A5015080360- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Emergency and Acute Care Studies
- Health Policy Implementation Science
- Healthcare Systems and Technology
- Patient Satisfaction in Healthcare
- Mental Health and Patient Involvement
- Health Systems, Economic Evaluations, Quality of Life
- Geriatric Care and Nursing Homes
- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare Quality and Management
- Trauma and Emergency Care Studies
- Intensive Care Unit Cognitive Disorders
- Delphi Technique in Research
- Interprofessional Education and Collaboration
- Empathy and Medical Education
- Evaluation and Performance Assessment
- Chronic Disease Management Strategies
- Hip and Femur Fractures
- Media Influence and Health
- Disaster Management and Resilience
- Child and Adolescent Psychosocial and Emotional Development
- Global Health Workforce Issues
- Ethics in Clinical Research
- Humor Studies and Applications
University of Manitoba
2016-2025
Institute for Community Health
2021-2023
George & Fay Yee Centre for Healthcare Innovation
2015-2022
Winnipeg Regional Health Authority
2009-2021
Manitoba Health
2013-2021
HCL Technologies (India)
2021
Concordia University
2011-2017
St. Boniface Hospital
2017
University of Oxford
2005
The implementation of accountable care organizations (ACOs), a new health payment and delivery model designed to improve lower costs, is proceeding rapidly. We build on our experience tracking early ACOs identify the major factors—such as contract characteristics; structure, capabilities, activities; local context—that would be likely influence ACO formation, implementation, performance. then propose how an evaluation program could structured guide policy makers payers in improving design...
The study of right-wing authoritarianism (RWA) and Social Dominance Orientation (SDO) as predictors prejudice has represented an attempt to explain group dynamics in terms individual traits. In contrast, I argue that the tendencies predict are actually a product dynamics. This article critiques personality approaches, focusing primarily on secondarily social dominance, defends model explains 2 variables discrete processes. According Dual Group Processes model, SDO reflects category...
This cross-site comparison of the early experience four provider organizations participating in Brookings-Dartmouth Accountable Care Organization Collaborative identifies factors that sites perceived as enablers successful ACO formation and performance. The pilots varied size, with between 7,000 50,000 attributed patients 90 to 2,700 physicians. had varying degrees performance-based payments; however, all formed collaborative new relationships payers created shared savings agreements linked...
Context: It is widely hoped that accountable care organizations (ACOs) will improve health quality and reduce costs by fostering integration among diverse provider groups. But how do implementers actually envision integration, what mean in terms of managing the many social identities ACOs bring together? Methods: Using lens identity approach, this qualitative study examined four nascent engaged with concept integration. During multiday site visits, we conducted interviews (114 managers...
Abstract Background Despite widespread belief in the importance of patient‐centred care, it remains difficult to create a system which all groups work together for good patient. Part problem may be that issue care itself can used prosecute intergroup conflict. Objective This qualitative study texts examined presence and nature language within discourse on care. Methods A systematic SCOPUS Google search identified 85 peer‐reviewed grey literature reports engaged with concept Discourse...
Integrated knowledge translation (IKT) flows from the premise that co-produced with decision-makers is more likely to inform subsequent decisions. However, evaluations of manager/policy-maker-focused IKT often concentrate on intermediate outcomes, stopping short assessing whether research findings have contributed identifiable organisational action. Such hesitancy may reflect difficulty tracing causes this distal, multifactorial outcome. This paper elucidates how an approach based realistic...
Abstract Background Co-production is an umbrella term used to describe the process of generating knowledge through partnerships between researchers and those who will use or benefit from research. Multiple advantages research co-production have been hypothesized, in some cases documented, both academic practice record. However, there are significant gaps understanding how evaluate quality co-production. This gap rigorous evaluation undermines potential co-producers. Methods tests relevance...
Abstract Background Engaging knowledge users in health research is accelerating Canada. Our objective was to examine perceptions of partnered among individuals involved funded Canadian projects between 2011 and 2019. Methods We invited 2155 recipients 1153 answer a questionnaire probing project characteristics research. described compared perceived effects involving the project, team cohesion, capability, opportunity motivation for working partnership two categories respondents: role...
Although well-established principles exist for improving the timeliness and efficiency of care, many organisations struggle to achieve more than small-scale, localised gains. Where care processes are complex include segments under different groups' control, elegant solutions promised by improvement methodologies remain elusive. This study sought identify common design flaws that limit impact flow initiatives.This qualitative was conducted within an explanatory case a Canadian regional health...
Health systems in many jurisdictions struggle to reduce Emergency Department congestion and improve patient flow across the continuum of care. Flow is often described as a systemic issue requiring "system approach"; however, implications this idea remain poorly understood. Focusing on Canadian regional health system whose problems have been particularly intractable, study sought determine what system-level flaws impede healthcare organizations from improving flow. This drew primarily...
Abstract: The idea of including patient perspectives in health‐services planning and evaluation is increasingly embraced by Canadian health authorities. This article argues that the validity a particular method not simply matter its scientific rigour; rather, it depends on what one considers to be meaning purpose involvement. Perspectives involvement can conceptualized terms continuum from consumerism (patients as customers who deserve satisfied) participatory democracy citizens with right...
Abstract Background Older adults are at high risk of developing delirium in the emergency department (ED); however, it is under-recognized routine clinical care. Lack detection and treatment associated with poor outcomes, such as mortality. Performance measures (PMs) needed to identify variations quality care help guide improvement strategies. The purpose this study gain consensus on a set statements PMs that can be used evaluate for older ED patients. Methods A 3-round modified e-Delphi was...
Centralized waiting lists (CWLs) are one solution to reduce the problematic number of patients without a regular primary care provider. This article describes different models CWLs for unattached implemented in seven Canadian provinces and identifies common issues implementation these CWLs.
There is emerging consensus that the growing problem of chronic disease demands major health system changes, as envisioned in Chronic Care Model (original and expanded). Yet implementation research has documented pitfalls trying to implement whole model at once; it more effective focus on one highly important change a time. This article responds decision-makers' need set priorities by comparing strength evidence for different interventions. It synthesizes broad range literature, including...
Purpose – Recognition of the importance and difficulty engaging physicians in organisational change has sparked an explosion literature. The social identity approach, by considering engagement terms underlying group identifications intergroup dynamics, may provide a framework for choosing among plethora proposed techniques. This paper seeks to address this issue. Design/methodology/approach authors examined how four disparate organisations engaged change. Qualitative methods included...
Given all the available knowledge about effective implementation, why do many organizations continue to have-or appear have-an implementation problem? Analysis of a 7-year corpus reports by Canadian health region's "embedded" research and evaluation unit sought discover source intractable difficulty implementing improvement. Findings suggested that problem was neither lack (decision-makers displayed sophisticated understanding fundamental issues) nor an inability take action (there existed...
This paper presents the findings of a systematic search and review examining acceptability e-mental health services for children, adolescents, young adults their parents healthcare providers. Multiple databases were searched abstracts screened to determine if they met study inclusion criteria. Findings from included studies synthesized within five dimensions acceptability: satisfaction, client expectations, uptake, adherence patient/provider experiences. Twenty-four included, suggest that...
Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be prerequisite for obtaining healthcare that timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the system. Yet, 4.6 million Canadians, approximately 15% Canada's population, are unattached; is, they do not have provider. To address critical need attachment, especially more vulnerable patients, six Canadian provinces implemented centralized...