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Abstracts
CALL FOR ABSTRACTS: EvidenceLive
Deadline Oct 31st, 2012 25-26 March 2013 Oxford, UK
We are interested in projects that are part of a rapidly changing Evidence-Based Healthcare movement:
- Teaching: projects that detail high quality training and education in the field of evidence-based healthcare, including using new educational technologies.
- Knowledge translation: projects that include synthesis, dissemination, exchange and application of knowledge to improve health.
- Evidence synthesis: projects that present new techniques to combine and present primary quantitative and qualitative evidence in comparative effectiveness research.
- Evidence-based policy: projects that inform the development of and/or the implementation of policy and guidelines.
- Reporting/Publication bias: Projects that analyse issues related to reporting standards across healthcare journals and different forms of publication bias.
- Evidence in low and middle income countries: Projects that evaluate the utilisation of evidence in healthcare and educational settings in low and middle income settings.
- Cost effectiveness and modelling: projects describing new methods for cost effectiveness studies.
- New techniques: projects that detail novel ways to identify, disseminate and implement evidence-based healthcare.
Grants & Awards
CIHR: Health Research Communications Award
Deadline: April 1, 2013
The purpose of this funding opportunity is to build capacity in health journalism and communications across all sectors of health research, including biomedical, clinical, health services and policy, and population and public health. By increasing the number of Canadians engaged in communicating and disseminating the results of health research, in a variety of formats, CIHR hopes to raise the level of understanding of health related issues and research among a variety of audiences, including the general public, health professionals and policy makers. It is expected that this targeted investment will lead to more effective communication of health research in Canada.
CIHR-Institute of Aging Betty Havens Prize for Knowledge Translation in Aging
Deadline February 18, 2013
The aim of the CIHR-Institute of Aging Betty Havens Prize for Knowledge Translation in Aging is to recognize outstanding achievements and excellence in knowledge translation in aging at a local or regional level, and to provide financial support to further foster excellence and innovation in knowledge translation activities.
Nominations for the Betty Havens Prize for Knowledge Translation in Aging must demonstrate that the nominee has:
- contributed significantly to moving research findings into practice or policy by facilitating the synthesis, dissemination, exchange and ethically sound application of knowledge at a local or regional level;
- KT activities that are specifically related/targeted to a community and/or region and are aimed at bridging the gap between knowledge and practice/policy and facilitating the dissemination, uptake and application of knowledge in this context;
- linked research/researchers with decision makers/knowledge users locally and/or regionally in order to improve the health of Canadians and/or health services/products and/or the Canadian health care system (policy or practice);
- KT efforts and strategies that have been successful in influencing or changing local, regional or provincial policy or practice;
- formed strong partnerships with other local/regional organizations.
Alzheimer Society Canada: Doctoral Awards, Post-Doctoral Awards, Young Investigator Grants, Regular Grants
Awards: 5 pm ET Monday November 12, 2012 Grants: 5 pm ET Friday November 23, 2012
Doctoral & Post-Doctoral Awards
Doctoral Awards provide an opportunity for promising individuals, pursuing a PhD, to begin the process of becoming future independent investigators in the field of Alzheimer’s disease and other dementias, and Postdoctoral Awards are for graduates with a PhD or MD who wish to gain additional research experience.
Young Investigator Grants
Young Investigator Grants are designed to help launch the careers of outstanding researchers who are entering their first phase of an academic appointment
ASRP Grant
Are designed to fund established researchers.
Fulbright Scholars Program
Deadline for both programs Nov 15, 2012
Student Program: available to Canadian graduate students who want to study and/or do research in the United States for nine months during the 2013-2014 academic year. Scholar and Chairs program: available to Canadian Scholars and senior professionals who want to lecture and/or do research in the United States during the 2011-2012 academic year
KT
Health Care Administration and Organization
Health Care Innovation and Quality Assurance
Organizational Change and Innovations
Research Methodology
Aging
KT
Psychometric testing of the Chinese evidence-based practice scales.
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Wang SC, Lee LL, Wang WH, Sung HC, Chang HK, Hsu MY, et al.
Journal of advanced nursing 2012 Nov;68(11):2570-2577
Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting. © 2012 Blackwell Publishing Ltd.
NHS: Research utilisation or knowledge mobilisation by health managers: Synthesising evidence and theory using perspectives of organisational form, resource based view of the firm and critical theory
Crilly T, Jashapara A, Trenhold S, Peckham A, Currie G, Ferlie E
NIHR Service Delivery and Organisation Programme, June 2012
The literature review builds on an earlier Scoping Review of the literature on knowledge mobilization which identified a gap in the healthcare literature and proposed work in three defined areas or domains. The first is Resource Based View of the Firm, a strategic management concept that examines how differences in capabilities, including knowledge, allow one firm to outperform another. There is no equivalent in healthcare. It states that strategic resources that are valuable, rare, difficult to imitate, and able to be exploited by organizational processes (VRIO principles), will give the firm a sustainable competitive advantage. The second is termed the Critical Perspective, concerned with power and authority in the workplace, which is alive to tensions between occupational groups such as doctors and managers. Two strands of particular interest are Foucauldian and neo-Marxist labour process critical theories. The third area is organizational form, which considers whether certain types of organization, such as networks, are better than others at mobilizing knowledge.
Health Care Administration & Organization
Reliable and Variable Rounder Care Delivery Model for Nursing Assistants and Patient Care Technicians
Non UofA Access
Minnier TE, Brownlee K, Kosko R, Kowinsky A, Martin SC, McLaughlin M, et al.
