Publications by authors named "Karen Harlos"

Background: Emerging evidence that meaningful relationships with knowledge users are a key predictor of research use has led to promotion of partnership approaches to health research. However, little is known about health system experiences of collaborations with university-based researchers, particularly with research partnerships in the area of health system design and health service organization. The purpose of the study was to explore the experience and perspectives of senior health managers in health service organizations, with health organization-university research partnerships.

View Article and Find Full Text PDF

Objective: To understand family physicians' perceptions of Manitoba's strategies for primary care renewal or reform (PCR).

Design: Qualitative substudy of an explanatory case study.

Setting: Rural and urban Manitoba.

View Article and Find Full Text PDF

Background: Partnerships between academic researchers and health system leadership are often promoted by health research funding agencies as an important strategy in helping ensure that funded research is relevant and the results used. While potential benefits of such partnerships have been identified, there is limited guidance in the scientific literature for either healthcare organisations or researchers on how to select, build and manage effective research partnerships. Our main research objective was to explore the health system perspective on partnerships with researchers with a focus on issues related to the design and organisation of the health system and services.

View Article and Find Full Text PDF

Primary care reform cannot succeed without substantive change on the part of providers. In Canada, these are mostly fee-for-service physicians, who tend to regard themselves as independent professionals and not under managerial sway. Hence, policymakers must balance two conflicting imperatives: ensuring the acceptability of renewal efforts to these physicians while enforcing their accountability for defined actions or outcomes.

View Article and Find Full Text PDF

Purpose: Healthcare policymakers and managers struggle to engage private physicians, who tend to view themselves as independent of the system, in new models of primary care. The purpose of this paper is to examine this issue through a social identity lens.

Design/methodology/approach: Through in-depth interviews with 33 decision-makers and 31 fee-for-service family physicians, supplemented by document review and participant observation, the authors studied a Canadian province's early efforts to engage physicians in primary care renewal initiatives.

View Article and Find Full Text PDF

Background: The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success.

Methods: We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines.

View Article and Find Full Text PDF

Introduction: The uptake of Clinical Practice Guideline (CPG) recommendations that improve outcomes in heart failure (HF) remains suboptimal. We will conduct a systematic review to identify implementation strategies that improve physician adherence to class I recommendations, those with clear evidence that benefits outweigh the risks. We will use American, Canadian and European HF guidelines as our reference.

View Article and Find Full Text PDF

Aim: To examine the impact of organisational factors on bullying among peers (i.e. horizontal) and its effect on turnover intentions among Canadian registered nurses (RNs).

View Article and Find Full Text PDF

Objective: We synthesized the management and health literatures for insights into implementing evidence-based change in healthcare drawn from industry-specific data. Because change principles based on evidence often fail to be translated into organizational practice or policy, we sought studies at the nexus of organizational change and knowledge translation.

Methods: We reviewed five top management journals to identify an initial pool of 3,091 studies, which yielded a final sample of 100 studies.

View Article and Find Full Text PDF

Purpose: The purpose of this paper is to examine anger associated with types of negative work events experienced by health administrators and to examine the impact of anger on intent to leave.

Design/methodology/approach: Textual data analysis is used to measure anger in open-ended survey responses from administrative staff of a Canadian hospital. Multivariate regression is applied to predict anger from event type, on the one hand, and turnover intentions from anger, on the other.

View Article and Find Full Text PDF

Research on work life quality in hospitals has focused on how nurses and physicians perceive or react to work conditions. We extend this focus to another major professional group - healthcare administrators - to learn more about how these employees experience the work environment. Administrators merit such attention given their key roles in sustaining the financial health of the hospital and in fulfilling management functions efficiently to support consistent, high-quality care.

View Article and Find Full Text PDF