The task of providing high quality care has become increasingly difficult as pressure mounts on both the funding and demand side of the provision equation. This challenge is particularly acute for health leaders caring for a growing elderly population in an already strained system. While our senior patient populations consume more expensive acute healthcare resources with higher frequency, they are also more likely to experience negative outcomes in these venues of care and often prefer to remain in their homes for as long as possible.
The Economic Learning Health System (eLHS) is a framework designed to guide continuous improvement and optimization of limited health care resources to achieve the highest possible quality of care for patients. This research project is aimed at applying this framework to the challenge of caring for seniors in British Columbia. Anticipated outcomes include an analytic infrastructure that will quantify care needs, simulate potential innovations to address these needs, and determine the most sustainable path to caring for our seniors now and in the future.
This project was funded by the Health System Impact Fellowship from CIHR, and is being conducted in partnership with the BC Ministry of Health. The fellow leading this project is Dr. William Hall – a health economist trained at UBC and creator of the eLHS framework. He will be working with Dr. Michael Law from the Centre for Health Services and Policy Research, and Christine Voggenreiter from the BC Ministry of Health.
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Lead exposure is an ongoing public health concern due to the association with cognitive deficits and neurodevelopmental disorders, particularly in children and infants. While several vectors of exposure (lead-containing paints and toys) have been reported, the prevalence of elevated blood lead levels has decreased over time with growing awareness. Nevertheless, contaminated drinking water has persisted as an important vector, especially in North America, where the most common source of lead is corrosion of plumbing materials, including lead services lines, brass fixtures and fittings, solders, and galvanized steel pipes. Striving to provide safe drinking water to its residents, British Columbia (BC) adopted Health Canada’s maximum acceptable concentration, 5 ug/L, in 2020. However, longitudinal data on lead exposure in water is limited in time and through consistent sampling approaches. The lack of consistent data represents a critical barrier to understanding the lead burden that is contributed from drinking water, thereby delaying appropriate prioritization of this exposure source for British Columbians, and limiting the implementation of mitigation strategies. The goal of this work is to provide the BC Ministry of Health with a comprehensive report of lead in drinking water in BC. This report will outline the risks associated with exposure and will seek to:
- Identify areas of concern.
- Determine whether concentrations are related to infrastructure (i.e. building specific, distribution materials), or water quality (e.g. pH, alkalinity, NOM) and treatment (e.g. corrosion control, disinfection).
- Use novel analytics to diagnose the source of lead in select water samples.
- Provide recommendation for remediation strategies where appropriate.
The expected deliverable is an extensive report of the above to foster evidence-based decision making.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Many types of healthcare professionals are legally regulated, meaning there are specific legal rules about the types of healthcare activities that they can do. This is to protect patients and the public from harm and to have a way to hold healthcare professionals accountable if they are practicing irresponsibly or inappropriately. Genetic counsellors are specialized healthcare providers who help patients and their families understand and adapt to the medical and psychological impacts of genetic conditions. Genetic counselling is a relatively new area of healthcare and there are not very many genetic counsellors in British Columbia. Because of this, genetic counsellors are not legally regulated at this time. To be able to explore the options for legal regulation of genetic counsellors in British Columbia, we need to better understand exactly what types of healthcare activities genetic counsellors do. To get this information, we plan to survey genetic counsellors to ask them which healthcare tasks are part of their jobs and if they expect that this will change in the future. We hope that this information can be used to decide when and how to legally regulate genetic counsellors in British Columbia to improve the safety of and access to clinical genetic services in the province.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
The early years are a critical time when physical and social development occurs. Children’s experiences during that period shape their behaviors, their learning capacity, and set their health, emotional, socioeconomic trajectories A recent report on the health and well-being of children in BC revealed profound disparities in sex, gender, geography, or data availability. The latter concerns population-level data and linked databases availability. Plus, the absence of a reproducible process to merge databases using a unique common identifier undermines the efforts to analyze and provide evidence for the wellbeing of children in BC.
This proposal seeks to explore a sustainable partnership-based model for connecting health population-level data to health care policymaking and health care delivery decision-making. The specific objectives are:
- Build a co-produced partnership-based process for interconnecting health care policy, decision making, population health monitoring, research, and health care delivery.