Nurse Leader 2012;10(5):28-31
Healthcare in its current state often experiences process breakdowns, resulting in dissatisfied patients, disillusioned caregivers, care errors or omissions, and delays in meeting patient needs. Near-misses are often caught, not by standardized processes, but by hard-working caregivers. To reduce these problems, staff at the Donald D. Wolff, Jr. Center for Quality, Safety, and Innovation at the University of Pittsburgh Medical Center (the center) created the Reliable Rounder (RR) and Variable Rounder (VR) Care Delivery Model as a new structure for the work of the patient care technician/nursing assistant (PCT/NA). The goal of this model is to ensure that the right patient gets the right care at the right time, every time, by dramatically redesigning the role of the unit PCT/NA. © 2012 Mosby, Inc.
Development and psychometric testing of the nursing culture assessment tool.
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Kennerly SM, Yap TL, Hemmings A, Beckett G, Schafer JC, Borchers A.
Clinical nursing research 2012 Nov;21(4):467-485
A valid and reliable nursing culture assessment tool aimed at capturing general aspects of nursing culture is needed for use in health care settings to assess and then reshape indicated troubled areas of the nursing culture. This article summarizes the Nursing Culture Assessment Tool’s (NCAT) development and reports on a cross-sectional, exploratory investigation of its psychometric properties. The research aims were to test the tool’s psychometric properties; discover its dimensionality; and refine the item structure to best represent the construct of nursing culture, an occupational subset of organizational culture. Empirical construct validity was tested using a sample of licensed nurses and nursing assistants (n = 340). Exploratory and confirmatory factor analysis (CFA) and logistical regression yielded a 6-factor, 19-item solution. Evidence supports the tool’s validity for assessing nursing culture as a basis for shaping the culture into one that supports change, thereby accelerating, improving, and advancing nursing best practices and care outcomes.
Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care. 
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McGilton KS, Sorin-Peters R, Sidani S, Boscart V, Fox M, Rochon E.
BMC geriatrics 2012 Oct 11;12(1):61
BACKGROUND: Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. METHODS: A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. DISCUSSION: The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with patients and to minimize agitation associated with considerable stress. The improvement of these interactions will lead to a reduction of agitation, which has the additional significance of increasing patients’ well-being, quality of life, and satisfaction with care.Trial RegistrationClinicalTrials.gov Identifier NCT01654029.
Low job satisfaction does not identify nurses at risk of future sickness absence: Results from a Norwegian cohort study.
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Roelen CA, Mageroy N, van Rhenen W, Groothoff JW, van der Klink JJ, Pallesen S, et al.
International journal of nursing studies 2012 Oct 5
Sickness absence is high in healthcare and contributes to nursing staff shortages reducing the efficiency and quality of patient care. Assessing the risk of sickness absence in working nurses opens opportunities for preventive strategies. Job satisfaction has attracted much attention in healthcare research and has been associated with sickness absence among nurses. OBJECTIVES: To investigate if job satisfaction scores are useful to identify working nurses at risk of future sickness absence. DESIGN: Prospective cohort study with a baseline period from November 2008 to March 2009 and 1-year follow-up. SETTINGS: Hospitals, nursing homes, and ambulant care settings in Norway. PARTICIPANTS: 2059 Norwegian nurses, of whom 1582 (77%) could be followed-up. METHODS: Nurses received a questionnaire at baseline and after 1-year follow-up. The questionnaire contained the Job Satisfaction Index (JSI), a 5-item scale measuring overall job satisfaction, and asked for sickness absence in the last 12 months. Baseline JSI scores were included in a logistic regression model with self-rated sickness absence at 1-year follow-up as outcome variable. Predictions of sickness absence were calibrated by the Hosmer-Lemeshow goodness-of-fit test. The ability of JSI scores to discriminate between nurses with and without sickness absence was examined by receiver operating characteristic analysis and expressed as area under the curve (AUC). RESULTS: Low job satisfaction was associated with higher odds of sickness absence (odds ratio [OR]=1.05; 95% confidence interval [CI] 1.01-1.09) and high (≥31 days) sickness absence (OR=1.10; 95% CI 1.06-1.14). Calibration was acceptable, but job satisfaction neither discriminated between nurses with and without sickness absence (AUC=0.54; 95% CI 0.51-0.58) nor between nurses with and without high (≥31 days) sickness absence (AUC=0.58; 95% CI 0.54-0.63). CONCLUSIONS: The results of this study indicated that job satisfaction was associated with sickness absence, though job satisfaction scores as measured with the JSI did not identify working nurses at risk of sickness absence. Copyright © 2012 Elsevier Ltd. All rights reserved.
Robert Wood Johnson Foundation: Nurse Reported Quality of Care A Measure of Hospital Quality
July 2012
Overall hospital quality and processes including measures of mortality, failure to rescue, and patient satisfaction are all indicative of hospital performance. In this study, nurse reported quality of care was a significant indicator of hospital quality. A retrospective secondary analysis was conducted. The study included 396 acute care hospitals from California, Pennsylvania, Florida, and New Jersey and 16,241 nurses. The quality of nursing care in each hospital was assessed using a single question: “How would you describe the quality of nursing care delivered to patients in your unit?” (Self-report responses included Excellent, Good, Fair, and Poor.) Data were collected from the Multi-State Nursing Care and Patient Safety Study from 2006–2007. The survey responses from the nurses were then linked to data from the 2006 to 2007 American Hospital Association Annual Survey. Key Findings: Nurse-reported quality of care was a significant predictor of outcomes and process measures that indicate hospital quality of care.
From admittance to discharge, nurses offer reliable information regarding the quality of care patients receive at a hospital. Additional examination of nurse reported quality and other outcomes would offer additional hospital quality insight.
