Evaluation of the Enhanced Seniors Team Initiative

Primary Investigators: Katy Mukai and Dr. Ann Holyrood

The Enhanced Seniors Team (EST) is an initiative under the Care Continuum Transformation Project (CCT) that the Vancouver Island Health Authority (VIHA) launched at Nanaimo Regional General Hospital. The EST focuses on improving care for frail, at-risk older adults being seen in the Emergency Department (ED). The aim of the EST is to initiate early, goal-directed care planning and evidence-based interventions to prevent cognitive and functional losses associated with acute illness among hospitalized older patients. The team collaborates with the medical and surgical unit teams to achieve patient goals, decrease hospital length of stay and improve transition to home. The interdisciplinary EST includes a case manager who helps reduce unnecessary hospital admissions by providing referrals that increase access to community-based services and resources.

The health authority wishes to evaluate the impact of the EST in Nanaimo in order to inform implementation of the model in other VIHA hospitals.

Evaluation of the Integration of Nurse Practitioners into the BC Healthcare System

The nurse practitioner (NP) role is new to BC and its impact has yet to be evaluated. The proposed multi-year study will evaluate a practice innovation – the integration of NPs into the BC healthcare system, and will establish a framework for sustainable ongoing evaluation of the impact of NP practice on those they serve and the health care system. The study process will be divided into three parts addressing the following broad questions:

  1. What changes result for patients, and what are the implications for the health care system when NPs become part of the care process?
  2. What is the impact of adding a NP to the functioning of collaborative health care teams?
  3. What are the practice settings and scope of practice of NPs working in BC?

The final work of the project team will be to use the study findings to develop an ongoing evaluation method for future data collection and evaluation of NPs’ practice and impact.

Evaluation of the Residential Program Care Delivery Model

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.

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

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.

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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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Utilization of an Interactive Internet-based Platform for Managing Chronic Diseases at a Distance

Chronic diseases represent an increasing burden for both the patient and healthcare system. Many people also now have more than one chronic disease. For those people with chronic diseases living in rural areas, the risk for hospitalization is more than 60% greater. These patients and their primary care providers face an enormous challenge in meeting their day-today health needs that patients with chronic diseases have.

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Leadership and Health System Re-Design

The purpose of this initiative is to develop leadership capacity in the Canadian health care system. This will be done by identifying and addressing gaps in applied research and practical knowledge within and between the researcher and decision-maker communities. These individuals will be brought together as networks so they can better understand and learn from each other. The networks (one national and five regional nodes) will carry out research on how to identify and apply the qualities of effective leadership in regional settings across Canada and how to adapt the knowledge learned into professional development and degree programs offered in those regions.

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