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Aboriginal community alcohol harm reduction policy (ACAHRP) project: a vision for the future.

https://arctichealth.org/en/permalink/ahliterature159852
Source
Subst Use Misuse. 2007;42(12-13):1851-66
Publication Type
Article
Date
2007
Author
Louis Gliksman
Margaret Rylett
Ronald R Douglas
Author Affiliation
Social, Prevention & Health Policy Research Department, Centre for Addiction & Mental Health, London, Ontario M5S 2S1, Canada. louis_gliksman@camh.net
Source
Subst Use Misuse. 2007;42(12-13):1851-66
Date
2007
Language
English
Publication Type
Article
Keywords
Alcoholism - prevention & control
Harm Reduction
Health Policy
Health Surveys
Humans
Ontario
Organizational Case Studies
Ownership
Population Groups
Abstract
Four First Nation communities in Ontario, Canada, formulated alcohol management policies between 1992 and 1994. An alcohol management policy is a local control option to manage alcohol use in recreation and leisure areas. Survey results indicate that decreases in alcohol use-related problems related to intoxication, nuisance behaviors, criminal activity, liquor license violations, and personal harm were perceived to have occurred. Furthermore, having policy regulations in place did not have an adverse effect on facility rentals. Band administrators and facility staff in each community felt the policy had had a positive effect on events at which alcohol was sold or served.
PubMed ID
18075913 View in PubMed
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Accountability, responsiveness and quality for clients model of home support: a model for improved home support services to promote aging at home.

https://arctichealth.org/en/permalink/ahliterature146209
Source
Healthc Pap. 2009;10(1):65-71; discussion 79-83
Publication Type
Article
Date
2009
Author
Judy Kelly
Alison Orr
Author Affiliation
Vancouver Coastal Health.
Source
Healthc Pap. 2009;10(1):65-71; discussion 79-83
Date
2009
Language
English
Publication Type
Article
Keywords
Aged
British Columbia
Health Services for the Aged - organization & administration
Home Care Services - organization & administration
Humans
Organizational Case Studies
Population Dynamics
Social Support
Abstract
As the proportion of older adults increases within the Canadian population, healthcare systems across the country are facing increased demands for home-based services, including home care nursing, rehabilitation, case management, adult day programs, respite, meal programs and home support. Home support is one of the core care services required in the community to enable older adults to remain at home as long as possible. In 2006, Vancouver Community introduced a new home support delivery and performance management model: the Accountability, Responsiveness and Quality for Clients Model of Home Support (ARQ Model) (VCH 2006). The main components of the ARQ Model are an expanded use of "cluster care" along with stable monthly funding for high-density buildings and neighbourhoods; the introduction of specific monthly and quarterly quality performance reporting; and the implementation of performance-based funding for home support. This article discusses the setup of the ARQ model, its ongoing evaluation and results achieved thus far.
PubMed ID
20057219 View in PubMed
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Achieving environmental excellence through a multidisciplinary grassroots movement.

https://arctichealth.org/en/permalink/ahliterature146381
Source
Healthc Manage Forum. 2010;23(4):144-55
Publication Type
Article
Date
2010
Author
Bryan Herechuk
Carolyn Gosse
John N Woods
Author Affiliation
Quality Planning & Performance Improvement Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada. bherechu@stjoes.ca
Source
Healthc Manage Forum. 2010;23(4):144-55
Date
2010
Language
English
French
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Conservation of Natural Resources
Humans
Ontario
Organizational Case Studies
Organizational Innovation
Organizational Objectives
Social Responsibility
Abstract
St. Joseph's Healthcare Hamilton (SJHH) supports a grassroots green team, called Environmental Vision and Action (EVA). Since the creation of EVA, a healthy balance between corporate projects led by corporate leaders and grassroots initiatives led by informal leaders has resulted in many successful environmental initiatives. Over a relatively short period of time, environmental successes at SJHH have included waste diversion programs, energy efficiency and reduction initiatives, alternative commuting programs, green purchasing practices, clinical and pharmacy greening and increased staff engagement and awareness. Knowledge of social movements theory helped EVA leaders to understand the internal processes of a grassroots movement and helped to guide it. Social movements theory may also have broader applicability in health care by understanding the passionate engagement that people bring to a common cause and how to evolve sources of opposition into engines for positive change. After early successes, as the limitations of a grassroots movement began to surface, the EVA team revived the concept of evolving the grassroots green program into a corporate program for environmental stewardship. It is hard to quantify the importance of allowing our staff, physicians, volunteers and patients to engage in changes that they feel passionately about. However, at SJHH, the transformation of a group of people unsatisfied with the organization's environmental performance into an 'engine for change' has led to a rapid improvement in environmental stewardship at SJHH that is now regarded as a success.
PubMed ID
21739814 View in PubMed
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Acting on audit & feedback: a qualitative instrumental case study in mental health services in Norway.

