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Health Human Resources Series Number 7 Better Data: Better Performance
Community Health Nursing in Ontario
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BLYTHE (PI), BAUMANN, UNDERWOOD, DANESH, ORECHINA (CO-PIS)
Maximizing “Brain Gain” In Health Care: Evaluating The Potential Of Internationally-Educated Nurses Currently Resident in Ontario
- Funded by: Ministry of Health (2004-2006)
- Stage: Data Collection
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- While the “brain drain” receives ample media attention, the potential “brain gain” has been ignored. Currently, the proportion of Canadian residents born outside of Canada is at the highest level in 70 years. Many of these new Canadians are internationally-trained nurses living in Ontario, unable to find employment as a nurse. This untapped supply of newcomers could play an important role in reducing the nursing shortage.
- The purpose of this study is to gather information about the stock of internationally-trained nurses residing in Ontario.
- In the short term, it is hoped that this project will increase decision-maker’s awareness of the potential for recruiting more internationally-trained nurses resident in Ontario into the nursing workforce.
- More accurate knowledge of the experience of the integration of nurses into the workforce will provide evidence on which to generate strategies to maximize a currently under-utilized human resource.
Outcomes: Report
Health Human Resources Series Number 3 2nd EDITION
Internationally Educated Nurses in Ontario Maximizing the Brain Gain
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BROWN PI), ANDERSON, BAKER, COTT, DORAN, DURBIN, GOERING, JAGLAL, SPENCE LASCHINGER, LIN, MARKEL, MCGILLIS HALL , MCKILLOP, MURRAY, PINK, TEARE (Co-Is).
Hospital Report 2002 and Beyond , Ontario Association (2002 – 2007)
- Funded By: Ministry of Health and Ontario Hospital
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The project will research and develop performance scorecards for the following types of Ontario hospitals: complex continuing care (2002/2003); emergency department care, rehabilitation, and complex continuing care (2003/2004); acute care, mental health, complex continuing care and rehabilitation (2004/2005); rehabilitation, complex continuing care, mental health (2005/2006) and; mental health, rehabilitation (2006/2007).
- The research includes researching, developing and evaluating indicators of financial performance and condition, clinical outcomes and utilization, patient satisfaction and innovation system change.
- Much of the research involves developing and testing risk adjustment models, benchmarks, data quality methods, inter-quadrant relationships, and quality improvement approaches.
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BROWN(PI), MCGILLIS HALL, LASCHINGER, & DORAN
Hospital Reports Research Collaborative
- Funded By: MOHLTC, Ontario Hospital Association (OHA) (2003 – 2013)
- Stage: Data analysis
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Evaluation of selected evidence-based indicators representative of nursing care for feasibility and validity.
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CAMERON (PI)& ARMSTRONG-STASSEN
The Work Environment And Retention Of Nurses Over 45 Years Of Age
- Funded By: NEUORU (2004 – 2006)
- Stage: Data collection
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research :
- To look at work environment factors affecting senior nurses and their continuance in the workforce. It is known that significant numbers of nurses leave nursing practicebefore 65 years of age which compounds the anticipated nursing shortage occurring in Canada. We hope to be able to identify factors that employers can consider to improve retention of these senior nurses.
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CHABOYER, COURTNEY, DUFFIELD (CO-PIS), SEATON-SYKES, FORRESTER, WALLIS AND HOLZHAUSER
Developing Evidence-Based Workforce Models For Nursing Services In Acute Care Hospitals
- Funded By: Australian Research Council (2005 – 2006)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Describe the activities undertaken By registered nurses, enrolled nurses and personal care workers in the provision of patient care in acute care settings.
- Determine the patient care activities that should be delivered and delegated By various levels of nursing care providers in the acute care setting.
- Develop evidence-based policy, professional and organizational guidelines for the delivery of nursing services in acute care hospitals.
- Research will provide guidance in the development of innovative strategies for work redesign.
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CHAMBERS, MCKINNONS, LOW, HAYWARD , MCKEY, MONTEMURO, MORDEN, NORTH,WYNDHAM, WILKINS, ALLCROFT, & THOMAS
A Demonstration Project To Pilot And Evaluate The Implementation Of A Virtual Library Education And Critical Analysis Resource Network In All Long-Term Care Facilities And Selected Organizations Delivering Care In Central South Ontario
- Funded By: Ontario Ministry of Health and Long-Term Care (2003 – present)
- Stage: Data collection
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Provide educational long-term care resource centre for staff .
- Provide a virtual library and support education modules that focus on creating a culture of inquiry using effective search strategies and applying the evidence to LTC practice.
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CHIEN, BROWNE, WEIR, ROBERTS, GAFNI, CROOK, MARKLE-REID, WALSH, WALSH, & COLWELL
The Effectiveness And Efficiency Of Alternative Approaches To Persons Requiring ComplexContinuing Care
- Funded By: CHSRF (2004-2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Facilitate improved continuity and earlier access to appropriate care for ALC patients with complex chronic illness residing in acute care.
- Minimize disruption in the lives of ALC patients requiring Complex continuing care (CCC) or Rehabilitation.
- Impact the relationships between acute care and post acute care environments (Rehabilitation, CCC, LTC, Home based care).
- Impact the relationship of RNs to patients and team members in different settings (acute care rehabilitation, community care teams, etc.).
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Deber, R. Williams, P.
CIHR Team Grant in Community Care and HHR
- Funded: CIHR (2006-2011)
- Stage: on-going
Sub grant - Theme 2 Health Human Resources (HHR)
Deber, R., Baumann, A., & Laporte, A.
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- This theme addresses the supply and employment shirts of health professionals, with particular emphasis on the sub sectors in which these providers work; the factors affecting the likelihood that they will continue working in their profession; differences by sub sector in retention (stickiness) and what workers do; and their training and educational needs.
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DEBER (PI), BRIMACOMBE, ADAMS, & VERRIER
Public And Private Funding In Financing And Delivery: Trends In Private Delivery Of Health Care
- Funded By: CIHR (2002 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Study examines the mix of public, private not-for-profit, and private for profit providers in a small business or a share-holder owned corporation who are involved in delivering health care; how this varies by sector; and how this in turn affects costs,
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DEBER (PI), WILLIAMS, BAUMANN, O’BRIEN-PALLAS, Et Al.
From Medicare To Home And Community (M-Thac): Overtaking The Limits Of Publicly-Funded Health Care In Canada
- Funded By: CIHR (2001 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Integrate health services, population health, and clinical research for examination of the policy and service delivery implications of our increased reliance on a broad range of community-based services, for a broad range of clients.
- Inform policy and service delivery by fostering timely, high-quality research that seeks to document and understand the implications of the shift to home and community, and its differential impact on diverse populations, in partnership between community-based and university-based researchers.
- Create a structure for conversation, mutual learning, and collaboration among community organizations and researchers about the implications of home and community care.
- Disseminate research findings and improve the transparency and accountability of decision making.
