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ABSTRACT Communities of Practice (CoPs) are a powerful strategy for supporting knowledge sharing amongst members working in a common field. Information, knowledge and evidence in the field of older adult healthcare and aging have grown... more
ABSTRACT Communities of Practice (CoPs) are a powerful strategy for supporting knowledge sharing amongst members working in a common field. Information, knowledge and evidence in the field of older adult healthcare and aging have grown exponentially over the past decade. This study reports results from a secondary qualitative analysis of ethnographic data to explore the cultural factors of two CoPs that members perceived to promote and constrain success. The CoPs, housed by the Seniors Health Knowledge Network (SHKN), were composed of stakeholders including formal care givers, and focused on wound care and complex care resolution for older adults. Participants spoke about five themes: 1) Hope and desire to cause real, effective change, 2) Appreciation for bringing together diverse people and experiences, 3) Aspiring to work together as a harmonious team, 4) Striving for strong work ethic and good practices to achieve efficiency and productivity and 5) Responses to tensions, worries and uncertainty. Drawing on the themes and the broader CoP literature, we provide strategies for developing, running and sustaining successful healthcare CoPs as an educational resource for formal care givers and other stakeholders. CoPs must be largely autonomous and self-organizing, and sponsoring bodies will need to restrict their activities to providing resources and support without imposing specific mandates. The most important implication of this work is that passion, work ethic, diversity and communication can help CoPs achieve harmony and success.
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Background Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19... more
Background Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians’ (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis ...
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Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world.Emerging concepts like One Health, integrated care models for COPD, and associations between oral and respiratory health are innovative ways to... more
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world.Emerging concepts like One Health, integrated care models for COPD, and associations between oral and respiratory health are innovative ways to approach COPD treatment. This study explored contemporary evidence on the inclusion of dental providers on interprofessional healthcare teams treating patients with COPD. The first objective was to explore the current state of interprofessional care for COPD, and the second objective was to explore dentistry used in interprofessional care. A rapid review was conducted from January–June 2020 using Scopus and PubMed. Upon assessing for duplication and relevance, 85 articles were included for Objective 1, and 194 for Objective 2. The literature suggests that when dental providers are included on interprofessional healthcare teams, treatment outcomes for patients with multi-morbid, chronic disease such as COPD, are improved. The papers collected for rev...
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ABSTRACT Communities of Practice (CoPs) are a powerful strategy for supporting knowledge sharing amongst members working in a common field. Information, knowledge and evidence in the field of older adult healthcare and aging have grown... more
ABSTRACT Communities of Practice (CoPs) are a powerful strategy for supporting knowledge sharing amongst members working in a common field. Information, knowledge and evidence in the field of older adult healthcare and aging have grown exponentially over the past decade. This study reports results from a secondary qualitative analysis of ethnographic data to explore the cultural factors of two CoPs that members perceived to promote and constrain success. The CoPs, housed by the Seniors Health Knowledge Network (SHKN), were composed of stakeholders including formal care givers, and focused on wound care and complex care resolution for older adults. Participants spoke about five themes: 1) Hope and desire to cause real, effective change, 2) Appreciation for bringing together diverse people and experiences, 3) Aspiring to work together as a harmonious team, 4) Striving for strong work ethic and good practices to achieve efficiency and productivity and 5) Responses to tensions, worries and uncertainty. Drawing on the themes and the broader CoP literature, we provide strategies for developing, running and sustaining successful healthcare CoPs as an educational resource for formal care givers and other stakeholders. CoPs must be largely autonomous and self-organizing, and sponsoring bodies will need to restrict their activities to providing resources and support without imposing specific mandates. The most important implication of this work is that passion, work ethic, diversity and communication can help CoPs achieve harmony and success.
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Additional file 2. Supplementary data for non-response bias assessment.
Additional file 1. Survey delivered to Canadian medical students.
IntroductionGiven the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing... more
IntroductionGiven the recurrent risk of respiratory illness-based pandemics, and the important roles family physicians play during public health emergencies, the development of pandemic plans for primary care is imperative. Existing pandemic plans in Canada, however, do not adequately incorporate family physicians’ roles and perspectives. This policy and planning oversight has become increasingly evident with the emergence of the novel coronavirus disease, COVID-19, pandemic. This study is designed to inform the development of pandemic plans for primary care through evidence from four provinces in Canada: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario.Methods and analysisWe will employ a multiple-case study of regions in four provinces. Each case consists of a mixed methods design which comprises: (1) a chronology of family physician roles in the COVID-19 pandemic response; (2) a provincial policy analysis; and (3) qualitative interviews with family physicians...
