Much has been made over the past fifteen years about the actual or impending shortage of physicians in Canada. The aging of the patient population increases the need, while the aging of the physician population reduces the supply. Recent dramatic increases in the number of medical students being trained in Canada should go some distance in addressing supply concerns. Less well-understood is the potential effect of changes in physicians’ decisions about when, and how quickly, to retire. Despite the fact that retirement decisions can have a large influence on the total available supply of physicians, surprisingly little is known about those decisions. The purpose of this project is to fill in some of those gaps in our understanding.
Continue reading “Exit Strategies: The Timing and Impacts of Physician Retirements”
The study addresses the burden of pediatric asthma in BC and the value a short course of oral steroids provides in reducing the acute care burden of asthma. The goal is to implement and evaluate an intervention to reduce the acute care burden of asthma exacerbations.
Continue reading “Reducing the Acute Care Burden of Childhood Asthma on Health Services in British Columbia”
After graduation from medical school, physician education continues in a residency program in the individual's chosen area of specialty (e.g., Surgery, Internal Medicine). Residency programs have grueling schedules with frequent on-call shifts. These shifts are at least 24 hours in length, starting from the morning of one day and extending to the next day. In teaching hospitals, residents often provide first line care and make important decisions independent of direct supervision. Their clinical performance is thus an important determinant of patient safety. Some have argued that shift length should be reduced to a more reasonable amount (e.g. <16 continuous hours) to reduce fatigue and medical errors, and to improve safety.
Continue reading “The Impact of a Resident Work Schedule Change on Patient Safety”
Adverse Drug Related Events (ADREs) are the most common type of preventable non-surgical adverse event related to medical care, and represent a leading cause of death. Each year, in BC alone, Emergency Departments treat an estimated 130,000 patients for ADREs, most of which are caused by medications prescribed in community settings. Unfortunately, community-based programs aimed at detecting and reducing drug-related problems have not led to a significant decline in morbidity, mortality or health services utilization. Emergency Department practitioners are well situated to play a pivotal role in the timely recognition and treatment of community-based ADREs. Unfortunately, Emergency Physicians currently detect only 50% of ADREs, missing opportunities to intervene.
Continue reading “Development of a screening strategy for community-based adverse drug related events in the emergency department”
Social pediatrics is a model of practice that places specific emphasis on the importance of the relationship between the practitioner and the child as well as focuses on family and community engagement as vital to the ways in which care is provided. Moreover, it is located in the child’s community and seeks to ensure care is accessible and responsive to the child and family’s health needs. To date, little is known about the processes needed to implement a social pediatrics model of practice within the current structure of the health system.
Continue reading “Social Pediatrics: A Responsive Interdisciplinary Coordinated Health [RICH] Model for Timely Accessible Services for At-Risk Families”
The Canadian Academic Detailing collaboration (CADC) includes academic detailing (AD) programs that routinely reach over 1,000 physicians in six provinces. They deliver evidence-based, independent information on optimal prescribing practices to physicians through one-on-one or small group visits. As the health system continues to face drug safety controversies and escalating costs of chronic disease, AD holds promise for providing physicians timely access to information and tools for better prescribing and case management. While there is evidence of AD effectiveness in special research projects, rigorous evidence is lacking of real-world impacts of ongoing AD programs.
Continue reading “Partnership for Ongoing Impact Assessment of Academic Detailing”
Influenza is a major cause of morbidity and mortality in Canada. Community attack rates range from 10 to 20 percent, but can be more than 50 percent in closed settings such as residential care facilities or schools. In BC, influenza vaccine is provided free to hose at increased risk of severe disease and/or death from influenza infection, including the elderly and people with chronic health conditions. Despite access to free vaccine, adult immunization rates in the eligible population remain too low.
Continue reading “Pharmacy Immunization Community Strategy”
Despite the recent increase in research activity to study multidisciplinary collaboration in primary healthcare teams, there has been a paucity of research focusing on building collaborative relationships between primary care (Family Health Teams, Family Health Networks, and Community Health Centres) and public health. Nurses, including public health nurses, family practice nurses and nurse practitioners, are in a strong position to act as leaders in building collaboration between primary care and public health to meet local community health needs.
Continue reading “Primary Health Care Leadership: Enhancing Collaboration between Primary Care and Public Health”
The goal of this study is to ensure patients with cancer and other fatal illnesses receive the right kind of end-of-life care at the right time and in the right place. For this to be possible, it is essential to improve the ability of clinicians to accurately assess how long these patients will live because their expected length of survival is a key factor in determining the types of care they will receive. In a research project involving one palliative care program in BC and two in Alberta, this team is assessing the extent to which health data that is collected routinely during initial and follow-up assessments can improve the accuracy of survival estimates.
Continue reading “Timely Access to End-of-life Care for Patients with Life-threatening Illness”
To evaluate the effectiveness of a three-year BC pilot of “Do Bugs Need Drugs?”, a public and professional education program developed to reduce antibiotic use and the spread of resistant organisms.
Continue reading “Changing Prescription Practices to Limit Selection for Resistant Organisms: A Population and System Approach”
