Congratulations to Dr. Carole Estabrooks
Dr. Estabrooks’ Canada Research Chair has been advanced to a Tier 1 CRC. This is the Faculty of Nursing’s first Tier 1 CRC. Way to go Carole!!! And thanks to everyone who’s worked with Carole on TREC!!!
Call for Abstracts Society for Social Medicine Annual Scientific Meeting
12th – 14th September 2012, London UK. Deadline 23.59 GMT ON Monday 19th March 2012.
The Society welcomes abstracts on all aspects of social medicine, including health services research, epidemiology, public health, statistics, sociology, psychology, health policy and/or mixed methods research.
Call for Abstracts NCCPH Summer Institute 2012
May 15-16, 2012, Kelowna BC Deadline Friday March 30, 2012.
The NCCPH 2012 Summer Institute will be holding a poster presentation to highlight new and interesting work. We invite you to participate by submitting an abstract for a poster presentation in relation to the following areas:
- the role of experience in evidence-informed decision making in public health
- knowledge translation promoting health equity
- examples of actions or projects that help advance health equity
Grants & Awards
KT Canada Summer Institute – Deadline Extended: March 26 2012
The deadline for applications to the KT Canada Summer Institute has been extended until March 26th at 23:59 ET. The summer institute is open to graduate students, fellows and junior faculty. Don’t miss out on this exciting opportunity.
Building capacity for evidence informed decision making in public health: a case study of organizational change.
Peirson L, Ciliska D, Dobbins M, Mowat D.
BMC public health 2012 Feb 20;12:137
Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit’s strategic initiative to develop capacity to make EIDM standard practice. METHODS: This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. RESULTS: The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. CONCLUSION: With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.
Looking for interaction: quantitative measurement of research utilization by Dutch local health officials.
de Goede J, van Bon-Martens MJ, Mathijssen JJ, Putters K, van Oers HA.
Health research policy and systems / BioMed Central 2012 Mar 13;10(1):9
In the Netherlands, local authorities are required by law to develop local health memoranda, based on epidemiological analyses. The purpose of this study was to assess the actual use of these epidemiological reports by municipal health officials and associated factors that affect this use. METHOD: Based on a conceptual framework, we designed a questionnaire in which we operationalized instrumental, conceptual, and symbolic use, the interaction between researchers and local health officials, and four clusters of barriers in this interaction process. We conducted an internet survey among 155 Dutch local health officials representing 35% of all Dutch municipalities. By means of multiple regression analyses, we gained insight into the related factors for each of the three types of research utilization. RESULTS: The results show that local health officials use epidemiological research more often in a conceptual than an instrumental or symbolic way. This can be explained by the complexity of the local policy process which is often linked to policies in other areas, and the various policy actors involved. Conceptual use was statistically associated with a presentation given by the epidemiologist during the policy process, the presence of obstructions regarding the report’s accessibility, and the local official’s personal belief systems and interests originating from different professional values and responsibilities. Instrumental and symbolic use increased with the involvement of local officials in the research process. CONCLUSIONS: The results of this study provide a partial solution to understanding and influencing research utilization. The quantitative approach underpins earlier qualitative findings on this topic. The outcomes suggest that RPHS epidemiologists can use different strategies to improve research utilization. ‘Blurring the boundaries’, and the enhancement of interfaces between epidemiologists and local health officials, like direct interactions into each other’s work processes, is expected to create better possibilities for optimizing research use.
An analysis of existing publications to explore the use of the diffusion of innovations theory and innovation attributes
Kapoor KK, Williams MD, Dwivedi YK, Lal B.
