Longwoods Radio

Award-winning journalist, The Globe and Mail

Dr. Mary Ferguson-Paré is the Vice President, Professional Affairs and Chief Nurse Executive, UHN Tuesday, April 21, 2009

Dr. Michael Guerriere is a Managing Partner, Courtyard Group Tuesday, March 3, 2009

Murray T. Martin is President and CEO, Hamilton Health Sciences. Cliff Nordal is President and CEO, St. Joseph's Health Care, London. Thursday, February 12, 2009 – Vancouver UBC Robson Square

Murray T. Martin is President and CEO of Hamilton Health Sciences. Cliff Nordal is President and CEO of St. Joseph's Health Care, London.

Vivek Goel is President and CEO, Agency for Health Protection and Promotion Tuesday, November 18, 2008

Matt Anderson is Chief Executive Officer of Toronto Central LHIN October 22, 2008

Dr. Alan Hudson is Lead of Access to Services/Wait Times for the Health Results Team, Ministry of Health and Long-Term Care. September 16, 2008

Enabling legislation, screening/triage, case management, and patient education facilitate more rapid discharge from acute care hospitals. The purpose of this study was to identify factors enhancing and limiting the performance of health care organizations, when it comes to timely discharge. An examination of six high performing organizations in England revealed that the organizational capacity, external environment, and interagency efficiencies influence effective discharge processes.

Patient safety has featured prominently on the health care agenda in recent years, but the majority of research has focused on the hospital setting rather than nursing homes. Using survey responses from a nationally representative sample of 2,840 nursing homes in the United States, this study examines patient safety culture in nursing homes, compares nursing home safety scores against hospital benchmark scores, and ascertains if and how the safety culture of nursing homes varies according to facility and market characteristics.

Research has shown that elderly residents in long-term care facilities face a relatively high risk of being restrained. Are nursing job demands and job control related to the risk of restraint use? These findings suggest that care practice, in terms of decreased restraint use, might be improved by enhancing the working conditions of nursing staff.

Tom Closson is the President and CEO of the Ontario Hospital Association

Dr. Michael Guerriere is Managing Partner of Courtyard Group and Editor-in-Chief for Electronic Healthcare. Tuesday, March 25, 2008

Breakfast with the Chiefs, Great Minds in Dialogue: Linda O'Brien-Pallas (Professor, University of Toronto, CHSRF/CIHR National Chair, Nursing Health Human Resources). Tom Closson (Healthcare management consultant & Past President and Chief Executive Officer of University Health Network).

A deficit situation prompted Hôtel Dieu Grace Hospital in Windsor, Ontario to examine aspects of the funding process. Coached by an American team, three experienced nurses were trained to work with physicians to explore opportunities to improve their documentation, and to work with the Health Records Technicians to optimize the accuracy of their efforts.

The Montérégie Health and Social Services Agency in Quebec takes a population-centred approach to service delivery. For the newly appointed public health managers in particular, the new structure has meant gaining competencies in new areas, from socio-demographic analysis to partnership development. This innovative initiative was recently featured in Promising Practices in Research Use, a series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to improve their ability to use research in the delivery of health services. Tell the Foundation your own stories and visit the Promising Practices inventory at http://www.chsrf.ca/promising/index_e.php.

In healthcare, a great deal of time, money and energy go into producing public reports for a wide range of audiences. Reporting strategies often target audiences like the general public, whose behaviour is not readily changed by the information in report cards. However, when it comes to effectively targeting groups that can actually use the data to achieve significant impacts, one audience stands out from the rest: health system managers and providers, who can interpret and apply performance data to improve the quality of care their organizations deliver. The evidence behind performance reports was recently summarized in Evidence Boost for Quality, a special subseries of Evidence Boost, produced by the Canadian Health Services Research Foundation to showcase healthcare issues where research indicates a preferred course of action in health services management and policy.

