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Accreditation: a cultural control strategy.

https://arctichealth.org/en/permalink/ahliterature156493
Source
Int J Health Care Qual Assur. 2008;21(2):146-58
Publication Type
Article
Date
2008
Author
André Paccioni
Claude Sicotte
François Champagne
Author Affiliation
Centre of Interdisciplinary Research on Rehabilitation of Greater Montreal, Quebec, Canada. andre.paccioni@umontreal.ca
Source
Int J Health Care Qual Assur. 2008;21(2):146-58
Date
2008
Language
English
Publication Type
Article
Keywords
Accreditation - organization & administration
Health Services Research
Humans
Leadership
Longitudinal Studies
Organizational Culture
Patient satisfaction
Primary Health Care - organization & administration
Quality Assurance, Health Care - organization & administration
Quebec
Abstract
The purpose of this paper is to describe and understand the effects of the accreditation process on organizational control and quality management practices in two Quebec primary-care health organizations.
A multiple-case longitudinal study was conducted taking a mixed qualitative/quantitative approach. An analytical model was developed of the effects of the accreditation process on the type of organizational control exercised and the quality management practices implemented. The data were collected through group interviews, semi-directed interviews of key informers, non-participant observations, a review of the literature, and structured questionnaires distributed to all the employees working in both institutions.
The accreditation process has fostered the implementation of consultation mechanisms in self-assessment teams. Improving assessments of client satisfaction was identified as a prime objective but, in terms of the values promoted in organizations, accreditation has little effect on the perceptions of employees not directly involved in the process. As long as not all staff members have integrated the basis for accreditation and its outcomes, the accreditation process appears to remain an external, bureaucratic control instrument.
This study provides a theoretical model for understanding organizational changes brought about by accreditation of primary services. Through self-assessment of professional values and standards, accreditation may foster better quality management practices.
PubMed ID
18578200 View in PubMed
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Addressing the determinants of child mental health: intersectionality as a guide to primary health care renewal.

https://arctichealth.org/en/permalink/ahliterature139222
Source
Can J Nurs Res. 2010 Sep;42(3):50-64
Publication Type
Article
Date
Sep-2010
Author
Charmaine M McPherson
Elizabeth A McGibbon
Author Affiliation
School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.
Source
Can J Nurs Res. 2010 Sep;42(3):50-64
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Canada
Child
Health Policy
Humans
Mental health
Primary Health Care - organization & administration
Social Justice
Abstract
Primary health care (PHC) renewal was designed explicitly to attend to the multidimensional factors impacting on health, including the social determinants of health. These determinants are central considerations in the development of integrated, cross-sectoral, and multi-jurisdictional policies such as those that inform models of shared mental health care for children. However, there are complex theoretical challenges in translating these multidimensional issues into policy. One of these is the rarely discussed interrelationships among the social determinants of health and identities such as race, gender, age, sexuality, and social class within the added confluence of geographic contexts. An intersectionality lens is used to examine the complex interrelationships among the factors affecting child mental health and the associated policy challenges surrounding PHC renewal. The authors argue that an understanding of the intersections of social determinants of health, identity, and geography is pivotal in guiding policy-makers as they address child mental health inequities using a PHC renewal agenda.
Notes
Erratum In: Can J Nurs Res. 2010 Dec;42(4):2 p preceding table of contents
PubMed ID
21086776 View in PubMed
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[Adequacy of health care services for young immigrant families].

