursing staff’s perceptions of how working with an NP affected their ability to provide care, function as a team and increase their knowledge and skill. Data used in this paper were obtained from nursing staff and managers who participated in focus groups that were part of case studies conducted in the second phase of a larger sequential, two-phase mixed-methods study. NPs used multiple approaches to increase staff knowledge and skills and improve quality of care. These findings describe the benefits of employing NPs in long-term care settings. Copyright © 2013 Longwoods Publishing.

The Patient-Centered Medical Home’s Impact on Cost and Quality, Annual Review of Evidence, 2013-2014 (US)
Milbank Memorial Fund, 2015

The Patient-Centered Primary Care Collaborative (PCPCC) has released its annual report, published with support from the Milbank Memorial Fund. This year’s report provides new evidence that the patient-centered medical home (PCMH) improves care and reduces costs. The publication includes an aggregation of PCMH outcomes from a combination of 28 peer-reviewed studies, state government program evaluations, and industry reports, the largest number of PCMH evaluations in a single year. The data supports the assertion that the PCMH can lead to a reduction in health care costs, inappropriate emergency department utilization, and inpatient hospitalizations:
-14 Peer-reviewed scholarly publications
-Six of the 10 studies reported reductions in cost (60 percent)
-12 of the 13 studies reported improvements in utilization (92 percent)
-All seven reported reductions in cost (100 percent)
-Six reported improvements in utilization (86 percent)
-7 Industry reports
-Four reported reductions in cost (57 percent)
-Six reported improvements in utilization (86 percent)
The report serves as a go-to resource for policymakers, providers, payers, and patients on the most recent evidence regarding the PCMH and its impact on the health care marketplace.

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Research Practice and Methodology

Assessing physical and cognitive function of older adults in continuing care retirement communities: Who are we recruiting?
Non UofA Access
Wrights AP, Fain CW, Miller ME, Rejeski WJ, Williamson JD, Marsh AP.
Contemporary clinical trials 2014 Dec 12;40C:159-165

In partnership with six Continuing Care Retirement Communities (CCRCs), the current study focused on the feasibility of recruiting a representative sample of residents and then assessing their functional health. MATERIAL AND METHODS: With our guidance, each of the six CCRCs recruited a volunteer (V-Group) and random (R-Group) sample of independent living residents. We provided face-to-face training and ongoing remote electronic support to the CCRC staff on the testing battery and the Web-based data entry system. The testing battery was consisted of demographic, physical function, and psychosocial assessments. RESULTS: After training, CCRC staff were receptive to the study goals and successfully used the data entry Website. In the V-Group (N=189), 76% were already participating in CCRC wellness programs. We attempted to recruit a random, unbiased (R-Group) sample of 20% (n=105) of eligible residents; however, only 30 consented to be tested and 70% of this group (21/30) were also already participating in a wellness program. Mean age of all participants was 82.9years. The V-Group had a higher Short Physical Performance Battery (SPPB) total score (least squares mean [SE], 9.4 [0.2] vs 8.2 [0.4], p=0.014) and SPPB gait speed component score (3.5 [0.1] vs 3.0 [0.2], p=0.007) and spent more time doing moderate-to-vigorous physical activity (300 [21] vs 163 [49] min/week, p=0.013) compared to the R-Group. IMPLICATIONS: While it is feasible to recruit, assess and transmit data on residents’ functional health in partnership with CCRCs, population validity was severely compromised. Attention needs to be given to the development of more effective methods to recruit less interested residents. Copyright © 2014 Elsevier Inc.

AHRQ: An Exploration of Methods and Context for the Production of Rapid Reviews
January 2015

To characterize rapid reviews and similar products, to understand the context in which rapid products are produced (e.g., end-users and purposes for rapid products), to understand methodological guidance and strategies used to make products rapid and describe how these differ from systematic review (SR) procedures, and to identify empiric evidence on the impact of methodological approaches on their reliability and validity. Methods. We searched the literature to identify rapid review methods, empiric evidence on rapid review methodology, and methodological guidance. We conducted interviews with members of organizations known to produce rapid reviews to characterize the types of rapid products produced and to understand the context and uses for rapid products, identify current practices, and understand the evolution of their programs and products. Conclusions. Rapid products have tremendous methodological variation. Overall, they vary on two important dimensions that are captured by the term “rapid review”: the timeframe for completion and extent of synthesis. The similarity of rapid products lies in their close relationship with the end-user to meet decisionmaking needs in a limited timeframe. The following are considerations for creating rapid products:
-products should be developed in the context of identified end-users and their specific decisionmaking needs and circumstances;
-a close relationship with the end-user and iterative feedback is essential;
-reliance on existing SRs require methods to summarize and interpret evidence;
-a highly skilled and experienced staff and the capacity to mobilize skilled staff quickly are critical;
-restricting scope may be necessary; • producers and users need to accept modifications to standard SR methods;
-limitations need to be clearly reported, particularly in terms of potential bias and shortcomings of the conclusions. Future research evaluating end-user perspectives will complement these findings and provide additional considerations for those interested in establishing a rapid response program or producing rapid products.