Explaining clinical behaviors using multiple theoretical models
Eccles M, Grimshaw J, MacLennan G, Bonetti D, Glidewell L, Pitts N, et al.
Implementation Science 2012;7(1):99
In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change. Methods These were five studies of the theory-based cognitions and clinical behaviors (taking dental radiographs, performing dental restorations, placing fissure sealants, managing upper respiratory tract infections without prescribing antibiotics, managing low back pain without ordering lumbar spine x-rays) of random samples of primary care dentists and physicians. Measures were derived for the explanatory theoretical constructs in the Theory of Planned Behavior (TPB), Social Cognitive Theory (SCT), and Illness Representations specified by the Common Sense Self Regulation Model (CSSRM). We constructed self-report measures of two constructs from Learning Theory (LT), a measure of Implementation Intentions (II), and the Precaution Adoption Process. We collected data on theory-based cognitions (explanatory measures) and two interim outcome measures (stated behavioral intention and simulated behavior) by postal questionnaire survey during the 12-month period to which objective measures of behavior (collected from routine administrative sources) were related. Planned analyses explored the predictive value of theories in explaining variance in intention, behavioral simulation and behavior. Results Response rates across the five surveys ranged from 21% to 48%; we achieved the target sample size for three of the five surveys. For the predictor variables, the mean construct scores were above the mid-point on the scale with median values across the five behaviors generally being above four out of seven and the range being from 1.53 to 6.01. Across all of the theories, the highest proportion of the variance explained was always for intention and the lowest was for behavior. The Knowledge-Attitudes-Behavior Model performed poorly across all behaviors and dependent variables; CSSRM also performed poorly. For TPB, SCT, II, and LT across the five behaviors, we predicted median R2 of 25% to 42.6% for intention, 6.2% to 16% for behavioral simulation, and 2.4% to 6.3% for behavior. Conclusions We operationalized multiple theories measuring across five behaviors. Continuing challenges that emerge from our work are: better specification of behaviors, better operationalization of theories; how best to appropriately extend the range of theories; further assessment of the value of theories in different settings and groups; exploring the implications of these methods for the management of chronic diseases; and moving to experimental designs to allow an understanding of behavior change.
Health Care Innovation and Quality Assurance
Reporting of quality indicators and improvement in hospital performance: the p.re.val.e. Regional outcome evaluation program.
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Renzi C, Sorge C, Fusco D, Agabiti N, Davoli M, Perucci CA.
Health services research 2012 Oct;47(5):1880-190
To evaluate whether reporting of hospital performance was associated with a change in quality indicators in Italian hospitals. DATA SOURCES/STUDY SETTING: Nationwide Hospital Information System for 2006-2009. STUDY DESIGN: We performed a pre-post evaluation in Lazio (before and after disclosure of the Regional Outcome Evaluation Program P.Re.Val.E.) and a comparative evaluation versus Italian regions without comparable programs. We analyzed risk-adjusted proportions of percutaneous coronary intervention (PCI), hip fractures operated on within 48 hours, and cesarean deliveries. DATA COLLECTION/EXTRACTION METHODS: Using standardized ICD-9-CM coding algorithms, we selected 381,053 acute myocardial infarction patients, 250,712 hip fractures, and 1,736,970 women who had given birth. PRINCIPAL FINDINGS: In Lazio PCI within 48 hours changed from 22.49 to 29.43 percent following reporting of the P.Re.Val.E results (relative increase, 31 percent; p < .001). In the other regions this proportion increased from 22.48 to 27.09 percent during the same time period (relative increase, 21 percent; p < .001). Hip fractures operated on within 48 hours increased from 11.73 to 15.78 percent (relative increase, 34 percent; p < .001) in Lazio, and not in other regions (29.36 to 28.57 percent). Cesarean deliveries did not decrease in Lazio (34.57-35.30 percent), and only slightly decreased in the other regions (30.49-28.11 percent). CONCLUSIONS: Reporting of performance data may have a positive but limited impact on quality improvement. The evaluation of quality indicators remains paramount for public accountability. © Health Research and Educational Trust.
Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London.
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Caldwell SE, Mays N.
Health research policy and systems / BioMed Central 2012 Oct 15;10(1):32
BACKGROUND: The publication of Best research for best health in 2006 and the “ring-fencing” of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the ‘second translational gap’ between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. METHODS: This study uses a variation of Goffman’s frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. RESULTS: Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. CONCLUSIONS: The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness.
Do guidelines influence the implementation of health programs? — Uganda’s experience.
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Nabyonga Orem J, Bataringaya Wavamunno J, Bakeera SK, Criel B.
Implementation science : IS 2012 Oct 15;7(1):98
BACKGROUND: A guideline contains processes and procedures intended to guide health service delivery. However, the presence of guidelines may not guarantee their implementation, which may be a result of weaknesses in the development process. This study was undertaken to describe the processes of developing health planning, services management, and clinical guidelines within the health sector in Uganda, with the goal of understanding how these processes facilitate or abate the utility of guidelines.
