Resources

Being a nurse practitioner is a demanding profession and, these 10 best iPhone apps for nurses have been solely created for this demanding, yet, rewarding career. The clever apps are fitting to a nurse's professional and lifelstyle requirements. Make a wise investment in your career with these 10 best iPhone apps for Nurses.

In August, Mountain States Healthcare Alliance, a 13-hospital integrated healthcare delivery system based in Johnson City, Tenn., received the 2012 National Quality Healthcare Award from the National Quality Forum, recognizing the system's achievement of multiple quality-focused goals. Rather than just representing a culmination of efforts, the award is spurring the system to continue providing quality care, according to Dennis Vonderfecht, president and CEO of MSHA.

"No matter how many quality awards we receive, we can never sit back and say we are satisfied with the level of quality we have achieved," he says. "So while we are extremely gratified to be recognized at this level, we will continue to work just as diligently to ensure that we are providing the best care possible to the people of our region."

Mobile medicine is everywhere. There's the iPhone app that lets you cut away images of muscle layers to see what lies beneath, an e-health record system for the iPad, and a smartphone-based blood pressure monitor. Here are a dozen innovative ones.

The use of Twitter as an effective social media tool for knowledge mobilization is still not understood. This was made clear to me by two things that happened this past week:

1. I was actively involved in a discussion with several members of EENet – the Evidence Exchange Network where the use of Twitter for research dissemination was called into question; and,
2. I performed a brief Twitter survey of the 16 classic Networks of Centres of Excellence in Canada (NCE) that focus on research-driven partnerships, and found that these NCEs are still not effectively using this valuable social media tool, despite the Government of Canada’s knowledge mobilization mandate for NCEs “to transform these discoveries into products, services, and processes that improve the quality of life of Canadians.”

International Simulation Standards: The Impact on Educators

In its sixth year, this interactive conference brought together nurses from practice and academia to share and promote the latest ideas and research to promote simulation in its widest context at all levels in nurse education. We welcomed poster and oral presentations, as well as interactive workshops from nurses and all the allied health professions to network and share at this two day event.
 

Choosing something that you are passionately interested in to research is a great first step on the road to successful academic writing but it can be difficult to keep the momentum going. Deborah Lupton explains how old-fashioned whiteboards and online networking go hand-in-hand, and advices when it is time to just ‘make a start’ or go for a bike ride.

As part of preparing for a workshop on academic publishing for early career academics, I jotted down some ideas and tips to share with the group which I thought I would post here. In the process of writing 12 books and over 110 peer-reviewed journal articles and book chapters over a career which has mostly been part-time because of juggling the demands of motherhood with academic work, I have developed some approaches that seem to work well for me.

These tips are in no particular order, apart from number 1, which I consider to be the most important of all.

Patient Leaders are patients, service users and carers, who work with others at strategic level to influence change in health and healthcare. Patient leadership is more than patient and public engagement and can make a unique contribution to improving services. This Guide - the first of its kind - explains what patient leadership means and the role and purpose of patient leaders. 

For new nurses, the world of healthcare, hospitals, and more can be overwhelming. And a degree, certification, and license can only do so much. This is why getting advice from someone with experience can be a life saver.

With that in mind, below are the 50 best blogs for new nurses. Whether looking locally or overseas, from a man or woman, or looking to work in a specific area of medicine, they can help immensely.
 

What are the key principles that maximize potential for successful transformational change in healthcare?

7C Principles Explained:

The excerpt is draft version from HealthCare Leaders’ Association of BC (HCLABC) Sept. 2010 Newsletter. The complete article is available at http://www.hclabc.bc.ca/files/HCLABC%20September%202010%20Newsletter.pdf See page 7.

Researched by Paul Gallant with input from Graham Dickson, Geoff Rowlands & Marilynn Kendall for HCLABC.

Today marks the culmination of a good few months listening to what users were saying and acting upon it. We have just rolled out our new ‘My Data’ section. This is the part of figshare that allows you to manage your research outputs. As well as being more more intuitive and simple to manage your research data both publicly and privately in the cloud. There are also a few new features to help make the free service as useful as possible.

Public health actors in public, community and academic networks may be called upon to work on public policies and, within the context of this work, to interact with policy makers at different levels (municipal, provincial, etc.). However, they often find that the content of their discourse does not meet all the information needs of these decision makers.

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?

This learning module has been created primarily with a researcher audience in mind, but care has been taken throughout to ensure that the language and content is meaningful and accessible to non-academics looking for guidance. The sections are written in every-day language and have been kept as jargon-free as possible, and the text has been broken up with many examples and case studies, illustrating points discussed in each section. We hope that all knowledge users who choose to partner with researchers, including communities and community members, clinicians and professional associations, government agencies and policy makers, service planners and providers, and the general public, will find the material valuable.

A key recommendation of the Institute of Medicine’s landmark report The Future of Nursing: Leading Change, Advancing Health is to have nurses achieve higher levels of education, with a goal of 80 percent of nurses holding a bachelor’s degree or higher by 2020. Now, a new study identifies the factors that best predict whether nurses will return to school to earn those degrees.

According to the study—part of the RN Work Project, funded by the Robert Wood Johnson Foundation— there are a variety of motivators, from desire for advancement to job dissatisfaction, that influence registered nurses (RNs) to pursue a bachelor of science in nursing (BSN) degree or higher. The study was published in the November/December issue of the Journal of Professional Nursing.

Motivators cited in the study include an interest in career and professional advancement, gaining new knowledge, improving social welfare skills, and being a positive model for one’s children. RNs identified a desire to achieve personal and job satisfaction and professional achievement as important intrinsic motivators. Nurses with graduate degrees are more likely to report being extremely satisfied with their jobs, compared with nurses who hold associate’s degrees, who more frequently report moderate to extreme dissatisfaction with their jobs.
 

Key Messages

• Quality improvement (QI) strategies are appropriate for improving certain clinical outcomes such as increasing colorectal screening and increasing foot examination rates for diabetic patients.
• It is difficult to evaluate the outcomes of QI strategies in primary healthcare because the approaches used vary and are often multifaceted.
• Studies measuring patient or provider perceptions of QI are few given the design constraints of randomized controlled trials, time-series studies and before-after studies.
• Currently, primary healthcare accreditation is non-government funded and voluntary with some countries offering financial incentives.
• There is a lack of research on primary healthcare teams and QI and accreditation; what little research is available is mostly done with family physicians.
• Further research is required in QI in primary healthcare including: the effect of QI on a broader range of patient outcomes; the most effective method for improving patient outcomes; impact on healthcare utilization; cost effectiveness; and impact on patient and provider perceptions.
• Research is required in primary healthcare on the effects of accreditation including: the effect of accreditation on patient outcomes; whether accreditation is an effective method to improve quality of care; impact on healthcare utilization; cost effectiveness; and impact on patient and provider perceptions.

These Resource Centres have been developed in collaboration with parents and experts at The Hospital for Sick Children, and are offered to families in partnership with BC Children's Hospital.

eGEMs (Generating Evidence & Methods to improve patient outcomes), a product of the Electronic Data Methods (EDM) Forum,* is an open access journal focused on using electronic clinical data to advance research and quality improvement, with the overall goal of improving patient and community outcomes.

The purpose of this report is to address the following three questions: what are the top three research priorities that ACAHO members are focused on? how do these priorities map against the Canadian Institutes of Health Research's (CIHR) four pillars of health research and the emerging health and health system challenges that have been identified by governments, health charities and CIHR?; and how are these priorities aligned with the federal government's Science and Technology Strategy and its sub-themes for health?

Social media has been used globally as a key vehicle for communication. As members of an innovative profession, many nurses have embraced social media and are actively utilizing its potential to enhance practice and improve health. The ubiquity of the Internet provides social media with the potential to improve both access to health information and services and equity in health care. Thus there are a number of successful nurse-led initiatives. However, the open and democratising nature of social media creates a number of potential risks, both individual and organisational. This article considers the use of social media within nursing from a global perspective, including discussion of policy and guidance documents. The impact of social media on both healthcare consumers and nurses is reviewed, followed by discussion of selected risks associated with social media. To help nurses make the most of social media tools and avoid potential pitfalls, the article conclusion suggests implications appropriate for global level practice based on available published guidance.

The Canadian Water Network and other research funding agencies are increasingly requiring that
research be designed, conducted and interpreted in consultation and collaboration with decisionmakers.  This ensures not only that research is relevant to decision-makers’ concerns, but also that research design emanates from an understanding of how the results will be relevant to decisionmakers and how researchers could assist them in making choices informed by the best available research. However, throughout this process of collaboration and consultation difficulties may arise that impede the formation of research partnerships.

To help facilitate collaborative research partnerships between decision-makers and researchers, we interviewed and consulted with individuals involved in the decision-making process (we call these individuals “end users”) in municipal, provincial and federal levels of government and advisory
agencies to provide advice to researchers based on their experience with research projects. Their
advice is summarized below.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2007-100572). The findings and conclusions in this document are those of the authors, who are responsible for its content; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

TeamSTEPPS Instructor Guide:
The TeamSTEPPS Instructor Guide 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. Comprehensive curricula and instructional guides include short case studies and videos illustrating teamwork opportunities and successes. Supporting materials include a pocket guide (the Essentials Course), CD-ROM and DVD, and evaluation tools. Instructor and Trainer workshop materials focus on change management, coaching, and implementation.

TeamSTEPPS Rapid Response Systems Guide:
The TeamSTEPPS Rapid Response Systems Guide 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 the rapid response system. Comprehensive curricula and instructional guides include short case studies and videos illustrating teamwork opportunities and successes. Supporting materials include CD-ROM and DVD, and evaluation tools.
 

The aging of baby boomers and an increased need to contain hospital costs in the United States has led many organizations to fine tune their services for patients who are in need of palliative care. Most patients prefer to remain in their home at this time of their life; palliative and coordinated care can help them maintain control of their care choices, avoid inpatient and emergency department costs, and increase their satisfaction with their end-of-life care.

The featured Innovations describe two programs that used palliative care to help elderly and terminally ill patients make greater use of hospice and home care services. A third program coordinated care for Medicare patients and their families, allowing them to define their wishes and options for end-of-life care, increase their use of hospice services, and reduce the incidence of inpatient stays.
 

The Effective Health Care (EHC) Program seeks the involvement of a wide range of stakeholders throughout the research process. AHRQ firmly believes that involving stakeholders from the beginning improves research results, and helps ensure that findings are relevant to users’ distinct concerns and have applications in real-world situations. This page links to resources for getting involved in the EHC Program, resources to help researchers involve patients, consumers, and others stakeholders, and ongoing work on methods for public and stakeholder engagement. Many of these resources have been developed by the AHRQ Community Forum.

Evolutionary theory, developmental systems theory, and evolutionary epistemology provide deep theoretical foundations for understanding programs, their development over time, and the role of evaluation. This presentation relates core concepts from these powerful bodies of theory to program evolution. The evolutionary developmental view is operationalized in terms of program and evaluation lifecycles, which are in turn aligned with multiple types of validity including viable validity. The resulting framework has important implications for many program management and evaluation issues. The presentation focuses on the appropriate role of randomized controlled trials and proposes a new definition of "evidence-based programs". From an evolutionary developmental perspective, prevailing interpretations of rigor and mandates for evidence-base programs pose significant challenges to program evolution. This perspective also illuminates the consequences of misalignment between program and evaluation lifecycles; the importance of supporting both researcher-derived and practitioner-derived programs; and the need for variation and lifecycle diversity within portfolios of programs.

Project Objectives

1. Develop a simple, robust, easy-to-use authoring system to create and edit scholarly articles
2. Deliver an editorial review and publishing system that can be used to submit, review, and publish scholarly articles

Antibiotic resistance is an issue health practitioners around the world face daily. An ongoing Canadian initiative, AntibioticAwareness.ca is coordinated by numerous health-related organizations across the country. These groups partnered last year to promote the first Antibiotic Awareness Day in Canada. That promotion extended to a week of activities during a Antibiotic Awareness Week, November 14-20, 2011.