Proceedings of the 2011 world congress on information and communication technologies, WICT 2011
‘Diffusion of Innovations’ is a theory that explicates the process of introducing new ideas (i.e. technological innovation) into a system via varied channels of communication. The purpose of this paper is to undertake a systematic review of the available literature to examine the current advances in the Diffusion Of Innovations (DOI) theory. The focus remains more inclined towards the diffusion attributes. ISI Web of Knowledge ® and Google Scholar were the two rigorously used search engines for our study. These engines fectched a total of 2073 published records that cited Rogers’ Diffusion of Innovation theory. Some of these publications were found to be available for download. Upon conducting a further search, 1145 published records were found to have used the 28 innovation attributes that were identified in a previous article on this subject. Statistical filtering then showed complexity to be the highly used attribute with 834 records having cited this attribute. Further review showed that all the five attributes adopted from Rogers’ work of study, represented the most frequently employed attributes for examining the rate of innovation adoption. © 2011 IEEE.
Health Care Administration & Organization
The integrality of situated caring in nursing and the environment.
ANS.Advances in nursing science 2012 Jan-Mar;35(1):14-24
Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry.
Health Care Innovation & Quality Assurance
Guidance for Evidence-Informed Policies about Health Systems: Linking Guidance Development to Policy Development
Lavis JN, Rottingen J, Bosch-Capblanch X, Atun R, El-Jardali F, Gilson L, et al.
PLoS Med 2012 03/13;9(3):e1001186
Contextual factors are extremely important in shaping decisions about health systems, and policy makers need to work through all the pros and cons of different options before adopting specific health systems guidance. A division of labour between global guidance developers, global policy developers, national guidance developers, and national policy developers is needed to support evidence-informed policy-making about health systems. A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level. Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development.
Further research is needed into the division of labour in guideline development and policy development and on frameworks for supporting system and political analyses.
More black box to explore: how quality improvement collaboratives shape practice change.
Shaw EK, Chase SM, Howard J, Nutting PA, Crabtree BF.
Journal of the American Board of Family Medicine : JABFM 2012 Mar;25(2):149-157
Quality improvement collaboratives (QICs) are used extensively to promote quality improvement in health care. Evidence of their effectiveness is limited, prompting calls to “open up the black box” to better understand how and why such collaboratives work. METHODS: We selected a cohort of 5 primary care practices that participated in a 6-month intervention study aimed at improving colorectal cancer screening rates. Using an immersion/crystallization technique, we analyzed qualitative data that included audio recordings and field notes of QICs and practice-based team meetings. RESULTS: Three themes emerged from our analysis: (1) practice staff became empowered through and drew on the QICs to advance change efforts in the face of leader/physician resistance; (2) a mix of content and media in the QIC program was important for reaching all participants; (3) resources offered at the QIC did little to spur practice change efforts. CONCLUSION: QICs offer a potentially powerful way of disseminating health care innovations through enhanced strategies for learning and change. Creating collaborative environments in which diverse participants learn, listen, reflect, and share together can enable them to take back to their own organizations key messages and change strategies that benefit them the most.
Organizational Learning: Subprocess Identification, Construct Validation, and an Empirical Test of Cultural Antecedents
Flores LG, Zheng W, Rau D, Thomas CH.
Journal of Management 2012;38(2):640-667
Organizational learning is key to an organization’s capability for continuous change and renewal. As a result, scholarly interest in identifying the antecedents of organizational learning has greatly increased over the past couple of decades. This study focuses on (1) identifying and measuring the distinct subprocesses that make up the organizational learning construct to obtain a more detailed understanding of the construct and (2) exploring the effect that organizational culture and, more particularly, four dimensions of culture-participative decision making, openness, learning orientation, and transformational leadership-have on each of the organizational learning subprocesses. The authors use two samples of subject matter experts and the responses of 631 managers to test their propositions. Their results yielded five independent but interrelated subprocesses-information acquisition, information distribution, information interpretation, knowledge integration, and organizational memory. Furthermore, their results indicate that the four different cultural antecedents studied have different kinds of significant relationships with each of the organizational learning subprocesses. This study contributes to the literature on organizational learning by identifying and validating the organizational learning subprocesses, and by offering a detailed picture of the relationship between key organizational antecedents to learning and the individual subprocesses of learning. In addition, since they use systematic and thorough methodological techniques to develop an instrument to test, measure, and validate those subprocesses of learning that constitute a common body of knowledge in this area, the authors’ instrument could prove to be a valuable tool for future research. © Southern Management Association 2012.