- Provide opportunities for training health researchers in a broad variety of disciplines in an environment characterized by interaction with community partners.
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DEGNER (PI), ESTABROOKS, & LASCHINGER
Evaluation of an Organizational Intervention to Improve Nursing Work Life through Training in Knowledge Translation: Phase I
- Funded By: CIHR (2005-2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Study will provide information on the usefulness of theory in supporting the practice of knowledge transfer by nurses in tertiary care hospitals, test indicators of nursing work life, which could be used to create nursing work life “geographies” in Canadian hospitals and integrate knowledge transfer into training and continuing education.
- The organizational intervention is an innovative approach to training nurses for knowledge transfer that could, if effective, be used in tertiary care hospitals across Canada.
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DICENSO
National Chair For Management Of Nursing Services
- Funded by: CHSRF, The University Health Network, & Ontario MOHLTC
- (2000 – 2010)
- Stage: Ongoing
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Focus is on capacity building bringing new researchers to the point where they can independently contribute to applied health services and policy research issues.
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DICENSO (PI) , ANGUS, ARMSTRONG, COCKERILL, COYTE, DAVIES, DORAN, EDWARDS, GOERING, HUTCHISON, MINORE, MONTELPARE, O’BRIEN-PALLAS, PONG, RIOUX, RUKHOLM, SPASOFF, & WOODWARD
Ontario Training Centre In Health Services And Policy Research
- Funded by: CHSRF & CIHR (2002 – 2012); Ontario MOHLTC, Mental Health & Rehabilitation Reform Branch (2002 – 2008); and Ontario MOHLTC (Research Unit) (2003 – 2004)
- Stage: Ongoing
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Using a consortium model which allows six universities (McMaster, Lakehead, Laurentian, Ottawa , Toronto , and York) to share their strengths.
Purpose of this training centre is to:
DICENSO, MINORE, PONG, RUKHOLM, WOODWARD, EDWARDS, ANGUS, COYTE, O’BRIEN-PALLAS, ARMSTRONG, SPASOFF, DORAN, MARTIN, & DAVIES
Development And Evaluation Of An Ontario Health Services Training Centre
- Funded By: Canadian Institutes of Health Research and the Canadian Health Services Research Foundation (2002 – 2007)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The OTC is intended to train and mentor graduate students as health services researchers. These students are registered in graduate faculties of any of the six universities that make up the OTC consortium.
- A knowledge gap exists between the policy making process, the delivery of health-related services and health services research, partly because there are too few health services researchers.
- The OTC is a consortium of six Ontario Universities that have come together to train graduate students as health services and health policy researchers. These universities include: McMaster, University of Toronto, Laurentian, Lakehead, University of Ottawa, and York.
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DORAN , MYLOPOULOS, KUSHNIRUK, NAGLE, STRAUS, SIDANI, HIRDES, LAURIE-SHAW, AFFONSO, TOURANGEAU, HILLAN
Outcomes in the palm of your hand: Improving the quality and continuity of patient care
- Funded By: Communication and Information Technology Ontario (CITO) and MOHLTC (2004 – 2006)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Provide health care managers and policy makers with valuable information for their use in designing more effective systems for communicating and utilizing patient health information and for improving the continuity and quality of care.
- Provide nurses with new opportunities for enhanced access to comprehensive and pertinent patient-related and health information.
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DUFFIELD , O’BRIEN-PALLAS, DIERS, HALL, KING, AISBETT(Co-PIs), & ROCHE
Nursing Workload, Skill Mix And Models Of Care Research
- Funded By: Ministry of New South Wales Health (2003 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Establish the relationship between nursing skill mix and models of nursing care on patient outcomes, case-mix adjusted.
- Collect empirical evidence on the impact of increased in-patient acuity and reduced length of hospital stay (LOS) on nurses’ workload.
- Research will be carried out in two complementary steps. First, routinely collected historical administrative data will be analysed. Information from this step will be used in the second step in which data will be collected prospectively at the ward/unit level.
- Research will fill important gaps in what is currently known about nursing workloads, skill mix, and models of care, and their impact on patient outcomes.
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FISHER, A., BAUMANN, A.
The Development of a Critical Care Nursing Workforce Profile and Nurse Tracking System in Ontario
- Funded: Ministry of Health and Long-Term Care (2008-2012)
- Stage: On-going
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The McMaster NHSRU site is developing a workforce planning system designed to predict staff retention, retirement rates, training and replacement rates and risk analysis based on nurse utilization. It will enable the MOHLTC to determine available critical care nursing resources at the provincial, LHIN and local community level.
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FORBES, ANDERSON , MORGAN, MARKLE-REID, HENDERSON, HAWRANIK, LEIPERT, & PARENT
The role of home care in dementia care
- Funded By: The Alzheimer Society of Canada (2005 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Describe the use and non-use of health care services By Canadians with dementia and the role of home care and other agencies in meeting their needs.
- Examine the impact of gender and place (rural/urban setting and province) in predicting use of these services.
- We will explore the following questions from the perspectives of unpaid and formal caregivers: a) what influences unpaid caregivers' decision to use or not use formal health care services; b) how do caregivers perceive the current availability, accessibility, and acceptability of health care services; and c) what is the role of home care and other service providers in supporting unpaid caregivers in caring for those with dementia?
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GODWIN, TRANMER (Co – PI’s), MCCANS, O’DONNELL, BOLTON , HARRISON, STAPLES, BEATTY, LAM, & HEYLAND
Primary Care Management/Action Plan For Advanced Chronic Diseases (The Roadmap Project)
- Funded By: Primary Care Health Transition Fund (2004-2006)
Purpose/Outcomes/Deliverable and Implications for clinical practice, policy, and research:
- The purpose of the RoadMAP project is to evaluate, using randomized trial methodology, an innovative, primary-care based, multidisciplinary model of care for patients with symptomatic COPD & CHF. The goals of this project are to optimize the:
- Management of patients with ACD (CHF/COPD) in the primary care setting
- Quality of life of patients with ACD (CHF/COPD)
- Access to, and utilization of, community-based services for patients with ACD
- Access to, and appropriate use of, tertiary and acute care services for patients with ACD
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The multi-component intervention is designed to: improve patients’ self care ability, facilitate access to the most appropriate services, ensure medical treatment is in accordance with consensus guidelines and promote consistency of health care communication. An advanced practice nurse with clinical specialist knowledge in COPD and HF working collaboratively with primary care practitioners forms the cornerstone of the intervention.
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HARRISON, MEDVES, TRANMER, & LAMB
Evidence For Practice: Nursing Implementation Study ( Queens University )
- Funded By: MOHLTC (2004-2007)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The Practice and Research in Nursing Group will take practice-based issues and respond with the most up to date evidence in practical forms for practitioners and policy developers.
- The group will actively include clinicians and researchers from varied fields of nursing, including acute care, chronic and long-term care, and community and home care. The focus will be on the provision of nursing practice, based on the best available evidence with the field of home care.