Aporia is dedicated to scholarly debates in nursing and the health sciences. The journal is committed to a pluralistic view of science and to the blurring of boundaries between disciplines. Aporia encourages the use of a wide range of epistemologies, philosophies, theoretical perspectives and research methodologies. In the critical analyses of health-related matters, Aporia advocates and embraces a wide range of epistemologies, philosophies and theories including but not limited to: cultural studies, feminism(s), neo-marxism, postmodernism, poststructuralism, postcolonialism and queer studies.

NIOSH Science Blog

Nursing assistants are a critical part of the dedicated staff who work day and night in nursing homes to keep residents safe, secure, cared-for, and comfortable. Yet the very workers ensuring the safety of our seniors are themselves at risk for workplace violence and assaults.

Recent NIOSH research based on the first large, nationally representative sample of nursing assistants reported that that nursing assistants in nursing homes have a high rate of work-related physical injuries from assault.1 Overall, 35% of nursing assistants reported physical injuries resulting from aggression by residents, and 12% reported experiencing a human bite during the year before the interview. Nursing assistants employed at nursing homes with special units for Alzheimer patients had a significantly elevated risk for assault injuries and human bites (37% reported injuries from assaults and 13% reported human bites).
 

Following on from the lists of academic tweeters published earlier this month, we have put together a short guide to using Twitter in university research, teaching, and impact activities, available to download as a PDF or view on Issuu.

How can Twitter, which limits users to 140 characters per tweet, have any relevance to universities and academia, where journal articles are 3,000 to 8,000 words long, and where books contain 80,000 words? Can anything of academic value ever be said in just 140 characters?

We have put together a short guide answering these questions, showing new users how to get started on Twitter and hone their tweeting style, as well as offering advice to more experienced users on how to use Twitter for research projects, alongside blogging, and for use in teaching.
 

BCEOHRN will be recognized and respected as providing national leadership in occupational and environmental health research which will ultimately protect human health.

In order to achieve our Vision, BCEOHRN’s Mission is:

* To facilitate interdisciplinary occupational and environmental health research through connecting and supporting people to create excellence in education and research results’ dissemination;

* To foster a truly provincial network that creates new efficiencies, partnerships and opportunities that will make BC a magnet for training, attracting and retaining top quality researchers.
 

Shared Vision

The Partners have a shared vision; this vision represents the place to which we are travelling on this shared journey. The vision is a future where BC First Nations people and communities are among the healthiest in the world. We envision healthy and vibrant BC First Nations children, families, and communities playing an active role in decision-making regarding their personal and collective wellness. We see healthy First Nations people living in healthy communities, drawing upon the richness of their traditions of health and well-being. In this vision, First Nations people and communities have access to high quality health services that are responsive to their needs, and address their realities. These services are part of a broader wellness system – a system that does not treat illness in isolation. These services are delivered in a manner that respects the diversity, cultures, languages, and contributions of BC First Nations 

The BC Health Quality Matrix was created through the collaboration of the BC Health Quality Network to provide a common understanding and framework for defining the quality of care. The Handbook is a guide to demonstrate the various uses of the Matrix.

The Michael Smith Foundation for Health Research is facilitating the development of a provincial
strategy health research strategy aimed at:

• Identifying specific actionsfor collaborative implementation by the health research community.
• Providing a framework fromwhich BC organizations can develop their own plans.

This document summarizes five focus sessions held with members of the health research community to
discuss five draft directions developed for the strategy.

The purpose of the British Columbia Patient Safety & Quality Council is to provide advice and make recommendations to the Minister of Health Services on matters related to patient safety and quality of care, and to bring health system stakeholders together in a collaborative partnership to promote and inform a provincially coordinated, innovative, and patient-centred approach to patient safety and quality improvement in British Columbia.

The Culture Change Toolbox is a collection of tools and interventions for changing culture. It’s full of ideas, examples, and exercises. For each tool there are tips on how to apply it and a description of which components of culture it helps to improve.

As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, the Institute of Health Economics has been commissioned to conduct three Knowledge Exchange events. The first of the Knowledge Exchange events: Becoming the Best: Building Sustainability - Game Changing Health Innovations was held on February 24th, 2011. The event was supported by Alberta Health Services in collaboration with Alberta Health and Wellness. Below are video records and powerpoint presentations provided at the event.
 

Presenters Steve and Joelle shared experiences adapting and implementing the bellwether methodology for use in two advocacy-related projects: evaluation of a communication campaign designed to deliver messages to local decision makers that promote library funding and prospective evaluation of an education reform campaign.

In November 2010, The Office of Behavioral and Social Sciences Research (OBSSR) of the National Institutes of Health (NIH) commissioned the leadership team of John W. Creswell, Ann Klassen, Vicki L. Plano Clark, and Katherine Clegg Smith to develop a resource that would provide guidance to NIH investigators on how to rigorously develop and evaluate mixed methods research applications. Pursuant to this, the team developed a report of "best practices" following three major objectives.

To develop practices that:

• assist investigators using mixed methods as they develop competitive applications for support from NIH;
• assist reviewers and staff for review panels at NIH who evaluate applications that include mixed methods research;
• provide the Office of Behavioral and Social Sciences Research (OBSSR), and the NIH Institutes and Centers, with "best practices" to use as they consider potential contributions of mixed methods research, select reviewers, plan new initiatives, and set priority areas for their science.

OBSSR convened a Working Group of 19 individuals (see Appendix A. NIH Working Group on Developing Best Practices for Mixed Methods Research) to review a preliminary draft of "best practices". This Group was comprised of experienced scientists, research methodologists, and NIH health scientists. These individuals were selected because of their expertise in NIH investigations, their specific knowledge of mixed methods research, and their experience in the scientific review process. The composition of the Working Group was diverse with members representing fields such as public health, medicine, mental health professions, psychology, sociology, anthropology, social work, education, and nursing. This Working Group met in late April 2011, and reviewed and made recommendations for the final document presented in this report.

Physicians need rapid access to the best current evidence on a wide range of clinical topics. But where to find it? Textbooks are frequently out-of-date, and we don't have the time to perform literature reviews while the patient is waiting.

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is. Although BETs initially had an emergency medicine focus, there are a significant number of BETs covering cardiothoracics, nursing, primary care and paediatrics.

This booklet looks at a new policy direction for health, introduced two years ago, which creates an environment where health professionals in the community are actively encouraged to work with one another, and with hospital-based clinicians to deliver health care in a co-ordinated and co-operative manner so that more services are delivered in the community, people wait less for services and are kept healthier in the community.

Treatments which were once hospital-only are increasingly being performed in the community by GPs and practice nurses who have received additional training from hospital specialists. Examples you’ll see in this booklet include intravenous antibiotics to treat the serious skin disease cellulitis, surgery to remove skin lesions and giving GPs direct access to diagnostic imaging (instead of having to refer patients to hospital for that imaging).
 

Aimed at fostering the broad adoption of effective health care interventions, this report proposes a blueprint for improving the dissemination of best practices by national quality improvement campaigns. The blueprint's eight key strategies are to: 1) highlight the evidence base and relative simplicity of recommended practices; 2) align campaigns with strategic goals of adopting organizations; 3) increase recruitment by integrating opinion leaders into the enrollment process; 4) form a coalition of credible campaign sponsors; 5) generate a threshold of participating organizations that maximizes network exchanges; 6) develop practical implementation tools and guides for key stakeholder groups; 7) create networks to foster learning opportunities; and 8) incorporate monitoring and evaluation of milestones and goals. The impact of quality campaigns also depends on contextual factors, including the nature of the innovation itself, external environmental incentives, and features of adopting organizations.

Thank you to everyone who made the 8th annual Bottom Line Conference a scene of excellent conversation on workplace mental health. Delegates heard moving and thought-provoking panellist stories and excellent motivating speakers, and then shared their ideas on what they could take back to their workplace.

Visit the Videos page to watch Workplace Stories and Leaders’ Perspectives, featuring our morning and afternoon panellists. Also, view the Resources page for Mary Ann Baynton’s presentation, Making it Safe: Blueprint for Psychological Safety and roundups of delegates’ discussions on barriers and solutions to psychological safety.

This article aims at advancing the still on-going conversations about the so-called research/practice gap. Some academics argue that it is not possible to develop knowledge that is both academically valuable and helpful for practice, while others hold the opposite view, justifying it on the basis of works published in top tier journals. The paper argues that the main reason scholars hold such contradictory views on this topic central to management science is the lack of explicitness of a number of founding assumptions which underlie their discourses, in particular the lack of explicitness of the epistemological framework in which the parties’ arguments are anchored.

The paper presents methodological guidelines for elaborating scientific knowledge both from and for practice, and illustrates how to use these guidelines on examples from a published longitudinal research project. In order to avoid the lack of explicitness pitfall, the paper specifies scientific and epistemological frameworks in which the knowledge elaborated in this methodological approach, when properly justified, can be considered as legitimate scientific knowledge.
 

A special issue of Healthcare Policy articulates the experiences, successes, challenges and lessons learned in the RTC journey.
 

This report marks the culmination of the Nursing Sector Study. The five year study consisted of two phases, and examined the nursing workforce for all three regulated nursing professions in Canada (Licensed Practical Nurses (LPN) Registered Nurses (RN), and Registered Psychiatric Nurses (RPN)). Phase I, which concluded in December 2004, examined the state of nursing human resources in Canada. A series of 15 technical research reports were completed which covered areas such as nursing mobility, the international labour market, nursing education in Canada, and many others.

The Collaborative secured its first project funding from the 2008 Knowledge Translation Competition as advanced by the Canadian Institutes of Health Research (CIHR). The knowledge synthesis was conducted from January 2009 to January 2010 and examined current evidence on the impact of IPE and collaborative practice on HHR outcomes.

We synthesized the evidence from a number of sources such as the peer-reviewd literature, reports from governments and other agencies and reports from projects conducted under Health Canada’s Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) initiative.

Four areas of impact emerged:

1. Workplace quality
2. Provider satisfaction
3. Student clinical placement & graduate employment choice
4. Cost benefits

The executive summary and full synthesis report is now available.

The purpose of CANR is to foster research-based nursing practice and practice-based nursing research by:

• providing information about research studies, methods, funding and other resources
• strengthening linkages between research, education, administration,and clinical practice
• representing members' interests to governments, funding agencies, and other nursing organizations
• recognizing excellence in research activities
• educating professionals and the public about the significance of the nursing research-practice partnership

Public Health Agency of Canada's Best Practices Portal

Your first step to planning health-related programs. The Portal is a virtual front door to community and population health interventions related to chronic disease prevention and health promotion.
 

aC3KTion Net is the Canadian Critical Care Knowledge Translation Network, a Canadian Institutes of Health Research funded Initiative which seeks to improve the implementation of evidence informed best practices in critical care.

aC3KTion Net will endeavor to fill a void in Canadian Critical Care Knowledge Translation by creating a web-based Network of critical care stakeholders, researchers and knowledge users to optimize resources and support collaborative KT activities. Ultimately aC3KTion Net will enable Canadian Critical Care communities to have access to evidence informed best practices in a timely and efficient manner. Our goal is to reduce the morbidity and mortality of critically ill patients and their impact on the Canadian health care system.

The seventh annual, 2013 CEO Forum promoted dialogue on implementation strategies for achieving efficiencies, improving disease management, and introducing new technologies, all through the lens of being patient- and family-centred. The Forum was chaired by Dr. Terrence Sullivan. Joining a group of esteemed healthcare leaders as presenters and panellists at the event is The Honourable Fred Horne, Minister of Health, Alberta.

The Pan-Canadian Health Human Resources Network is inviting all Graduate Students and Post-Doctoral Students doing a dissertation or post-doctoral fellowship on topics related to Health Human Resources to join our network and spotlight your dissertation or post-doctoral fellowship research topic on our website.
 