https://arctichealth.org/en/permalink/ahliterature212002
Source
Can J Public Health. 1996 May-Jun;87(3):152-7
Publication Type
Article
Author
S. Gravel
G. Legault
Author Affiliation
Direction de la Santé Publique, Régie régionale Montréal-Centre, Québec.
Source
Can J Public Health. 1996 May-Jun;87(3):152-7
Language
French
Publication Type
Article
Keywords
Adolescent
Adult
Attitude to Health
Child
Child Welfare
Child, Preschool
Community Health Centers
Emigration and Immigration
Family - psychology
Health services needs and demand
Humans
Infant
Infant, Newborn
Primary Health Care - organization & administration
Quebec
Questionnaires
Abstract
This article relates the results of descriptive exploratory research conducted through interviews with 297 young immigrant families and 40 health and social workers on the primary health problems encountered by the families and on how they resolved these problems. Families and workers rank problems in different orders of priority. While families give priority to the health problems of their children, workers give priority to the problems encountered by the mothers, and in particular, mental health problems. Families and workers alike express a desire for help from the health and social service system for these problems. For families, this help would come from family doctors and nurses. These health providers are subsequently consulted; when they are not, language is determined to be the main obstacle to accessibility. Difficulties related to cultural compatibility of services are seen as more numerous by workers than by families.
PubMed ID
8771914 View in PubMed
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Adopting electronic medical records: are they just electronic paper records?

https://arctichealth.org/en/permalink/ahliterature108722
Source
Can Fam Physician. 2013 Jul;59(7):e322-9
Publication Type
Article
Date
Jul-2013
Author
Morgan Price
Alex Singer
Julie Kim
Author Affiliation
Department of Family Practice, University of British Columbia, Vancouver. morgan@leadlab.ca
Source
Can Fam Physician. 2013 Jul;59(7):e322-9
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Decision Making, Computer-Assisted
Diffusion of Innovation
Electronic Health Records - utilization
Humans
Manitoba
Medical Records Systems, Computerized
Practice Management, Medical - organization & administration
Primary Health Care - organization & administration
Qualitative Research
Abstract
To understand the key challenges to adoption of advanced features of electronic medical records (EMRs) in office practice, and to better understand these challenges in a Canadian context.
Mixed-methods study.
Manitoba.
Health care providers and staff in 5 primary care offices.
Level of EMR adoption was assessed, and field notes from interviews and discussion groups were qualitatively analyzed for common challenges and themes across all sites.
Fifty-seven interviews and 4 discussion groups were conducted from November 2011 to January 2012. Electronic medical record adoption scores ranged from 2.3 to 3.0 (out of a theoretical maximum of 5). Practices often scored lower than expected on use of decision support, providing patients with access to their own data, and use of practice-reporting tools. Qualitative analysis showed there were ceiling effects to EMR adoption owing to how the EMR was implemented, the supporting eHealth infrastructure, lack of awareness or availability of EMR functionality, and poor EMR data quality.
Many practitioners used their EMRs as "electronic paper records" and were not using advanced features of their EMRs that could further enhance practice. Data-quality issues within the EMRs could affect future attempts at using these features. Education and quality improvement activities to support data quality and EMR optimization are likely needed to support practices in maximizing their use of EMRs.
Notes
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PubMed ID
23851560 View in PubMed
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[ADP-based records in primary health care. Rationalization or reorganization?].

https://arctichealth.org/en/permalink/ahliterature211894
Source
Tidsskr Nor Laegeforen. 1996 May 10;116(12):1470-3
Publication Type
Article
Date
May-10-1996
Author
B. Hofmann
J. Tørstad
Author Affiliation
Telenor Forskning og Utvikling, Tromsø
Source
Tidsskr Nor Laegeforen. 1996 May 10;116(12):1470-3
Date
May-10-1996
Language
Norwegian
Publication Type
Article
Keywords
Efficiency, Organizational
Humans
Medical Records Systems, Computerized
Norway
Primary Health Care - organization & administration - standards
Abstract
Computer-based patient record systems have become very common in the primary health service, but their effects have seldom been documented. Three surveys were carried out in the municipality of Sør-Varanger, in 1993, 1994 and 1995, to discover how such a system has affected the running of the municipal medical centres. The most significant changes were organisational. Certain tasks changed hands, others were dispensed with, and new ones were added. Information on patients became more readily available, and services to the public were improved. Many more patients received an answer to questions concerning information in the case record, and far fewer forms had to be filled in manually. Despite this, computerisation had seemingly led to little change in effectiveness, and the total load of work remained the same. The survey also showed that simple extensions to the system could produce marked improvements.
PubMed ID
8650636 View in PubMed
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Advanced practice nursing in Canada: has the time really come?