https://arctichealth.org/en/permalink/ahliterature295007
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
01-31-2018
Author
Monica Stolt Pedersen
Anne Landheim
Merete Møller
Lars Lien
Author Affiliation
Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.B. 104, 2340, Brumunddal, Norway. monica.stolt.pedersen@sykehuset-innlandet.no.
Source
BMC Health Serv Res. 2018 01 31; 18(1):71
Date
01-31-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Benchmarking
Evidence-Based Practice
Feedback
Health Personnel
Humans
Medical Audit
Mental Disorders - rehabilitation - therapy
Mental Health Services - organization & administration - standards
Norway
Organizational Case Studies
Qualitative Research
Quality Improvement
Abstract
The National Guideline for Assessment, Treatment and Social Rehabilitation of Persons with Concurrent Substance Use and Mental Health Disorders, launched in 2012, is to be implemented in mental health services in Norway. Audit and feedback (A&F) is commonly used as the starting point of an implementation process. It aims to measure the research-practice gap, but its effect varies greatly. Less is known of how audit and feedback is used in natural settings. The aim of this study was to describe and investigate what is discussed and thematised when Quality Improvement (QI) teams in a District Psychiatric Centre (DPC) work to complete an action form as part of an A&F cycle in 2014.
This was an instrumental multiple case study involving four units in a DPC in Norway. We used open non-participant observation of QI team meetings in their natural setting, a total of seven teams and eleven meetings.
The discussions provided health professionals with insight into their own and their colleagues' practices. They revealed insufficient knowledge of substance-related disorders and experienced unclear role expectations. We found differences in how professional groups sought answers to questions of clinical practice and that they were concerned about whether new tasks fitted in with their routine ways of working.
Acting on A&F provided an opportunity to discuss practice in general, enhancing awareness of good practice. There was a general need for arenas to relate to practice and QI team meetings after A&F may well be a suitable arena for this. Self-assessment audits seem valuable, particular in areas where no benchmarked data exists, and there is a demand for implementation of new guidelines that might change routines and develop new roles. QI teams could benefit from having a unit leader present at meetings. Nurses and social educators and others turn to psychiatrists or psychologists for answers to clinical and organisational questions beyond guidelines, and show less confidence or routine in seeking research-based information. There is a general need to emphasise training in evidence-based practice and information seeking behaviour for all professional groups.
Notes
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PubMed ID
29386020 View in PubMed
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Adaptation and implementation of the nurse-family partnership in Canada.

https://arctichealth.org/en/permalink/ahliterature128390
Source
Can J Public Health. 2012;103(7 Suppl 1):eS42-8
Publication Type
Article
Date
2012
Author
Susan M Jack
Dianne Busser
Debbie Sheehan
Andrea Gonzalez
Emily J Zwygers
Harriet L Macmillan
Author Affiliation
School of Nursing, McMaster University, Hamilton, Ontario. jacksm@mcmaster.ca
Source
Can J Public Health. 2012;103(7 Suppl 1):eS42-8
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Child, Preschool
Feasibility Studies
Female
Home Care Services - organization & administration
Humans
Infant
Maternal-Child Nursing - organization & administration
Models, Nursing
Models, organizational
Ontario
Organizational Case Studies
Pilot Projects
Pregnancy
Professional-Family Relations
Program Evaluation
Public Health Nursing - organization & administration
Qualitative Research
Vulnerable Populations
Young Adult
Abstract
International agencies are required to adapt, pilot and then evaluate the effectiveness of the Nurse-Family Partnership (NFP) prior to broad implementation of this public health intervention. The objectives of this qualitative case study were to: 1) determine whether the NFP can be implemented in Canada with fidelity to the US model, and 2) identify the adaptations required to increase the acceptability of the intervention for service providers and families.
108 low-income, first-time mothers in Hamilton, Ontario, received the NFP intervention. In-depth interviews were conducted with NFP clients (n=38), family members (n=14) and community professionals (n=24).
Hamilton, Ontario.INTERVENTION AND DATA COLLECTION: An intensive nurse home visitation program delivered to women starting early in pregnancy and continuing until the child was two years old. Processes to adapt and implement the NFP were explored across seven focus groups with public health nurses and managers. Eighty documents were reviewed to identify implementation challenges. Data were analyzed using directed content analysis.
The NFP model elements are acceptable to Canadian health care providers, public health nurses and families receiving the intervention. The primary adaptation required was to reduce nurse caseloads from 25 to 20 active clients. Recommendations for adapting and implementing all model elements are described.
The NFP model requires minor adaptations to increase the acceptability of the intervention to Canadian stakeholders. A consistent approach to adapting the NFP program in Canada is necessary as provincial jurisdictions commit themselves to supporting an experimental evaluation of the effectiveness of the NFP.
PubMed ID
23618049 View in PubMed
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Adapting the Hamilton Health Sciences critical care pandemic triage protocol.

https://arctichealth.org/en/permalink/ahliterature144550
Source
Healthc Q. 2010;13(2):60-3
Publication Type
Article
Date
2010
Author
Chris Kaposy
Natalie Bandrauk
Daryl Pullman
Rick Singleton
Fern Brunger
Author Affiliation
Faculty of Medicine, Division of Community Health and Humanities, at Memorial University of Newfoundland, St. John's, Newfoundland. christopher.kaposy@med.mun.ca
Source
Healthc Q. 2010;13(2):60-3
Date
2010
Language
English
Publication Type
Article
Keywords
Decision Making
Disease Outbreaks
Emergency Service, Hospital
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology - therapy
Newfoundland and Labrador - epidemiology
Organizational Case Studies
Triage - methods - organization & administration
PubMed ID
20357547 View in PubMed
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Adapting to the context and learning from earlier experience: the implementation of a national breakthrough collaborative in the context of social services in Sweden.

https://arctichealth.org/en/permalink/ahliterature147789
Source
Qual Manag Health Care. 2009 Oct-Dec;18(4):231-8
Publication Type
Article
Author
Josephine Lindgren
Author Affiliation
Medical Management Centre, Department of Learning, Informatics, Management & Ethics, Karolinska Institutet, Stockholm, Sweden. josephine.lindgren@skl.se
Source
Qual Manag Health Care. 2009 Oct-Dec;18(4):231-8
Language
English
Publication Type
Article
Keywords
Child
Child Behavior Disorders - rehabilitation
Child, Preschool
Cooperative Behavior
Humans
Interprofessional Relations
Interviews as Topic
Learning
Organizational Case Studies
Pilot Projects
Program Development
Social Work - methods - organization & administration
Sweden
Abstract
Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with special attention given to features of the implementation context that appeared to facilitate or hinder its success.
We used a case study approach to describe the processes used in the pilot project as well as to characterize the context. Our analysis was guided by a framework consisting of earlier identified factors for success including "motivate and empower the teams" and "ensure teams have measurable and achievable targets."
We observed several context-specific factors. These included measuring challenges connected to large cooperating teams. Specifically, teams representing different organizations needed more time to carry out a breakthrough collaborative than those in clinical health care settings. As in breakthrough collaboratives conducted in health care settings, early measurement efforts enabled a clearer sense of direction, which may have served to reinforce motivation among team members. This study highlights features that may have universal importance in influencing the success of breakthrough collaboratives to improve the quality of social services.
PubMed ID
19851230 View in PubMed
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The adaptive nature of implementation practice: case study of a school-based nutrition education intervention.

https://arctichealth.org/en/permalink/ahliterature115493
Source
Eval Program Plann. 2013 Aug;39:10-8
Publication Type
Article
Date
Aug-2013
Author
Sherri Bisset
Louise Potvin
Mark Daniel
Author Affiliation
Department of Social and Preventive Medicine, Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal & IRSPUM, Université de Montréal Public Health Research Institute, Québec, Canada. Sherri.Bisset@criucpq.ulaval.ca
Source
Eval Program Plann. 2013 Aug;39:10-8
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Child
Child, Preschool
Cooking
Food Habits
Health Education - organization & administration
Health Plan Implementation - methods - organization & administration
Humans
Models, Psychological
Organizational Case Studies
Poverty
Psychology, Social
Quebec
Schools
Abstract
To describe how and why nutritionists implement and strategize particular program operations across school contexts.
Instrumental case study with empirical propositions from Actor-Network Theory (ANT). Data derived from interviews with interventionists and observations of their practices.
Seven primary schools from disadvantaged Montreal neighborhoods.
Six nutritionists implementing the nutrition intervention in grades 4 and 5. From 133 nutrition workshops held in 2005/06, 31 workshops were observed with audio-recordings.
Little Cooks--Parental Networks aims to promote healthy eating behaviors through engagement in food preparation and promotion of nutrition knowledge.
The program-context interface where interventionists' practices form interactively within a given social context.
Coding inspired by ANT. Interview analysis involved construction of collective implementation strategies. Observations and audio-recordings were used to qualify and quantify nutritionists' practices against variations in implementation.
Nutritionists privileged intervention strategies according to particularities of the setting. Some such variation was accounted for by school-level social conditions, individual preferences and nutritionists' past experiences.
Implementation practices are strategic and aim to engage educational actors to achieve intervention goals. These results challenge implementation frameworks centered on purely technical considerations that exclude the social and interpretive nature of practice.
PubMed ID
23501242 View in PubMed
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Adoption of an innovation to repair aortic aneurysms at a Canadian hospital: a qualitative case study and evaluation.

https://arctichealth.org/en/permalink/ahliterature160317
Source
BMC Health Serv Res. 2007;7:182
Publication Type
Article
Date
2007
Author
Nathalie M Danjoux
Douglas K Martin
Pascale N Lehoux
Julie L Harnish
Randi Zlotnik Shaul
Mark Bernstein
David R Urbach
Author Affiliation
Department of Health, Policy, Management and Evaluation, University of Toronto, Toronto, Canada. nathalie.danjoux@utoronto.ca
Source
BMC Health Serv Res. 2007;7:182
Date
2007
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Aortic Aneurysm, Abdominal - surgery
Blood Vessel Prosthesis Implantation - methods - utilization
Decision Making, Organizational
Diffusion of Innovation
Hospitals, Urban - organization & administration
Humans
Ontario
Organizational Case Studies
Organizational Innovation
Qualitative Research
Vascular Surgical Procedures - methods - utilization
Abstract
Priority setting in health care is a challenge because demand for services exceeds available resources. The increasing demand for less invasive surgical procedures by patients, health care institutions and industry, places added pressure on surgeons to acquire the appropriate skills to adopt innovative procedures. Such innovations are often initiated and introduced by surgeons in the hospital setting. Decision-making processes for the adoption of surgical innovations in hospitals have not been well studied and a standard process for their introduction does not exist. The purpose of this study is to describe and evaluate the decision-making process for the adoption of a new technology for repair of abdominal aortic aneurysms (endovascular aneurysm repair [EVAR]) in an academic health sciences centre to better understand how decisions are made for the introduction of surgical innovations at the hospital level.
A qualitative case study of the decision to adopt EVAR was conducted using a modified thematic analysis of documents and semi-structured interviews. Accountability for Reasonableness was used as a conceptual framework for fairness in priority setting processes in health care organizations.
There were two key decisions regarding EVAR: the decision to adopt the new technology in the hospital and the decision to stop hospital funding. The decision to adopt EVAR was based on perceived improved patient outcomes, safety, and the surgeons' desire to innovate. This decision involved very few stakeholders. The decision to stop funding of EVAR involved all key players and was based on criteria apparent to all those involved, including cost, evidence and hospital priorities. Limited internal communications were made prior to adopting the technology. There was no formal means to appeal the decisions made.
The analysis yielded recommendations for improving future decisions about the adoption of surgical innovations. ese empirical findings will be used with other case studies to help develop guidelines to help decision-makers adopt surgical innovations in Canadian hospitals.
Notes
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PubMed ID
18005409 View in PubMed
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498 records – page 1 of 50.