Research Methodology And Practice
The Role of Group Dynamics in Mixed Methods Health Sciences Research Teams
Curry LA, O’Cathain A, Clark VLP, Aroni R, Fetters M, Berg D.
Journal of Mixed Methods Research 2012 January 01;6(1):5-20
This article explores the group dynamics of mixed methods health sciences research teams. The authors conceptualize mixed methods research teams as “representational groups,” in which members bring both their organizational and professional groups (e.g., organizational affiliations, methodological expertise) and their identity groups, such as gender or race, to the work of research. Although diversity and complementarity are intrinsic to mixed methods teams, these qualities also present particular challenges. Such challenges include (a) dealing with differences, (b) trusting the “other,” (c) creating a meaningful group, (d) handling essential conflicts and tensions, and (e) enacting effective leadership roles. The authors describe these challenges and, drawing from intergroup relations theory, propose guiding principles that may be useful to mixed methods health sciences research teams.
A Mixed Methods Sampling Methodology for a Multisite Case Study
Sharp JL, Mobley C, Hammond C, Withington C, Drew S, Stringfield S, et al.
Journal of Mixed Methods Research 2012;6(1):34-54
The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a statewide education policy initiative in the United States. The authors designed a four-stage sequential mixed methods site selection strategy to select eight sites in order to capture the broader context of the research, as well as any contextual nuances that shape policy implementation. The authors anticipate that their experience would provide guidance to other mixed methods researchers seeking to maximize the rigor of their multisite case study sampling designs.
Establishing a new journal for systematic review products
Moher D, Stewart L, Shekelle P.
Systematic Reviews 2012;1(1):1
Welcome to a new age in publishing systematic reviews. We hope the launch of Systematic Reviews will resonate with a broad spectrum of readers interested in using them in a variety of ways, such as providing comprehensive and up to date evidence for patient management, informing health policy, and developing rigorous practice guidelines. Systematic reviews are increasingly popular. Our journal is committed to publishing a wide variety of well conducted and transparently reported systematic reviews and associated research. We are open access and electronic and not confined by space and so offer scope for publishing reviews in detail and providing a modern and innovative approach to publishing. We look forward to participating in the voyage with all of our readers.
Methods and metrics challenges of delivery-system research.
Alexander JA, Hearld LR.
Implementation science : IS 2012 Mar 12;7(1):15
BACKGROUND: Many delivery-system interventions are fundamentally about change in social systems (both planned and unplanned). This systems perspective raises a number of methodological challenges for studying the effects of delivery-system change–particularly for answering questions related to whether the change will work under different conditions and how the change is integrated (or not) into the operating context of the delivery system. METHODS: The purpose of this paper is to describe the methodological and measurement challenges posed by five key issues in delivery-system research: (1) modeling intervention context; (2) measuring readiness for change; (3) assessing intervention fidelity and sustainability; (4) assessing complex, multicomponent interventions; and (5) incorporating time in delivery-system models. For each issue, we provide recommendations for how research may be designed and implemented to overcome these challenges. Results and conclusions We suggest that a more refined understanding of the mechanisms underlying delivery-system interventions (treatment theory) and the ways in which outcomes for different classes of individuals change over time are fundamental starting points for capturing the heterogeneity in samples of individuals exposed to delivery-system interventions. To support the research recommendations outlined in this paper and to advance understanding of the “why” and “how” questions of delivery-system change and their effects, funding agencies should consider supporting studies with larger organizational sample sizes; longer duration; and nontraditional, mixed-methods designs.
RAND Europe evaluated the National Institute for Health Research Leadership Programme in an effort to help the English Department of Health consider the extent to which the programme has helped to foster NIHR’s aims, extract lessons for the future, and develop plans for the next phase of the leadership programme. Successful delivery of high-quality health research requires not only an effective research base, but also a system of leadership supporting it. However, research leaders are not often given the opportunity, nor do they have the time, to attend formal leadership or management training programmes. This is unfortunate because research has shown that leadership training can have a hugely beneficial effect on an organisation. Therefore, the evaluation has a particular interest in understanding the role of the programme as a science policy intervention and will use its expertise in science policy analysis to consider this element alongside other, more traditional, measures of evaluation.