- Populations of focus will be cross sectors of care with particular emphasis on topics related to chronic conditions, maternal child health and patient safety.
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HEYLAND, TRANMER, GAFNI, COOK, GIACOMINI, & KUHL
Understanding And Improving Communication And Decision Making At The End Of Life
- Funded By: CIHR (2004 – 2009)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The primary objective of the project is the creation of a New Emerging Team (NET) in Palliative/End of Life (P/EOL) Care Research located at Kingston General Hospital and Queen’s University with affiliates at other universities and hospitals across Canada.
- The team will describe, understand, evaluate, and ultimately improve communication and decision-making at the end of life. Our focus is on the clinical, psychological, and social aspects of these interactions and the health care system in which these interactions take place.
- We will evaluate the policy and economic issues surrounding these interactions, which both frame and respond to clinical decisions. We will examine the resource and policy pressures on decisions and decision makers, as well as the health system consequences of clinical decisions.
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HOLNESS (PI), COREY, HOUSE, LISS, PURDHAM, SASS-KORTSAK, SCOTT SILVERMAN, TARLO, VERMA, ABEL, EAKIN, FAUGHNAN, HARGREAE, HOSEIN, KERR, LOU, LOUGHEED, PRATT, SKOTNICKI-GRANT, & SWITZER-MCINTYRE
Centre Of Research Expertise In Occupational Disease
- Funded By: Ontario Workplace Safety and Insurance Board (WSIB) (2003 – 2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Stress-related problems are becoming a major source of disability claims for nurses. This centre will provide expert guidance on research in this area and as a co-investigator could provide seed money for grants for nursing-related research.
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HUTCHISON (PI), ABLESON , BRAZIL , CHAMBERS, CILISKA, DENTON , EYLES, GIANCOMINI,HURLEY, PLOEG, WOODWARD, & ZEYTINOGLU
Community Care Research Centre
- Funded By: CIHR (2001 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- A partnership of public and voluntary community care agencies in Hamilton, Ontario and an interdisciplinary group of McMaster University researchers from health, social, and management sciences.
- The research program will focus on the organization and delivery of communityhealth and social support services. Research activities will span clinical, health and social services, health policy, health systems, and determinants of health research.
- Objectives include:
- Generating new knowledge in the field of community care
- Building research and evaluation capacity in community care
- Stimulating interagency and intersectoral collaboration and resource sharing in research
- Providing opportunities for agency staff and managers to acquire and apply research skills
- Promoting the application of research evidence to clinical practice,management, and policy making.
- Five research projects have been identified as priorities for the first year, including:
- Integration, coordination and continuity of care for socially disadvantaged seniors
- health promotion with immigrant and refugee clients
- Telephone support services for family caregivers
- Organizational and community values about community care
- Guidelines for the identification and management of elder abuse by staff and volunteers of community care agencies.
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HUTTON, SEMOGAS, & CLEVERLEY\When Grade Nine Girls Help Each Other to Succeed.
- Funded By: Hamilton Community Foundation (2004-2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Provide access to peer support and social skills training through the formation of a Girls’ Circle who work together on common interests and goals.
- Enhance opportunities related to careers and school for participants through community service.
- Build a sustainable community business resource network to support Girls’ Circle activities.
- Improved relationships, quality of life, perceived health, and school performance amongst participants.
- Market skill acquisition amongst participants related to goal setting, community service learning and through involvement with a fundraising plan.
- Greater involvement of community members.
- Increased knowledge of opportunities for jobs and careers.
- Increased education opportunities through the scholarship fund.
- To conduct evaluation of the intervention as having potential as a promising practice to reduce persistent poverty.
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KERR, MUSTARD (PIS), BIGELOW, FERNIE, FRASER, KEIR, & LASCHINGER
Evaluation Of Overhead Patient Lift Devices In Ontario
- Funded By: Ontario MOHLTC
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- In the May 2004 provincial budget, the Government of Ontario announced a commitment to invest $60M in fiscal year 2004/05 in the purchase and installation of patient lifting equipment in Ontario health care institutions. This investment is expected to be sufficient to purchase and install more than 12,000 new overhead lifts and will also support the provision of staff training services.
- There is a clear need for rigorously conducted research that would evaluation the effectiveness of this program.
- This study will evaluate the new lift installation programme from three key perspectives: does such a programme help prevent lifting-related injuries in health care staff; does it improve or at least maintain the quality of patient care; and does the program improve or at least maintain the quality of work life for health care staff directly involved in patient lifting.
- The overall emphasis of the evaluation will be a determination of the cost effectiveness of the lift programme.
- A carefully conducted and thorough study on this topic will provide policy makers withthe essential cornerstone for an evidence base that could contribute immensely to the literature on workplace interventions aimed at improving the employee health.
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LASCHINGER (PI), & FINEGAN
Testing a Multi-Level Model of Workplace Empowerment in Hospital Nursing Settings: A National Study
- Funded By: SSHRC (2005-2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Study will test a multilevel model of the effect of structural empowerment on unitand individual outcomes over time in a national sample of staff nurses and their immediate managers who work in hospital settings.
- Efforts must be made to create more positive work environments for nurses to address the issue of recruitment and retention. Managers play an enormously important role in creating positive working conditions for staff, and arguably greatly influence the extent to which conditions of work empowerment are in place.
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LASCHINGER, WONG (Co-PIs), ARMSTRONG-STASSEN, KERR WHITE, D’AMOUR, SAXE-BRAITHWAITE, MATTHEWS, VINCENT, RITCHIE, WILK, SEMENIUK, SHAMIAN, GRINGS, OKE, WARD, & MAPA
A Profile Of The Structure And Impact Of Nursing Management In Canadian Hospitals
- Funded By: CHSRF (2003 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
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LINGARD, REGEHR, BAKER, BOHNEN, REZNICK, ORSER, DORAN, ROTSTEIN, TAN, & ESPIN
Team Talk II: A Multi-Institutional Evaluation of a Checklist Intervention to Structure Communication and Promote Patient Safety in the Operating Room
- Funded By: Canadian Institutes for Health Research (2004 – 2007)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Refine our existing categorization of team communication practices relevant to information management and transfer in the operating room setting.
- Develop and pilot a comprehensive, usable checklist instrument to systematize information management and transfer.
- Develop and pilot a reliable and valid observational scale for use in assessing the impact of the checklist instrument on team communication practices.
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MARK (pi), & PINK
Research Training: Health Care Quality and Patient Outcomes
- Funded By: National Institute for Nursing Research (2004 – 2009)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The purpose of this grant is to provide pre- and post-doctoral research training in nursing related to quality healthcare and patient outcomes.
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MAUDER, (PI), LANCEE, MCGILLIS HALL , HUNTER, GUPTA, ROURKE, BALDERSON, RAYMOND, NAGLE, BENNETT, PECZENIUK, PETRYSHEN, STEINBERG, PAIN, STEWART, BORGUNDVAAG, FERNANDES, WASYLENKI, GOLDBLOOM, VELDHORST, & KEATINGS
Psychological and Occupational Impact of the SARS Outbreak on Healthcare Workers.