METHODS: Qualitative and quantitative research methods were used to collect and analyze data. Data collection was undertaken at the levels of the central Ministry of Health, the district, and service delivery. Qualitative methods included review of documents, observations, and key informant interviews, as well as quantitative aspects included counting guidelines. Quantitative data were analyzed with Microsoft Excel, and qualitative data were analyzed using deductive content thematic analysis. RESULTS: There were 137 guidelines in the health sector, with programs related to Millennium Development Goals having the highest number (n = 83). The impetus for guideline development was stated in 78% of cases. Several guidelines duplicated content, and some conflicted with each other. The level of consultation varied, and some guidelines did not consider government-wide policies and circumstances at the service delivery level. Booklets were the main format of presentation, which was not tailored to the service delivery level. There was no framework for systematic dissemination, and target users were defined broadly in most cases. Over 60% of guidelines available at the central level were not available at the service delivery level, but there were good examples in isolated cases. There was no framework for systematic monitoring of use, evaluation, and review of guidelines. Suboptimal performance of the supervision framework that would encourage the use of guidelines, assess their utilization, and provide feedback was noted. CONCLUSIONS: Guideline effectiveness is compromised by the development process. To ensure the production of high-quality guidelines, efforts must be employed at the country and regional levels. The regional level can facilitate pooling resources and expertise in knowledge generation, methodology development, guideline repositories, and capacity building. Countries should establish and enforce systems and guidance on guideline development.
Managing boundaries in primary care service improvement: A developmental approach to communities of practice.
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Kislov R, Walshe K, Harvey G.
Implementation science : IS 2012 Oct 15;7(1):97
BACKGROUND: Effective implementation of change in healthcare organisations involves multiple professional and organisational groups and is often impeded by professional and organisational boundaries that present relatively impermeable barriers to sharing knowledge and spreading work practices. Informed by the theory of communities of practice (CoPs), this study explored the effects of intra-organisational and inter-organisational boundaries on the implementation of service improvement within and across primary healthcare settings and on the development of multiprofessional and multi-organisational CoPs during this process. METHODS: The study was conducted within the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester–a collaborative partnership between the University of Manchester and local National Health Service organisations aiming to undertake applied health research and enhance its implementation in clinical practice. It deployed a qualitative embedded case study design, encompassing semistructured interviews, direct observation and documentary analysis, conducted in 2010-2011. The sample included practice doctors, nurses, managers and members of the CLAHRC implementation team. FINDINGS: The study showed that in spite of epistemic and status differences, professional boundaries between general practitioners, practice nurses and practice managers co-located in the same practice over a relatively long period of time could be successfully bridged, leading to the formation of multiprofessional CoPs. While knowledge circulated relatively easily within these CoPs, barriers to knowledge sharing emerged at the boundary separating them from other groups existing in the same primary care setting. The strongest boundaries, however, lay between individual general practices, with inter-organisational knowledge sharing and collaboration between them remaining unequally developed across different areas due to historical factors, competition and strong organisational identification. Manipulated emergence of multi-organisational CoPs in the context of primary care may thus be problematic. CONCLUSIONS: In cases when manipulated emergence of new CoPs is problematic, boundary issues could be addressed by adopting a developmental perspective on CoPs, which provides an alternative to the analytical and instrumental perspectives previously described in the CoP literature. This perspective implies a pragmatic, situational approach to mapping existing CoPs and their characteristics and potentially modifying them in the process of service improvement through the combination of internal and external facilitation.
Organizational Change & Innovation
To adopt or not to adopt innovation: A case study of team-based learning
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Freeman M.
International Journal of Management Education 2012;10(3):155-168
Evidence of the benefits of an innovation is a necessary but not sufficient condition for its adoption in higher education. This paper reports an investigation of decision making to adopt team-based learning (TBL), an innovation for structuring collaborative small-group learning that has been acclaimed over recent decades. In this study two sets of respondents were asked to reflect on the adoption process, using Rogers’ (2003) diffusion of innovation model (with modifications) to frame both the questions and responses. Despite TBL’s relative advantages, the results show a crucial factor affecting adoption of TBL is its compatibility with the would-be adopter’s teaching approach and with the dominant organisational culture; other factors are TBL’s visibility, trialability, and complexity. In the ensuing discussion, strategies for addressing the apparent chasm between the mainstream majority and early adopters of innovation are outlined. © 2012 Elsevier Ltd.
Research Methodology
Factors relating to effectiveness data use in healthcare management
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Simonen O, Viitanen E, Blom M.
International Journal of Productivity and Performance Management 2012;61(7):752-764
Purpose: The aim of this study is to produce information concerning factors which may hamper or promote the use of effectiveness data in secondary health care middle and upper management. Additionally, the study aims to acquire knowledge of the ways in which the managers would generate effectiveness data for use in their own work. Design/methodology/approach: The study was conducted by interviewing department directors, chief medical officers and directors of nursing (n=38) in the surgical, medical and psychiatric divisions of the five largest hospital districts in Finland. Findings: The use of effectiveness data in management was hampered by factors relating to research, managerial work and the organization. Factors relating to the production of effectiveness data, managerial behaviour and a universal demand for evidence-based operations were considered conducive to the use of such information. Managers would cultivate the use of effectiveness data by improving its accessibility, usability and visibility. Practical implications: The findings may help healthcare organizations in developing the use of effectiveness data in their decision-making. Originality/value: The paper addresses managers’ willingness to apply effectiveness data in decision-making although the present quality, reliability and accessibility of effectiveness data do not meet the managers’ needs. The use of effectiveness data in management can be influenced by enhancing organizational patterns of action and supporting managerial decision-making. © Emerald Group Publishing Limited.
Guidelines for randomized clinical trial protocol content: a systematic review.
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Tetzlaff JM, Chan AW, Kitchen J, Sampson M, Tricco A, Moher D.