CHSRF's reports and papers related to health services research.

Humans respond fairly predictably to economic incentives. Like mice in a maze, if someone moves the cheddar, we’ll probably change course. So by putting a nickel here and removing a dime there, those that determine our income can tweak our behaviours to produce specific results. At the same time, we’re not always at the whim of the almighty dollar. The resourceful among us often find ways of using the payment scheme to their advantage.

In healthcare, payment schemes are always contentious. When governments start talking about new ways of funding hospitals, the costliest component of healthcare in Canada,[1] some get wary. Activity-based funding (ABF), a scheme that pays hospitals on the basis of “activities” performed, rather than the traditional lump sum per year, is a prime example.[2] Critics fear that ABF may be a stepping stone toward greater for-profit* hospital care in Canada,[3] may lead to rural hospital closures and could be a disincentive for hospitals to provide much-needed, but high cost per unit, care.[4] After close inspection, the evidence and expert commentary suggest that ABF can be employed in ways that benefit patients, increase transparency and lead to more efficient use of hospital resources.
 

Welcome to CHA Learning

CHA Learning, the Canadian Healthcare Association's distance learning provider, has offered professional development opportunities to healthcare professionals from across Canada for over 55 years. Every year, between 500 and 600 adult learners take advantage of CHA Learning's distance learning offerings to broaden their knowledge base within their chosen careers. Courses range from food services management, health information management, general healthcare management, to quality improvement, long term care management, and risk management and safety in health services.

The Canadian Interprofessional Health Collaborative promotes collaboration in health and education. We are educators, policymakers, health providers, students and citizens who are committed to changing the healthcare system for the better. Membership is free to everyone with an interest in making lasting changes to Canadian heathcare.

2012 Conference Resources

Conference Chair, Lloyd Craig, shared the top five priorities for psychologically safe and healthy workplaces.

Notes from delegates' morning discussion.

Notes from delegates' afternoon discussion.

In our morning program, Dr. Ali Dastmalchian and Claudia Steinke provided an overview of studies on workplace health promotion, key factors that contribute to better outcomes and the role of empowerment in implementing change.

In our afternoon program, Dr. Joti Samra offered an overview of several free resources available to help employers and employees assess, improve and maintain mental health.

This conference workshop from CMHA's Mental Health Works initiative provided delegates with skills to recognize when a worker may be struggling with a mental health issue, more effectively discuss sensitive issues with employees, and create accommodation strategies that work.

In our conference workshop, LCol Stéphane Grenier provided an understanding of the value of involvement of people living—and working—with mental health issues in dealing with mental health challenges within the workplace environment.

• 5 priority elements, and moving to standards, for psychologically safe and psychologically healthy workplaces (184KB PDF)
• Delegates' Priority Steps for Building Their Psychologically Healthy Workplace
• What Delegates Committed to Take to Their Workplaces
• Promoting psychological health in organizations: a focus on workplace relations (519KB PDF)
• Resources to Help You build Your Psychologically Healthy Workplace (1.5MB PDF)
• Complex Issues. Clear Solutions
• Building Peer Support Networks in the Workplace (1.21MB PDF)

Listing of Canadian nursing specialty assocations with contacts.

An insider explains the responsibilities of researchers and reviewers in getting it right.

The Canadian Nurses Association (CNA) is a federation of 11 provincial and territorial nurses' associations and colleges representing 139,893 registered nurses and nurse practitioners. CNA is the national professional voice of registered nurses, supporting them in their practice and advocating for healthy public policy and a quality, publicly funded, not-for-profit health system.

CNA speaks for Canadian registered nurses and represents Canadian nursing to other organizations and to government nationally and internationally. It gives registered nurses a strong national association through which they can support each other and speak with a powerful, unified voice. It provides registered nurses with a core staff of nursing and health policy consultants and experts in other areas such as communication and testing. CNA provides the exam by which all registered nurses, except in Quebec, are tested to ensure they meet an acceptable level of competence before beginning practice. CNA’s active role in legislative policy influences the health-care decisions that affect nursing professionals every day. It has published a large number of documents, including the Code of Ethics for Registered Nurses.

When Private Becomes Public:  The Ethical Challenges and Opportunities of Social Media

The main objectives of this article are to:

• initiate a conversation about the rules, social norms and etiquette for work-related uses of social media, which are not well established;
• review ethical challenges and opportunities that arise in various practice settings when nurses use social media, both as individuals and as a collective;
• re-state the central importance of patient confidentiality and privacy to nursing practice;
• reinforce the notion that use of social media is not considered in any way “private” but is firmly within the public domain, with a potential audience of many thousands, if not millions; and
• acknowledge and support nurses’ use of social media in their efforts to promote social justice, while being sensitive to the ethical concerns these forms of communication may raise.

Nursing care across the stroke continuum is based upon awareness and understanding of the complexities of cerebrovascular disease, understanding of current best practices and translation to the practice setting. Major contributions to stroke nursing knowledge and practice therefore, arise from interdisciplinary research. In 2008, the Canadian Stroke Strategy released the Canadian Best Practice Recommendations for Stroke Care, which provided a comprehensive set of evidenced-based recommendations and guidelines. The focus of these workshop modules is to facilitate nurses’ acquisition of knowledge related to evidence informed practice and to prepare nurses to assume a leadership role in the management of interdisciplinary patient care.

There are four interactive modules addressing a component of the stroke care continuum: Prevention of Stroke, Hyperacute Stroke Management, Acute Inpatient Stroke Care, Stroke Rehabilitation and Community Re-integration.

Each module contains a power point slide deck, a Facilitators Guide and a Participant Workbook. Each of these modules can be used independently or combined with the other modules. Each module requires approximately 3.5 hours to complete.

To further support knowledge translation, 2 additional modules have been developed: Stroke 101 and Stroke Reverse Jeopardy.Stroke 101 provides a basic overview of stroke pathophysiology and Stroke Reverse Jeopardy can be utilized to facilitate knowledge transfer.
 

The PEBC’s evidence-based guidelines and standards are published in peer-reviewed scientific journals, as well as on CCO’s web site. Cancer Care Ontario built on the PEBC’s well-established expertise in producing clinical guidelines for the care of individual patients to include the development of organizational and system standards that set expectations for organizations delivering cancer services in terms of personnel, expertise, facilities and services.

Cancer View Canada connects Canadians to online services, information and resources for cancer control.

It is an ever-evolving portal that brings together resources for cancer prevention, screening, treatment, and supportive, palliative and end-of-life care.

Through its collaborative tools, Cancer View Canada also links people in the Canadian cancer community to each other.

In this section you will find cancer control resources to help those working in the health system.

Center for Disease Control moderated blog written by a team of health care professionals on health care safety topics.

Safe Patient Handling

Overextension incidents are the leading source of workers’ compensation claims and costs in healthcare settings. The primary outcome associated with such incidents are musculoskeletal disorders (MSDs). MSD risks are found in housekeeping, food service and other areas where workers manually handle heavy, awkward loads or perform repetitive forceful hand work. The single greatest risk factor for MSDs in healthcare workers is the manual moving and repositioning of patients, residents or clients. Rising obesity rates in the United States1 impact the physical demands on caregivers. The aging of the workforce likely contributes to the problem; the average age of a registered nurse in the U.S. is approximately 47 years. Also contributing to the negative health consequences of manual handling is the shortage of nurses—Peter Buerhaus, a researcher at Vanderbilt University Medical Center, has estimated that there will be a shortage of 250,000 nurses by the year 2025 in the US.
 

CDC’s E-learning Essentials Guide is designed for course developers and training decision makers who may be new to e-learning. The guide identifies six components essential to quality e-learning and explains how to use them to engage learners in the most effective ways.

Instructional designers and e-learning developers from across CDC are among the subject matter experts consulted for the development of this guide.

The chart below summarizes each component. Click on a component in the left column to go to that section within the guide.
 

People getting medical care can catch serious infections called health care-associated infections (HAIs). While most types of HAIs are declining, one – caused by the germ C. difficile* – remains at historically high levels. C. difficile causes diarrhea linked to 14,000 American deaths each year. Those most at risk are people, especially older adults, who take antibiotics and also get medical care. When a person takes antibiotics, good germs that protect against infection are destroyed for several months. During this time, patients can get sick from C. difficile picked up from contaminated surfaces or spread from a health care provider's hands. About 25% of C. difficile infections first show symptoms in hospital patients; 75% first show in nursing home patients or in people recently cared for in doctors' offices and clinics. C. difficile infections cost at least $1 billion in extra health care costs annually.

Disinfectants and cleaners are essential products for preventing disease transmission in healthcare facilities, but they pose risks for work-related eye and respiratory irritation, sensitization, asthma-like symptoms, and respiratory distress for workers. A NIOSH study published in the May 14, 2010 Morbidity & Mortality Weekly Report provides the first multistate report on work-related symptoms among healthcare staff in three states, with recommendations for preventing illness and injury.

The Center for Health Systems Research and Analysis (CHSRA) was formed in 1973 as a collaborative effort between the departments of Industrial Engineering and Preventive Medicine at the University of Wisconsin-Madison. At CHSRA, researchers seek to improve long-term care and health systems by creating performance measures and developing information and decision support systems. CHSRA research and development projects serve a variety of audiences.

The goal of this website is to help develop, disseminate, and evaluate resources that can be used to practise and teach EBM for undergraduate, postgraduate and continuing education for health care professionals from a variety of clinical disciplines.

Today’s society has a growing interest in maintaining and improving the health of entire populations.

As a result, there is a need for trained professionals who understand the intricacies of population health, have the tools to accurately examine, analyse and evaluate health data, and realise the importance of this work to inform and advance positive health outcomes within societies.

This new certificate program in Population Health Data Analysis meets these needs.
 

The overall aim of the project was to understand the nature of changing management cultures in the NHS and explore their relationships with changing organisational performance. Specifically we sought to:
- identify and classify the extant cultures in key NHS organisations;
- explore how these cultures evolve and transform over time, both in response to external policies and as a result of internal or cross-boundary drivers;
- analyse the (longitudinal) relationships between changes in culture and performance at both an organisational and a local health economy level.

Health care in Canada is currently undergoing significant reforms at regional, provincial,
and national levels. The manner in which scarce health resources will be utilized is foremost
in the minds of health care stakeholders. The Electronic Health Record (EHR) has been
advanced as an innovation that will both reduce health costs and improve patient care.
Numerous studies and reference papers describe the advantages of the EHR; however, little
attention has been directed to assessing the human and fiscal resources necessary to
implement and effectively manage the EHR. As Canadian health settings move from paper to
electronic health records, the role of Health Information Management (HIM®1) professionals
will correspondingly change to meet the demands of an increasingly digital workplace.

In 2009, the Health Informatics and Health Information Management Sector Study (O’Grady
2009) confirmed a significant skills shortage and increasing demand for HIM and health
informatics (HI) professionals by 2014. Study findings suggested that HI and HIM skills
deficits would significantly delay the development and implementation of the EHR in
Canada. EHR implementation is inarguably a laudable policy direction; however, significant
challenges will remain without a corresponding systematic effort to develop the human
resources necessary to support its implementation and maintenance.

Picking Up the Pace is Canada’s premiere event showcasing how to implement change in primary healthcare by presenting more than 47 innovations selected by an expert committee from across Canada.

The CHSRF/CIHR Chair on Knowledge Transfer and Innovation began operating in the summer of 2000, and is receiving financial support for ten years as part of the CADRE program (Capacity for Applied and Developmental Research and Evaluation in health services and nursing). The CADRE program is a partnership between the Canadian Health Services Research Foundation (CHSRF) and the Canadian Institutes of Health Research (CIHR). The Chair is made up of researchers, graduate and non-graduate students and managers. The objective of the Chair is to further our scientific understanding of knowledge transfer and innovation in health services, to train and support students pursuing master's and Ph.D.'s in this field, and to encourage and facilitate the transfer of knowledge in general.  The Chair:

• Trains students at the bachelor's, master's and doctoral level.
• Receives postdoctoral trainees from around the world.
• Participates in numerous research projects in knowledge transfer and innovation.
• Distributes a free weekly newsletter on knowledge transfer and innovation in the health services.
• Is developing a continuously evolving database, entitled KU-UC, which contains documents on knowledge transfer, innovation and health service policies and management. This database can likewise be consulted free of charge.