- Use a collaborative approach to identify critical questions and analyze relevant health policy, research, and practice priorities.
- Support the development of a monitoring and surveillance system for healthy child development that follows key child development indicators over time.
This research program will formalize a strong partnership and a replicable process on data analysis between the BC Ministry of Health and the Human Early Learning Partnership, a School of Population and Public Health research unit. This process will also enable a monitoring and surveillance system of key indicators of the children’s health and wellbeing. Finally, this work will lay the foundations to create linked health and social databases from other ministries to inform policy and substantially reduce current disparities in BC.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
In late 2020, the Government of British Columbia committed to a policy of free contraception for all. This first-in-Canada policy presents an opportunity to address the cost barrier that limits access to contraception, and to understand and address how other identity factors like race, ethnicity, religion, age, and ability intersect with gender to affect the experience of contraceptive access. The goal of this project is therefore to use a gender and diversity lens called Gender-Based Analysis Plus (GBA+) to support the planning, implementation and evaluation of free contraception policy and programs in BC. Specifically, a family planning researcher will work with the BC Ministry of Health to engage with stakeholders about the impact of free contraception on communities known to face various barriers to safe and appropriate contraception care. Stakeholder engagement will be complemented by reviews of the relevant scientific evidence as well as invited presentations from researchers doing work connected to gender, diversity, and contraception. In alignment with the Ministry mandate to provide free contraception for all and addressing systemic discrimination, the results will be shared with policy makers to inform decisions about free contraception policies and programs and will be used to inform templates and guidelines for future GBA+.
Source: CIHR Funding Decisions Database
This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the BC Ministry of Health (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.
Consistent access to high-quality family medicine improves the health of the population and lowers the costs of health care. Reports of family medicine shortages and of difficulties in accessing family physicians are ubiquitous in British Colombia (BC). To address shortages and access challenges, the Ministry of Health needs a clear understanding of how many active family doctors are working within provincial borders, how many are providing comprehensive and patient-centered care, how they structure their practices, and how patients access (or do not access) the services they provide.
The Ministry also needs a method to accurately estimate the future supply of family physicians and services in order to proactively design and implement policies that will address upcoming accessibility issues. These challenges are particularly salient given the upcoming rollout of team-based care across the province.
To address these issues, this fellowship will integrate the results of several ongoing studies into a strategy for proactive physician workforce planning, supporting recruitment and retention efforts and the development and evaluation of new models of family medicine practice. It will provide granular data on the supply of comprehensive care, identify current and future gaps, and inform policy on training, recruitment and retention of family physicians. Ultimately, it will enhance the capacity for evidence-informed workforce planning within BC’s Ministry of Health, leading to downstream improvements in access to family medicine across the province.
In 2010, the Patients as Partners Initiative of the British Columbia (BC) Ministry of Health began work to improve the BC healthcare system by partnering with patients to empower patients and to develop and support the implementation of sustainable healthcare policies. This quality improvement initiative provides leadership, strategy, policy, collaboration, and funding to bring patient voice, choice, and representation to the forefront of the health sector.
This initiative's spectrum of patient engagement activities is performed across many projects using the International Association of Public Participation (IAP2) approach of inform, consult, involve, collaborate and empower at the individual, community, and health system levels. A small but growing number of publications cover the principles, measurement, and evaluation of patient engagement in various aspects of the healthcare system. But to date, no measures or quality indicators have been validated to assess the outcome and impact of patient engagement activities. Further research is vital to providing evidence-informed tools to quantitatively evaluate both the impact of integrating the patient/public perspective into planning, policy and services of BC's healthcare system and the impact that engagement is having on health outcomes.
The overall aim of this project is to identify, validate, and implement quality indicators of patient engagement at the individual, community, and system level within the Patients as Partners Initiative by the BC Ministry of Health. This will be conducted in a three-phase study: 1) a scoping review will identify key quality indicators from the published and grey literature; 2) a Delphi study with a 20-member panel of key stakeholders will validate the identified indicators; and 3) a stakeholder consultation workshop will facilitate creation of a plan to pilot test and routinely collect the quality indicator to measure and evaluate the success of patient engagement.
