Current Projects
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2018-2023
2020-2022 2020-2022 2020-2021 2020-2021 2020-2021 2019-2020 |
ED-UCATE: Partnering with Parents and Youth to Co-design Discharge Communication Interventions for Pediatric Emergency Care
Research Coordinator: Sharon Amey Funding: CIHR Project Grant Discharge communication in a pediatric emergency department can be a challenging time for parents, youth and clinicians. Most discharge communication interventions that have been evaluated in the literature target parents but few consider how the chaotic nature of an emergency department might impact communication. To date, parents and youth have not been involved in designing discharge communication interventions. Inadequate discharge communication can lead to poor health outcomes and can result in unnecessary return visits to the emergency department. We aim to evaluate a strategy for partnering with parents, youth and emergency department clinicians to co-design discharge communication interventions for asthma and minor head injury. Evaluation of a Patient Managed Tool to Improve Discharge Communication in Emergency Practice Settings Research Coordinator: Noelle Ozog Funding: IWK Health TRIC Grant More than 90% of people who are discharged from an emergency department (ED) are given information for their continued care at home. It is essential for there to be good communication between the healthcare providers and patients/caregivers to ensure that information is both shared and understood. However, that is often not the case. Research on discharge communication in EDs so far has targeted either patients and/or caregivers with minimal consideration of the environment in which the communication occurs. In addition, there has been very limited development of co-designed or co-evaluation of tools prior to implementation. Our service partners are committed to the involvement of patients and families in the design, implementation and evaluation of health services. Our team of patients, caregivers, clinicians and researchers have used a theory-based co-design approach to develop a patient managed communication tool to improve recall and comprehension of important discharge information shared during an emergency department visit. The aim of our project is to evaluate our communication tool to determine its usability and acceptability by patients, caregivers and ED healthcare providers in Nova Scotia. The focus of this project will be on children who are seen in EDs outside of urban pediatric centers. We will use our findings to refine the communication tool and develop implementation strategy for scale up and sustainability in Nova Scotia. Understanding Children with Medical Complexity in the Maritime Provinces Research Coordinator: Holly McCulloch Funding: Priority Project - Maritime SPOR Support Unit Children with complex health conditions make up only a small fraction of the total child population, but account for almost one-third of all child health expenditures. This high-risk group requires a high level of care coordination and support, and their impact on the healthcare system is difficult to quantify because many of these children receive care across provincial jurisdictions. The challenge lies in identifying these children, particularly at a population level. The opportunity to appropriately allocate healthcare resources to this group in an efficient manor is dependent on being able to accurately identify and classify these children. Multiple algorithms to identify these children at a population have been developed, but the accuracy of these tools has not yet been validated. Our interdisciplinary team composed of clinicians and researchers from Nova Scotia (NS), Prince Edward Island (PEI), and New Brunswick (NB) seeks to validate these algorithms in our Maritime Provincial context using linked administrative datasets. This dataset will allow us to better understand these children’s healthcare usage, help improve these children’s health management, and decrease their disproportionate burden on the healthcare system. Co-design of a Patient/Caregiver Discharge Communication Tool for Emergency Practice Settings Research Coordinator: Sharon Amey Funding: CIHR Catalyst Grant Most people who visit an emergency department will be discharged home at the end of their visit with information on how to manage their care at home. Good communication between healthcare providers and patients or their caregivers is critical to ensure important information is shared and understood throughout the emergency department stay. However, patients and/or caregivers often leave the emergency department without receiving or understanding all of the information required to achieve optimal health. To date, strategies to improve discharge communication in emergency departments have primarily targeted patients and/or caregivers with minimal consideration of the environment in which the communication occurs. Further, patients and/or caregivers have rarely, if ever, been involved in the design or evaluation of discharge communication tools prior to implementation. According to the Institute of Medicine, health literate organizations assess barriers to information exchange and enable people to access and use health information and services. Our service partners are committed to the involvement of patients and families in the design, implementation and evaluation of health services. Our team of patients, caregivers, clinicians and researchers have used a theory-based co-design approach to develop a patient managed communication tool to improve recall and comprehension of important discharge information shared during an emergency department visit. The aim of our project is to evaluate our communication tool to determine its usability and acceptability by patients, caregivers and emergency department healthcare providers. The focus of this project will be on children who are within the urban centers treated at tertiary care facilities. We will use our findings to refine the communication tool and develop an implementation plan for a future multi-site trial with emergency departments across Canada. Use of a Learning Health System Framework to Examine Quality and Safety Improvement at the IWK