The "hard, relentless, never-ending" work of focusing on discharge: a qualitative study of managers' perspectives.

Purpose: Interventions to hasten patient discharge continue to proliferate despite evidence that they may be achieving diminishing returns. To better understand what such interventions can be expected to accomplish, the authors aim to critically examine their underlying program theory.

Design/methodology/approach: Within a broader study on patient flow, spanning 10 jurisdictions across Western Canada, the authors conducted in-depth interviews with 300 senior, middle and frontline managers; 174 discussed discharge initiatives.

Managing intergroup silos to improve patient flow.

Background: Health care managers face the critical challenge of overcoming divisions among the many groups involved in patient care, a problem intensified when patients must flow across multiple settings. Surprisingly, however, the patient flow literature rarely engages with its intergroup dimension.

Purpose: This study explored how managers with responsibility for patient flow understand and approach intergroup divisions and "silo-ing" in health care.

Using integrated technology to create quality care for older adults: a feasibility study.

Purpose: Slow changes in older adults' health status are often not detected until they escalate. Our aim was to understand if e-technology can enhance the safety and quality of older adult care by detecting changes in health status early.

Methods: E-technology was implemented with 30 seniors in an assisted living facility.

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis.

Background: Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care.

Methods: We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains.

Evaluation of the awareness and effectiveness of IT security programs in a large publicly funded health care system.

Background: Electronic health records are becoming increasingly common in the health care industry. Although information technology (IT) poses many benefits to improving health care and ease of access to information, there are also security and privacy risks. Educating health care providers is necessary to ensure proper use of health information systems and IT and reduce undesirable outcomes.

Evaluation of the antipsychotic medication review process at four long-term facilities in Alberta.

Purpose: The goal of this evaluation was to understand how four long-term care (LTC) facilities in Alberta have implemented medication reviews for the Appropriate Use of Antipsychotics (AUA) initiative. We aimed to determine how interprofessional (IP) collaboration was incorporated in the antipsychotic medication reviews and how the reviews had been sustained.

Methods: Four LTC facilities in Alberta participated in this evaluation.

Scope of practice review: providers for triage and assessment of spine-related disorders.

Purpose: This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care.

Methods: We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice.

Optimizing the interprofessional workforce for centralized intake of patients with osteoarthritis and rheumatoid disease: case study.

Introduction: This case study was part of a larger programme of research in Alberta that aims to develop an evidence-based model to optimize centralized intake province-wide to improve access to care. A centralized intake model places all referred patients on waiting lists based on severity and then directs them to the most appropriate provider or service. Our research focused on an in-depth assessment of two well-established models currently in place in Alberta to 1) enhance our understanding of the roles and responsibilities of staff in current intake processes, 2) identify workforce issues and opportunities within the current models, and 3) inform the potential use of alternative providers in the proposed centralized intake model.

A prediction algorithm for first onset of major depression in the general population: development and validation.

Objective: Prediction algorithms are useful for making clinical decisions and for population health planning. However, such prediction algorithms for first onset of major depression do not exist. The objective of this study was to develop and validate a prediction algorithm for first onset of major depression in the general population.

Development and validation of prediction algorithms for major depressive episode in the general population.

Background: To develop and validate sex specific prediction algorithms for 4-year risk of major depressive episode (MDE) using data from a population-based longitudinal cohort.

Methods: Household residents from 10 provinces were randomly recruited and interviewed by Statistics Canada. 10,601 participants who were aged 18 years and older and who did not meet the criteria for MDE in the 12 months prior to a baseline interview in 2000/01 were included in algorithm development; data from 7902 participants who were aged 18 and older and who were free of MDE in 2004/05 were used for validation.