https://arctichealth.org/en/permalink/ahliterature196671
Source
Nurs Stand. 1999 Nov 3-9;14(7):49-54
Publication Type
Article
Author
K. de Leon-Demaré
K. Chalmers
D. Askin
Author Affiliation
University of Manitoba, Faculty of Nursing, Winnipeg, Manitoba.
Source
Nurs Stand. 1999 Nov 3-9;14(7):49-54
Language
English
Publication Type
Article
Keywords
Canada
Forecasting
Humans
Job Description
Needs Assessment
Nurse Practitioners - education - organization & administration
Primary Health Care - organization & administration
Abstract
Nurse practitioners in Canada have experienced many of the problems facing those in the UK. In this paper, first presented at this year's meeting of the Commonwealth Nurses' Federation, the authors explain the events.
PubMed ID
11075128 View in PubMed
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Age equity in different models of primary care practice in Ontario.

https://arctichealth.org/en/permalink/ahliterature129640
Source
Can Fam Physician. 2011 Nov;57(11):1300-9
Publication Type
Article
Date
Nov-2011
Author
Simone Dahrouge
William Hogg
Meltem Tuna
Grant Russell
Rose Ann Devlin
Peter Tugwell
Elizabeth Kristjansson
Author Affiliation
C.T. Lamont Primary Health Care Research Centre, �lisabeth Bruyère Research Institute, Ottawa, ON. sdahrouge@bruyere.org
Source
Can Fam Physician. 2011 Nov;57(11):1300-9
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Capitation Fee - standards
Chronic Disease
Community health centers - standards
Cross-Sectional Studies
Delivery of Health Care - organization & administration - standards
Fee-for-Service Plans - standards
Female
Health Care Surveys
Health promotion
Healthcare Disparities - organization & administration - standards
Humans
Linear Models
Logistic Models
Male
Middle Aged
Ontario
Primary Health Care - organization & administration - standards
Quality of Health Care
Socioeconomic Factors
Abstract
To assess whether the model of service delivery affects the equity of the care provided across age groups.
Cross-sectional study.
Ontario.
One hundred thirty-seven practices, including traditional fee-for-service practices, salaried community health centres (CHCs), and capitation-based family health networks and health service organizations.
To compare the quality of care across age groups using multilevel linear or logistic regressions. Health service delivery measures and health promotion were assessed through patient surveys (N = 5111), which were based on the Primary Care Assessment Tool, and prevention and chronic disease management were assessed, based on Canadian recommendations for care, through chart abstraction (N = 4108).
Older individuals reported better health service delivery in all models. This age effect ranged from 1.9% to 5.7%, and was larger in the 2 capitation-based models. Individuals aged younger than 30 years attending CHCs had more features of disadvantage (ie, living below the poverty line and without high school education) and were more likely than older individuals to report discussing at least 1 health promotion subject at the index visit. These differences were deemed an appropriate response to greater needs in these younger individuals. The prevention score showed an age-sex interaction in all models, with adherence to recommended care dropping with age for women. These results are largely attributable to the fact that maneuvers recommended for younger women are considerably more likely to be performed than other maneuvers. Chronic disease management scores showed an inverted U relationship with age in fee-for-service practices, family health networks, and health service organizations but not in CHCs.
The salaried model might have an organizational structure that is more conducive to providing appropriate care across age groups. The thrust toward adopting capitation-based payment is unlikely to have an effect on age disparities.
Notes
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PubMed ID
22084464 View in PubMed
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Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model.

