CDM was launched in Fraser Health in July 2010, with plans to implement the model across all residential care beds in the Health Authority. The model consists of three inter-related aspects: staff mix, funding methodology and direct care hours. CDM sets a goal of reaching 3.36 direct care hours per resident per day across Fraser Health by targeting residents, their families and staff in residential care programs in FH-operated facilities. The evaluation project will examine Phase 1 of the implementation of CDM (July 2010 to January 2011) and will include monitoring funding indicators as well as quality of care indicators.
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Evaluation of Collaborative Practice Project
The focus of this evaluation program will be the impact of Collaborative Practice on three residential facilities: Banfield Pavilion, Evergreen House and Minoru Residence. Collaborative Practice Program has two key characteristics: 1) it is an approach to matching staff to patient needs through participation of nurses, unions, professional practice and clinical and operational leaders; 2) it promotes a team-oriented model of nursing care. The purpose of the evaluation will be to assess and compare the impact of the program at these three sites on health human resources and patient outcomes.
The evaluation of Collaborative Practice will include six main areas of focus:
- impact on clinical outcomes
- impact on health human resources
- nursing staff engagement
- consistent collaborative approach to care
- impact on clinician roles
- productivity
Advance Care Planning Evaluation in Hospitalized Elderly Patients
The primary purpose of this study is to evaluate Advance Care Planning (ACP) to determine from the patient and families’ perspectives, the prevalence of ACP, satisfaction with end of life (EOL) communication and decision-making, and to enable local or regional teams to develop and implement specific action plans aimed at increasing the quality and quantity of ACP efforts specifically, and the overall quality of EOL care in general.
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Why are so many patients dissatisfied with knee replacement surgery? Exploring variations of the patient experience
The purpose of this research is to determine why such high numbers of patients – up to 1 in 5 – who undergo knee replacement surgery are dissatisfied with the outcomes of their surgery. Total Knee Arthroplasty (TKA), is the most requested joint replacement surgery in Canada, and will continue to increase in response to the needs of an aging population. A greater understanding of the variations in patient outcomes, and the factors that contribute to the dissatisfaction rate, will inform surgical program planning and help to standardize procedures and services to achieve better outcomes.
Evidence Values and Priority Setting Methods in Cancer Control
The overarching goal of this study is to develop a framework to combine evidence and public values to set priorities for cancer control programs (including prevention, screening, treatment and palliative/supportive care). Its objectives are to: (a) develop better methods for identifying, interpreting and applying evidence in different cancer control decision-making contexts; and (b) better understand if, when, and how public engagement and public values should play a part in priority setting processes for cancer control.
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Studies Towards the Total Synthesis of Eleutherobin and Designed Analogues for Cancer Therapy
Cancer is one of the leading causes of death among Canadians, and therefore the identification of new cancer therapies is of great importance. To that end, researchers have found that the structurally diverse defence chemicals provided by sessile marine organisms offer great potential in the fight against cancer. In fact, in the past decade more than 30 natural products isolated from marine sources have entered preclinical and clinical trials as potential treatments for cancer. However, it is rarely ecologically or economically feasible to obtain the active ingredient by harvesting the natural source. Fortunately, synthetic organic chemistry – where molecules are fabricated in the laboratory through a series of chemical transformations – can serve as an alternative source of these compounds. Eleutherobin was originally isolated from a rare soft coral located of the coast of Western Australia in 1997, and in preliminary tests it has shown many promising anti-cancer properties. In fact, taxol, a member of the same class of agents, has already been used to treat more than one million patients suffering from advanced breast and ovarian cancers. Over the past two years, Jeffrey Mowat has spearheaded research centered on the development of a concise synthesis of eleutherobin and analogues of this substance as candidates for cancer treatment. However, so far, eleutherobin's preclinical evaluation has been hampered by lack of material from the natural source or chemical synthesis. Mr. Mowat's current research project addresses this situation through the development of a synthetic strategy that would significantly reduce the number of steps required to access eleutherobin and facilitate its preclinical evaluation. His research also provides a venue for the construction of analogues of eleutherobin, the biological evaluation of which may well lead to the discovery of new, improved antimitotic drugs for cancer therapy.
Development of Clinical Standards of Care for Huntington disease Intermediate Allele Predictive Test Results
Predictive testing for Huntington disease (HD) has been available since 1986. This genetic test has the ability to ‘predict’ whether individuals will develop HD in their lifetime and possibly pass the disease onto their children. Some individuals who undergo predictive testing receive an unusual test result, called an ‘intermediate allele’ (IA), which differs from a gene positive or negative result. While individuals with an IA will never develop HD themselves, there remains a risk that their children or grandchildren could subsequently develop the disorder. Currently, knowledge gaps exist with respect to IA for HD. Specifically, the current International Predictive Testing Guidelines do not address the possibility of this result, nor are the complexities surrounding this result acknowledged in the literature. Alicia Semaka’s research, which is the largest empirical study on HD IAs to date, will not only address these gaps, but also inform the development of clinical standards of care for communicating IA results during predictive testing. The specific objectives of Ms. Semaka’s research are to determine the prevalence of IAs in British Columbia’s general population; determine quantified risk estimates for the likelihood that an individual with an IA will have a child who will develop the disease in their lifetime; and lastly, describe the psychological and social impact of receiving an IA result. Collectively, the three objectives of this unique, multidisciplinary study will provide the foundation for the development of clinical standards and practice recommendations for IA predictive test results. These standards will help ensure that this subset of patients receive appropriate information, support, education and counselling throughout the predictive testing process.