- Funded By: CIHR (2004 – 2006)
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MCGILLIS HALL (PI).
Nurse Staffing and Quality Nursing Work Environment Indicators: A Critical Synthesis of the Literature and Pilot Study of the Feasibility of Collecting Indicator Data
- Funded By: Ontario Ministry of Health and long-term care (2003 – 2006)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The purposes of this research are: (a) to conduct a critical review and analysis of the literature on input or structural variables in work settings that can be considered indicators of the quality of nurse's work life in health care settings in Ontario, and (b) to conduct a pilot study to determine the feasibility of collecting data related to these indicators.
- The indicators include: staff mix ratios for full-time, part-time and casual nursing staff; educational background of nursing staff; experience of nursing staff; use of overtime hours; use of agency staff; absenteeism hours; number of grievances; level of autonomy and decision making experienced By nurses; professional development opportunities; span of control of unit manager; scope of nursing leadership role; team functioning; organizational climate and culture; job stress; productivity and workload. The goal of this analysis of the literature is to provide sound information related to measures that can be used for the pilot feasibility study.
- Ultimately this research will inform decisions and recommendations regarding the complementary data required to link to the clinical outcome database being developed and tested in the Nursing and Health Outcomes Study.
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MCGILLIS HALL (PI), DORAN, & LASCHINGER
Nursing Report 2002: Indicator Testing And Validation
- Funded By: Ontario MOHLTC and OHA (2002 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Introduce and structure a nursing perspective within the Hospital Report Series in Ontario.
- Nursing Report 2001 identified evidence-based indicators representative of nursing care through input from key stakeholders and leaders in nursing in Ontario.
- Evaluate the selected indicators for feasibility and validity.
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MCGILLIS (PI), & LASCHINGER
Nursing Report: A Component of Hospital Reports 2002 and Beyond
- Funded By: Ontario MOHLTC and the (OHA) (2002 – 2008)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The overall purpose of the Nursing Report project was to introduce and structure a nursing perspective within the Hospital Reports series in Ontario. In the first year of the project, evidence-based indicators representative of nursing care were identified with input from key stakeholders and leaders in nursing in Ontario. In this second year, these indicators will be tested for feasibility and validity.
- In 2001, the first year of the project, evidence-based indicators representative of nursing care were identified with input from key stakeholders and leaders in nursing in Ontario. In forthcoming years, these indicators have been tested for feasibility and validity, and included in future iterations of the Hospital Reports series.
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McKEY (PI)
Leadership Practices, Organizational Commitment, and Conditions of Work Effectiveness of Chief Nursing Officers in Ontario ’s Restructured Hospitals
- Funded by: NEUORU (2001 – Completion of dissertation)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To provide a foundation for nursing leadership research that focuses on leadership practices and work effectiveness.
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O'BRIEN-PALLAS (PIs)
NURSING HEALTH HUMAN RESOURCES FOR THE NEW MILLENIUM-NATIONAL CHAIR FOR NURSING HUMAN RESOURCES
- Funded By: CHSRF, The University Health Network, & Ontario MOHLTC (2000 - 2010)
- Stage: Ongoing
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Worked closely with provincial and federal policy decision-making bodies (e.g., Ontario Joint Provincial Nursing Committee and Canadian Nursing Advisory Committee) to ensure that evidence is used in making HHR decisions.
- Provided mentoring and educational opportunities to doctoral students, a CHSRF Career Reorientation Scientist, and research apprentices.
- Consultant for CHSRF and Canadian Institute of Health Information related to national policy issues and publications.
- Fostered international linkages with Australia, United States, Japan, and United Kingdom to support dissemination and understanding of current HHR statistics and quality of worklife issues
- Participated in design and implementation of the Dorothy M. Wylie Nursing Leadership Institute for nurses, administrators, and policy-makers.
- Further information about Chair activities is available at: www.hhr.utoronto.ca
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O'BRIEN PALLAS, TOMBLIN MURPHY (CO-PIS), BIRCH,THOMSON, DUFFIELD, ALKSNIS GUNDERSON, ROOTMAN, PRINGLE, HUGHES, PENNOCK, KEPHART, HUBERT,TOMBLIN, NEVILLE, SMADU, & LEMONDE
DECISION MAKERS: SHAMIAN, AUFFREY, MACMILLAN, COGHLAN, CLOSSEN, WARD, & MOORE.
Health Human Resources Modelling: Challenging The Past, Creating The Future
- Funded by: Canadian Health ServicesResearch Foundation, Open Grants Competition (2002-2005).
- Status: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Research addresses the dynamic nature of the needs for nursing human resources, specifically the challenges involved in the provision and management of human resources that are responsive to those needs.
- To enhance existing demographic-focused approaches to Health Human Resources
- Planning (HHRP) by moving beyond considerations of supply and utilization to consider the factors and shocks that influence the health system.
- Project 1 will assess changes in the levels and distribution of health over time and will provide decision makers with an evidence base that will allow the matching of nurse resources to changing population health needs.Project 2 will focus on understanding the way other inputs constrain or enhance the rate of production of nurse human resources in the hospital sector.
- Project 3 will assist in developing evidence-based strategies for retaining different target groups of nurses.
- This program involves partnerships between decision makers, policy makers, and researchers from Ontario, Nova Scotia, Newfoundland & Labrador, Prince Edward Island, New Brunswick, and Saskatchewan.
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O'BRIEN-PALLAS, TOMBLIN-MURPHY, SHAMIAN (Co-PIs), LASCHINGER, BIRCH, D’AMOUR, GALLANT, KEPHART, MCGILLIS-HALL, SMADU, THOMAS, & VERRIER
Understanding The Costs And Outcomes Of Nurses' Turnover In Canadian Hospitals
- Funded by: CHSRF (2003-2006), Health Canada
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:To examine how the rate and intensity of nursing turnover (the loss of humancapital as providers leave and the lost productivity as new hires are oriented) impact patient satisfaction and safety, nurse satisfaction, health and safety, and system outcomes (turnover costs). An understanding of the correlates and the impact of turnover will assist policy makers to design mechanisms and policies to effectively recruit and retain nurses as market competition increases due to shortages.
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PETER (PI), SPALDING, CONRAD, KENNY, & MCKEEVER
Ethical Dimensions Of Home Care Policies For Children And Youth
- Funded By: The Hospital for Sick Children Foundation (2003 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Identify key elements/dimensions of health policy that are ethically relevant to the home care of children and youth. These will inform both a conceptual and practical analysis of the inherent ethical issues at a macro, meso, and micro level.
- Identify systematically within provincial and territorial home care legislation, regulations, and policies, key policy elements or dimensions that are relevant to children and youth.
- Conduct a conceptual analysis of these documents by making transparent their underlying values and their potential impact upon children and their families through the critique of the terms, principles, and arguments used both in their development and in the discourse of health reform.