This paper reviews existing definitions, terms, conceptual models, taxonomies, standards, methods and research designs which describe the scope of health systems research as well as the barriers and opportunities that flow from them.
Health Care in Canada
Association of Hospital Spending Intensity With Mortality and Readmission Rates in Ontario Hospitals
Stukel TA, Fisher ES, Alter DA, Guttmann A, Ko DT, Fung K, et al.
JAMA : the journal of the American Medical Association 2012 Mar 14;307(10):1037-1045
Context The extent to which better spending produces higher-quality care and better patient outcomes in a universal health care system with selective access to medical technology is unknown. Objective To assess whether acute care patients admitted to higher-spending hospitals have lower mortality and readmissions. Design, Setting, and Patients The study population comprised adults (>18 years) in Ontario, Canada, with a first admission for acute myocardial infarction (AMI) (n = 179 139), congestive heart failure (CHF) (n = 92 377), hip fracture (n = 90 046), or colon cancer (n = 26 195) during 1998-2008, with follow-up to 1 year. The exposure measure was the index hospital’s end-of-life expenditure index for hospital, physician, and emergency department services. Main Outcome Measures The primary outcomes were 30-day and 1-year mortality and readmissions and major cardiac events (readmissions for AMI, angina, CHF, or death) for AMI and CHF. Results Patients’ baseline health status was similar across hospital expenditure groups. Patients admitted to hospitals in the highest- vs lowest-spending intensity terciles had lower rates of all adverse outcomes. In the highest- vs lowest-spending hospitals, respectively, the age- and sex-adjusted 30-day mortality rate was 12.7% vs 12.8% for AMI, 10.2% vs 12.4% for CHF, 7.7% vs 9.7% for hip fracture, and 3.3% vs 3.9% for CHF; fully adjusted relative 30-day mortality rates were 0.93 (95% CI, 0.89-0.98) for AMI, 0.81 (95% CI, 0.76-0.86) for CHF, 0.74 (95% CI, 0.68-0.80) for hip fracture, and 0.78 (95% CI, 0.66-0.91) for colon cancer. Results for 1-year mortality, readmissions, and major cardiac events were similar. Higher-spending hospitals had higher nursing staff ratios, and their patients received more inpatient medical specialist visits, interventional (AMI cohort) and medical (AMI and CHF cohorts) cardiac therapies, preoperative specialty care (colon cancer cohort), and postdischarge collaborative care with a cardiologist and primary care physician (AMI and CHF cohorts). Conclusion Among Ontario hospitals, higher spending intensity was associated with lower mortality, readmissions, and cardiac event rates.
This analytical product focuses on disparities in primary health care by examining differences in access, use and appropriateness of primary health care for Canadians who have ambulatory care sensitive conditions according to their income, geography, health conditions and sex. The results will assist in identifying barriers to and difficulties in accessing primary health care services and assessing whether all Canadians are receiving an appropriate level of care according to their needs.
The disappearing subject: exclusion of people with cognitive impairment and dementia from geriatrics research.
Taylor JS, Demers SM, Vig EK, Borson S.