Systematic reviews 2012 Sep 24;1(1):43
BACKGROUND: All randomized clinical trials (RCTs) require a protocol; however, numerous studies have highlighted protocol deficiencies. Reporting guidelines may improve the content of research reports and, if developed using robust methods, may increase the utility of reports to stakeholders. The objective of this study was to systematically identify and review RCT protocol guidelines, to assess their characteristics and methods of development, and to compare recommendations. METHODS: We conducted a systematic review of indexed literature (MEDLINE, EMBASE and the Cochrane Methodology Register from inception to September 2010; reference lists; related article features; forward citation searching) and a targeted search of supplementary sources, including a survey of major trial funding agencies in six countries. Records were eligible if they described a content guideline in English or French relevant to RCT protocols. Guidelines were excluded if they specified content for protocols for trials of specific procedures or conditions or were intended to assess trial quality. We extracted guideline characteristics and methods. Content was mapped for a subset of guidelines that described development methods or had institutional endorsement. RESULTS: Forty guidelines published in journals, books and institutional reports were included in the review; seven were specific to RCT protocols. Only eight (20%) described development methods which included informal consensus methods, pilot testing and formal validation; no guideline described all of these methods. No guideline described formal consensus methods or a systematic retrieval of empirical evidence to inform its development. The guidelines included a median of 23 concepts per guideline (interquartile range (IQR) = 14 to 34; range = 7 to 109). Among the subset of guidelines (n = 23) for which content was mapped, approximately 380 concepts were explicitly addressed (median concepts per guideline IQR = 31 (24,80); range = 16 to 150); most concepts were addressed in a minority of guidelines. CONCLUSIONS: Existing guidelines for RCT protocol content varied substantially in their recommendations. Few reports described the methods of guideline development, limiting comparisons of guideline validity. Given the importance of protocols to diverse stakeholders, we believe a systematically developed, evidence-informed guideline for clinical trial protocols is needed.
Writing implementation research grant proposals: Ten key ingredients.
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Proctor EK, Powell BJ, Baumann AA, Hamilton AM, Santens RL.
Implementation science : IS 2012 Oct 12;7(1):96
BACKGROUND: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers. DISCUSSION: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application. SUMMARY: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.
Aging
The Influence of Cognitive Status on Elder Food Choice and Meal Service Satisfaction.
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Crogan NL, Short R, Dupler AE, Heaton G.
American Journal of Alzheimer’s Disease and Other Dementias 2012 Oct 4
Background: This article describes the testing of a new nursing home food delivery system that empowers elders to choose the foods they want to eat and gives them an active voice in menu development. Methods: Using a 2-group, repeated measures design, 61 elderly residents from 2 eastern Washington nursing homes were recruited to participate in a 6-month study. Outcome measures included food and meal service satisfaction, body weight, serum prealbumin, and food intake. Results: Serum prealbumin levels and body weight increased post intervention for treatment group residents. Mini-Mental Status Examination (MMSE) scores were not associated with the changes in serum prealbumin, body weight, or food intake. Discussion: The MMSE scores did not influence the resident’s ability to actively participate in the rate the food process or choose the foods they liked and preferred to eat. Cognitive impaired older adults experienced weight gain similarly to higher functioning elderly individuals.
Being flexible and tuning in: professional caregivers’ reflections on management of violent behaviour in nursing homes.
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Isaksson U, Astrom S, Graneheim UH.
International journal of older people nursing 2012 Oct 10
Violence towards caregivers in the care of older people is a challenge attracting increasing attention in nursing research. However, studies that focus on the approaches caregivers in nursing homes resort to and how they manage everyday care situations involving threats and violent situations are relatively few. AIMS AND OBJECTIVES: This qualitative, descriptive study aimed to illuminate professional caregivers’ reflections on managing residents’ violent behaviour in nursing homes. METHODS: The study was based on 41 interviews in which the caregivers reflected on their own courses of action in violent situations. The interviews were subjected to qualitative content analysis. RESULTS: This study showed that caregivers were flexible and in tune with the resident by averting and defusing threatening and violent situations. The caregivers tried to give care in line with the residents’ condition, control their own spontaneous reactions and interpret the residents’ reactions as communicative signs indicating how they should interact with the resident in the situation. As a last resort, when previous approaches had been unsuccessful, the caregivers took a firm stand, confronted the resident and the violent behaviour more directly, but with respect and with the residents’ best interests in mind. CONCLUSIONS: These findings illuminate how caregivers successfully can manage threatening and violent behavior in nursing homes by being flexible and tuning in with the resident but also by taking a firm stand with the residents’ best interests in mind. To be flexible and in tune with residents, it is important to know the residents’ personal histories. This may mean involving stakeholders, such as family members and friends, in the care of residents with violent behaviour. IMPLICATIONS FOR PRACTICE: We believe that it is important to involve stakeholders in the care of threatening and violent residents in nursing homes as it is important to get information on the residents’ personal history. However, there are risks when interpreting residents’ behaviour in light of their personal histories as relatives experiences may be subjective and the information may give the caregivers preconceived ideas about the resident. © 2012 Blackwell Publishing Ltd.
Effect of forced transitions on the most functionally impaired nursing home residents.
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Thomas KS, Dosa D, Hyer K, Brown LM, Swaminathan S, Feng Z, et al.
Journal of the American Geriatrics Society 2012 Oct;60(10):1895-1900
To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home (NH) residents with the highest levels of functional impairment.
DESIGN: Retrospective cohort study. SETTING: One hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav. PARTICIPANTS: Six thousand four hundred sixty-four long-stay residents residing in at-risk NHs for at least three consecutive months before landfall of Hurricane Gustav. MEASUREMENTS: Using Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long-stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate. RESULTS: The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality. CONCLUSION: The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.