- Conduct a practical analysis to develop a position paper regarding home care for children and youth to direct future policy development in relation to the KirBy and Romanow reports.
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PLOEG& BRAZIL(PIs)
Preventive Primary Care Outreach
- Funded By: MOHLTC, Primary Health Care(2004-2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The purpose of this study is to evaluate the impact of a Preventive Primary Care Outreach (PPCO) intervention compared to usual care for seniors aged 75 years and over who are at risk of functional decline. This intervention will be provided to clients of family physicians who are members of Primary Care Networks.
- Study objectives are to:
- Evaluate the impact of the PPCO intervention to usual care on (a) health-related quality of life, (b) use of health and social services and associated costs, (c) functional status, (d) mortality, (e) institutionalization, and (f) self-rated health.
- Assess participants’ satisfaction with the PPCO program.
- The study is a randomized controlled trial. Individuals who screen positive for risk of functional decline will be invited by their family physician to participate in the study. We will recruit 640 patients for the study.
- In the intervention group, the nurse will conduct an initial home visit to complete a comprehensive, multidimensional assessment, identify problem areas, and develop a recommended plan of care.
- It is expected that participants in the intervention group will receive approximately 10 hours of nursing contact over the 12 months of the intervention.
- This will include 3 home visits per participant as well as telephone contacts with the participant and contacts with the family physician and other health and social care providers.
- The proposed study will address limitations of research conducted to date by incorporating the following features:
- Screening of seniors for risk using a tool with demonstrated predictive validity
- Adequate sample size to detect clinically important and policy relevant effects
- Use of the Resident Assessment Instrument for Home Care (RAI-HC) for comprehensive assessment and intervention
- A primary outcome measure (quality adjusted life years) that integrates quality and length of life
- An economic analysis to assess the cost-effectiveness of the intervention.
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PLOEG& HUTCHISON(PIs)
FORMATIVE EVALUATION OF A COLLABORATIVE PROGRAM TO BUILD RESEARCH AND EVALUATION CAPACITY IN HAMILTON COMMUNITY CARE AGENCIES
- Funded By: MOHLTC, Primary Health Care (2004-2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To examine the extent to which the CCRC collaborative partnership has been able to implement a program to build research, program evaluation, knowledge-based practice and quality management capacity in Hamilton community care agencies.
- To assess the impact in Hamilton community care agencies of the CCRC collaborative partnership to enhance research and evaluation capacity.
- To identify barriers to and facilitators of building research and evaluation capacity in Hamilton community care agencies.
- To develop recommendations to strengthen the CCRS’s effectiveness in building research and evaluation capacity in Hamilton community care agencies.
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RAINA, (PI) SANTAGUIDA, TANIGUCHI, BRAZIL & DENTON
Diffusion And Dissemination Of Evidence-Based Interventions For Prevention And Screening Of Diseases In The Elderly
- Funded By: CIHR (2003-2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The purpose of this research is to develop and evaluate methods to disseminate evidence-based interventions for the prevention and screening of diseases in the elderly through a systematic review of the literature. The outcomes will be a report and journal article.
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RATHWELL, DEBER (Co-PIs), BRECKENRIDGE, NAUENBERG, NEVILLE, TOMPSON, KENNY, NESTMAN, & CONRAD
Building A Public Dialogue Framework For Defining The Medical Basket
- Funded By: CHSRF (2002 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Program purpose is to produce a framework and process for pubic dialogue about the definition of the Medicare basket in Canada.
- Objectives are as follows:
- To develop a preliminary framework which will guide data collection and analysis regarding the different approaches to collective funding of health services across jurisdictions and sectors
- To investigate the approaches to defining the basket of services to be covered across Canada, European countries, and the private health insurance sector using this framework
- To clarify ethical implications of the identified approaches
- To incorporate the findings into a revised framework and design a strategy for conducting dialogue with the revised framework as the guide
- To test the acceptability of the framework and proposed process for conducting dialogue with key decision makers and community representatives in Ontario and the Atlantic provinces.
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RATHWELL (PI), JOFFRES, NESTMAN, DEBER
A New Direction: Canadian Lessons From International Experiences With Strategic Resource Allocations.
- Funded By: Canadian Institutes for Health Research (CIHR) (2005-2008).
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The aims of the study are fivefold:
- Compare selected international experiences of resource reallocations at the macro and meso levels By public and private funding agencies and of the struggle to reconfigure state market relations when conditions change
- Assess the extent to which resource reallocations meet tests of allocative efficiency, fair financing, stewardship, and citizen engagement in public and private purchasing agencies
- Test the transferability and acceptability of best practices in resources reallocations to Canada
- Develop a decision making procedure in which normative judgements inherent to resource reallocation decisions can be explicitly discussed
- Develop policy recommendations for Canadian decision-makers engaged in reforming the health care system.
- The research will examine decision making for resource reallocations in 7 countries : Australia , England , France , Germany , New Zealand , Sweden , and Netherlands . We will examine both public and private purchasing agencies at the macro and meso levels, that is, at the federal or national level of government (macro), and the provincial/state ( Australia)/regional ( France)/district/county ( Sweden) levels of government (meso), as appropriate in each of the selected countries.
- The study will seek to answer these crucial policy questions:
- How do different countries define and apply strategic resource reallocation at the macro and meso level?
- What are the processes (consultation with whom and on what basis) and the criteria (economic, social, cultural, technological, political) utilized in deciding whether or not to add or de-list a service in the existing public and private baskets? If the public sector de-insures, does it communicate such decisions to the private insurance sector? On what basis does the private insurance sector pickup de-insured services and what impact does this have on profit and not-for profit firms?
- Do decision-makers have access to the relevant intelligence required for strategic purchasing? If the information base is inadequate, what other factors or ‘evidence’ are taken into consideration?
- How do state pluralistic and corporatist tendencies influence resource reallocation in an era of globalization and technological changes?
- How do political and explicit ethical considerations as well as normative judgements implicit in interpretations of concepts like necessary care, effectiveness, cost effectiveness, responsiveness, and stewardship influence strategic resource reallocations?
- What are the trade-offs of strategic purchasing?
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ROOS (PI), DEBER, & FORGET
Exploring Alternative Funding Models For Canadian Health Care (renewal)
- Funded By: CIHR (2004 – 2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- We propose a set of analyses focusing upon the implications which the distribution of costs in a population has for total costs under different funding arrangements. The analyses will examine five categories of health expenditures and funding formulae aggregating at the level of: individuals, families, enrolled populations, or geographically-based units. Additional analyses will explore (using both actual data and simulations to capture longer time periods) year-By-year relationships of each individual’s total costs over time.
- We will be concerned with the effects of funding arrangements on different socioeconomic groups. Particular attention will be paid to the factors associated with high health expenditures.
