Family Medicine Supervisors' Preferences for Improving Their Teaching Skills in Senior Care.

Background And Objectives: Many clinical supervisors in family medicine feel ill-equipped to teach senior care to their family medicine residents (trainees). We therefore sought to explore their preferred learning strategies for improving their clinical and teaching skills with regard to senior care.

Methods: In this qualitative study, we conducted focus groups and interviews with supervisors from four family medicine clinics, to explore their preferred educational strategies.

How interprofessional teams of students mobilized collaborative practice competencies and the patient partnership approach in a hybrid IPE course.

To develop collaborative competencies of future health and social services professionals, the Université de Montréal (UdeM) offers interprofessional education (IPE) in partnership with patients. To meet the challenges of IPE, UdeM turned to digital tools to enable interprofessional teams of students to collaborate online and face-to-face. The collaborative flipped classroom for IPE with patient partnership is the conceptual framework for the pedagogical method used for this study.

Development of Patient-Inclusive Teams: Toward a Structured Methodology.

Over the last few years, the role of patients in the health system has become essential to improving the quality of care and services. However, the literature shows that patient engagement is not always ideally applied to improve the quality and safety of care and that patient engagement can be tokenistic. Through experiences conducted in Quebec, it is possible to outline a structured process involving both professional stakeholders and patients that illustrates optimal conditions to be applied for successful teamwork involving patients.

What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations.

Informational role self-efficacy: a validation in interprofessional collaboration contexts involving healthcare service and project teams.

Background: Healthcare professionals perform knowledge-intensive work in very specialized disciplines. Across the professional divide, collaboration becomes increasingly difficult. For effective teamwork and collaboration to occur, it is considered necessary for individuals to believe in their ability to draw on their expertise and provide what others need to perform their job well.

Patient Engagement: The Quebec Path.

The issue on "The Patient Experience in Ontario 2020: What is Possible?" taught us how Ontario is trying to shift to a consistent culture of patient engagement at all levels of its healthcare system, from clinical to organizational and political. In this commentary, the authors share some of the avenues that have been taken in Quebec to structure patient engagement in a comprehensive way within and across stakeholder and patient populations. The model selected in Quebec is based on partnership of care and services, which includes not only patient involvement, but also interprofessional collaboration among professionals (Pomey et al.

[Experimentation of care partners program in psychiatry: the model Montreal].

Unlabelled: The approach of the partnership of care and services developed by the direction collaboration dans patient partnership (DCPP) of the Faculty of medicine of the University of Montreal, considers the patient as a full care actor, in the same way as healthcare professionals, his experientiel knowledges are recognized and the patient develops gradually his self-determination. Since 2010, in order to allow cultural changes involved with this approach, the 'Program Partners of Care' (PPC) facilitated resource patient' integration and involvement into Continuous Improvement Committees (CIC), within 29 general and specialized health care teams in 19 health and social services facilities in Quebec, among wich four teams specialized in mental health. The purpose of the article is to describe briefly this approach, to demonstrate that it is successfully applicable to mental health clienteles, under certain conditions.

[The Montreal model: the challenges of a partnership relationship between patients and healthcare professionals].

A promising approach to improve the population's health and the quality of care and services provided by the health system consists of patient engagement at all levels of the health system together with training of health professionals. Since 2010, a new rational model based on the partnership between patients and healthcare professionals has been developed at the University of Montreal's Faculty of Medicine. This patient partnership model is based on the recognition of the patient's experiential knowledge gained from living with a disease, which is complementary to the healthcare professional's scientific knowledge.

Implementation of interprofessional learning activities in a professional practicum: The emerging role of technology.

To prepare future healthcare professionals to collaborate effectively, many universities have developed interprofessional education programs (IPE). Till date, these programs have been mostly courses or clinical simulation experiences. Few attempts have been made to pursue IPE in healthcare clinical settings.

The patient-as-partner approach in health care: a conceptual framework for a necessary transition.

The prevalence of chronic diseases today calls for new ways of working with patients to manage their care. Although patient-centered approaches have contributed to significant advances in care and to treatments that more fully respect patients' preferences, values, and personal experiences, the reality is that health care professionals still hold a monopoly on the role of healer. Patients live with their conditions every day and are experts when it comes to their own experiences of illness; this expertise should be welcomed, valued, and fostered by other members of the care team.

Innovating in teaching collaborative practice with a large student cohort at Université de Montréal.

Université de Montréal implemented an interprofessional education (IPE) curriculum on collaborative practice in a large cohort of students (>1,100) from 10 health sciences and psychosocial sciences training programs. It is made up of three one-credit undergraduate courses (CSS1900, CSS2900, CSS3900) spanning the first 3 years of training. The course content and activities aim for development of the six competency domains identified by the Canadian Interprofessional Health Collaborative.