Health Centre During COVID-19 Research Coordinator: Daniel Crowther Funding: Nova Scotia COVID-19 Health Research Coalition The COVID-19 pandemic has caused health care organizations to make rapid changes to the way they deliver care to patients and families. There have been huge shifts across the health system to ensure the quality and safety of health care during this challenging time. The IWK Health Centre has responded quickly to COVID-19 by making changes to the way care is delivered, including changes to policies and physical space, canceling non-essential surgeries, and moving staff to different areas of the health centre to meet the changing needs. A Learning Health System is a framework that promotes repeated cycles of learning and improvement to ensure we are using best practices in health care delivery. A Learning Health System framework can provide a clear structure for improving care in response to a global pandemic. The goal of this study is to use a Learning Health System framework to examine the IWK Health Centre COVID-19 pandemic planning and identify strategies that we can use to be prepared for future pandemics. We will examine several sources of data, including health administrative data, interviews with staff and patients from the IWK Health Centre, and pandemic planning documents, to answer our research questions. We will organize the findings using the Learning Health System framework to give us a clearer picture of how the IWK Health Centre has responded to COVID-19. We will work with IWK Health Centre staff and patients to review the findings and identify strategies that would be useful. The findings from this study will be important for planning and responding to future pandemics. Exploring Respite Care for Children with Medical Complexity and their Families in Nova Scotia Research Coordinator: Sydney Breneol Respite care is an essential health service for children with medical complexity and their families to support a successful transition from hospital to community-based care. Respite care is often conceptualized as providing a break to caregivers from caregiving demands, while also providing time for those being cared for to interact with individuals outside of their usual caregiving unit. Previous research exploring respite care programs for families of children with medical complexity has revealed a number of potential models of care. However, there has yet to be one ideal model of care recognized to support respite care delivery for this population. The overall goal of this project is to gain an increased understanding into the experiences and needs of children with medical complexity and their families seeking access to respite care services in Nova Scotia. The objectives of this research are to: (1) Describe the experiences of Nova Scotian families with children with medical complexity seeking respite care services; (2) Identify the barriers and enablers to accessing respite care services in Nova Scotia; (3) Identify the key components to a successful pediatric respite care strategy for Nova Scotian families of children with medical complexity. PED-UCATE: Pediatric Emergency Department Use of Communication Technologies to Activate Transitions Home Effectively Research Coordinator: Sharon Amey Funding: CIHR Operating Grant Most people visiting the emergency department will leave the hospital and return home to manage their own medical condition. Communication between healthcare providers and patients or their caregivers during these visits can impact patient outcomes. Miscommunication of important information can lead to negative health problems. To date, strategies to improve discharge communication in emergency department have primarily targeted patients and/or caregivers with minimal consideration of the context in which the communication occurs. Further, patients and/or caregivers have rarely, if ever, been involved in the design or evaluation of discharge communication tools. According to the Institute of Medicine, health literate organizations are healthcare organizations that remove barriers and enable people to access and use health information and services. As a health literate organization, we have committed leadership at the health service leave and involvement of patients and families in the design, implementation and evaluation of the services that we provide at IWK Health Centre. Our team of patients, caregivers, clinicians and researchers used a theory-based co-design approach to develop a patient/caregiver managed communication tool prototype to improve recall and comprehension of important discharge information shared during an emergency department visit. The aim of our project is to evaluate the prototype of the communication tool with test users to determine its usability and acceptability by patients and caregivers as well as to see whether the tool can be adaptability to different emergency care settings. We will use our findings to develop the final product of our communication tool and come up with a research plan to apply for future funding opportunities for evaluating and implementing the tool in emergency settings across Canada. |
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2016-2018
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Youth and Parent Engagement Scoping Review
Research Coordinator: Daniel Crowther Funding: NSHRF Development & Innovation Grant Current evidence indicates patient involvement in health services research contributes to the creation of more accessible and acceptable services and improved relevance and acceptance of research findings. However, the literature examining youth and parent engagement in health care interventions is not well defined or organized and has yet to be systematically reviewed. This project will map the existing evidence describing parental engagement in designing healthcare interventions for pediatric tertiary care. |
Completed Projects
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2017-2018
2015-2018 2015-2018
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Building a Strategy to Support Parent and Youth Partnership in Patient-Oriented Research in the Maritimes