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Background Communities of Practice are formed by people who interact regularly to engage in collective learning in a shared domain of human endeavor. Virtual Communities of Practice (VCoP) are online communities that use the internet to... more
Background Communities of Practice are formed by people who interact regularly to engage in collective learning in a shared domain of human endeavor. Virtual Communities of Practice (VCoP) are online communities that use the internet to connect people who share a common concern or passion. VCoPs provide a platform to share and enhance knowledge. The Policy Circle is a VCoP that connects mid-career professionals from across Canada who are committed to improving healthcare policy and practice. We wanted to understand the perceived value of the VCoP. Methods We used qualitative and quantitative survey research to explore past and current Policy Circle members’ thoughts, feelings, and behaviours related to the program. Our research was guided by the Value Creation Framework proposed by Wenger and colleagues. Three surveys were created in collaboration with stakeholders. Data were analyzed within cohort and in aggregate across cohorts. Qualitative data was analyzed thematically, and quan...
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Research Interests: Knowledge Management, Organizational Culture, Leadership, Knowledge sharing, Qualitative Research, and 12 morePublic Health, Knowledge Translation, Health Care Management, Medicine, Model, Business and Management, Health Care Organization, Public health systems and services research, Organizational Innovation, Public Health Services, Delivery of Health Care, and Interviews as topic
Effective and efficient methods of succession planning are integral to the success of organizations across the health care system. We explored current health organizations' senior leadership transition processes.... more
Effective and efficient methods of succession planning are integral to the success of organizations across the health care system. We explored current health organizations' senior leadership transition processes. Participants were in senior level leadership and decision-making positions in hospitals within Ontario, Canada. Most of the participants did not have formal transition plans and instead relied on the human resources department to plan for succession. We discuss these processes through three themes: (1) preplanning for a transition, (2) the transition process, and (3) barriers to successful transitions. The results of this study confirm the ideas that leadership style combined with experience and personal preferences dominates a leader's onboarding process. Like any complex organizational process, transitions ought to be iterative, flexible, and in line with the needs of individuals, the organizations, and the context. This research also provides further analysis around the broader contextual and cultural issues inherent to succession planning.
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Introduction Health systems are a complex web of interacting and interconnected parts; introducing an intervention, or the allocation of resources, in one sector can have effects across other sectors and impact the entire system. A... more
Introduction Health systems are a complex web of interacting and interconnected parts; introducing an intervention, or the allocation of resources, in one sector can have effects across other sectors and impact the entire system. A prerequisite for effective health system reorganisation or transformation is a broad and common understanding of the current system amongst stakeholders and innovators. Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are common chronic diseases with high health care costs that require an integrated health system to effectively treat. Study description This case study documents the first phase of system transformation at a regional level in Ontario, Canada. In this first phase, visual representations of the health system in its current state were developed using a collaborative co-creation approach, and a focus on COPD and HF. Multiple methods were used including focus groups, open-ended questionnaires, and document review, to develop a...
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Research Interests: Communication, Education, Domestic Violence, Focus Groups, Public Relations, and 15 moreKnowledge sharing, Implementation Science, Public Health, Health Services Research, Knowledge Translation, Medicine, Knowledge Exchange, Humans, Female, Data Collection, Ontario, Longitudinal Studies, Cross Sectional Studies, Interviews as topic, and Medical and Health Sciences
This chapter will help you: define types, characteristics, and roles of teams in the context of public health; identify common challenges experienced by teams; consider strategies to foster high-performing teams; Suggest methods to... more
This chapter will help you: define types, characteristics, and roles of teams in the context of public health; identify common challenges experienced by teams; consider strategies to foster high-performing teams; Suggest methods to assess, evaluate, and improve team effectiveness.
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Background: Understanding how patients perceive their role in the healthcare team can improve overall satisfaction of care and health outcomes. However, it has been challenging to capture the diversity of patient experiences using... more
Background: Understanding how patients perceive their role in the healthcare team can improve overall satisfaction of care and health outcomes. However, it has been challenging to capture the diversity of patient experiences using traditional research approaches. The goal of this study was to explore the perspectives of patients involved in an interprofessional team-based chronic disease management program for chronic obstructive pulmonary disease using visual research techniques. Methods: Our visual approach began with patients autonomously drawing (or mapping) experiences with their healthcare team. The maps were explored with the patients through focus group discussions. Maps were inductively coded to identify similarities and differences between participants’ perceptions. Focus group transcripts were first analyzed independently, then compared to and integrated into the map analysis. Findings: Overall, participants (n = 13) were satisfied as patients of team-based care. Particip...
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Additional file 1. Patient & Provider Focus Group/Interview Guides.