Problems arise when circumstances in the world change and conventional wisdom does not.

The present federally funded Canadian healthcare system has been driven principally by insured physicians and hospitals providing acute and episodic care that is a poor match to the changing demographics of persons with chronic disease living longer. The current health system consumes nearly one-half of provincial budgets.

There are solutions.

Discussions of healthcare reform must acknowledge the following context: on the one hand, public opinion data suggest that Canadians are increasingly concerned about the future viability of public healthcare; on the other hand, Canadians remain highly supportive of universal healthcare in principle, and they remain largely pleased with their own interactions with the system.

There has been a striking increase in public spending on healthcare over the last 10-15 years. Specifically, controlling for inflation, per capita spending on healthcare in Canada was more than 50% higher in 2010 than in 1996.
 

Key Messages

• Recent developments within the Canadian health sector highlight a perpetually shifting landscape, coupled with an increasing demand for practical approaches to implementing effective change.
• The purpose of this project was to identify a suite of evidence-informed approaches to support change in small and large systems that are applicable to a variety of contexts within the Canadian health system.
• Key issues that leaders and managers face in responding to and initiating change were used to identify evidence-informed approaches.
• A variety of theories, models, approaches, tools, techniques and instruments that decision makers can effectively use to oversee change exist; these approaches need to be deliberately chosen, with attention to stage of change and context, so as to have maximum utility and impact.
• More attention to change readiness and change capacity prior to initiating change would contribute to better understanding about what strategies and approaches would help to initiate and support change effectively.
• More formal learning regarding change in the four key areas of preparing for change, implementing change, spreading change, and sustaining change would be of benefit to decision makers.
• Developers of university credit and non-credit professional development programs for leaders and managers should be encouraged to make the study of change a prominent feature in their curricula.
• National and provincial agencies should be encouraged to develop a support platform devoted to leadership development in support of change in the Canadian health system (online access to tools and direct access to expertise).
• While using approaches to change may be useful, increased attention to conceptualizing the change process would likely lead to more effective implementation and results.

Between 2004 and 2007, the Canadian Health Services Research Foundation (CHSRF) funded a
Knowledge Brokering Demonstration Site Program (hereafter, KB program). The program provided
funding support to six healthcare organizations to pilot innovative approaches in the field of
knowledge brokering.

All six healthcare organizations were supported in hiring staff specialized in the promotion of
evidence-based decision-making. The role of the “knowledge brokers” was largely focused on bringing
researchers, managers, and decision-makers together to engage in collaborative problem solving. The
budget for the KB program totaled $1, 400,000 over the three-year period.

Study examines who is returning and why

Soon after their discharge from hospital, more than 180,000 Canadians were readmitted to acute care in 2010, reveals a study from the Canadian Institute for Health Information (CIHI). In those jurisdictions where detailed emergency department (ED) data was available—Alberta, Ontario and Yukon—nearly 1 in 10 acute care patients returned to the ED within seven days of hospital discharge. The study, All-Cause Readmission to Acute Care and Return to the Emergency Department, included more than 2.1 million hospitalizations across the country. It looked at surgical, medical, pediatric and obstetric patients to better understand who returned to acute care after discharge and for what clinical reason.

“Better understanding of the factors influencing readmission rates is an important step for improving the quality of care for Canadians,” says Jeremy Veillard, Vice President of Research and Analysis at CIHI. “Although readmissions cannot always be avoided, research suggests that in many cases they may be prevented.”

Citizen engagement, sometimes referred to as public involvement or participation, and societal or community engagement, is about meaningful involvement of individual citizens in policy or program development. It generally includes all of the activities organizations take to involve the communities they serve in directing policies and priorities or in their governance. It also frequently refers to processes where members of the general public, as opposed to representatives of stakeholder groups, are the main foci of the engagement, who are meaningfully involved in two-way interactions consisting of dialogue and deliberation with the health care organization or group. Ultimately citizen engagement is about sharing decision making power and responsibility for decisions.

This guidebook is intended for all researchers (new and experienced) who write grant applications in any area of health research, including basic biomedical research, clinical research, the social sciences and the humanities.

This guidebook provides tips about:

• applying for a grant as a Principal Investigator (PI)
• writing papers
• building and managing your research team and laboratory
• managing your time

Health Impact Assessment (HIA) is a practice that aims to evaluate the potential impacts of a policy, program or project on population health so as to minimize the negative and maximize the positive effects.

The founding documents of HIA identify citizen participation as one of the cornerstones of HIA. In fact, some maintain that an HIA remains incomplete without the effective and concrete participation of the community (Dannenberg, Bhatia et al., 2006, p.266).

The aim of this report is to introduce public health actors to the issues surrounding citizen participation in HIA. We will first examine the principal arguments in favour of citizen participation. We will then put these arguments into perspective, by also addressing some of the obstacles and risks associated with citizen participation in HIA.
 

Increasingly, there is a growing demand for advanced practice nursing (APN) in Canada and around the world. As clinical experts, leaders and change agents, APNs are recognized as an important human resource strategy for improving access to high-quality, cost-effective and sustainable models of healthcare.

This special report was commissioned by CHSRF to develop a better understanding of the roles of APNs, the contexts in which they are currently being used, and the health system factors that influence the effective integration of advanced practice nursing in the Canadian healthcare system. Three types of APNs were the focus of this report: clinical nurse specialists (CNSs), primary healthcare nurse practitioners (PHCNPs), and acute care nurse practitioners (ACNPs).

With advanced nursing degrees and extra training and experience, nurse practitioners are helping Canadians get more access to quality health care. In community clinics, health-care centres, doctors’ offices, nursing homes and emergency departments, nurse practitioners diagnose and manage illnesses like diabetes, order and interpret tests, write prescriptions and a whole lot more.

Nursing 2.0

Many of our nursing colleagues are networking, sharing information and developing themselves
professionally by using social media. How are they doing it without risking their professional and personal reputations? 

Editing documents using centralised online cloud storage is an increasingly popular workflow adjustment, making documents more easily accessible and more transparently adaptable. There is great potential for academics and researchers to explore the variety of free services available. Kim Mann shares her experience here of using Google Drive to write a conference panel summary with long-distance colleagues. She finds the technology to be particularly conducive to the brainstorming stages as well as to the improvement of the finished output.

University Health Network (UHN) became a demonstration site to test a health human resource planning model to foster inter-organizational collaboration, knowledge transfer and exchange of nurses between an urban academic health science centre and a remote region in northern Ontario. Funding support was provided by the Ontario Ministry of Health and Long-Term Care. The partnership between UHN, Weeneebayko Health Ahtuskaywin (WHA) and James Bay General Hospital (JBGH) addressed retention, recruitment, professional practice development, planning and succession planning objectives. The primary goal of this partnership was to supply the staffing needs of WHA/JBGH with UHN nurses at a decreased cost for four- to six-week placement periods. This resulted in a marked decrease in agency use by approximately 40% in the WHA site during the months UHN nurses were practicing in the north, with an overall agency cost savings of $165,000 reported in the pilot year.

From “Evidence to Action.” It sounds like a prime-time cop drama; solving mysteries with a few good shootouts and chases in between collecting clues and interpreting evidence to nail down an answer and a bad guy.

Well, it’s not quite as exciting as television — and there are hopefully no bullets flying or a real bad guy — but it is about collecting evidence, interpreting facts and putting that knowledge together to solve a problem. It is the 2012 International Council of Nurses (ICN) International Nurses Day (IND) kit. And, it is the project the ICN thinks nurses around the globe should be working on for the next year.
 

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.  

Dear Colleagues and Friends,

It is my pleasure to present the Proceedings of the 11th International Congress on Nursing Informatics (NI2012) sponsored by the IMIA-NI SIG. As you now know, the NI series of conferences is the leading gathering in the world for nurses, midwives, and others interested in the use of health information and communication technology to improve global health. This event is held every three years in a different part of the world. Our time spent in Montreal at NI 2012 provides tremendous opportunity for discussion and meaningful interaction amongst the most talented professionals in the field of nursing and nursing informatics.

Our theme, Advancing Global Health through Informatics, reflects the team-centered and interdisciplinary approach that is required to truly transform the health of our nations, our communities, and our patients. This Congress is truly global in scope. With contributions from 38 different countries and a tremendous response to our call for presentations, we have facilitated significant knowledge transfer from experts working in clinics, hospitals, universities and institutions large and small, local and regional, national and global.

The mission of the EI Consortium is to advance research and practice of emotional and social intelligence in organizations through the generation and exchange of knowledge. The Consortium for Research on Emotional Intelligence in Organizations is currently made up of 8 core members and 56 additional members who are individuals with a strong record of accomplishment as applied researchers in the field. There also are six organizational and corporate members. The Consortium was founded in the spring of 1996 with the support of the Fetzer Institute. Its initial mandate was to study all that is known about emotional intelligence in the workplace.

Leadership

These educational courses help nurses make pivotal changes in the nursing profession – one leader at a time. From human resource issues to using evidence to define standards of practice, these courses cover the entire nursing management spectrum.

Workplace Issues

From disaster preparedness to implementing evidence-based nursing research into everyday practice, these courses will give nurses the tools they need to be prepared when workplace issues arise.

The Core Public Health Functions Research Initiative (CPHFRI) is a program of research focused on public health systems renewal in British Columbia (BC). This research involves a team of interdisciplinary academic researchers, and national, provincial and local public health knowledge users and practitioners. The overall goal of CPHFRI (“see-free”) is to develop a research program, along with training opportunities, that studies the impact and outcomes of the Core Public Health Functions Framework in BC. Learn about our research projects. We also hope to increase the capacity of knowledge users to use evidence to improve public health policy and practice that will ultimately improve the health of the population.

AS NURSES, most of us have experienced one of our patients "coding." No matter what the circumstances, you felt that surge of adrenaline that enables you to rapidly recognize an unresponsive, apneic patient, activate the resuscitation team, and provide basic life support until the team arrives. This is what nurses do-we save lives and so much more.

But maybe you've also had this experience: After an unsuccessful resuscitation attempt, someone says, "He was 90 years old with metastatic cancer. What were we thinking?" It leaves us with the uneasy feeling that something should be different.

End-of-life decision making is always difficult and should be well thought out before a crisis. The decision to forgo CPR can be one of the hardest decisions a patient or family member has to make.

Writing to me about end-of-life concerns, one of you asked for "good, solid statistics about CPR in older adults" and requested some resources for family members. Evidence-based nursing is built upon examining the research, so I searched for pertinent studies that provided those "good solid statistics." Here's what I found.

Self directed learning module produced by the College of Registered Nurses of BC exploring clinical decision making in nursing practice.

Culture is the way we think, our values, our attitudes, our perceptions, and our beliefs. It’s also about
how we act, our habits and our typical behaviours.  It’s not about one person. Culture is about our
shared beliefs, what we expect of each other, what’s considered normal, and our shared patterns
of behaviour that determine how our organization functions. It’s “the way we do things around here.” 

If we conceptualize knowledge translation (KT) as an ever-turning cycle of policy-informed research leading to evidence-informed policy, then priority setting is where this cycle often begins to move. A singular KT tool in identifying policy needs and research options, deliberative priority setting selects the right people to brainstorm on the right issues to determine what a society's, a system's, or an institution's priorities are. Exactly how we determine the "right people," select the "right issues," and arrive at a set of fair and inclusive priorities is the subject of this Module.