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Aging

Voices of Alzheimer Caregivers on Positive Aspects of Caregiving.
Non UofA Access
Cheng ST, Mak EP, Lau RW, Ng NS, Lam LC.
The Gerontologist 2015 Jan 21

To discover positive gains as constructed by family caregivers of relatives with Alzheimer’s disease. DESIGN AND METHODS: Fifty-seven Hong Kong Chinese primary caregivers provided 669 diary recordings over an 8-week period, describing daily events and experiences in which positive gains were achieved. The diaries were analyzed independently by two researchers using thematic analysis. RESULTS: Ten themes related to positive gains were identified: (a) insights about dementia and acceptance of the condition, (b) a sense of purpose and commitment to the caregiving role, (c) feelings of gratification when the care-recipient (CR) was functioning relatively well, (d) mastering skills to handle the CR, (e) increased patience and tolerance, (f) cultivating positive meanings and humor amidst difficult circumstances, (g) letting go of things, such as when the CR’s qualities had been lost or personal agenda had become unrealistic, (h) developing a closer relationship with the CR, (i) finding support, and (j) feeling useful helping other caregivers. IMPLICATIONS: In addition to treating negative outcomes such as depression, practitioners and researchers should, identify means to promote positive gains. Strategies mentioned in the caregivers’ diaries, such as reframing stressful situations in a more positive light, may provide input into the design of such interventions. © The Author 2015.

Doll therapy: an intervention for nursing home residents with dementia.
Non UofA Access
Shin JH.
Journal of psychosocial nursing and mental health services 2015 Jan 1;53(1):13-18

The use of dolls as a therapeutic intervention for nursing home residents with dementia is relatively new. The current article describes a research study implemented with nursing home residents in Korea to examine the effects of doll therapy on their mood, behavior, and social interactions. A one-group, pretest-posttest design was used to measure the impact of doll therapy on 51 residents with dementia. Linear regression demonstrated statistically significant differences in aggression, obsessive behaviors, wandering, negative verbalization, negative mood, and negative physical appearance after introduction of the doll therapy intervention. Interactions with other individuals also increased over time. Findings support the benefits of doll therapy for nursing home residents with dementia; however, further research is needed to provide more empirical evidence and explore ethical considerations in the use of doll therapy in this vulnerable population.

Systematic review of systematic reviews for the management of urinary incontinence and promotion of continence using conservative behavioural approaches in older people in care homes.
Non UofA Access
Roe B, Flanagan L, Maden M.
Journal of advanced nursing 2015 Jan 23

To synthesize evidence from systematic reviews on the management of urinary incontinence and promotion of continence using conservative/behavioural approaches in older people in care homes to inform clinical practice, guidelines and research. BACKGROUND: Incontinence is highly prevalent in older people in care home populations. DESIGN: Systematic review of systematic reviews with narrative synthesis. DATA SOURCES: Electronic searches of published systematic reviews in English using MEDLINE and CINAHL with no date restrictions up to September 2013. Searches supplemented by hand searching and electronic searching of Cochrane Library and PROSPERO. REVIEW METHODS: PRISMA statement was followed, as were established methods for systematic review of systematic reviews. RESULTS: Five systematic reviews of high quality were included, three specific to intervention studies and two reviewed descriptive studies. Urinary incontinence was the primary outcome in three reviews with factors associated with the management of urinary incontinence the primary outcome for the other reviews. CONCLUSION: Toileting programmes, in particular prompted voiding, with use of incontinence pads are the main conservative behavioural approach for the management of incontinence and promotion of continence in this population with evidence of effectiveness in the short term. Evidence from associated factors; exercise, mobility, comorbidities, hydration, skin care, staff perspectives, policies and older people’s experiences and preference are limited. The majority of evidence of effectiveness are from studies from one country which may or may not be transferable to other care home populations. Future international studies are warranted of complex combined interventions using mixed methods to provide evidence of effectiveness, context of implementation and economic evaluation. © 2015 John Wiley & Sons Ltd.