Supplemental Material, sj-docx-1-ehp-10.1177_01632787211040859 for Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence by Hosung (Joel) Kang, Cecilia Flores-Sandoval, Benson Law and Shannon Sibbald in... more
Supplemental Material, sj-docx-1-ehp-10.1177_01632787211040859 for Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence by Hosung (Joel) Kang, Cecilia Flores-Sandoval, Benson Law and Shannon Sibbald in Evaluation & the Health Professions
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Background: Peer-to-peer (P2P) learning occurs when individuals from similar social groups or professions help each other to learn new knowledge skills or problem solving. Peer-to-peer learning is used across many disciplines but has not... more
Background: Peer-to-peer (P2P) learning occurs when individuals from similar social groups or professions help each other to learn new knowledge skills or problem solving. Peer-to-peer learning is used across many disciplines but has not been widely studied in primary care or chronic disease management. This study explored the use of an interprofessional P2P approach to support the implementation of a chronic disease management program in primary care for patients with chronic obstructive pulmonary disease (COPD), known as Best Care COPD (BCC). Methods and findings: A single descriptive case study design was used to explore P2P learning implementation approach. Focus groups and key informant interviews were held with providers involved in implementation (n = 26). Three key components of the P2P approach were identified: 1) an interprofessional team, 2) iterative peer-led training, and 3) continuous peer connection. Three recommendations are provided to support future P2P efforts: 1)...
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Research Interests: Geography, Evidence Based Practice, Focus Groups, Implementation Science, Health Services Research, and 15 moreKnowledge Translation, Health Administration, Medicine, Narration, Humans, Health Research, Female, Male, Middle Aged, Adult, Community Health and Preventive Medicine, Health Services Administration, Clinical Competence, Interviews as topic, and Medical and Health Sciences
Creating a knowledge translation trainee collaborative: from conceptualization to lessons learned in the first year
Research Interests: Nursing, Evidence Based Medicine, Collaboration, Implementation Science, Health Services Research, and 15 moreKnowledge Translation, Medicine, Learning, Canada, Humans, Meeting report, Concept Formation, Female, Male, Goals, Information Dissemination, Collaborative, Educational Status, Cooperative Behavior, and Medical and Health Sciences
Background: In Canada, there is widespread agreement about the need for integrated models of team-based care. However, there is less agreement on how to support the scale-up and spread of successful models; there is limited empirical... more
Background: In Canada, there is widespread agreement about the need for integrated models of team-based care. However, there is less agreement on how to support the scale-up and spread of successful models; there is limited empirical evidence to support this process in chronic disease management. We studied the supporting, and mitigating factors required to successfully implement and scale-up an integrated model of team-based care in primary care.Methods: We conducted a collective case study using multiple methods of data collection including interviews, document analysis, living documents, and a focus group. Our study explored a team-based model of care for chronic obstructive pulmonary disease (COPD) known as Best Care COPD (BCC) that has been implemented in primary care settings across Southwestern Ontario. BCC is a quality improvement initiative that was developed to enhance the quality of care for patients with COPD. Participants included healthcare providers involved in the de...
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Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient... more
Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practi...
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Background: Understanding and aligning staff core values with organizational values has been shown to contribute to positive work attitudes and increased organizational performance in the private sector. Little is known about the role of... more
Background: Understanding and aligning staff core values with organizational values has been shown to contribute to positive work attitudes and increased organizational performance in the private sector. Little is known about the role of values in local public health. Purpose: To identify public health staff core values, and to improve the alignment between staff values and organizational values (known as values congruence). Methods: A Tribal Leadership exercise was used as part of a multi-stage strategic planning process at Canada’s largest autonomous local public health agency. Results: Five sessions were held with 146 public health staff; 156 different values were reported. These were narrowed down to four core values: collaboration, integrity, empowerment, and striving for excellence. Staff reported high levels of satisfaction with the process and its outcome. Implications: This exploratory case study suggests the Mountains and Valleys exercise can be valuable for assessing publ...
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Background Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disease that requires comprehensive approaches to manage; it accounts for a significant portion of Canada’s annual healthcare spending. Interprofessional teams... more
Background Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disease that requires comprehensive approaches to manage; it accounts for a significant portion of Canada’s annual healthcare spending. Interprofessional teams are effective at providing chronic disease management that meets the needs of patients. As part of an ongoing initiative, a COPD management program, the Best Care COPD program was implemented in a primary care setting. The objectives of this research were to determine site-specific factors facilitating or impeding the implementation of a COPD program in a new setting, while evaluating the implementation strategy used. Methods A qualitative case study was conducted using interviews, focus groups, document analysis, and site visits. Data were deductively analyzed using the Consolidated Framework for Implementation Research (CFIR) to assess the impact of each of its constructs on Best Care COPD program implementation at this site. Results Eleven CFIR ...