Journal of the American Geriatrics Society 2012 Mar;60(3):413-419
To evaluate exclusion of persons with cognitive impairment from research in geriatrics by determining its frequency, method, and rationale and treatment in the resulting publications. DESIGN: All original research articles published in 2008 and 2009 in the Journal of the American Geriatrics Society (n = 434) were reviewed using a structured data collection tool. SETTING: The Journal of the American Geriatrics Society. PARTICIPANTS: There were no participants in this study. MEASUREMENTS: Data captured included recruitment method, explicit criterion for exclusion of persons with cognitive impairment, justification of exclusion criterion, reason given for exclusion, percentage of individuals excluded, and mention of exclusion as a possible limitation. RESULTS: Of 434 articles examined, 16% used recruitment methods likely to reduce participation by persons with cognitive impairment. At least 29% of studies (n = 127) employed explicit exclusion criteria. Half used the Folstein Mini-Mental State Examination (MMSE), with variable cut points (10, 12, 17, 18, 23, 26), and 19% excluded individuals for “having dementia” without specifying how this was determined. Few (6%) provided any justification for exclusion criteria used, only 43% gave any reason for exclusion, and only 14% discussed exclusion as a possible limitation. CONCLUSION: Persons with cognitive impairment are frequently excluded from research, often without rationale or mention of exclusion as a limitation or any discussion of its potential effect on the evidence base in geriatrics. When necessary, exclusion should be done thoughtfully and with awareness that this may reduce the clinical utility of study findings.
Health-promoting interventions for persons aged 80 and older are successful in the short term-results from the randomized and three-armed elderly persons in the risk zone study.
Gustafsson S, Wilhelmson K, Eklund K, Gosman-Hedstrom G, Ziden L, Kronlof GH, et al.
Journal of the American Geriatrics Society 2012 Mar;60(3):447-454
To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up. DESIGN: Randomized, three-armed, single-blind, controlled trial performed between November 2007 and May 2011. SETTING: Two urban districts of Gothenburg, Sweden. PARTICIPANTS: Four hundred fifty-nine community-living adults aged 80 and older not dependent on the municipal home help service. INTERVENTION: A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit. MEASUREMENTS: Change in frailty, self-rated health, and ADLs between baseline and 3-month follow-up. RESULTS: Both interventions delayed deterioration of self-rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12-3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated. CONCLUSION: Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.
Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.
White HK, Corazzini K, Twersky J, Buhr G, McConnell E, Weiner M, et al.
Journal of the American Geriatrics Society 2012 Mar;60(3):525-531
To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A Veterans Affairs Community Living Center and two community nursing homes in North Carolina. PARTICIPANTS: Residents (n = 21), family members (n = 21), and direct-care nursing staff (n = 21) were recruited, with equal numbers in each group from each site. MEASUREMENTS: Participants rated the importance of 62 items from the Centers for Medicare and Medicaid Services Artifacts of Culture Change instrument. Participants sorted cards reflecting each culture change artifact in two phases, identifying and ranking those of more and less importance to them to derive one distribution of preferences for each respondent. Q-sort analysis identified groups of respondents who prioritized similar items; qualitative analysis sought themes or explanations for the responses. RESULTS: Wide variation in respondent preferences was observed. Some respondents viewed several items that others valued highly as unimportant or undesirable. Some items were not high priorities for any respondents. Four groups of respondents with similar preferences were identified: practical and independence-focused respondents, who prioritized ease of use of the physical environment; staff-focused respondents, who prioritized nursing staff retention and development; consistency and choice-focused respondents, who prioritized stable nurse staff-resident relationships and resident choice; and activity and community-focused respondents, who prioritized community gathering spaces and activities. CONCLUSION: Resident, family, and staff priorities for culture change vary, and diverse priorities of stakeholders should be considered to inform culture change efforts on a local and national level.
Education of health professionals in the 21st century – the Lancet Commission’s report and its relevance to global health
Monday March 19th, 16:00-17:30, ECHA 2-490
This talk will summarize the genesis and key recommendations of the Lancet Commission on Education for Health Professionals in the 21st Century (2010). Dr. Bhutta will share some thoughts on the issues and challenges that face schools of public health and programs in global health, as well as how the Lancet Commission proposes to create an enabling environment to help address them.
Maternal and child health and survival globally: Challenges and opportunities
Tuesday March 20, 2012 12:00 – 13:00 ECHA 1-498
Dr. Bhutta will address the status and epidemiology of maternal and child health on an international scale, as well as innovations to address some of the barriers in reaching the unreached.