Patient-Centered Care for Older Adults with Multiple Chronic Conditions: A Stepwise Approach from the American Geriatrics Society
Non UofA Access
One of the greatest challenges in geriatrics is the provision of optimal care for older adults with multiple chronic conditions, or “multimorbidity.” More than 50% of older adults have three or more chronic diseases, with distinctive cumulative effects for each individual. The American Geriatrics Society (AGS) convened a panel with expertise in these topics. The goal was to develop an approach by which clinicians can care optimally for older adults with multimorbidity. This document is not a guideline. Therefore, it does not issue recommendations based on rigorous evaluation of the quality of evidence for specific clinical questions with assessments of harms and benefits. Rather it sets out guiding principles that, taken together, provide an approach to clinical management for older adults with multimorbidity.
Medication adherence in older adults with cognitive impairment: a systematic evidence-based review.
Non UofA Access
Journal of the American Geriatrics Society 2012 Oct;60(10):1957-1968.
Cognitive impairment challenges the ability to adhere to the complex medication regimens needed to treat multiple medical problems in older adults. OBJECTIVE: Our aim was to conduct a systematic evidence-based review to identify barriers to medication adherence in cognitively impaired older adults and interventions aimed at improving medication adherence. METHODS: A search of MEDLINE, EMBASE, PsycINFO, GoogleDocs, and CINAHL for articles published between 1966 and February 29, 2012 was performed. Studies included older adults with a diagnosis of cognitive impairment of any degree (mild cognitive impairment or mild, moderate, or severe dementia). To identify barriers to adherence, we reviewed observational studies. To identify relevant interventions, we reviewed clinical trials targeting medication adherence in cognitively impaired older adults. We excluded studies lacking a measure of medication adherence or lacking an assessment of cognitive function, case reports or series, reviews, and those focusing on psychiatric disorders or infectious diseases. Population demographics, baseline cognitive function, medication adherence methods, barriers to adherence, and prospective intervention methodologies were extracted. RESULTS: The initial search identified 594 articles. Ten studies met inclusion criteria for barriers to adherence and three met inclusion criteria for interventional studies. Unique barriers to adherence included understanding new directions, living alone, scheduling medication administration into the daily routine, using potentially inappropriate medications, and uncooperative patients. Two studies evaluated reminder systems and showed no benefit in a small group of participants. One study improved adherence through telephone and televideo reminders at each dosing interval. The results of the review are limited by reviewing only published articles, missing barriers or interventions due to lack of subgroup analysis, study selection and extraction completed by 1 reviewer, and articles with at least an abstract published in English. CONCLUSIONS: The few studies identified limit the assessment of barriers to medication adherence in the cognitively impaired population. Successful interventions suggest that frequent human communication as reminder systems are more likely to improve adherence than nonhuman reminders. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.
A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities.
Non UofA Access
Shanley C, Boughtwood D, Adams J, Santalucia Y, Kyriazopoulos H, Pond D, et al.
BMC health services research 2012 Oct 9;12(1):35
BACKGROUND: People with dementia and their family carers need to be able to access formal services in the community to help maintain their wellbeing and independence. While knowing about and navigating one’s way through service systems is difficult for most people, it is particularly difficult for people from culturally and linguistically diverse (CALD) communities. This study addresses a lack of literature on the use of formal services for dementia by people from CALD backgrounds by examining the experiences and perceptions of dementia caregiving within four CALD communities – Italian, Chinese, Spanish and Arabic-speaking – in south western Sydney, Australia. METHODS: The study used a qualitative design and the methods included focus groups with family carers and one-to-one interviews with bilingual/bicultural community workers, bilingual general practitioners and geriatricians. A total of 121 family carers participated in 15 focus groups and interviews were held with 60 health professionals. All fieldwork was audiotaped, transcribed and subjected to thematic analysis. RESULTS: People from CALD communities are often unfamiliar with the concept of formal services and there may be strong cultural norms about maintaining care within the family, rather than relying on external services. CALD communities often have limited knowledge of services. There is a preference for services that will allow families to keep their relative at home, for safety as well as cultural reasons, and they are particularly reluctant to use residential care. While there is a preference for ethno-specific or multicultural services, mainstream services also need to ensure they are more flexible in providing culturally appropriate care. Positive outcomes occur when ethno-specific services work in partnership with mainstream programs. Dementia service providers need to develop a trusting relationship with their local CALD communities and promote their services in a way that is understandable and culturally acceptable to members of these communities. CONCLUSIONS: While members of CALD communities may have difficulties accessing formal services, they will use them if they are culturally and linguistically appropriate and can meet their needs. There are a number of ways to improve service provision to CALD communities and the responsibility for this needs to be shared by a range of stakeholders.
International Federation on Ageing: Current and emerging issues facing older Canadians
March 2012
Ageing issues are complex and not only about seniors. The notion of a life course perspective was introduced more than a decade ago yet is seeing resurgence in the context the labor market strategies, the work-life balance, the role of family caring and being active and connected as we age. In the study of current and future issues facing older Canadians, all levels of governments, industry and the non-governmental sectors revealed not only layers of a discreet subject (such as an ageing workforce) but more importantly the interrelationships among the issues and the interconnectedness between the issues.
Events
UofA
KUSP Brown Bag: Feeling more at home: Implementation of dementia care guidelines in a Swedish Nursing home
Wednesday October 24, 12:00-13:00 5-140 ECHA Includes lunch!!!
Dr. Anne-Marie Boström will be presenting this paper
Get Out and Stay Out: Conversations about multiculturalism
2-490 ECHA Thursday November 1, 2012, 5 pm
Dr. Alana Lentin, University of Western Sydney will speak on The crisis of multiculturalism: Racism in a Neoliberal age. And Dr. Mojtaba Mahdavi, University of Alberta, will give a talk entitled Towards a Dignity of Difference? Neither End of History Nor Clash of Civilizations.