- We will use an evidence-based approach to assessing the implications of various proposed funding formulae while taking into account the distribution of health expenditures in an actual population. This renewal application will:
- Update and extend the data used in the analysis, which currently include attributable hospital and physician costs for each Manitoba resident, 1997-1999. We will include pharmaceutical costs, nursing home costs, and home care costs. We will use data over the 1996-2003 period
- Develop and validate a Markov model which allows us to analyze the trajectory of individual costs over long periods of time (up to a lifetime)
- Use this enhanced database and Markov modelling to examine the implications of proposed funding formulae that use the individual or family as the unit of aggregation (e.g., medical savings account variants). We will pay particular attention to cost trajectories over time and to the characteristics of those individuals with the highest expenditures
- Examine the implications of proposed funding arrangements that use larger units of aggregation, both self-selected (such as various primary care reform models) and geographical (such as regional funding formulae)
- The research will accordingly be able to test a series of related hypotheses about the implications of skewed distributions of expenditures for alternative funding formulae. From a policy standpoint, it will also highlight the potential implications of various proposals for the small proportion of individuals with the greatest costs. For example, research will help explore the potential for disease management as an alternative way to control costs.
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RUSSELL, SCARDAMALIA, BERETIER, CAMPBELL, MCKEY, LEE, KEATING, & HENDERSON
Interprofessional Knowledge Building in Health Care: A Canadian Collaborative Design
Experiment to Support Interprofessional Practices and Team Work Using Computer Technology
- Funded By: CANARIE – OLTE Learning Grant (2003-Present)
- Stage: Data analysis
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Collaborative Research grant will enable work on a project called “Beyond Best Practice: Research Based Innovation Learning and Knowledge Work”.
- This is an international collaboration with leaders in the field of education and research from 14 other universities in Canada, the US, Asia, and Europe. The overall goal of the project is to create the knowledge base for the development of innovative capacities over the lifespan and to actually create and develop the technology for such innovations.
To engage in collaborative e-learning, problem solving, and constructive knowledge building. By the end of this year-long project the learning outcome will be production of a Patient Centred Care Philosophy, which will underpin the interprofessional practice model at HHSC.
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SEMOGAS , KIRKPATRICK, GEORGE, BLYTHE, & CLEVERLEY
From Nowhere to Somewhere: Profiles of Individuals Experiencing Chronic Homelessness and Alcoholism Transiting to a Managed Alcohol Environment
Funded By: SSHRC (2004-2006)
Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The goal of this research is to understand the impact of the transition from the streets to supported housing for individuals experiencing chronic homelessness and chronic alcoholism. This will be accomplished by eliciting the views and observations made by participants in portraying their experiences as they move from the streets to supported housing.
- The objectives of the project are to:
- Identify the circumstances that led to becoming homeless and chronically dependent on alcohol
- Chronicle the experience of moving from the streets to a supported housing initiative
- Identify benchmarks of success in participating in a managed alcohol environment
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SHAMIAN, PORTER, & SCHROEDER
Healthy Workplaces Related to Home & Community Nursing
Decision Makers: Shamian, Porter
- Funded By: Health Canada (2005-2008)
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SHAMIAN , MILDON, GOODWIN, TALOSI, & NORTON
VON Canada Mobility Study
- Funded By: MOHLTC (2004 – 2006)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The Mobility Study will involve surveying staff and volunteers who currently provide services, or have previously provided services and have left VON within the past 18months, in five branches: Pictou, Cape Breton , Niagara , Ottawa and Sudbury . Two branches, Niagara and Sudbury , have been affected by contract losses, and the other three branches, Pictou, Cape Breton and Ottawa-Carleton, are in a stable situation.
- The study will provide valuable insight into the experiences staff and volunteers have had while coming to, staying with or leaving VON. The study will provide information for further research, and will influence policy direction at the government level.
- The goal of the survey is to provide a picture of mobility of staff in homecare.
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SIDANI (PI), DAVIS, STREINER, DORAN, BEATON, & MCGILTON
Alternative Approaches To Assessing Outcomes In Health Services Research
- Funded By: CIHR (2004 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Examining the utility of three approaches for assessing health-oriented patient outcomes: prospective assessment, retrospective pretest, and transition or perceived change.
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SIDANI(PI), EPSTEIN, BOOTZIN, MORITZ, & SECHREST
Alternative Methods For Clinical Research
- Funded By: National Institute of Health - National Institute of Nursing Research
- (2001 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Determine the extent to which accounting for the influence of client characteristics, preference for treatment, and dose of the intervention on outcomes affects the validity of conclusions in intervention effectiveness research.
- Examine the utility of the theory-driven approach as an alternative to the RCT for evaluating the effectiveness of interventions.
- Results will inform researchers of alternative strategies for designing intervention evaluation studies that incorporate features of everyday practice while maintaining internal validity. The goal is to enhance the clinical relevance of research.
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SLIFKIN (PI) & PINK
Cooperative Agreement For The National Evaluation Of The Rural Hospital Flexibility Program
- Funded By: Technical and Non-Financial Assistance for the Office of Rural Health Policy (2003 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Project will access impact of Flex Program on rural hospitals and communities and role of states.
- Flex program goals are: 1) Improving access to and the quality of health care services; 2) Improving the financial performance of CAHs; and 3) Engaging rural communities in health care system development.
- Monitoring project has three main components. G. H. Pink will direct the financial element of the second component, “Institutional Performance,” which will use secondary and primary data to assess the impact of the Flex Program on hospital financial status and quality of care, and to develop benchmarks for financial performance and quality improvement for small rural hospitals.
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SNELLING (PI), EHRLICH, GRAFTON, MACLEAN, & MICHEL
Evaluation Of Nurse Practitioner Pre-Postnatal Provincial Programme With 10 Ontario Health Units
- Funded By: Ontario MOHLTC (2003 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To evaluate the Nurse Practitioner Pre-Postnatal programme currently underway in affiliation with 10 public health units in Ontario. The evaluation is being undertaken as a partnership between PHRED and CHRU.
- Site visits conducted for Phase I. Qualitative data analysis to be started in September.
- Final Report to MOHLTC in 2006.
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STAUS(PI), BAKER, DAVIS, SIBBALD, KUSHNIRUK, DORAN, ZWARENSTEIN, REDELMEIRER, LINGARD, BOHNEN, MCCARTHY, MATLOW, ETCHELLS, HEBERT, CHIGNELL, VINCENTE, & AFFONSO
Innovations In Patient Safety And Knowledge Translation
- Funded by: CIHR (2003 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:Provides funding to train doctoral and post-doctoral students.
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STEWART (PI), BROWN, BURGE, CAMPBELL, DICENSO, DOZOIS, Et. Al .
Interdisciplinary Training In Primary Health Care Research
- Funded By: CIHR (2002 – 2008)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
Build a critical mass of skilled primary health care researchers who will work in successful interdisciplinary research teams.
