scholarly journals Supporting policy and practice in Ontario through ICES’ Applied Health Research Question (AHRQ) Program

Author(s):  
Lisa Ishiguro ◽  
Diana An ◽  
Lesley Plumptre ◽  
Jenine Paul ◽  
Graham Mecredy ◽  
...  

ICES upholds a strong reputation for generating high-quality evidence to inform policy and practice through its collaborations with a broad range of health system stakeholders including government policymakers and healthcare providers including clinicians. Supported by the Ontario Ministry of Health and Ministry of Long-Term Care, the ICES Applied Health Research Question (AHRQ) Program leverages the data holdings and, scientific and clinical expertise to generate evidence tailored to the information needs of requestors. This paper outlines the approach, process, strengths, challenges and the resulting influence and impact to the healthcare landscape in Ontario.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.


2017 ◽  
Vol 28 (6) ◽  
pp. 692-707 ◽  
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
Pamela Durepos ◽  
Lynn McCleary ◽  
Jenny Ploeg ◽  
...  

The goal of this study was to examine current rates of resident deaths, Emergency Department (ED) use within the last year of life, and hospital deaths for long-term care (LTC) residents. Using a mixed-methods approach, we compared these rates across four LTC homes in Ontario, Canada, and explored potential explanations of variations across homes to stimulate staff reflections and improve performance based on a quality improvement approach. Chart audits revealed that 59% of residents across sites visited EDs during the last month of life and 26% of resident deaths occurred in hospital. Staff expressed surprise at the amount of hospital use during end of life (EOL). Reflections suggested that clinical expertise, comfort with EOL communication, clinical resources (i.e., equipment), and family availability for EOL decision making could all affect nondesirable hospital transfers at EOL. Staff appeared motivated to address these areas of practice following this reflective process.


2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tafara Mapuvire

PICO question In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed There were no papers that answered the PICO question Strength of evidence Zero Outcomes reported Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg Conclusion Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  


2021 ◽  
Vol 6 ◽  
Author(s):  
Sanghamitra Pati ◽  
Rajeshwari Sinha ◽  
Pranab Mahapatra

To meet the long term care demands of chronic diseases as well as multimorbidity, healthcare providers from different disciplines need to work collaboratively in practice. This requires healthcare providers to be appropriately trained on delivery of inter-professional care (IPC) and health communication aspects during formative professional years. In this study, we have looked at the prevailing undergraduate and postgraduate healthcare professional curricula to understand the focus on health communication and on IPC for the delivery of multidisciplinary care for multimorbidity management. We observe that while there are exclusive courses on health communication being delivered at different levels, the focus on IPC is still in stages of infancy. The IPC component is just beginning to be woven into the health professional curricula through elements like competency-based curriculum, rotational posting, inter-departmental engagements. At the same time, the need to put curricular attention on multimorbidity is also highlighted here. There remains wider scope for strengthening learning on health communication and IPC among different disciplines within the curricula in the context of multimorbidity. We expect our findings to provide key inputs to academic planners and policy makers towards the introduction of adequate curricular components for addressing multimorbidity along with necessary prescriptions for health communication and IPC in India.


Author(s):  
Kai Leichsenring ◽  
Jenny Billings ◽  
Henk Nies

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 396-396
Author(s):  
J Keefe ◽  
D Taylor ◽  
B Parker ◽  
L Tay ◽  
H Cook

2020 ◽  
Vol 21 (4) ◽  
pp. 209-216
Author(s):  
Jiska Cohen-Mansfield

Purpose The impact of COVID-19 has most dramatically affected the older population, and nursing homes have become infection hotspots. As a response, governments have ordered isolation of older adults in geriatric institutions owing to the high risk of critical illness and mortality. The purpose of this paper is to discuss the potential impact of current policies on nursing homes and community-based care and provide suggestions for improvement in care. Design/methodology/approach Taking the situation in Israel as an example, the author discussed major systemic problems pertaining to long-term care facilities and to community based care; the neglect of mental health; systemic deficiencies in end of life care; and the need to revise communications concerning COVID-19. Findings Within each of the identified areas, recommended changes in strategy, policy and practice can help mitigate the dramatic impact of COVID-19 on the living experience of the older population. Originality/value Drawing on the Israeli experience, this paper presents current shortcomings in the policy response to COVID-19 regarding nursing homes and community-based care and provides recommendations that are applicable to other contexts as well. Although some of these have been suggested or even practiced in some locations, many continue to be neglected and have not been discussed even as COVID-19 continues to infect societies around the globe.


2021 ◽  
Vol 12 ◽  
Author(s):  
Hui Zhang ◽  
Dandan Chen ◽  
Ping Zou ◽  
Nianqi Cui ◽  
Jing Shao ◽  
...  

Background: To date, a large body of literature focuses on the experience of healthcare providers who cared for COVID-19 patients. Qualitative studies exploring the experience of healthcare workers in the workplace after recovering from COVID-19 are limited. This study aimed to describe the experience of healthcare workers who returned to work after recovering from COVID-19.Methods: This study employed a qualitative descriptive approach with a constructionist epistemology. Data were collected through semi-structured in-depth interviews with 20 nurses and physicians, and thematic analysis was used to identify themes from the interview transcripts.Results: Three major themes about the psychological experiences of healthcare workers who had recovered from COVID-19 and returned to work were identified: (1) holding multi-faceted attitudes toward the career (sub-themes: increased professional identity, changing relationships between nurses, patients, and physicians, and drawing new boundaries between work and family), (2) struggling at work (sub-themes: poor interpersonal relationships due to COVID-19 stigma, emotional symptom burden, physical symptom burden, and workplace accommodations), (3) striving to return to normality (sub-themes: deliberate detachment, different forms of social support in the workplace, and long-term care from organizations).Conclusions: The findings have highlighted opportunities and the necessity to promote health for this population. Programs centered around support, care, and stress management should be developed by policymakers and organizations. By doing this, healthcare workers would be better equipped to face ongoing crises as COVID-19 continues.


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