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Background While the importance of medical students’ demographic characteristics in influencing the scope and location of their future practice is recognized, these data are not systematically collected in Canada. This study aimed to... more
Background While the importance of medical students’ demographic characteristics in influencing the scope and location of their future practice is recognized, these data are not systematically collected in Canada. This study aimed to characterize and compare the demographics of Canadian medical students with the Canadian population. Methods Through an online survey, delivered in 2018, medical students at 14 English-speaking Canadian medical schools provided their age, sex, gender identity, ethnicity, educational background, and rurality of the area they grew up in. Respondents also provided information on parental income, occupation, and education as markers of socioeconomic status. Data were compared to the 2016 Canadian Census. Results A total of 1388 students responded to the survey, representing a response rate of 16.6%. Most respondents identified as women (63.1%) and were born after 1989 (82.1%). Respondents were less likely, compared to the Canadian Census population, to iden...
Role clarification is consistently documented as a challenging process for inter professional healthcare teams, despite being a core tenet of interprofessional collaboration. This paper explores the role clarification process in two... more
Role clarification is consistently documented as a challenging process for inter professional healthcare teams, despite being a core tenet of interprofessional collaboration. This paper explores the role clarification process in two previously unexplored contexts: i) in the dissemination phase of a quality improvement (QI) program, and ii) as part of interorganizational partnerships for the care of chronic disease patients. A secondary analysis using asynchronous purposive coding was conducted on an innovative pan-Canadian Chronic Obstructive Pulmonary Disease QI program. Our study reveals that the iterative structure of QI initiatives in the spread phase can offer numerous unique benefits to role clarification, with the potential challenge of time commitment. In addition, the role clarification process within interorganizational partnerships proved to be relatively well-structured, characterized by three phases: relationship conceptualization or early contact, familiarization, and ...
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Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care... more
Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care system. With direct investment of <$1-million CAD, a pan-Canadian quality improvement collaborative (QIC) supported the spread of INSPIRED to 19 teams in the 10 Canadian provinces contingent upon participation in evaluation. The collaborative evaluation followed a mixed-methods summative approach relying on collated quantitative data, team documents, and surveys sent to core members of the 19 teams. Survey questions included a series of multiple-choice responses, Likert scale ratings, and open-ended questions. The qualitative evaluation entailed key informant interviews and focus groups undertaken between February and April 2016 post-collaborative. Teams reported that the year-long QIC helped bring focus to a needed, though often overlooked area of...
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Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and... more
Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective experiences in the form of one-sentence and one-word responses, at the beginning and end of the interview, respectively. Half of all participants associated the risk of falls with negative words; however, all participants used positive sentences to describe their exper...
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Background This study was a retrospective evaluation of an unsuccessfully implemented team-based, chronic disease management program, with an aim to understand more about implementation barriers. The program, the Chronic Disease... more
Background This study was a retrospective evaluation of an unsuccessfully implemented team-based, chronic disease management program, with an aim to understand more about implementation barriers. The program, the Chronic Disease Management Initiative (CDMI) was a new collaborative model of care for patients with COPD. It utilized customized health information and interactive tools, mainly smartphones, for ongoing disease management. The program’s goal was to demonstrate that integrated team-based models of care could improve patient care, as well as reduce readmission rates and emergency department visits. The program planning for CDMI began in 2017, followed by the implementation and evaluation period in 2018. After a 10-month implementation period, the program was unable to enroll a sufficient number of patients to examine if there was an improvement in patient outcomes. Methods A retrospective case-study design using multiple data sources was used to gather feedback from particip...
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Background The use of networks in healthcare has been steadily increasing over the past decade. Healthcare networks reduce fragmented care, support coordination amongst providers and patients, improve health system efficiencies, support... more
Background The use of networks in healthcare has been steadily increasing over the past decade. Healthcare networks reduce fragmented care, support coordination amongst providers and patients, improve health system efficiencies, support better patient care and improve overall satisfaction of both patients and healthcare professionals. There has been little research to date on the implementation, development and use of small localized networks. This paper describes lessons learned from a successful small localized primary care network in Southwestern Ontario that developed and implemented a regional respiratory care program (The ARGI Respiratory Health Program - ARGI is a not-for-profit corporation leading the implementation and evaluation of a respiratory health program. Respiratory therapists (who have a certified respiratory educators designation), care for patients from all seven of the network’s FHTs. Patients rostered within the network of FHTs that have been diagnosed with a c...