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STORCH(PI), & SHAMIAN
Leadership For Ethical Policy And Practice
- Funded By: CHSRF (2004 – 2007)
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TOMBLIN MURPHY, O’BRIEN-PALLAS, (PIS), BIRCH, WANG, & LI
Health Human Resource Planning: An Examination Of Relationships Among Nursing Service Utilization, And Estimate Of Population Health, And Overall Health Outcomes In The Long-Term Care And Community Sectors In The Province Of Ontario
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- In this proposed study, an analysis of the association between levels of nursing inputs and patient and system outcomes in the Long-Term Care and Community sectors in Ontario will be used to inform decisions about the required levels of nursing for RNs and RPNs as well as unregulated workers.
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TOURANGEAU, MCGILTON (Co-PIs),TEARE, & WODCHIS
Understanding Determinants Of Outcomes In Complex Continuing Care
- Funded By: CHSRF (2004 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Explore determinants of three outcomes for stroke patients recovering in complex continuing care in Ontario hospitals: patient atsifaction with care, length of patient stay, and location of patient discharge.
- Satisfaction with care data are being collected from study patients. Other data are being collected from study patient’s Minimun Data Set (MDS) records.
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TOURANGEAU (PI), TU, DORAN, PRINGLE, O'BRIEN-PALLAS, & MCGILLIS HALL
Nursing And Other Determinants Of Hospital Level Outcomes Such As 30-Day Mortality And Readmission Rates
- Funded by: CIHR (2002 - 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To propose and test theoretical models describing relationships between nursing-related and other hospital characteristics with two hospital quality of care indicators: 30-day mortality and 30-day readmission rates.
- Study the determinants of 30-day mortality and readmission rates for hospitalized patients with a focus on studying nursing-related structures and processes that might influence hospital mortality and readmission rates.
- Findings will be used to develop decision-assisting tools for hospitals to use when planning strategies aimed at improving 30-day mortality and unplanned readmission rates.
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TRANMER, GODWIN (CoPIs), MCCANS, O’DONNELL, BOLTON , HARRISON , STAPLES, BEATTY, LAM, & HEYLAND
Primary Care Management/Action Plan For Advanced Chronic Diseases (The Road Map Project)
- Funded by: MOHLTC (2004 – 2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To determine the effectiveness of a new model of nursing care--a primary care based, nurse specialist--on guideline adherence and patient outcomes .
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TRANMER , GREEN, ROBB– BLENDERMAN, GROOME, GROLL, GINSBURG, & MCCANS
Health And Well Being In Older Persons Living With Cancer
- Funded By: Oncology Nursing Society Foundation (2004-2006)
Purpose/Outcomes/Deliverable and Implications for clinical practice, policy, and research:
- As novel treatments are developed and implemented, we need to ensure that the health care delivery system is optimally designed to support the delivery of complex cancer care.
- The specific research objectives are:
- To systematically measure, over the course of a year cardiovascular health, using validated measures, the symptom burden, social support and health related quality of life (HRQL) in older persons with cancer
- To describe these measures across disease site and treatment modality
- To determine the prevalence of cardiovascular illness and cardiovascular risk factors across disease site
- Where possible (i.e., n > 64 for disease site), across disease sites determine if there are relationships between cardiovascular health, levels of symptom distress, functional comorbidity, social support and HRQL
- To describe the informal and formal supports that are accessed by elderly patients with cancer
- To compare the characteristics of elderly cancer patients who receive treatment at Kingston Regional Cancer Centre (KRCC) with the characteristics of the elderly cancer population registered in the Ontario Cancer Registry.
- This research is relevant to the increasing number of elderly patients with cancer, their caregivers and to health care providers. The information gained from this study will contribute to the future planning of regionally based, age sensitive health services for older persons living with cancer.
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TRANMER , GREEN, ROBB– BLENDERMAN, GROOME, GROLL, GINSBURG, & MCCANS
Identifying Factors Associated With Functional Decline In Older Women Living With Breast Cancer: Development And Validation Of A Self-Reported Risk Profile (Srrp)
- Funded By: Canadian Breast Cancer Foundation (2005-2007)
Purpose/Outcomes/Deliverable and Implications for clinical practice, policy, and research:
- The primary purpose is to develop a multi-dimensional, self-reported risk profile (SRRP), relevant to functional status and well-being in older women with newly diagnosed breast cancer being treated with curative intent.
- Functional status assessment strategies that are easy to implement and accessible for the majority of older persons with cancer should assist in the planning of appropriate health care and support services.
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TRANMER (PI), HARRISON, MCCANS, O’CALLAGHAN, DAY, & GROLL
The Influence Of Gender On Self-Care Capacity, Access To Informal And Formal Supports, And Health Care Outcomes In Elderly Patients With Heart Failure: Regional Perspective
- Funded by: CIHR (2004 – 2007)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- To determine across a health care region the gender differences in supportive care resources and functional outcomes in older persons living with chronic illness, specifically congestive heart failure, to inform the development of a personal and social risk profile for functional well being.
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TRANMER , HARRISON, MCCANS, O’CALLAGHAN, DAY, & GROLL
A Regional Perspective Of Gender Differences In Functional Decline Of Older Persons Living With Symptomatic Heart Failure: The Role Of Supportive Resources
- Funded By: CIHR(2004-2007)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Heart failure (HF) is a prevalent chronic cardiovascular condition of particular concern to the elderly and their caregivers. Despite substantial medical advances in the understanding and management of HF, the course of the illness remains unpredictable. Acute exacerbations of HF are associated with poor management of heart failure symptoms, frequent visits to hospitals, and create substantial burden for the patient, family and health care system.
- Because of the chronicity of the condition, much of the responsibility and burden of management and care rests with the HF patient and/or their caregiver. The older female population with HF represents a unique and highly vulnerable group as the underlying pathophysiology may be different, diagnosis may be delayed, and accessto, and utilization of, informal and formal support systems may be less. For the older female (and male), there is limited information about the processes of care associated with optimal outcome.
- Therefore, the primary aim of this study is to gain a better understanding of the personal, social and system supportive resources that contribute to functional decline in older persons living with symptomatic HF, and the gender differences in this profile and the relative impact of these resources on functional decline. We hypothesize that women with HF, in comparison to their male counterparts, will have lower levels of functional well being and fewer available supportive resources, when age and disease severity are controlled for.
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TREGUNNO, (PI), DORAN, MCGILLIS HALL , BAKER JEFFS, & AFFONSO
Leadership To Promote Patient Safety Culture And Learning In Critical Care
- Funded By: CHSRF (2004 – 2006)
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Explore the ways in which the critical care environment contributes to/or prevents the delivery of safe patient care. It will also explore the perceptions of multiple direct care providers simultaneously as a means of maximizing knowledge about critical care teamwork and the role of nursing leaders in transforming the safety culture.
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UNDERWOOD (Pi), BAUMANN, BLYTHE, EHRLICH , DEBER & EL AMMEDINE
Community Nursing Capacity: How Many Nurses Are There, What Are The Enablers And Barriers For Their Practice?