The Workplace Health Research Laboratory (WHRL) at Brock University gathers, analyzes, reports and interprets the information that HR professionals and senior management need to build productive and engaged workforces.

This is a presentation to the 2008 Ontario University Registrar's Association Annual Conference.

Digital Collections is the National Library of Medicine's free online archive of biomedical books and videos. All the content in Digital Collections is in the public domain and freely available worldwide. Digital Collections provides unique access to NLM's rich, historical resources.

Digital Collections uses a suite of open source and NLM-created software. For more information on the development and technical description of Digital Collections, see the NLM Digital Repository Project information page.
 

Jennifer Stinson was a nurse at The Hospital for Sick Children (SickKids) in Toronto who enjoyed brainstorming new ideas for improving care, especially for the kids with cancer she treats. But even as she gained status by getting her PhD and becoming a clinician scientist, she came up against persistent bureaucratic and organizational barriers to innovation.

• Discover new tools
• See what other educators use
• Rate and review your favorite tools

It's free!

Today I am sharing with you a video tutorial created by a guy who is Google Apps for Education Certified Trainer and in which he expalains in a step by step process how you can use Google Forms to create self-grading assessment. The video is not long it is just a little over 7 minutes but I really loved it and I am pretty sure you will as well.

Research evidence has the potential to inform policy and practice decisions to ensure better outcomes for children, young people and communities - yet often the impact of research is not maximised. This web article aims to provide brief, to the point information on how to increase the likelihood of your research making a difference.

What is knowledge exchange?
First things first – what do we actually mean by knowledge exchange? There is growing evidence that the successful uptake of research knowledge requires more than one way communication. Pushing research messages from research producers to the users of research is not enough - but genuine interaction is needed amongst researchers, policy makers and other stakeholders. This interaction is known as Knowledge Exchange. (Lavis et al. 2003)

This tool has been designed to help you learn about eHealth and how it affects your daily practice as a nurse.

It will also provide you with the necessary background information to appreciate how eHealth can enhance your nursing practice and client care, by covering such subjects as:

• how eHealth can support nursing roles, client care, and client empowerment,
• the historical development of eHealth, and
• the linkages between nursing, quality care, and eHealth

The following lists of free resources has been taken from library subject guides and resource lists. e-HLbc has not evaluated any of the following resources.

Please note that several of the listed resources are known to collect and report what their users have been searching. Please consult the privacy policy of any resource before downloading it to your mobile device.

Descriptions of each resource are taken directly from the home page or "about" page of the resource.

The Electronic Health Library of BC provides the academic and health care community of British Columbia with easy access to online health library resources. The purpose of the e-HLbc is to support and improve practice, education, and research in the health sciences.

Member organizations include all publicly funded BC post-secondary institutions providing health education, the BC Ministry of Advanced Education, the BC Ministry of Health, the BC Ministry of Children and Family Development, all BC Health Authorities, and the BC College of Physicians and Surgeons.

Health care costs are growing at an unsustainable rate throughout much of the world. In response, many governments are taking steps to prod the health care industry to aggressively expand its use of IT. The potential long-term benefits to all parties, measured in cost savings and improved medical outcomes, will be vast. But the near- to intermediate-term disruption to the industry will be significant, translating into both costs and opportunities for industry players and the entire health-care ecosystem.

Research shows that when patients are engaged in their health care, it can lead to measurable improvements in safety and quality. To promote stronger engagement, Agency for Healthcare Research and Quality (AHRQ) is developing a guide to help patients, families, and health professionals work together as partners to promote improvements in care.

The sufficient-cause model, also known as “causal pies,” is a causal model commonly taught in introductory epidemiology courses. Under the sufficient-cause model, outcomes are usually not caused by a single causative factor, but by a combination of “component causes” (exposures) that might occur minutes or years apart.1,2 A person gets the outcome only if he or she has accumulated all component causes. Together, the combination of component causes that are sufficient to cause an outcome is called a “sufficient cause.” Typically, there is more than one sufficient cause for each outcome, meaning that there are different mechanisms by which a person can get the same outcome.

Some students struggle with the sufficient-cause model and other causal models because the concepts can seem abstract, even when examples are given. We have developed a fun and intuitive game called “Causal Pie Bingo!” that introduces students to the sufficient-cause model in a format that makes these examples more concrete.
 

At the 2010 National Research Service Award (NRSA) meeting, directors of T32 training programs funded by the Agency for Healthcare Research and Quality (AHRQ) discussed the importance of sharing knowledge and working more closely together. Following this rich discussion, AHRQ issued a request for proposals for the formation of a study group to explore the feasibility of establishing a mechanism for collective knowledge production, specifically the formation of a learning collaborative. Collaborations are formed when two or more stakeholders invest their resources (e.g., talent, information, money), to solve problems that they could not solve by themselves. Central to this concept of collaboration is knowledge translation and knowledge transfer.

Collaborations have become necessary for organizations performing complex work, with emerging technologies and rapidly changing environments. The rapidly changing field of health services research necessitates knowledge transfer and translation among health services researchers spanning multiple disciplines and housed in a number of organizations representing the public and private sectors in academic, medical, public health, and numerous other settings.

PowerPoint presentation from Session 904 - Building a "Super" Logic Model: Development of a System of Tiered Logic Models to Identify Key Outcomes in a Large Nonprofit Organization

Expert Lecture Sponsored by the Presidential Strand Chair - Gail Barrington, Barrington Research Group Inc Presenter - Melanie Barwick, The Hospital for Sick Children Discussant - Daniel Stufflebeam, Western Michigan University

Presentation

Nurse Practitioners (NPs)

In a review of studies comparing the primary care provided by NPs to primary care provided by physicians (MDs), researchers found that patients of both groups had comparable health outcomes. NPs were found to out perform MDs in measures of consultation time, patient follow-up, and patient satisfaction (Naylor and Kurtzman 2010).

Two recent international systematic reviews report no differences between patients treated by NPs and MDs in terms of health outcomes, type of care provided, or resources used. They also found patients seeing NPs were more satisfied and had longer consultations (Horrocks et al., 2002; Laurant et al., 2008).

Systematic reviews and syntheses of evidence are increasingly used to inform public policy decisions. Growing budgetary pressures mean that decision makers often need to consider evidence on the costs and efficiency of alternatives as well as their effects. There are a number of methodological challenges in the identification, appraisal, synthesis, interpretation and use of economic evidence. This article draws on a recently published edited volume to review the latest developments, proposals and controversies in these aspects of economic evidence synthesis methodology. It focuses on two broad classes of approach: systematic review to summarize and compare the findings of existing economic analyses and synthesis of new economic results using decision models. The availability and scope of economic evidence is currently limited in many fields, but improving. Increased engagement between economists, the wider evidence synthesis community, and decision makers is needed to improve both the production and use of economic evidence. Further research to improve the evidence base that underpins application of economic evidence synthesis methodology will need to embrace a broader range of methods than economic evaluation and systematic review alone.

This website provides a collection of links to evidence-based practice, including:

• Resources
• Reviews
• Guidelines
• Critiques
• Calculators
• Statistics
• Research Centres
• Literature

The ANCC Magnet Recognition Program® (MRP) requires hospitals to have evidence-based practice embedded in the culture of the organization. In the documentation, hospitals must demonstrate that nurses evaluate and use published research in all aspects of clinical and operational processes.

The ANCC also expects nurses to conduct research projects and that knowledge from these projects will be shared with nurses within and outside the organization.

Although the two requirements have the potential for overlapping concepts in the minds of many nurses, evidence-based practice and research projects are distinctly different—and, if the differences are not recognized, it is possible for an organization's documentation to fail to adequately explain how it meets both requirements.
 

There are 4 basic steps in Evidence Based Practice*

• Step 1 - Convert your information need into an answerable question
• Step 2 - Find the best evidence
• Step 3 - Appraise search results for validity and usefulness
• Step 4 - Apply the findings to your clinical practice and evaluate your professional performance

The basic aim of this tutorial is to walk you through these steps in an effort to make the process easier and more understandable for you.

Let’s take an example and work through the process. You may want to use this worksheet as you proceed through the tutorial.

Scenario:
Infections in hospitals can be spread on the hands of healthcare workers. It takes minutes to follow the hand hygiene policy exactly before entering a room to deliver patient care. On a busy hospital unit where nurses care for many critically ill patients, those minutes add up. Many hospitals have turned to alcohol-based handrubs to save time and put hand cleaners closer to patients. You are wondering if alcohol based handrubs placed inside the patients rooms would increase the incidence of handwashing and decrease nosocomial infection.

*adapted from: Sackett DL, Straus SE, Richardson WS [and others]. Evidence-Based Medicine: How to Practice and Teach EBM. 2nd ed. London: Churchill-Livingstone, 2000:3-4.

This tutorial is designed for students in healthcare fields, medical professionals, faculty, and anyone else interested in evidence-based practice. This tutorial comprises two lessons:

Lesson 1: The 5-Step Process
In Lesson 1, you will learn about the 5-step process for evidence-based practice.

Lesson 2: Using EBP—Case Scenarios
In Lesson 2, you will have the opportunity to roll up your (virtual) sleeves and apply the 5-step process. You’ll explore several case scenarios and determine how you would handle them.

This tutorial also includes references for you to explore as you choose. Access these by clicking the References button in the navigation bar above.
 

ARE HOSPITAL FUNDING MECHANISMS IN CANADA DESIGNED TO PROVIDE EFFICIENT CARE?
Canadian governments are spending more on healthcare than ever. Driven by technological innovation, population aging, inflation and other factors, public healthcare expenditures are forecast to continue to increase, causing concern about the sustainability of Canada’s publicly funded systems. The hospital sector accounts for over 28% of total healthcare expenditures in Canada. Although this share has fallen considerably over the past few decades, hospitals continue to represent the largest single component of healthcare expenditures. Hospital expenditures are
projected to exceed $55 billion in 2010. 

Evidence suggests that provinces differ in terms of healthcare spending efficiency, which implies that there should be an opportunity for improvement. An often-cited source of inefficiency in the Canadian hospital sector is the reliance on ‘global budgets’ as the primary source of hospital funding. Global budgets can perpetuate inefficient care because they offer little incentive to reduce costs or foster innovation.

Based on a paper commissioned by CHSRF,this brief provides a summary of the available evidence on promising hospital funding options and their impact on the following goals: timely and equitable access, optimal volume of care, quality, efficiency and constraining future cost increases.

BMJ Group and McMaster University's Health Information Research Unit are collaborating to provide you with access to current best evidence from research, tailored to your own health care interests, to support evidence-based clinical decisions.

This service is unique: all citations (from over 120 premier clinical journals) are pre-rated for quality by research staff, then rated for clinical relevance and interest by at least 3 members of a worldwide panel of practicing physicians. Here's what we offer:

• A searchable database of the best evidence from the medical literature
• An email alerting system
• Links to selected evidence-based resources

BACKGROUND: In older adults, diminished balance is associated with reduced physical functioning and an increased risk of falling. This is an update of a Cochrane review first published in 2007.
OBJECTIVES: To examine the effects of exercise interventions on balance in older people, aged 60 and over, living in the community or in institutional care.
SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE and EMBASE (to February 2011).
SELECTION CRITERIA: Randomised controlled studies testing the effects of exercise interventions on balance in older people. The primary outcomes of the review were clinical measures of balance.
DATA COLLECTION AND ANALYSIS: Pairs of review authors independently assessed risk of bias and extracted data from studies. Data were pooled where appropriate.
MAIN RESULTS: This update included 94 studies (62 new) with 9,917 participants. Most participants were women living in their own home. Most trials were judged at unclear risk of selection bias, generally reflecting inadequate reporting of the randomisation methods, but at high risk of performance bias relating to lack of participant blinding, which is largely unavoidable for these trials. Most studies only reported outcome up to the end of the exercise programme. There were eight categories of exercise programmes. These are listed below together with primary measures of balance for which there was some evidence of a statistically significant effect at the end of the exercise programme. Some trials tested more than one type of exercise. Crucially, the evidence for each outcome was generally from only a few of the trials for each exercise category.