Research Coordinator: Lauren MacEachern Funding: CIHR Patient-Oriented Research Collaboration Grant Partnerships between youth, parents and health care professionals can improve outcomes for children and youth. However, best practice evidence to support partnerships between youth, parents and researchers in child-oriented research is less robust. Methods for including parents and youth in health research in the Maritimes vary widely, with little infrastructure available to guide meaningful engagement. Mechanisms and processes are urgently needed to support the inclusion of parents, children and youth as partners in child health research. The overall goal of our project is to co-develop a strategy, with input from parents, patient engagement experts and members of the research community, to support parent-researcher partnerships in patient-oriented research in the Maritimes. Our project outputs will build capacity for patient-oriented research in a child health context. PrEPP Study Research Coordinator: Christine Cassidy Funding: IWK/NSHA TRIC Grant The PrEPP study will implement a patient and parent expectation (PrEPP) questionnaire at 4 emergency departments in Nova Scotia to explore emergency department productivity, resource utilization and patient satisfaction with care. This study consists of 3 phases: 1) The PrEPP tool will be implemented in EDs for a 10-month period 2) We will reflect on the tool, examine our outcome measures and refine our implementation approach if necessary 3) We will re-implement the questionnaire into emergency departments Exploring Provider-Caregiver Communications: An Observation Study
Research Coordinator: Andrea Bishop Funding: CIHR Operating Grant This multi-site study will determine whether clinicians include the essential content and process elements in discharge communication with caregivers. The study will also identify communication strategies and document caregiver recall and comprehension. The data collection methods used will include non-participant observation through the use of video recording, as well as chart audits and caregiver follow-up. Publication(s): Understanding discharge communication behaviours in a pediatric emergency care context: a mixed methods observation study protocol |
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2015-2017
2015-2017 2016-2017 2015-2017 |
Complex Transitions of Care Study
Funding: IWK/NSHA TRIC Grant Transitions in care for children and families with complex care needs to their home districts in Nova Scotia is not optimal. The current structures and processes result in an unnecessary burden to families and patients and the healthcare system. We will use an integrated mixed methods approach to examine the current structures and processes from a patient centered perspective. This study consists of 3 phases: 1) We will use a case study design to develop multiple cases to examine the transition experience for a range of children and families with complex care needs 2) We will conduct focus groups with health care providers and parents to identify barriers and facilitators for transitions in care 3) We will host a one day workshop for multiple stakeholders to discuss findings and develop an action plan Publication(s): Strategies to support transitions from hospital to home for children with medical complexity: A scoping review Regional/Community ED Discharge Communication Qualitative Study
Research Coordinator: Allyson Gallant Funding: NSHRF Establishment Grant This study is exploring the process, content, and barriers and facilitators of discharge communication in the context of pediatric emergency care in 10 Regional/Community emergency departments across Nova Scotia. In the upcoming months we will carry out one emergency clinician focus group, as well as 6-12 interviews with caregivers at each site. Parent & Clinician Discharge Communication Qualitative Study
Funding: CIHR Operating Grant This research is examining the process and content of discharge instructions in emergency pediatric care at 6 emergency care sites across Canada. At each site, one focus group with emergency room clinicians (8-12) as well as 12 interviews with caregivers, and 2 interviews with adolescent girls will be completed in the upcoming months. REAL KT Curriculum
Funding: NSHRF Catalyst Grant Knowledge Translation (KT) is the application of knowledge to help improve health care services and the health care system. Bridging the gap between research and practice is essential to ensuring that Nova Scotians are receiving the best health care possible. The aim of this interactive curriculum is to build awareness of and capacity in KT activities in Nova Scotia and to provide the opportunity for research and decision-makers to work collaboratively. A series of workshops will be held to engage participants from different sectors of the health care system in Nova Scotia in a facilitated dialogue about KT. Local experts in KT will share current best practices regarding the use and implementation of KT science and practice. |
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2015-2016
2013-2015 |
REAL Change Intervention Workshop
Funding: NSHRF Catalyst Grant The REAL Change Intervention Workshop is funded by the NSHRF and aims to bring small teams of stakeholders in the Nova Scotia health system and public health sector together to design and implement a practice or policy change. The teams benefit from the support of knowledge translation (KT) experts and KT coaches to guide through a systematic approach to designing and evaluating their practice or policy change. This support ensures their practice or policy changes are successfully implemented and have a lasting impact on population health. Discharge Communication Delphi Study
Funding: CIHR Operating Grant This Delphi Study identified content for inclusion which will aid to ultimately develop best practice guidelines for discharge communication for caregivers of children who present to the emergency department. Using a delphi study technique, emergency department physicians and nurses from across the country were surveyed to come to a consensus on the top 5 content items which should be communicated to all caregivers across six different illness presentations. Publication(s): Essential Content for Discharge Instructions in Pediatric Emergency Care: A Delphi Study |