Using research to inform management and policy is already difficult notwithstanding when popular culture supports measures that are counterintuitive to the best research.

How can we hold health care managers accountable if what they are managing cannot be measured? If we are to build a better health system, we need a better information sharing system so that all governments and all providers can be held accountable to Canadians.

Patient Safety Leadership Walkarounds (PSLWA) have been identified in the literature as a powerful tool to develop patient safety culture by connecting senior leaders and front line staff in open dialogues about patient safety. (Leonard et al, 2004) Many organizations report that this strategy promotes teamwork, facilitates communication and offers an opportunity for constructive dialogue on collective approaches to improve patient, and in some cases, client safety.

We describe our experience with a Nursing Usability Laboratory, where human factors design principles were applied to common nursing procedures. This paper will be of interest to any hospital seeking to enhance safety by applying human factors design principles.

Graham Scott is Chair of Canadian Institute for Health Information (CIHI) and Glenda Yeates is President and Chief Executive Officer, CIHI.

St. Peter's Residence at Chedoke in Hamilton, Ontario, a 210-bed long-term care facility, is building the capacity of front-line employees to become engaged in quality improvement. With training and tools, teams made up of front-line and other staff are becoming engaged in creating a quality improvement culture. This innovative initiative was recently featured in Promising Practices in Research Use, a series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to improve their ability to use research in the delivery of health services.

Saskatchewan's Chronic Disease Management Collaborative is a quality improvement model that brings together healthcare providers to learn about, test and share experiences with improvement ideas in diabetes and coronary artery disease care. This innovative initiative was recently featured in Promising Practices, a monthly series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to try to improve their ability to use research in the delivery of health services.

To ensure the safe care of patients repatriated to HDGH, we have implemented a process that identifies patient needs prior to their repatriation. The process provides us with critical information regarding a patient's condition well before repatriation so our staff can confirm that we can safely meet the patient's needs. The process is simple and easy for both the sending and receiving facilities to adopt.

Titles include The Obstetric Pathology of Poverty: Maternal Mortality in Kep Province, Cambodia; Maternal Chronic Ill Health Negatively Affects Child Survival in a Poor Rural Population of Pakistan; and The Relationship of Sexual and Gender-Based Violence to Sexual-Risk Behaviour among Refugee Women in Sub-Saharan Africa.To read these and other articles on Women's health in developing countries visit www.worldhealthandpopulation.com.

A partnership between health services researchers from Queen's University and the University of Ottawa, a community nursing agency and a home care authority in Ottawa led to major improvements in the quality of care for people with leg ulcers. The synthesis of both external and local evidence played a key role in the adoption of an evidence-based protocol and provided the critical context to support a significant reorganization of the existing service delivery model. This case demonstrates that, with a collaborative partnership approach, systematic and transparent research processes can be rapidly developed to support policy change.

It is included on Longwoods' Radio with their kind permission. EXTRA stands for Executive Training for Research Application, a program to promote the movement of research findings directly into the management of the health care system. One of the first participants, and one of the program's staunchest proponents, Dr. James Worthington, explains how EXTRA made a difference to him, and how his project had an impact at the Ottawa Hospital.

Building on its vision to be a leader in health innovation, Trillium Health Centre has undertaken a unique approach towards creating a supportive infrastructure to promote a culture of continuous quality improvement and to empower staff and physicians to deliver evidence-based care consistently, appropriately and safely. Although the hospital's approach to best practice may be unique in comparison to other hospitals, it is one that can be replicated and applied at other healthcare organizations.

The Grey Bruce Health Network began developing regional clinical pathways in 2002 (Meleskie and Wilson 2003). The Total Hip Replacement (THR) pathway was one of the first developed. A three-stage pathway, the THR pathway has an acute stage for the first five hospital days following surgery, a post-acute stage for convalescent care in hospital and a community-care stage for community physiotherapy after hospital discharge. Pilot results (119 patients) have shown an increase in information transfer, streamlining care and increasing efficiencies (capacity savings of over $92,000), increased usage of best practices, more consistent care across the continuum of care and decreased length of stay (by 1.55 days) at the regional hospital centre.