Pain Revisited 2012
Friday Nov 2, 2012 12:30-16:30 2-39 Corbett hall
This year’s highly informative presenters from a diverse range of professional backgrounds will discuss: pain research in military members; spirituality and pain coping; calcium channels and neuropathic pain; what parents want: information needs prior to hospitalization for surgery; acute pain in hospitalized chronically ill children; pain –in the brain?; and others.
An Introduction to BioMed Central, SpringerOpen, and Chemistry Central
Wednesday Oct 24, 13:00-14:00 2022 Dentistry/Pharmacy Building
BioMed Central, SpringerOpen and Chemistry Central are all open access initiatives from Springer Publishing. A representative from Springer will provide an overview of each initiative, discuss the journals available, the submission process, and answer any questions you may have about publishing in an open access journal via Springer. The target audience for this session is faculty and grad students.
How to win tenure and influence people (or at least other researchers): A panel discussion on decision making around academic publishing
Thursday Nov 8, 2012 12:00-13:00 ECHA 4-036
Academic publishing is one of the most crucial aspects of scholarship in the modern University. Choosing where to submit an article has direct implications for our careers, influence and reputations. In this session, we will discuss aspects of making strategic decisions about where to publish academic work. Dr. Jeff Johnson is well known researcher internationally and has published for many years across disciplines in chronic disease. Dr. Tania Bubela writes about her research in the less-traditional areas of intellectual property, and theory in both legal and medical journals. Dr. Dawn Kingston is a newer faculty member who is publishing in paediatrics. Hannah O’Rourke is a doctoral student establishing her publishing in elderly care. Come for a lively discussion and share your own insights!
My Leaky Body, Tales from the Gurney
Monday October 29, 2012 from 19:00 PM to 20:30 ECHA 2-490
My Leaky Body, Tales from the Gurney is a play, a book and an interactive workshop series based on Devaney’s experiences in the health care system. “Raw, harrowing, and darkly funny, Julie Devaney argues convincingly for fixes to the system and better training for all medical personnel.” Julie was named one of 2011’s Women Health Heroes by Best Health Magazine and has attracted national media attention.
Non UofA
AHS & Covenant Health 6th Annual Nursing Research Day
Friday Nov 23, 2012 Robbins Learning Center Royal Alexandra Hospital Lunch is provided
To register, email Sandy Matthews with your name, title, organization, and email address.
Online
KT Canada: Effectiveness and development methodology of printed educational materials: the Decision Box example
Thursday Nov 8, 2012 10:00-11:00 MT 12:00-13:00 ET
Learning Objectives:
- To review the evidence on the effectiveness of printed educational materials
- To understand the challenges in involving users in the development of knowledge tools
- To apply the KTA framework to the development and implementation of the Decision Box
Courses
Workshop: A Method for Synthesizing Knowledge to Inform Public Policy Decision Makers – JASP 2012
National Collaborating Centre for Healthy Public Policy, Montréal, PQ Nov 26, 2012 IN FRENCH
This one-day workshop, to be held in French, is intended for public health professionals who are expected to produce knowledge syntheses to inform policy makers.
The learning objectives of the day are to enable participants to:
- Use an analytical framework that addresses several dimensions that are relevant to public policies and important to document (effectiveness, unintended effects, equity, cost, feasibility and acceptability).
- Construct the logic model of a public policy in order to guide data collection.
- Develop a literature review strategy that is both rigorous and adapted to public policies.
- Establish the steps to follow to organize deliberative processes in order to enhance the data from the literature review with the expertise of local actors.
IHI: Innovation College
February 11-12, 2013, Cambridge MA, Cost US$2950
IHI is now offering an opportunity to learn firsthand our approach to innovation, through a new program called The Innovation College. Participants will work closely with IHI’s research and development faculty and a small group of peers during a two-and-a-half-day meeting – followed by six months of conference calls and email contact – to learn how to develop and execute the best new ideas and designs. At the end of this program, participants will be able to use these innovation approaches in their own organizations to generate novel solutions to current and future challenges.
Comprehensive CIHR Proposal Development Worshop
Ryerson University, Toronto ON November 12-13, 2012 Cost $535
This two-day comprehensive seminar is geared for those who wish to submit winning research proposals to the Canadian Institutes of Health Research. It is taught by experienced grant writers and evaluators who are physicians.
Preparing a Successful CIHR Master’s Award Application
Monday November 5, 2012 10:30-11:30 2F1.04 Water Mackenzie Health Sciences Centre
Strategies for and characteristics of a successful CIHR Master’s Award application will be discussed. We will hear from two University of Alberta researchers, Drs. Ming Chan and Christina Rinaldi, who have previously sat on CIHR Master’s Panel A and B, respectively. A question and answer period will follow
CASP International Training Week
March 18-22, 2-13 Oxford, UK
3 day Introduction to Evidence-based Health Care. This will cover study design; critical appraisal of different types of studies, e.g. RCTs, Systematic Reviews, Qualitative Studies; and Making Sense of Results). Followed by: 2 day CASP Training the Trainer workshop The broad aim of the Training the Trainer workshops are to help participants develop the competence and confidence to teach critical appraisal skills, and run a CASP-style workshop.
Online
Professional Specialization Certificate in Population Health Data Analysis
The new on‐line Professional Specialization Certificate in Population Health Data Analysis program provides a unique opportunity for health professionals to learn a diverse set of skills from multiple disciplines. The flexible entry program allows you to start in any term and to take up to two courses without applying to the full program.