Experimental Therapies in Pediatric Chronic Care, Medical Freedom Acts, and Medical Ethics: Who Has the Last Word
Friday, 23 March 2012 12:00—12:45 Classroom F 2J4.02 WMC
In Canada’s multicultural society, there is a steady increase in the number of patients with chronic medical conditions who use or request (by themselves or through their proxies) therapies that are
generally described as ‘unconventional’, ‘complementary’, or ‘alternative’, and which are conveniently denoted in this research as ‘experimental therapies’. In recent years, courts in Canada and the United States (US) have heard cases involving minors who reject conventional therapies in favour of experimental interventions. Resolution of these difficult cases is complicated by the consent requirements for pediatric patients. With this growing trend, some Canadian provinces have promulgated laws, known as Medical Freedom Laws like their counterparts in the US, that redefine the threshold of liability for physicians who use unconventional ‘alternative’ therapies in the treatment of their patients. While these laws-when analyzed along with the Healthcare Consent Acts of some Canadian provinces-seem to diminish the professional liability often associated with physician practice of unconventional medicine, a combination of professional, legal and ethical norms operate to define what should count as legally and ethically appropriate practice. This presentation draws from this constellation of norms in exploring the question posed by the title
The time is right to bring together significant stakeholders from across our campus to engage in a dialogue about establishing the future of data stewardship at the University of Alberta. This Summit will address the issues of producing, managing, sharing and preserving research data from the perspective of the biosciences and Northern research. Subsequent Summits will address other areas of research on campus.
Author Talk: Mobbing: Causes, Consequences, and Solutions by Maureen Duffy & Len Sperr Thursday March 22nd 1200-130ECHA 4-036
Dr. Maureen Duffy will be here to speak about her new book which focuses on mobbing and its implications in nursing and in health care
Save the Date: Research Administration Day
Thursday May 31, 2012
Full program details will be released in April.
The Use of the Arts to Translate Knowledge about Home Care
501 Festival Avenue, Sherwood Park AB
2012 National Australian Conference on Evidence Based Clinical Leadership
August 13-14, 2012 Adelaide, Australia
The National Australian Conference will bring together the experiences of evidence-based researchers and reviewers, guideline developers, clinicians, educators, policy makers, administrators and consumers to work toward improving techniques and methods of getting evidence into practice. This conference will provide informative sessions, a conference dinner and fabulous networking opportunities so that health professionals can continue the evolving journey of reforming healthcare by transforming clinical leadership in evidence-based practices.
2012 Canadian interRAI Conference
May 7-10 2012 Vancouver Early Bird Deadline March 21, 2012
The 6th Canadian interRAI Conference provides an important forum that brings together researchers, policy makers and practitioners using the interRAI system of instruments used in various health care settings across Canada. These evidence-based electronic instruments capture client/patient assessment information that is used to support care planning and delivery, quality improvement, health system management and policy.
UBC Sauder School of Business: If You’re Not Keeping Score You’re Only Practicing: Evaluating a System-wide Lean Implementation
Wednesday, March 21, 2012, 9:00-10:00 am MT
Lean methods date back to the Toyota Production System which was developed shortly after World War II. Of late, they are finding wide spread usage in health care. In industry, the primary objective of Lean is to enhance corporate earnings, but in health care, Lean seeks to improve patient-centered care and system efficiency. Lean evaluations have tended to be ad hoc, usually focusing on before and after pictures, graphical displays or vignettes. With Lean’s widespread adoption in health care, a framework for its evaluation is sorely needed. This talk provides guidelines for evaluating a comprehensive Lean program based on insights gained developing a framework to evaluate “imPROVE”, a significant Lean initiative undertaken by the Provincial Health Services Authority (PHSA) in British Columbia. This talk will not present results of the imPROVE evaluation but will focus on concepts, methods and observations.
- To review methods for involving stakeholders in the indicator development process.
- To discuss the application of GRADE (the Grading of Recommendations Assessment, Development and Evaluation) in indicator development and selection.
- To describe the challenges in developing and testing broadly applicable performance measures for high impact, relatively low frequency, conditions.