- Funded By: MOHLTC (2004-2006)
- Stage: Data collection
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- The purpose of this study is to determine the demographic trends and the enablers and barriers to Ontario community nurses practicing their full scope of skills and knowledge. Data collection methods include data analysis of registration information, focus groups and a survey of nurses and policy makers throughout Ontario. The results of the study will provide recommendations to the provincial government about public health, home health and other community nurses that will help them to create policies to strengthen the capacity of community and public health systems.
Outcomes Report
Health Human Resources Series Number 7 Better Data: Better Performance
Community Health Nursing in Ontario
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UNDERWOOD, BAUMANN, CILISKA, MEAGHER-STEART, DEBER, MACDONALD, EHRLICH, SCHOENFELD, LAVOIE-TREMBLAY, BLYTHE, LAPORTE, MUNROE, KNIBBS
Building Community and Public Health Nursing Capacity Study
- Funded: CHSRF, PHAC, Health Canada, British Columbia Ministry of Health, NHSRU & Vancouver Coastal Health (2006-2009)
- Status: Report Writing
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
-
Both qualitative and quantitative research methods will be used to conduct this program of study. The results of the studies will provide decision makers and administrators with clear information about the CHN capacity across Canada which will support their workforce planning efforts. Similarly, these decision makers will gain insights into effective deployment of CHNs which in turn will strengthen CHN recruitment and will support sustainable community health services capacity. There also will be recommendations about organizational characteristics to optimize specifically the role of the PHNs to ensure that they can have a greater impact on the health of the communities they serve.
Health Human Resource Series Number 13. Demographic Profile of Community Health Nurses in Canada 1996-2007. Hamilton, Ontario: Nursing Health Services Research Unit, McMaster University.
Health Human Resource Series Number 15. Building Canadian public health nursing capacity :implications for action. Hamilton, Ontario: Nursing Health Services Research Unit, McMaster University.
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Valaitis, R. , Schofield, R., Akhtar-Danesh, N., Baumann, A., Ehrlich, A., Underwood, J. & Martin-Misener, R.
Phase II: Strengthening the Quality of Community Health Nursing Practice: A Pan-Canadian Survey of Community Health Nurses’ Learning Need. Community Health Nurses Association of Canada. 2008 – 2009
Health Human Resource Series Number 17. Phase 2 Strenthening The Quality Of
Community Health Nuring Practice.A Pan Canadian Survey of Community
Health Nurses’ Continuing Education Needs.
Valaitis, R. Nelligan, P. & McCarthy, J. MacDonald, M., Martin-Misener, R., Meagher-Stewart, D., O’Mara, L., Wong, S., Akhtar-Danesh, N., Baumann, A., Beatty, G., Blatherwick, J., Burge, F., Dicenso, A., Dobbins, M., Ehrlich, A., English, P., Gould, L., Harris, S., Kaczorwoski, J., Lee, J., Munroe, V., McDonald, J., Troy, C., Woodman, M., Young, L.,
Building Primary Health Care Nursing Leadership to Enhance Collaboration between Primary Health Care and Public Health
- Funded: CHSRF REISS Program. (2008-2011) (NHSRU Seed Funding).
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VIENS, LAVOIE-TREMBLAY,MAYRAND LECLERC, GELINAS, DUBOIS, SPENCE LASCHINGER, SOUNAN, HAMELIN-BRABANT, ANDERSON, RHEAUME, STRINGER, HAINES, ET BAUMANN
Programme de Recherche participative et evaluative visant l’Optimisation de la gestion des milieux de travail: Application de Connaissances, Transfert d’expertise, Intervention novatrices, Formation de leaders transformationnels.
- Funded By: CHSRF (2006-2010)
- Stage: Start up
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
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VOHRA
Canadian Foundation for Innovation, New Opportunities Fund Research, “Building a Pediatric N-of-1 Research Service”
Reviewer: Shamian
- Funded By: Canadian Foundation fro Innovation (2005-2009)
Purpose/Outcomes/Deliverable and Implications for clinical practice, policy, and research:
- The purpose of an N-of-1 approach is to allow for individualized patient care while allowing the methodological rigour afforded by a randomized controlled trial. In this way, it is the "pinnacle" of the evidence pyramid, as it generates high quality evidence that is relevant to a given patient. The purpose of the CFI is to request infrastructure support to allow for this kind of approach to the evaluation of natural health products in children.
- "N-of-1" has the potential to provide idealized patient care, removing a large component of potential bias that currently affects treatment decisions. Since natural health product research is limited in children due to lack of sufficient data about safety and efficacy, an N-of-1 approach limits the number of children exposed to unproven therapies. Like clinicians and parents, policy-makers (e.g. Health Canada) are currently limited by a lack of pediatric data with which to make evidence-based decisions - N-of-1 is an ideal method to develop this evidence-base, a powerful tool to sift through the 50,000 natural health products sold in Canada, separating those that demonstrate promising efficacy, from those that demonstrate none.
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WELLS(PI), MCGILL, FRAZER, GREEN, THEGERGE, RANNEY, MEDLEY, MACGREGOR, COLE, KEIR, MOORE, CALLAGHAN, HAINES, KERR, NAQVI, & POTVIN
Centre Of Research Expertise For An Action Centre For The Prevention Of Work-Related Musculoskeletal Disorders
- Funded By: Ontario Workplace Safety and Insurance Board (WSIB) (2003 – 2008)
- Stage: Start-up
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research
- Muskuloskeletal problems are the largest single category of work-related disability claims for nurses. This centre will provide expert guidance on research in this area and as a co-investigator could provide seed money for grants for nursing-related research.
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WILKINS, SCHINDEL MARTIN, MONTEMURO, & MCKEY
Long-Term Care Best Practice Resource Centre Education Opportunities for Partners
- Funded By: Manulife of Canada (2001- present)
- Stage: Data analysis
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- Focus on effectiveness of educational modules creating the culture of inquiry using effective search strategies and applying evidence to LTC practice.
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WODCHIS, (PI), ANDERSON , TEARE, PINK, & MCGILLIS HALL
Strategic Financial Investment in Nurse Staffing and Education: Implications for Quality and Cost Performance in Hospital-Based Long Term Care.
- Funded By: CIHR (2005 – 2007)
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YASSI (PI), BRYCE, GERSHON, BIGELOW, COPES, CORBIERE, DALY, KERR, NOBLE, PATRICK, & QURESHI
Barriers And Facilitators To Implementing Protective Measures Against Sars For Healthcare Workers: A Collaborative Interdisciplinary Study
- Funded By: CIHR (2004-2006)
- Stage: Completed
Purpose/Outcomes/Deliverables and Implications for clinical practice, policy, and research:
- SARS had a major impact on nurses, especially in Ontario and BC. This project will explore the key organizational issues that affected nurses' experiences during the SARS outbreak. It will use focus groups and surveys to examine factors in BC and Ontario that may have contributed to the difference in SARS outcomes between the two areas.
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