Spring Courses include:
- Epidemiological statistics (January to April 2013)
- Longitudinal analysis and multi‐level modeling of population health data (January to April 2013)
How to Make Your Research Open Access (Whether You’re at Harvard or Not)
Tuesday Oct 23, 2012 10:30 am MT 12:30 pm ET Session will be archived for watching whenever you have time
How do you make your own work open access (OA)? The question comes up from researchers at schools with good OA policies (like Harvard and MIT) and at schools with no OA policies at all. We invite you to join Peter Suber and Stuart Shieber of the Harvard Open Access Project, the Berkman Center community, and Office for Scholarly Communication in an open forum on the Harvard OA policies, concrete steps for making your work OA, and questions on any aspect of OA, especially from the perspective of publishing researchers.
NHSRU: Leveraging Data to Make Better Decisions – An Overview of Databases
Join us for a free seven-part webinar series that identifies opportunities to extract information from databases to facilitate your research. This series explores the availability and utility of key health human resource (HHR) databases in Ontario and addresses potential challenges and barriers to using these databases.
Sharing Clinical Research Data: A Workshop
Pharmaceutical companies, academics, and government agencies such as the Food and Drug Administration and the National Institutes of Health have large quantities of clinical research data. Data sharing within each sector and across sectors could facilitate scientific and public health advances and could enhance analysis of safety and efficacy. Much of this information, however, is never published. This workshop will explore barriers to sharing of clinical research data, specifically clinical trial data, and strategies for enhancing sharing within sectors and among sectors to facilitate research and development of effective, safe, and needed products.
ILCA Workshop – Older Adults with Addictions & Mental Health Disorders
Mon Nov 5th – Sun Dec 2nd, 2012 (4 weeks) online weekly at your discretion Cost: $240, Students $120
Taught by Marilyn White-Campbell, Geriatric Addiction Specialist, Community Outreach Programs in Addictions (COPA)
News
Greta Cummings has been appointed Centennial Professor at the University of Alberta
The Centennial Professorship is among the most prestigious of awards at the University of Alberta and is bestowed on members of the academy who have achieved outstanding distinction in their area of research and scholarship, teaching and who have earned favourable regard from the community.
Government of Canada: Taking Action to Improve the Health of Canadians
The Government of Canada welcomes the opportunity to respond to the report of the Standing
Senate Committee on Social Affairs, Science and Technology, Time for Transformative Change:
A Review of the 2004 Health Accord. This comprehensive review was an important
accountability mechanism to update Canadians on progress achieved under the Accord.
More powers given to nurse practitioners in British Columbia
The B.C. government is giving nurse practitioners more authority in a move that Health Minister Margaret MacDiarmid says will make the health-care system more efficient, especially in rural communities, saving doctors, nurses and patients time. Ms. MacDiarmid announced on Thursday that nurse practitioners will be able to admit and discharge patients, an expansion to their current roles, which include diagnosing, prescribing and ordering diagnostic tests to treat common medical conditions.
Canadian Journal of Nursing Research Call for Applicants: Associate Editor & Editorial Board
Deadline November 15, 2012
The CJNR (formerly known as the Canadian Journal of Nursing Research) is a journal for research in nursing and related health disciplines in Canada. If interested, please send a message and recent CV to the cjnr.nursing@mcgill.ca
Journal of Advanced Nursing seeks an editor
Deadline for application October 31, 2012. Position commences in January 2013
One of the current team of Editors, Kader Parahoo, will be stepping down at the end of 2012. Therefore we are seeking applications for the position to complete a team of four Editors within one of the leading international nursing journals. The Journal of Advanced Nursing (JAN) is an international, peer-reviewed scientific journal which contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy.
Resources
AHRQ: Improving Patient Safety Systems for Patients With Limited English Proficiency: A Guide for Hospitals
Research suggests that adverse events affect patients with limited English proficiency (LEP) more frequently, are often caused by communication problems, and are more likely to result in serious harm compared to those that affect English-speaking patients. This guide focuses on how hospitals can better identify, report, monitor, and prevent medical errors in patients with LEP.
AHRQ: TeamSTEPPS® Enhancing Safety for Patients With Limited English Proficiency Module
The TeamSTEPPS Limited English Proficiency module is designed to help you develop and deploy a customized plan to train your staff in teamwork skills and lead a medical teamwork improvement initiative in your organization from initial concept development through to sustainment of positive changes. This evidence-based module will provide insight into the core concepts of teamwork as they are applied to your work with patients who have difficulty communicating in English. Comprehensive curricula and instructional guides include short case studies and videos illustrating teamwork opportunities and successes.
Personal Support Workers Competencies for Quality Palliative Care in Long Term Care
Development of Personal Support Worker (PSW) Competencies in long-term care is a sub-project of a five year CommunityUniversity Research Alliance funded by the Social Sciences and Humaniies Research Council (SSHRC) enitled Improving the Quality of Life for People Dying in Long Term Care Homes. The goal of the project is to develop, through Paricipatory Acion methods, a palliaive care philosophy in long-term care (LTC).
National Collaborating Centre for Health Public Policy: A Framework for Analyzing Public Policies: Practical Guide
September 2012
This document presents a structured process based on an analytical framework that reflects a public health perspective, while at the same time integrating other concerns of policy makers. The document addresses four questions:
- What public policies does this analytical framework apply to?
- In what types of situations is it useful?
- Which policy facets does it focus on?
- How is the analysis carried out?
STATS: Take a quantitative leap
From George Mason University, this is an interesting website designed for journalists to understand statistical information in health research and to translate this research for media outlets. It also includes information on understanding and interpreting statistics.