In today’s scientific realm, a large amount of the research being conducted is never published in any way. Unpublished research could include negative data, unexplained observations, or simply data that are not deemed “interesting” enough to any journal. Given the continued reduction in research funding in many areas around the world, should investigators waste their time on research that may have already been done (but not published)? What if researchers could easily publish data that would otherwise be simply left alone and never shared? And what if those data could be accessed, reused, and cited by others?

Figshare offers an effective solution to the issue of the incredible amounts of unpublished data sitting on researchers’ computers around the world. At figshare, researchers can sign up for free accounts and upload data in any file format (common uploads include figures, posters, full manuscripts, raw data sets, and videos). All data are published immediately under a Creative Commons license, allowing for instantaneous discovery by anyone around the world. Perhaps more importantly, each contribution is given its own digital object identifier (DOI), a unique identifying code that provides a permanent link to the file in question. DOIs are found with increasing frequency in reference lists, meaning that items on figshare can be cited easily in peer-reviewed literature if desired.

Ontario Renal Network

The National Kidney Foundation Disease Outcomes Quality Initiative (NKF KDOQI) ™ has provided evidence-based clinical practice guidelines for all stages of chronic kidney disease (CKD) and related complications since 1997. Recognized throughout the world for improving the diagnosis and treatment of kidney disease, the KDOQI Guidelines have changed the practices of numerous specialties and disciplines and improved the lives of thousands of kidney patients
 

Healthcare decision makers—including clinicians and other healthcare providers—increasingly turn to systematic reviews for reliable, evidence-based comparisons of health interventions. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies. They can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. But the quality of systematic reviews varies; often the scientific rigor of the collected literature is not scrutinized or there are errors in data extraction and meta-analysis.

The First Nations Health Council was created in 2007 to implement the 10-year Tripartite First Nations Health Plan on behalf of BC First Nations. The Plan's goal is to improve the health and well-being of First Nations and to close the health gap between First Nations and other British Columbians.

Background: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework for Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts.

GEO offers grantmakers a practical perspective on how to increase the capacity of their organizations to tap the transformative power of evaluation for learning. With key questions, guidelines and action steps, this new guide equips grantmakers to tackle evaluation for learning with “four essentials”: Lead, Plan, Organize and Share.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.  

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. 

Manitoba Centre for Health Policy.

This report summarizes the results of Phase 1 of the Canadian Institute for Health Research (CIHR) funded From Evidence to Action project (2005-2008). The purpose of From Evidence to Action is to identify barriers specific to evidence-informed health service planning and decision making (EIDM) with regional health authorities (RHAs), and to develop strategies, credible to decision-makers, to address these barriers. Project partners included all eleven RHAs in Manitoba, along with the Manitoba Centre for Health Policy. From Evidence to Action was based on a key finding of the evaluation of The Need to Know Project: the importance of addressing organizational barriers to research use in RHA planning and decision-making. The Need to Know Team members form the Advisory Committee for the project.

CPHA is pleased to launch a new platform to facilitate the exchange of real-life experiences, tools and resources about initiatives implemented by communities and their health and social service organizations to improve health and address health equity through the social determinants of health (SDH). These experiences are drawn from sites across Canada, touching on a wide range of SDH-related issues and benefiting a variety of populations.

Statistics suggest that the prevalence of maladies, medical conditions and probability for medical conditions exist more intensely in rural areas, yet no noteworthy studies have been directed primarily to the sector. A group of residents and healthcare professionals in a rural Ontario community in Huron County propose to create a centre to research healthcare issues in rural populations, the first community-driven rural research centre in Canada. Most of healthcare-related research conducted in Canada and elsewhere is based on results of surveys taken of test populations close to large urban medical centres of learning or practice, with projections of results for rural sector populations.

Irrespective of the traits they study, social and behavioral scientists understand that no two people will express a given trait in exactly the same manner. Variation is the rule, and social and behavioral researchers try to uncover the reasons for those differences.

Historically, research in social and behavioral science has focused on environmental contributions to human variation, while biologists studied inherited variation in anatomy and physiology. Yet exciting newer research suggest that genes and environment participate in a complicated dynamic to influence not only health and disease, but also social and behavioral traits.

The nature/nurture debate has confounded research on social and behavioral phenotypes since the late nineteenth century. This program takes the position that the debate is unhelpful and misleading, because no gene operates outside of an environment - beginning with the environment of the cell and extending to the influences of the external world.
 

Nurse Practitioner-Led Clinic

A Nurse Practitioner-Led Clinic can provide ongoing care while helping promote disease prevention and healthy living. Nurse practitioners can diagnose and treat common injuries and illnesses, write some prescriptions and order blood and diagnostic tests. You can also find nurse practitioners working throughout the province in Family Health Teams and other types of clinics.

Objective: This feature article on knowledge transfer presents principles and strategies to support the development of short communiqués to end-users.

Participants: Formal and informal knowledge brokers are the targeted users of the strategies.

Methods: Research studies and conceptual literature in knowledge transfer informed the development of brief-Knowledge Transfer (b-KT) principles. Principles are explained and a sample of how they informed the development of KIT-Tip Sheets is offered to promote ways to use principles in knowledge dissemination.

Results: b-KT principles can be used as a framework to guide the development of short communiqués by knowledge brokers in work practice but also in the health, social and rehabilitation domains. In addition, these principles promote the participation of end-users in the development of knowledge transfer.

Conclusions: Formal evaluation is needed on the use of these principles in achieving the uptake and use of knowledge by end-users.

A forum for sharing research and best practices worldwide in the prevention of needlesticks and occupational exposures to bloodborne pathogens.

Defining the problem...

Healthcare workers are a critical resource in every corner of the globe -- the infrastructure without which healthcare cannot exist. But in caring for us, they place themselves at risk daily of contracting life-threatening infections from bloodborne pathogens, including HIV, hepatitis B and hepatitis C. Injuries from needles and other sharp medical devices, along with accidental exposures to blood and body fluids from splashes and sprays, are the most serious occupational hazard faced by healthcare workers.
 

This briefing looks at the case of Cambridge University Health Partners, the management organisation of the Cambridge Academic Health Science Centre (AHSC).  An AHSC is a partnership between one or more universities and healthcare providers focusing on the tripartite mission of research, clinical care and teaching. AHSCs work on the principle that the collaboration between university and healthcare providers creates greater value than their operating alone. Our briefing reports on the nature and characteristic of one such partnership, and how such outcomes are achieved collaboratively.

Resources provide tips and strategies for writing effective grant proposals from McMaster University.

Tips from McGill University Health Centre.

Go beyond the “grey zone”: Take advantage of some of the best IS expertise among HTA agencies worldwide with CADTH’s new online resource for grey literature searching, Grey matters: a practical search tool for evidence-based medicine.

Knowledge translation (KT) is about raising knowledge users' awareness of research findings and facilitating the use of those findings. Only a minority of researchers would call themselves experts in KT, and with KT still an emerging field, there exists a need to build capacity not only in developing research proposals with a KT approach but also in assessing those proposals for scientific merit and potential impact. The Canadian Institutes of Health Research (CIHR) has written this guide as one resource to fill this knowledge gap. We hope this guide will help to strengthen projects that involve a KT approach, while also ensuring that the review of KT within grant proposals is more rigorous and transparent.

The guide is divided into two sections, each tailored to one of CIHR's two forms of KT: integrated knowledge translation (iKT) and end-of-grant KT. Integrated knowledge translation requires that knowledge users (who will be described later in this guide) be members of the research team and participate in many stages of the research process. End-of-grant KT requires applicants to submit a plan for how they will translate their findings when the research is completed. It is worth noting that iKT programs require a dissemination plan, so those involved with iKT proposals should consult both sections. As mentioned, there is a section in the guide specific to each approach. The target audience for this guide is CIHR applicants and reviewers, but the concepts are transferable to a broader audience
 

G-I-N PUBLIC is a working group of researchers, health professionals and consumers who promote ways to inform and involve the public in clinical guideline activity around the world. G-I-N PUBLIC uses a wiki website to post information about how patients and the public can be involved in guideline development. You can find information about projects in various countries, practical information such as handbooks on public involvement and lots of literature references.

Slideshow demonstrating correct hand washing procedure.

Evidence and perspectives for funding health care in Canada.

Health Care in Canada is CIHI’s annual flagship report on the health care system and the health of Canadians. Since 2000, it has been a resource that tables fundamental issues facing the health care system. Addressing questions surrounding patient safety, wait times, health care spending and analyses on how the system has adapted over time to meet changing needs has made Health Care in Canada a key source for the public and policy-makers alike.

This year’s report provides perspective on changes in the health care system and on current thinking surrounding health care and outcomes of care. As with its predecessors, Health Care in Canada 2010 draws on both internal and external information and data and introduces international comparisons where appropriate.

Fall from slips and trips are the second leading cause of injury to B.C. healthcare workers. This study, funded through WorkSafeBC's Research Secretariat, is a detailed investigation of workplace falls over a 3-year period among healthcare workers in a large B.C. health region. The study looked at the incidence of falls in acute, residential, and community care by occupation, time of year, day of the week, time of day, and location of work, as well as contributing factors.

Health Indicators 2010, the 11th in a series of annual reports, presents the most recent health indicator data from the Canadian Institute for Health Information (CIHI) and Statistics Canada on a broad range of measures. As in the past, the report seeks to answer two important questions: “How
healthy are Canadians?” and “How healthy is the Canadian health system?” Health regions and other stakeholders may use this information to identify areas where improvements are needed and to learn from jurisdictions with the best outcomes. Each indicator falls into one of the four  dimensions of the Health Indicator Framework listed below:
• Health status—provides insight on the health of Canadians, including well-being, human function and selected health conditions.
• Non-medical determinants of health—reflects factors outside of the health system that affect health.
• Health system performance—provides insight on the quality of health services, including accessibility, appropriateness, effectiveness and patient safety.
• Community and health system characteristics—provides useful contextual information, rather than direct measures of health status or quality of care.

In addition to presenting the latest indicator data, this year’s report focuses on health disparities, the fifth dimension in the framework. Measuring and reporting health disparities are important because some of them may be reduced or prevented. Reducing health disparities could help to address the
problem of excess mortality and morbidity, ease economic burden and boost the nation’s health profile as a whole.

A Social Network for Health Informatics Professionals and Students

This course consists of a brief introduction followed by three lessons. Within these lessons there are video clips, case studies, and knowledge check questions.

This report is the second in a series focused on health outcomes of care jointly produced by Statistics Canada and the Canadian Institute for Health Information (CIHI). In the first report, A Framework for Health Outcomes Analysis, we explored the feasibility of conducting health outcomes analyses using existing data, with a specific focus on diabetes and depression.2 The analysis was guided by the Health Outcomes Conceptual Framework, which places health outcomes within the context of the care path experienced by patients as well as important patient and health system factors hypothesized to be associated with health outcomes of care. Among the key highlights of this first report was the recognition that reporting and understanding health outcomes from a population perspective is important to better understand what care works best for whom. Results of the analytical work conducted in the areas of depression and diabetes clearly demonstrated that existing data sources are very limited in their ability to provide information regarding health outcomes of care. Despite best efforts to use existing survey, administrative and clinical registry data in the most extensive ways, clear data gaps continue to exist at the pan-Canadian level. Specifically, there is a lack of standard, comprehensive and repeated measures of health status at the population level as well as of comprehensive information regarding the full spectrum of health care services received that would follow an individual along the continuum of care received and resulting outcomes.

Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems. Over time Health Systems Evidence will also contain a continuously updated repository of economic evaluations in these same domains, descriptions of health system reforms, and descriptions of health systems.