Educational needs of health care providers working in long-term care facilities with regard to pain management.

Background: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF), with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs).

Predictors of quality-of-care processes in geriatric assessment units: toward a better organizational framework.

Objectives: To identify the structural and patient characteristics associated with better care processes in older vulnerable hospitalized patients.

Design: Retrospective study.

Setting: Forty-four Geriatric Assessment Units (GAU).

Quality-of-care processes in geriatric assessment units: principles, practice, and outcomes.

Objectives: To assess quality-of-care processes and to examine whether care processes are associated with short-term postdischarge outcomes in older vulnerable hospitalized patients.

Design: Retrospective study.

Setting: Forty-nine Geriatric Assessment Units.

A discharge summary adapted to the frail elderly to ensure transfer of relevant information from the hospital to community settings: a model.

Background: Elderly patients admitted to Geriatric Assessment Units (GAU) typically have complex health problems that require multi-professional care. Considering the scope of human and technological resources solicited during hospitalization, as well as the many risks and discomforts incurred by the patient, it is important to ensure the communication of pertinent information for quality follow-up care in the community setting. Conventional discharge summaries do not adequately incorporate the elements specific to an aging clientele.

Short-term geriatric assessment units: 30 years later.

Background: The increasing number of hospitalized elderly persons has greatly challenged decision makers to reorganize services so as to meet the needs of this clientele. Established progressively over the last 30 years, the short-term Geriatric Assessment Unit (GAU) is a specialized care program, now implemented in all the general hospital centres in Quebec. Within the scope of a broader reflection upon the appropriate care delivery for elderly patients in our demographic context, there is a need to revisit the role of GAU within the hospital and the continuum of care.

[Do the activities of day programs for the elderly correspond to their various needs?].

This study was carried out to explore the fit between health and functional characteristics of Day Program participants and the types of program activities they were offered in Day Programs. The subjects were 132 participants from 5 Day Programs in Montreal. Four different participant profile groups were identified using cluster analysis.

Determinants of adult day center attendance among older adults with functional limitations.

Objective: To examine factors related to regularity of adult day center (ADC) attendance among seniors with functional limitations.

Methods: Using data collected as part of a larger study, we identified the proportion of scheduled days attended among 101 ADC users in Montréal and identified determinants of this attendance.

Results: More regular attendance was associated with previous profession of ADC participant or spouse in a sector other than health care, receiving formal help for activities of daily living or instrumental activities of daily living on days of expected ADC participation, participating for the whole day rather than half a day, lower participation in prevention and health-promotion activities, and lower caregiver burden among persons with cognitive impairments and higher caregiver burden among persons without cognitive impairments.

Development of an individualized service plan tool and rules for case management in Québec.

From past experience with integrated service delivery, there appears to be a need for a clinical tool to help case managers plan, monitor, and coordinate services. In this context the Québec Ministry of Health and Social Services created a task force to suggest improvements to the Individualized Service Plan tool included in the Multiclientele Assessment Tool. This article reports the findings of this multidisciplinary task force working with various clienteles (older, with physical or mental disabilities, mental diseases).

Interprofessional learning in the trenches: fostering collective capability.

The greatest resource for improving interprofessional learning and practice is the knowledge, wisdom, and energy of professionals who adapt to challenging situations in their everyday work. We call collective capability the ability of a group of professionals to balance two interdependent levels of organization of practice: what professionals know and what they do collectively over time. Organizing what professionals know links the relational value--caring for patients--to the knowledge value of practice.

[Utilization of day care services by frail seniors].

This study consists of a secondary analysis of data collected during the SIPA demonstration project. Its purpose is to identify the proportion of Adult Day Care (ADC) users as well as the determinants of use in this group of persons 65 years old and over receiving home care services in Montreal. Results show that 18.

Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia.

Background: This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada.

Methods: A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics) and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work), from primary or secondary levels of care, including long-term care.

Implementation and effects of an individual stress management intervention for family caregivers of an elderly relative living at home: a mixed research design.

The purpose of this project was to evaluate the implementation and effects of a stress management intervention for family caregivers of elderly persons. The intervention was implemented through an action research design with the collaboration of case managers working in community health centers. A total of 81 caregivers participated in the study.

Integrated services for frail elders (SIPA): a trial of a model for Canada.

The complex formed by chronic illness, episodes of acute illness, physiological disabilities, functional limitations, and cognitive problems is prevalent among frail elderly persons. These individuals rely on assistance from social and health care programs, which in Canada are still fragmented. SIPA (Services intégrés pour les personnes âgées fragiles) is an integrated service model based on community services, a multidisciplinary team, case management that retains clinical responsibility for all the health and social services required, and the capacity to mobilize resources as required and according to the care protocol.