This case study illustrates how strong nursing leadership, in conjunction with a transformational change approach, led to the successful implementation of a new documentation system at two hospitals within one organization. The project process is described in detail, including a discussion of lessons learned, and recommendations are provided for the leadership of future multi-site projects.

Electronic Medical Records (EMR) allows physicians to manage information more effectively, reducing stress and increasing value to patients.Hear first-hand a Canadian doctor's experience with EMR, and learn the practical benefits of switching a medical office from paper to electronic.Practice Solutions Ltd. is a Canadian Medical Association company, offering trusted technology solutions to medical practices.

In 2004, the Canadian Adverse Events Study (Baker et al. 2004) determined the incidence rate of adverse events (AE) in Canada to be 7.5%. This translates to approximately 185,000 for the almost 2.5 million annual hospital admissions in Canada. The study noted "close to 70,000 of these AEs were potentially preventable."

A Case Study: Toronto East General Hospital Pioneers Healthcare Worker Safety

Knowledge translation at the Manitoba First Nations Centre for Aboriginal Health Research emerged through several population health research initiatives conducted in partnership with Canadian Indigenous peoples.

This project brought together a team of researchers and decision-makers to conduct policy-relevant research to support the introduction of advanced nursing practice roles in British Columbia. The results have since been used to guide legislative and regulatory development and to design a nurse practitioner education program.

Incomes in Canada, as in many other countries, are becoming increasingly unequal. The resources and political influence of the super-rich underlie the growing prominence of the "elite" agenda: lower taxes, smaller government and privatization or shrinkage of social programs.

Collaborative partnerships can help improve integration and quality in local healthcare systems. We describe an innovative approach that was implemented following the formation of a tri-provider partnership between homecare and two acute care hospitals.The result was a pilot project in which both homecare clients and non-urgent hospital patients could be served in a hospital-based ambulatory nursing care clinic.

Cataract removal is an increasingly common surgical procedure. Today in Canada, however, the waiting time for this procedure may be unacceptably long for many patients.

This study describes a series of interventions linking hospitals, medical staff physicians, long-term care providers and mental health services in the metropolitan area of Syracuse, New York. The objectives of these interventions were to improve patient outcomes and system-wide efficiency.

The Constitution created by the Trudeau government is now threatening Canada's medicare system. What can be done to defend it?

Reverse the flow of Kafka's fable of the Imperial Message and you have the problem of Knowledge Transfer - the message is not getting through.

Effective interdisciplinary research requires the institutional equivalent of the CT scanner's integrative capacity. The normal dynamics of university-based research, however, pull instead toward disciplinary solitudes.

Healthcare is not a high-reliability industry. The adverse event rate is on the order of 10-2; industries such as aviation, nuclear power and railways achieve rates of 10-5 or better. Increasing awareness of this contrast has made "patient safety" a major topic of concern.

This paper outlines the systematic approach used at Bluewater Health, to recognize the importance of quality of work life and progresses from diagnosis to implementation of improvements, with positive outcomes.

The following article describes the rationale, guiding principles, key components and future directions of APTS's "To Be Tobacco Free" program.

The desire to create an environment where nurses were valued, supported and empowered led to the development of a Nursing Professional Practice Council within an Ontario Public Health Unit.

To mitigate the quality and safety chasm, nursing leadership at St. Michael's Hospital undertook a strategic plan to enhance the nursing professional practice environment.

Responsibilities of governing and managing the affairs of a healthcare organization have been in the forefront of Ontario Hospitals with the introduction of Bill 8.

This paper describes 10 steps necessary to develop a centralized managed porter system.

This case study describes the plans and strategies for the sourcing of Registered Nurses at The Ottawa Hospital.