The world's most comprehensive, free access point for evidence to support policymakers, stakeholders and researchers interested in how to strengthen or reform health systems or in how to get cost-effective programs, services and drugs to those who need them

Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems. Over time Health Systems Evidence will also contain a continuously updated repository of economic evaluations in these same domains, descriptions of health system reforms, and descriptions of health systems.
 

The aim of this website is to share expertise and experience on health care systems with policy makers, managers of health services, health care providers and health system researchers. The website is a product of a network of partners on health systems, which individual members can be found at the bottom of this page. The network is funded by the Belgian government (Directorate-General for Development Co-operation).

How this site will save you time

• Public health content filtered for you from the literature and stored in a searchable registry
• Content that has been quality rated
• Design informed by public health decision makers across Canada
• For each review with an accompanying summary statement, evidence and implications, clearly spelled out in 2 pages
• Building networks with colleagues in your program area

This site will save you time by addressing two major barriers identified by public health and health promotion decision makers: 1) identifying public health/health promotion literature in large medical databases such as MEDLINE, and 2) accessing well-done reviews synthesizing the literature evaluating the effectiveness of numerous public health and health promotion interventions.

The latest research from PricewaterhouseCoopers’ Health Research Institute (HRI), HealthCast provides rich insight from 3,500 consumers around the world, including 500 Canadians, as well as 590 global health leaders (50 in Canada). In-depth interviews were conducted with 225 top executives in government, hospital systems, insurance companies, physician groups,
pharmaceutical and life science companies and technology firms in 50 countries, including 35 Canadian experts.

This Canadian Compendium is designed to complement the HRI global report by providing a summary of key highlights from the Canadian perspective. What are the healthcare concerns of Canadian consumers, the true end users of the healthcare system? What are healthcare leaders saying about moving Canada towards an innovative system of customized care and prevention?
What does healthcare look like now and how will things change through to 2020? This Compendium offers a robust overview of the challenges, strengths and opportunities of healthcare in Canada.
 

Search to find health workforce initiatives that are being implemented across Australia to build capacity, boost productivity and improve the distribution of health professionals

Today, it’s not enough for scientists to be experts in research and research methods. It is becoming
more and more apparent that scientists need to be entrepreneurs, with skills in finance, business, and even communications to be successful.

If you are not able to communicate your research and the results of your work effectively, it will be impossible to expect others to understand and apply your research. As a matter of fact, more and
more scientific journals are recognizing the importance of appropriate communication, requiring that articles submitted must be edited into a more readable, understandable format: ‘‘The writing has
become more and more technical and only a few scientists in a particular niche can understand any given article,’’ cites the Ottawa Citizen in December 2007.  Moreover, the journal Science now
requires articles to be submitted in plain language: ‘‘Cross-fertilization of ideas from one field to another is a huge source of new ideas, and this process ends up being cut off if people can’t understand each other’s work.’’

This website brings together people from across industries who have an interest in matters pertaining to high reliability organizations (defined as "organizations which have fewer than normal accidents"). The site features articles, examples of high reliability organizations, a Risk Mitigation Model, as well as archives from their annual conference.

“In Canada in health care we’re at a point where most hospitals accept the role of social media for branding and communication, but only the lead adopters are using it for patient engagement and for clinical use.” – Ann Fuller, public relations director, Children’s Hospital of Eastern Ontario (CHEO)

Call up the website home page for any large Canadian hospital and you’ll likely spot the familiar icons that link to the institution’s facebook, Twitter and YouTube accounts.

Hospitals are inherently conservative institutions and, as such, have been relative latecomers to adopt social media, which are broadly defined as digital channels that can facilitate timely, collaborative and interactive communication.

As they enter the social media fray, hospitals face a host of challenges and decisions. These range from basic upkeep—nothing is more frustrating to a potential user than a neglected or stale-dated facebook or Twitter account—to deciding how interactive to be with patients, and what staff should be trained and involved in social media use.

The Saskatchewan RN Association's discussion paper. In today’s work environments, RNs are frequently faced with increased requests and requirements to work extra shifts and overtime. Fatigue has been identified as a contributing factor to medical errors which can impact patient safety. The  purpose of this discussion paper is to present the research and literature related to fatigue and to make recommendations. The responsibilities of RNs, RN managers/employers, educators and researchers are outlined.

The job of a leader has become more difficult and dangerous than ever courtesy of anti-bullying laws. State governments have been caving in to public pressure to pass tough anti-bullying laws to make the workplace safer for employees. However, they are a Catch-22: the harder you try to comply with them, the worse the bullying gets

Key Points

• Any Web site should make it easy for you to learn who is responsible for the site and its information (see Question 1).
• If the person or organization in charge of the Web site did not write the material, the Web site should clearly identify the original source of the information (see Question 4).
• Health-related Web sites should give information about the medical credentials of the people who have prepared or reviewed the material on the site (see Question 6).
• Any Web site that asks you for personal information should explain exactly what the site will and will not do with that information (see Question 9).
• The U.S. Food and Drug Administration and Federal Trade Commission are federal government agencies that help protect consumers from false or misleading health claims on the Internet (see Question 12).

Keeping up to date with research and managing an ever-increasing number of journal articles is skill that must be well-honed by academics. Here, Alex Hope sets out how his workflow has developed using Zotero, Dropbox, Goodreader and his iPad.

I use a variety of methods to keep on top of research in my field, and to search for articles when preparing a paper or presentation. Foremost is the use of RSS feeds to deliver alerts of new articles in journals I follow. I use Google Reader to manage my feeds and usually browse through new feed articles using Flipboard on my iPad or iPhone. If I come across an interesting article that I think I may like to read and use, I email myself the link. This means that when I check my email every morning, I can navigate to the article and save it in my reference manager for reading and marking up. If I am researching a paper, I tend to search journal repositories such as Web of Knowledge, although more often than not I find Google Scholar finds what I need quickly and accurately. Finally I am finding that Twitter is a fantastic resource for uncovering new research as an increasing number of researchers and research groups have a presence.

Patients are most at risk for experiencing gaps in care that lead to rehospitalization during the transition between care settings. The focus of this guide is the transition of residents from the hospital to the skilled nursing facility (SNF) setting and the associated transfer of responsibility from the hospital to the SNF care team. (SNF is an umbrella term that includes nursing homes, long-term care facilities, acute rehabilitation facilities, and post-acute care facilities.)

Based on a synthesis of the literature, interviews with experts, direct observations in SNFs, and workgroups with clinicians at field sites, this How-to Guide highlights four promising changes for an ideal transition and several other changes that merit further testing. Key tools and resources to help organizations implement these changes are also included.
 

The IHI Improvement Map is an open resource, available free of charge for anyone, anywhere who share's IHI's mission of improving health care.

We have created this user-friendly, online tool to make the contents of the Improvement Map easily accessible.

You can use this tool to create your overall improvement plan, set and align priorities, and then dive deeply into the knowledge base in areas in which you've chosen to focus.

In this new feature, the IHI Open School will highlight some of the most innovate Chapters in its network. We will feature information on the Chapter, and focus on a new innovation or project they’ve developed.

We’re looking for other Chapters to feature. Has your Chapter held a successful event or created a Chapter resource that you think we should highlight in the Chapter Spotlight? Send us an email at openschool@ihi.org and tell us what innovative projects your Chapter has done recently.

The IHI Improvement Map

The Improvement Map is a free interactive, web-based tool designed to bring together the best knowledge available on the key process improvements that lead to exceptional patient care.
 

Comparative Effectiveness

The mission of the comparative effectiveness portfolio is to provide health care decision makers—including patients, clinicians, purchasers, and policymakers—with up-to-date, evidence-based information about their treatment options to make informed health care decisions
 

A healthier working environment is linked to a healthier workforce. Nurses who rate their
facilities as positive environments have fewer absences due to illness, lower rates of
musculoskeletal pain, and better self-rated health.1 Research shows that organizational and
managerial support lessen nurse dissatisfaction and burnout.2 As well, a positive link has
been identified between nurses’ job satisfaction and patient outcomes. A study conducted in
Ontario teaching hospitals showed that patient satisfaction with nursing care was directly
related to how satisfied nurses were with their jobs.

Detecting and promptly reporting changes in a nursing home resident's condition are critical for ensuring the resident's well-being and safety. Such changes may represent a patient safety problem, and they can be a signal that the resident is at increased risk for falling and other complications.

Training nursing home staff—particularly nursing staff—to be on the lookout for changes in a nursing home resident's condition and to effectively communicate those changes is one tool nursing home administrators can employ to improve patient safety, create a more resident-centered environment, and reduce the number of falls and fall-related injuries.
 

An increasing number of health care systems and providers offer services and tools that encourage and empower patients to take an active role in their own health care. The ability to access medical records, test results, and other health information online can increase patient involvement and facilitate patient—provider communication.
 

For download; First published in 2012 by Mental Health Commission of Canada

Educators create online courses for the same reasons that they became teachers to begin with: to educate students, broaden their awareness of the world and thereby improve the students’ lives. And with massive open online courses (MOOCs), educators can now reach many more students at a time. But MOOCs offer many other benefits to the education community, including providing valuable lessons to the instructors who teach them.

Online courses inherently allow students to create their own pathways through the material, which forces educators to think about the content in new ways. And MOOCs offer professors fresh opportunities to observe how their peers teach, learn from one another’s successes and failures and swap tactics to keep students engaged. This is, in turn, makes them better teachers.

MOOCs are still the wild west of higher education, and there is no “one size fits all” approach to building one. At Coursera, we’ve been working with educators as they experiment with designing courses for this new format, and for a student body of unprecedented proportions. (For example, Duke University’s Think Again: How to Reason and Argue by Walter Sinnott-Armstrong and Ram Neta has more than 180,000 enrolled students.) We’re reimagining many aspects of what it means to teach a course, ranging from lecture delivery, to assignments, to strategies for engaging the online community of students.

We currently offer online courses in the areas of quality improvement, patient safety, and leadership.  Each course takes one to two hours to complete and consists of several lessons taking 15-30 minutes each.

Many of you will be surprised to find that you already know quite a lot about designing instruction. You plan for your courses by determining what skills and knowledge your new students already have, create assessments based on the goals of your course, and (hopefully) make adjustments along the way as you evaluate your own teaching in relation to your students' reactions.

However, as we move into using newer technologies in the classroom, many faculty "forget" their good teaching practices to focus solely on the technology. What happens? Weak instructional practices and rather boring lessons: we default to the presentation of facts through a teacher-centered strategy. How many boring PowerPoint lectures have you seen lately?

Using the principles and models of instructional design, we can avoid many of the problems often experienced by new teachers or anyone facing the requirement to use newer technologies in teaching.

In 2008, The Change Foundation conducted a series of focus groups with patients who were frequent users of the health-care system, and family and friend caregivers of people with multiple chronic conditions. In those discussion groups, we heard that patients and informal caregivers had concerns about the delivery of health-care services (The Puzzlemaker). These concerns included:

• a lack of coordination and communication among health-care providers—in particular, in the connecting of the hospital care process with the home-and-community-care process—which left them feeling frustrated, confused and forgotten;
• a lack of confidence that necessary information had been transferred from one provider to another or one setting to another, which left them worrying and wondering who was responsible for what; and,
• being asked to repeat tests and assessments, and provide the same medical histories and symptom reports to a series of providers. This left them wondering about waste, inefficiency and potential risks to their health.

Since its inception in 2005, the Robert Wood Johnson Foundation’s (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI) has sought to identify specific ways nurses affect patient care quality and outcomes. Over five years, the program supported interdisciplinary teams that involved nursing scholars and scholars from other disciplines in research projects—from the conceptual study design to the adoption in practice of new measures of standards of care. The final grant solicitation was conducted in 2010.

This report highlights the groundbreaking and important work of the 40 grantees supported by INQRI. The program was led by Mary Naylor, PhD, RN, FAAN, and Mark Pauly, PhD, of the University of Pennsylvania, in partnership with Lori Melichar, PhD, and her colleagues at RWJF.