https://arctichealth.org/en/permalink/ahliterature146163
Source
Healthc Q. 2009;13 Spec No:98-104
Publication Type
Article
Date
2009
Author
Sandra Delon
Blair Mackinnon
Author Affiliation
Chronic Disease Prevention & Oral Health, Alberta Health Services.
Source
Healthc Q. 2009;13 Spec No:98-104
Date
2009
Language
English
Publication Type
Article
Keywords
Alberta
Chronic Disease - prevention & control
Consumer Participation
Continuity of Patient Care - organization & administration
Decision Support Techniques
Disease Management
Evidence-Based Practice
Health Care Reform - organization & administration
Humans
Long-Term Care
Models, organizational
National Health Programs
Organizational Case Studies
Patient Education as Topic
Patient Participation
Patient-Centered Care
Primary Health Care - organization & administration
Self Care
Systems Integration
Total Quality Management - organization & administration
Abstract
Alberta's integrated approach to chronic disease management programming embraces client-centred care, supports self-management and facilitates care across the continuum. This paper presents strategies implemented through collaboration with primary care to improve care of individuals with chronic conditions, evaluation evidence supporting success and lessons learned from the Alberta perspective.
PubMed ID
20057258 View in PubMed
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The Alumni program: redefining continuity of care in psychiatry.

https://arctichealth.org/en/permalink/ahliterature203317
Source
J Psychosoc Nurs Ment Health Serv. 1999 Jan;37(1):23-9
Publication Type
Article
Date
Jan-1999
Author
H. Hobbs
J H Wilson
S. Archie
Author Affiliation
McMaster University Medical Centre, Hamilton Health Sciences Corporation, Ontario, Canada.
Source
J Psychosoc Nurs Ment Health Serv. 1999 Jan;37(1):23-9
Date
Jan-1999
Language
English
Publication Type
Article
Keywords
Aftercare - methods - organization & administration
Case Management - organization & administration
Chronic Disease
Continuity of Patient Care
Humans
Long-Term Care - methods - organization & administration
Mental Health Services - organization & administration
Ontario
Patient care team
Patient Participation
Patient-Centered Care - methods
Primary Health Care - organization & administration
Program Evaluation
Psychiatry - organization & administration
Psychotic Disorders - rehabilitation
Self Care - methods
Sick Role
Abstract
The Alumni Program is a novel approach to the continuing care and preventive treatment of clients with "chronic" mental illness. This approach demands a different conceptualization of outpatient psychiatric intervention. The infectious disease model has been deliberately replaced with a chronic illness model that more accurately reflects the course and natural history of psychiatric illness. The Alumni Program is similar to the approach employed with other chronic medical conditions like arthritis, asthma, or diabetes. The program has complementary roles for both specialty psychiatric clinicians and family practitioners. In addition, the program empowers clients and their families to play a key role in their own ongoing adaptation and adjustment to chronic illness while striving for optimal wellness.
PubMed ID
9921462 View in PubMed
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The Ambulatory Sentinel Practice Network: purpose, methods, and policies.

https://arctichealth.org/en/permalink/ahliterature240865
Source
J Fam Pract. 1984 Feb;18(2):275-80
Publication Type
Article
Date
Feb-1984
Author
L A Green
M. Wood
L. Becker
E S Farley
W L Freeman
J. Froom
C. Hames
L J Niebauer
W W Rosser
M. Seifert
Source
J Fam Pract. 1984 Feb;18(2):275-80
Date
Feb-1984
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Child
Child, Preschool
Confidentiality
Data Collection
Female
Governing Board - organization & administration
Humans
Infant
Informed consent
Male
Middle Aged
Organizational Objectives
Policy Making
Primary Health Care - organization & administration - standards
Quality Control
Research
United States
Abstract
The Ambulatory Sentinel Practice Network (ASPN) is a network of primary health care practices across the United States and Canada offering (1) a laboratory for the study of populations under the care of primary care providers, and (2) surveillance of primary care problems and services. This paper reports the methods and policies developed and used by ASPN to conduct studies and describes the initial sentinel practices.
PubMed ID
6699565 View in PubMed
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530 records – page 1 of 53.