Psychosocial Resources: Moderators or Mediators of Frailty Outcomes?
Non UofA Access
Dent E, Hoogendijk EO.
Journal of the American Medical Directors Association 2015 Jan 27.

Characterized by a diminished reserve and a reduced ability to cope with stressors, frailty is a multidimensional syndrome that remains one of the most fundamental challenges to health and aged care systems worldwide. Frailty is a dynamic entity, and as such, may be amenable to change with physical activity, protein supplementation, and/or a reduction in polypharmacy.3 In addition to these biomedical factors, an older adult’s psychosocial resources also can be considered as a potential target for frailty intervention, particularly in the early stages of frailty.

How older people cope with frailty within the context of transition care in Australia: implications for improving service delivery.
Non UofA Access
Walker R, Johns J, Halliday D.
Health & social care in the community 2015 Mar;23(2):216-224

Transition care is increasingly common for older people, yet little is known about the subjective experience of the transition care ‘journey’ from the perspective of clients themselves. This study examines how older people cope with frailty within the context of a dedicated transition care programme and discusses implications for improving service delivery. Qualitative in-depth interviews were carried out during 2011 in the homes of 20 older people who had recently been discharged from a transition care programme operating in Adelaide, South Australia (average age 80 years, 65% female). Thematic analysis identified three key themes: ‘a new definition of recovery’, ‘complexities of control’ and ‘the disempowering system’. Despite describing many positive aspects of the programme, including meeting personal milestones and a renewed sense of independence, participants recognised that they were unlikely to regain their previous level of functioning. For some, this was exacerbated by lacking control over the transition care process while adapting to their new level of frailty. Overall, this research highlighted that benefits associated with transition care can be undermined by fragmentation in service delivery, loss of control and uncertainties around future support. © 2014 John Wiley & Sons Ltd.

Longitudinal Changes in Nursing Home Resident-Reported Quality of Life: The Role of Facility Characteristics.
Non UofA Access
Shippee TP, Hong H, Henning-Smith C, Kane RL.
Research on aging 2014 Aug 12

Improving quality of nursing homes (NHs) is a major social priority, yet few studies examine the role of facility characteristics for residents’ quality of life (QOL). This study goes beyond cross-sectional analyses by examining the predictors of NH residents’ QOL on the facility level over time. We used three data sources, namely resident interviews using a multidimensional measure of QOL collected in all Medicaid-certified NHs in Minnesota (N = 369), resident clinical data from the minimum data set, and facility-level characteristics. We examined change in six QOL domains from 2007 to 2010, using random coefficient models. Eighty-one facilities improved across most domains and 85 facilities declined. Size, staffing levels (especially activities staff), and resident case mix are some of the most salient predictors of QOL over time, but predictors differ by facility performance status. Understanding the predictors of facility QOL over time can help identify facility characteristics most appropriate for targeting with policy and programmatic interventions. © The Author(s) 2014.

The Health Foundation: Hospital admissions from care homes (UK)
2015

It is estimated that around 325,000 older people live in care homes1 in England, representing around four per cent of people aged 65 and over. Aside from social care needs, these residents will also require healthcare. Data collected by the Care Quality Commission (CQC) and reported by the British Geriatrics Society (2011) estimate that over half of older people in care homes do not have access to all the services and support they require from the National Health Service (NHS). Despite this, there have been very few population level studies around hospital use by care home residents. In this report, we explore whether routinely collected information on hospitalisations from care homes could be used to enhance the understanding of hospital use by care home residents, and thus target areas for shared learning, improvements or regulatory activity.

Department of Health policy document: Improving care for people with dementia(UK)
January 2015

On 7 May 2014 Public Health England and the Alzheimer’s Society, supported by corporate and public sector partners, launched the Dementia Friends campaign, a major social movement aimed at improving understanding of dementia and changing attitudes towards people with the condition.
By the end of 2015, we will also:
-get at least 20 cities, towns and villages working towards becoming dementia friendly – 78 communities across England have signed up to the foundation-stage recognition process, more than trebling the original ambition
-work with the British Standards Institute (BSI) to develop a Publically Available Specification (PAS) for dementia friendly communities. The PAS will build on the foundation-stage recognition process and support communities who wish to take further steps towards becoming dementia friendly
create at least 1 million Dementia Friends – people who are confident offering support to people with dementia, there are currently over 870,000
-As part of the dementia friendly communities programme, work is also being taken forward in specific areas, including financial services, retail, transport, technology, the arts, sport and leisure and rural communities.

Health Quality Council of Alberta: Supportive Living Family & Resident Experience Survey Reports Canada-flat-icon
January 2015

The Health Quality Council of Alberta (HQCA) has released results of the first provincial survey reports that measure the experience of residents and families with the quality of care and services received at supportive living facilities in Alberta. This research was conducted between April 2013 and January 2014 by the HQCA in collaboration with Alberta Health and Alberta Health Services, and provides a baseline measurement about residents’ and family members’ experiences at 134 supportive living level 3 and 4 facilities across the province.

RAND: Valuing the Care We Provide Our Elders (US)
2015

Family members and friends are the primary source of long-term care for the elderly in the United States. There is little doubt about the significance and size of this informal, unpaid workforce — a recent study found that one in five adults provides regular care for an elderly relative or friend — but estimates of the costs of this care are out of date. And informal care is in no way “free.” These caregivers are giving up valuable time, either from their jobs or from other potentially productive activities. So what is the annual price tag of this informal care?

A Multi-Method Investigation of Dementia and Related Services in Saskatchewan Canada-flat-icon
Rural Dementia Action Research (RaDAR) Team, University of Saskatchewan

In partnership with the Saskatchewan Health Quality Council, this report involves a comparison of actual to best practices in dementia care, with three components:
1) A review of best practices across the care continuum of health and social services for individuals with dementia and their families
2) An analysis of administrative health data to determine the 12-month incidence and prevalence of dementia among individuals aged 45 and older in the province of Saskatchewan by database of identification, demographic characteristics (age group, sex, and rural/urban residence), and health region
3) An environmental scan of dementia-related services and resources across the continuum of care, specifically service availability and primary health care orientation of such services, provincially and by health region.

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Events

Online

CFHI Webinar: Experience-Based Design: Accelerating Improvement and Adding Value
Monday 9 February 10:00-11:00 MT

Engaging patients and citizens is an essential lever for quality improvement, where partnerships provide different insights and better ideas than providers working on their own. At Virginia Mason Hospital and Medical Center, understanding the experience of those delivering and receiving care is foundational to all quality improvement initiatives undertaken through the Virginia Mason Production System. Using case examples of their improvement work in pancreatic cancer, Susan Haufe and Mary Cranny will illustrate how Experience-Based Design is integrated into LEAN processes in order to understand what customers consider value-add while improving quality, including the experience of patients and families.

SEDL Webinar: Individual Placement and Support (IPS) Model of Supported Employment: Translating Research for Vocational Rehabilitation Practice,
Wednesday 11 February 13:00-14:20 MT

In “Individual Placement and Support (IPS) Model of Supported Employment: Translating Research for Vocational Rehabilitation Practice,” we will look closely at how one particular area of research, the IPS model of supported employment, has influenced VR counselor practice and behavior.

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Courses

KT Canada Summer Institute on Knowledge Translation
15-17 June Edmonton AB
DEADLINE for application 16 March

The Summer Institute is aimed at graduate students, post-doctoral and clinical fellows, and junior faculty who study issues relevant to KT and those who want to learn more about how to advance their research skills in this area. We encourage applications from trainees and junior faculty working in a wide range of disciplines that span all of CIHR’s research themes (biomedical, clinical, health services, and population health).

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News

Ontario Long Term Care Association partners with SCA Personal Care, Cardinal Health Canada, and ArjoHuntleigh to advance quality of care for Ontario’s seniors Canada-flat-icon

The Corporate Alliance Partnership program is designed to provide a year-long platform for three commercial partners to work closely with the Ontario Long Term Care Association in delivering high-quality programming and educational opportunities to its membership. The program encompasses a multi-pronged, innovative approach, which allows the Association to support its members in knowledge-building and to provide learning opportunities that promote safe, quality long-term care for Ontario’s seniors.

Welcoming Criticism as an Early Career Academic

Early-career academics often have an assumption that receiving criticism is a negative experience and try to avoid it. Here’s a process for responding to it.

Can Alzheimer’s be treated with the arts? Researchers aim to determine the answer (US)

Many researchers agree evidence seems promising that the arts can improve cognitive function and memory, bolster a person’s mood and sense of well-being, and reduce stress, agitation and aggression. But many previous studies have been too limited or poorly designed to say for sure.

Damage from cancelled census as bad as feared, researchers say Canada-flat-icon

The cancellation of the mandatory long-form census has damaged research in key areas, from how immigrants are doing in the labour market to how the middle class is faring, while making it more difficult for cities to ensure taxpayer dollars are being spent wisely, planners and researchers say.

Wait times for primary and specialist care longest in Canada, among 11 countries Canada-flat-icon

Older Canadians report having longer waits and more difficulties seeing a doctor or nurse when they need medical attention than older people in 10 comparator countries. When they do see their doctor, however, results are more positive for many aspects of their care.

Seniors’ advocate calls for cameras in care homes after disturbing hidden footage revealed Canada-flat-icon

Seniors advocate Carol Wodak with the Seniors Action Liaison Team is calling for homes like Kipnes to install cameras throughout their facilities. She said it shouldn’t be up to families to monitor their loved ones’ care.

Integrated Care and Support Pioneers (UK)

The aim of the Integrated Care Pioneers Program is to make health and social care services work together to provide better support at home and earlier treatment in the community to prevent people needing emergency care in hospital or care homes. The first annual report for the Integrated Care Pioneers Program sets out the experiences of the first 14 areas that took part in the program. It provides examples of best practice to help other areas to develop innovative ways of joining up their health and social care services. The program has been expanded to 11 new areas.

An Unexpected Bingo Call: You Can’t Play (US)

Many facilities house healthy seniors and those who are ill or disabled, people who need assistance and people who don’t. Some have been known to adopt exclusionary policies, mandating separate facilities and activities for those requiring different levels of care. In 2011, for instance, a C.C.R.C. in Norfolk, Va., called Harbor’s Edge barred those in assisted living and nursing units from a popular waterfront dining room. The facility eventually reversed its policy after fuming residents and families contacted the local long-term-care advocate, a lawyer, local news media and The Times.

App Gives Students an Incentive to Keep Their Phones Locked in Class

Resisting the urge to pull out your phone in class is quite difficult for many students, apparently. There are texts to answer, emails to read, snapchats to send, and rude comments to post on Yik Yak. But two students at California State University at Chico have created something they hope will persuade students to keep their phones tucked firmly in their pockets: An app that rewards them with coupons for local businesses when they exhibit self-control and leave their phones untouched during class.

Should You Skip Revise and Resubmit?

I was once told by a senior scholar that if a journal asks you to revise and resubmit a manuscript, you should, instead, leave it mostly as is and immediately submit it somewhere else. In some sense, that advice seems logical, and is certainly a timesaver if you can get the piece published as is rather than revising it. But the idea of ignoring revision suggestions also seems questionable and almost irresponsible.

Cochrane identifies priority topics for review

We are pleased to announce the publication of the first Cochrane-wide Priority Review List. The creation of this list represents the achievement of a key milestone for Target 1.1 Prioritisation, a part of Cochrane’s Strategy to 2020. In this target we set out to identify about 200 Cochrane reviews, either new titles or reviews requiring updates, that best meet the needs of healthcare and health policy decision makers. Areas that will be of interest to KUSP FYI readers:
-Care practices in care homes
-Information, training and support for informal caregivers of people with dementia
-Environmental and behavioural modifications for improving food and fluid intake in people with dementia
-Hospital nurse staffing models and patient and staff related outcomes
-Audit and feedback: effects on professional practice and health care outcomes
-The effects of on-screen, point of care computer reminders on processes and outcomes of care
-Continuous quality improvement: effects on professional practice and healthcare outcomes
-Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations

More Staff Critically Needed to Meet Complex Resident Care Needs Canada-flat-icon

Without increased staff, long term care residents will not get the care they need and will increasingly be at risk, warns the Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). “At 3.4 hours per resident per day, current staffing levels continue to fall far short of the 4.0 hours per resident per day recommended by the Sharkey Report in 2008,” says Tim Siemens, OANHSS Board Chair.

Government of Ontario launches updated plan for health care Canada-flat-icon

Of note, the action plan calls for:
-More nursing, personal support, home-making and rehabilitation therapy services at home
-Improved dementia supports, including new memory clinics

Premiers urge Ottawa to do more on infrastructure, seniors’ health care Canada-flat-icon

One of the meeting’s accomplishments was a consensus on the need for a national strategy on seniors’ health care. Both the Canadian Medical Association and the Canadian Nurses Association had urged the premiers to address the issue at the meeting, and they heeded the call. “There are many different avenues where an aging population is affecting us in terms of our economic ability but also in terms of cost,” Ghiz said.

No Complaints of Pain is a Problem

I spend a great deal of time reading nurses’ notes from both nursing homes and hospitals. In most cases, the patients/residents clearly have multiple potential sources of pain–cancer, arthritis, contractures and wounds. It is often the case that the nurse documents behaviors that are consistent with the experience of pain, such as combative behaviors, poor oral intake, and insomnia, however, the recognition of pain as the etiology of the symptom is seldom identified.

Need more Long Term Care beds says Alberta Minister of Health Canada-flat-icon

The solution to the hospital bed shortage crisis is more long-term-care beds in the community and that is the minister of health’s priority, his press secretary says.

Despite promise, not all Ontario long-term care homes inspected Canada-flat-icon

The provincial government promised that every long-term care home in Ontario would have a thorough inspection completed by mid-January, but a CTV News investigation reveals that hasn’t happened. In fact, while there’s been significant progress, nearly a quarter of all homes don’t have a completed and published inspection in the last year.

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Resources

Translating Ageing Research Network

CARDI has created an online network to promote knowledge translation in ageing research. It aims to promote good practice on how research can improve the lives of older people. The Translating Ageing Research Network (TARN) on LinkedIn will promote the dissemination of ageing research to impact on policy and practice.

2014 Tri-Agency Financial Administration Guide now available Canada-flat-icon

The three federal granting agencies — the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council of Canada (NSERC), and the Social Sciences and Humanities Research Council of Canada (SSHRC) — have posted the 2014 Tri-Agency Financial Administration Guide on their respective Web sites. The guide is effective January 1st, 2015 and supersedes all previous versions.

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Opportunities

The Institute for Clinical Evaluative Sciences (ICES) is inviting all Ontario organizations that are users of research evidence to submit Applied Health Research Questions (AHRQs) Canada-flat-icon
DEADLINE 12 February

An AHRQ is a question posed by a health system Knowledge User that, if answered, may improve or benefit the Ontario health care system. Knowledge Users, users of research evidence, include policy development staff, planners and decision makers from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Other organizations with knowledge users include, but are not limited to:
-other government ministries
-Local Health Integration Networks (LHINs)
-hospitals (acute and rehabilitation)
-Community Care Access Centres
-provincial associations and agencies across Ontario (e.g., Ontario Brain Institute)

Editorial Consultant: Journal of Nursing Regulation

The editorial consultant will oversee the JNR’s editorial operations, including acquisitions, managing the peer review process, performing some editing of manuscripts, communicating with authors, overseeing production and design and collaborating with the editor-in-chief and other members of the editorial team to create a professional journal that is distributed on time.

Fuse PhD Studentship: How to get research findings into practice in the changing landscape of public health
Supervisor: Professor Dorothy Newbury-Birch
School of Health & Social Care, Teesside University
Middlesbrough UK
DEADLINE 19 February

Using an ongoing research study as a case study this PhD will explore how to get effective research findings into practice in the changing public health landscape and the school environment. The student would explore with school practitioners/ students/parents/policy makers and public health colleagues how to embed an alcohol intervention into routine school practice. Theories of implementation including Normalisation Process Theory will be explored and an implementation model to be used in practice will be developed and trialed.

Assistant Scientific Director Canada-flat-icon
Institute of Gender and Health, Canadian Institutes of Health Research
Montréal PQ
DEADLINE 13 February

The Assistant Scientific Director provides primary support to the Scientific Director in fostering and promoting the strategic initiatives of the Institute. The Assistant Scientific Director works directly with Montreal-based and Ottawa-based Institute and CIHR staff; senior federal and provincial government officials; Canadian and international researchers and trainees; senior staff of other CIHR Institutes; and Institute stakeholders to conceive, develop, implement and evaluate programs and projects to ensure the Institute meets its goals.

Knowledge Translation and Policy Manager Canada-flat-icon
Institute of Gender and Health, Canadian Institutes of Health Research
Montréal PQ
DEADLINE 13 February

The Knowledge Translation and Policy Manager leads the knowledge translation (KT) and strategic communications portfolios at the CIHR Institute of Gender and Health (IGH), including the management of KT projects, policy initiatives, communications activities, funding opportunities, budgets and partnerships.

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