Researchers investigated such topics as nurses’ roles in avoiding hospital readmissions; addressing hospitalized patients’ risks for falls; reducing patients' pressure ulcers; improving pain outcomes; resolving medication discrepancies; and the effects of nurse staffing and skill mix on patient outcomes.

“INQRI research provides a robust body of results that can be shared with policy-makers, hospital administrators and others who determine how nursing resources will be distributed to improve the quality and outcomes of patient care,” wrote the report authors.

The linked reports were prepared by the Interior Health Research Department for the purposes of decision support, program planning and/or evaluation.

This leading practice guide on the integration of internationally educated nurses (IENs) into the workplace is intended to assist employers of IENs. Given the aging nursing workforce, effective management of IEN recruitment, retention and integration is a priority.

On this site, you will find the following sections:

• Why you should hire IENs and what they bring to the workplace
• How you can create a harmonious workforce that optimizes skills and knowledge
• Case studies of organizational successes and leading practices
• Links to useful resources and references, including interviews with healthcare organizations

Health-care workers face a high risk of developing injuries to their muscles, tendons or other soft-tissues, including back pain. These injuries are also known as musculoskeletal disorders (MSDs).

Activities such as lifting and handling patients are one of the main causes of MSDs in health-care workers.

Many prevention initiatives – such as using mechanical patient lifts, physical exercise programs or education programs – have been used to try to prevent MSDs from occurring in health-care workers. However, little is known about the effectiveness of these programs.

IWH conducted a systematic review to summarize the existing scientific literature on the effectiveness of MSD prevention programs for health-care workers.

The findings and recommendations from this review will be of interest to those involved in health and safety issues in health-care settings, including health-care workers, managers, policy-makers, unions researchers and others.

As a part of the "Effective Continuing Professional Development for Translating Shared Decision Making in Primary Care" project funded by the Canadian Institutes for Health Research we are pleased to post our inventory of programs and training activities dedicated to shared decision making. This inventory is a detailed list of international training activities from around the world, designed for all kinds of healthcare professionals. The activities teach professionals about shared decision making and help them integrate the approach into their daily practice.

Nursing is a physically and mentally demanding profession.

Add in the stress of a high-paced, chaotic emergency department (ED), and it's quite clear that emergency nurses benefit greatly from resources at their fingertips that generate efficiencies and assist in the delivery of quality patient care.

Yet there is a glaring problem that often makes it difficult for ED nurses to perform at the highest possible level: great disparities in nurse educational standards and clinical practices.

When nurses join new facilities, they are often at a loss as to their new ED's procedures and protocols, leading to internal problems such as communication breakdowns, workflow and throughput inefficiencies, clinical errors and low staff morale.
 

Health Council of Canada Commissioned Discussion Paper

In this paper, we assess Canada’s current system of post-market surveillance and outline several
recent initiatives in this country.We also examine in detail the approaches adopted in other
jurisdictions that are taking steps to improve pharmacovigilance.Our examination of drug safety
regimes in the European Union (EU), the United States (US), the United Kingdom (UK),
New Zealand, and France identified important issues with respect to governance, funding,
independence and research standards, transparency, data access and ownership, and public
oversight that are relevant to Canada. A comparison of international approaches highlights
the strengths and weaknesses of these strategies relative to our own situation. The key issues
that need to be addressed to enhance public safety and confidence in pharmaceuticals in
Canada are discussed.

Founded in January 2007, Knowledge Mobilization Works is a consulting and training company based in Ottawa, Canada. We are dedicated to helping individuals and organization move what is collectively known into what we do. Our goal is simple: help make better decisions to produce better outcomes.

We define knowledge mobilization as the complex process of making knowledge ready for service or action to create new value and benefits. The concept of “readiness” is recognition that while data and information can be analyzed by machines and presented in various ways, for this analysis to become knowledge, the content requires a social life with feedback loops that support the adaptation to variations in contexts, capacities of individuals and organizations, and cultures (both social and institutional).

We offer a range of services that are combined in ways that best support each of our clients. Our CFIT model brings together consulting, facilitation, imagination, and training into comprehensive and customized packages that meets the needs of each client to improve their specific condition. From our perspective, the client is always at the centre of what we do.

Welcome to the KS Canada / SC Canada website - the home of Canada's primary network of researchers, health professionals, trainees and other stakeholders all engaged in knowledge synthesis.

KS Canada is proud to announce the launch of Systematic Review Protocol Registration! This international initiative will be officially launched on February 18, 2011 in Vancouver, BC. For more details please see the following flyers: Registering Systematic Review Protocols (English PDF) or Enregistrement des revues systematiques (Français PDF).
Complete this form to register it is FREE 

The Heart and Stroke Foundation of Canada (HSFC) has developed this guide to outline our approach to Knowledge Transfer and Exchange (KTE). The Guide is a working draft and will evolve with our understanding of how best to integrate KTE in our research programs. The Guide outlines:

•  HSFC’s definition of KTE;
•  requirements for KTE plans within grant applications for strategic initiatives;
•  key factors that reviewers may consider when assessing KTE plans; and
•  additional KTE-related resources.

The information provided in this Guide is meant to give an overview of KTE, from an HSFC perspective, and provide some helpful hints and additional resources related to KTE.

Although the focus of this Guide is on KTE within HSFC strategic funding initiatives, we encourage KTE in all research supported by the Foundation.

This KT casebook, the third in a series produced by Alberta Innovates – Health Solutions,
acknowledges research and innovation initiatives across the broad spectrum of health in Alberta. While the research involves different populations, stakeholders, and settings, the results highlight the strength and diversity of knowledge translation in the province.

A critical component of the knowledge translation process is dissemination or communicating the results of research projects. This dissemination or end-of-grant KT is often targeted to academia and other researchers and does not always lead to the successful uptake of research evidence into policy and practice.

The projects in this casebook concentrate on integrated KT, recognizing the importance of actively engaging potential end-users of research such as clinicians, policy-makers, and the public, throughout the research process. This method is collaborative, participatory, and focuses on reaching the widest possible audience.

Knowledge derived from research and experience may be of little value unless it is put into practice. As a way of thinking about this challenge and how to start closing the “know-do” gap, the process of knowledge translation has emerged. It is defined as “the synthesis, exchange, and application of knowledge by relevant stakeholders to accelerate the benefits of global and local innovation in strengthening health systems and improving people’s health.” Given the broad scope of this challenge, both in general and specifically in regard to ageing and health, the World Health Organization’s Department of Ageing and Life Course has developed a guiding framework for the application of knowledge translation to ageing and health.

The objective of this framework is to assist policy- and decision -makers in integrating evidence-based approaches to ageing in national health policy development processes, specific policies or programmes addressing older population needs and other health programmes concerned with such issues as HIV, reproductive health, chronicle diseases etc.

The framework provide guidance through all the elements necessary for the transfer of knowledge and evidence into the policy development process. It can be used as a checklist in a situation analysis or in the planning process; and it may also serve as as a background document to inform decisions about existing conditions for knowledge transfer.

Knowledge translation (KT), transfer and exchange, transfer, diffusion, mobilization, health innovation or commercialization, are all terms that have been used to describe the complex set of activities involved in advancing knowledge generated from research into effective changes in health policy, practice, or products. KT strategies are varied and might include presentations to non-academic stakeholders, brochures, summary reports, roundtable discussions or face–to-face meetings. The list of evidence-based KT strategies is growing steadily.

As part of MSFHR's commitment to supporting the use of health research to improve health (knowledge translation, or KT), an online survey was launched in March 2012 to identify resource and training needs related to the use of health research evidence in practice and policy across the province.

The Health Systems Research Centre (HSRC) in the Department of Management Science is a grouping of management scientists with a common interest in the development and application of management science/operational research methods, quantitative and qualitative, to important health systems issues. Whilst the health systems research issues tackled are wide and varied, many of them relate to the general challenges of helping health systems to make better use of available resources, in terms of both improving efficiency and improving patient experiences. Much of it concerns Knowledge Transfer, be it between researchers and practitioners, between industry and healthcare, or between the health systems of different countries.

These free self assessment tools can help individuals identify where their leadership strengths and development needs lie, to assist with personal development.

Consisting of a short questionnaire for each domain, you will also find a personal development plan template included. There are three versions of the self assessment tool available
 

View the latest rounds, clinical announcements and educational presentations created by PHSA agencies in the PHSA Webcast Catalogue (Mediasite).

The PHSA Webcast Catalogue showcases the Webcasting Service provided by our Media Production & Services. The Webcasting Service uses Mediasite to capture live events along with audio, video and any computer presentations (such as PowerPoint) for viewing live or on demand via the web.
 

On Sunday, 30 September, a debate began on Twitter – later dubbed #Twittergate – about the etiquette and ethics of live-tweeting academic conferences. Summarising the crux of the matter, journalist Steve Kolowich later writes: "Scholars often present unpublished work at conferences. But while they may be willing to expose an unpolished set of ideas to a group of peers, academics may be less eager to have those peers turn around and broadcast those ideas to the world".

Both the ‘green’ and the ‘gold’ models of open access tend to preserve the world of academic journals, where anonymous reviewers typically dictate what may appear. David Gauntlett looks forward to a system which gets rid of them altogether.

Every week there’s something new in the open access debate. A couple of weeks ago the Finch report concluded that all publicly-funded research should indeed be made available free online (hurray!). But it favoured the so-called ‘gold’ model of open access, in which the highly profitable academic journal industry carries on as normal, but switches its demand for big piles of cash away from library journal subscriptions and over to authors themselves – or their institutions (boo!). Campaigners such as Stevan Harnad questioned why the Finch committee had not favoured the ‘green’ model, where authors put copies of their articles in free-to-access online repositories – the answer being, it was assumed, a successful blitz of lobbying by the publishing industry.

Canadian Academy of Health Sciences.

Twenty‐three different organizations sponsored this assessment. They all share an interest in defining the impacts of health research and learning how to improve the returns on investments in health research. Our remit from these sponsors was: Is there a “best way” (best method) to evaluate the impacts of health research in Canada, and are there “best metrics” that could be used to assess those impacts (or improve them)? Based on our assessment, we propose a new impacts framework and a preferred menu of indicators and metrics that can be used for evaluating the returns on investment in health research.

The government wants to place patients’ needs, wishes and preferences at the heart of clinical decision-making, a vision articulated by the Secretary of State for Health, Andrew Lansley, in the phrase ‘nothing about me, without me’. But what does this mean in practice?

Making shared decision-making a reality: No decision about me, without me aims to answer that question. It clarifies what is meant by the term shared decision-making and what skills and resources are required to implement it and it also outlines what action is needed to make this vision a reality.

Change management (CM) is foundational to achieving effective and efficient use of information and communications technologies (ICT) for health. Successful change implementation results in solution adoption and other long-term benefits such as improved patient care and positive organizational impacts. Success occurs when the systems, processes, tools and technology of the change initiative are embedded in the new way clinicians do their everyday work. CM is an essential driver of adoption, realizing many benefits of health ICT initiatives across Canada.

Recognizing this, Infoway has established and supports the Pan-Canadian Change Management Network, a grassroots collaborative of change management leaders that has come together to develop and guide leading practices in change management for health ICT projects.

There are few academics who are interested in doing research that simply has no influence on anyone else in academia or outside. Some perhaps will be content to produce ‘shelf-bending’ work that goes into a library (included in a published journal or book), and then over the next decades ever-so-slightly bends the shelf it sits on. But we believe that they are in a small minority. The whole point of social science research is to achieve academic impact by advancing your discipline, and (where possible) by having some positive influence also on external audiences - in business, government, the media, civil society or public debate.

Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems. Health Systems Evidence also contains a continuously updated repository of economic evaluations in these same domains, descriptions of health system reforms, and descriptions of health systems, as well as a variety of types of complementary content (e.g. World Health Organization documents about health systems).

Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems.