How to measure the collective intelligence of primary healthcare teams?

Introduction: The capacity for teams and organizations to evolve and to thrive in ever-shifting environments is attributed to their collective intelligence. Collectively, intelligent team could prevent repetition of past mistakes and can help organizations and people work more efficiently. Researchers aimed to find a framework or a tool that could help explain collective intelligence in primary healthcare organizations.

Context and implementation of advanced nursing practice in two countries: An exploratory qualitative comparative study.

Background: The complexity and difficulties involved in the development and implementation of health innovations, such as advanced practice nursing roles, result in slow and sporadic international acceptance. To manage this complexity, it is advisable to deepen understanding of the context in which these innovation processes take place. However, there is little research specifically concerned with contextual factors that influence the implementation of advanced practice nursing roles.

Formalisation and subordination: a contingency theory approach to optimising primary care teams.

Objective: While there is consensus on the need to strengthen primary care capacities to improve healthcare systems' performance and sustainability, there is only limited evidence on the best way to organise primary care teams. In this article, we use a conceptual framework derived from contingency theory to analyse the structures and process optimisation of multiprofessional primary care teams.

Design: We focus specifically on inter-relationships between three dimensions: team size, formalisation of care processes and nurse autonomy.

Stakeholder Views on Solutions to Improve Health System Performance.

Context: Significant reforms are needed to improve healthcare system performance in Quebec. Even though the characteristics of high-performing healthcare systems are well-known, Quebec's reforms have not succeeded in implementing many critical elements. Converging evidence from political science models suggests stakeholders' preferences are central in determining policy content, adoption, and implementation.

Healthcare reforms, inertia polarization and group influence.

Healthcare systems performance is the focus of intense policy and media attention in most countries. Quebec (Canada) is no exception, where successive governments have struggled for decades with apparently intractable problems in care accessibility overall, poor performance, and rising costs. This article explores the underlying causes of the disconnection between the high salience of healthcare system dysfunctions in both media and policy debates and the lack of policy change likely to remedy those dysfunctions.

Analytical typology of multiprofessional primary care models.

Background: There is only limited evidence to support care redefinition and role optimization processes needed for scaling up of a stronger primary care capacity.

Methods: Data collection was based on a keyword search in MEDLINE, EMBASE and CINAHL databases. Three thousand, two hundred and twenty-nine documents were identified, 1851 met our inclusion criteria, 71 were retained for full-text assessment and 52 included in the final selection.

Structural analysis of health-relevant policy-making information exchange networks in Canada.

Background: Health systems worldwide struggle to identify, adopt, and implement in a timely and system-wide manner the best-evidence-informed-policy-level practices. Yet, there is still only limited evidence about individual and institutional best practices for fostering the use of scientific evidence in policy-making processes The present project is the first national-level attempt to (1) map and structurally analyze-quantitatively-health-relevant policy-making networks that connect evidence production, synthesis, interpretation, and use; (2) qualitatively investigate the interaction patterns of a subsample of actors with high centrality metrics within these networks to develop an in-depth understanding of evidence circulation processes; and (3) combine these findings in order to assess a policy network's "absorptive capacity" regarding scientific evidence and integrate them into a conceptually sound and empirically grounded framework.

Methods: The project is divided into two research components.

Supporting nurse practitioners' practice in primary healthcare settings: a three-level qualitative model.

Background: While greater reliance on nurse practitioners in primary healthcare settings can improve service efficiency and accessibility, their integration is not straightforward, challenging existing role definitions of both registered nurses and physicians. Developing adequate support practices is therefore essential in primary healthcare nurse practitioners' integration. This study's main objective is to examine different structures and mechanisms put in place to support the development of primary healthcare nurse practitioner's practice in different healthcare settings, and develop a practical model for identifying and planning adequate support practices.

The Impact of a Researcher's Structural Position on Scientific Performance: An Empirical Analysis.

This article discusses the nature and structure of scientific collaboration as well as the association between academic collaboration networks and scientific productivity. Based on empirical data gathered from the CVs of 73 researchers affiliated with an academic research network in Canada, this study used social network analysis (SNA) to examine the association between researchers' structural position in the network and their scientific performance. With reference to Granovetter's and Burt's theories on weak ties and structural holes, we argue it is the bridging position a researcher holds in a scientific network that matters most to improve scientific performance.

Nurse practitioners, canaries in the mine of primary care reform.

A strong and effective primary care capacity has been demonstrated to be crucial for controlling costs, improving outcomes, and ultimately enhancing the performance and sustainability of healthcare systems. However, current challenges are such that the future of primary care is unlikely to be an extension of the current dominant model. Profound environmental challenges are accumulating and are likely to drive significant transformation in the field.

Integrated Primary Care Teams (IPCT) pilot project in Quebec: a protocol paper.

Introduction: The overall aim of this project is to help develop knowledge about primary care delivery models likely to improve the accessibility, quality and efficiency of care. Operationally, this objective will be achieved through supporting and evaluating 8 primary care team pilot sites that rely on an expanded nursing role within a more intensive team-based, interdisciplinary setting.

Methods And Analysis: The first research component is aimed at supporting the development and implementation of the pilot projects, and is divided into 2 parts.

A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis.

Background: Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration.

Role clarification processes for better integration of nurse practitioners into primary healthcare teams: a multiple-case study.

Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP).

[Perceived needs and social participation of people with mild traumatic brain injury].

Introduction: Only limited data are available concerning the perception of quality of life and social participation of people with mild Traumatic Brain Injury (mTBI). The APIC personalized community integration support programme encourages people with TBI to achieve significant daily living or leisure activities.

Objectives: To explore the social participation needs and expectations of people with mTBI.

Fee increases and target income hypothesis: data from Quebec on physicians' compensation and service volumes.

Recent years have witnessed important public investments in physicians' compensation across Canada. The current paper uses data from Quebec to assess the impact of those investments on the volumes of services provided to the population. While total physician compensation costs, average physician compensation and average unit cost per service all rose extremely fast, the total number of services, number of services per capita and average number of services per physician either stagnated or declined.

Synthesis and properties of a cuprate superconductor containing double mercury-oxygen layers.

A cuprate superconductor containing double mercury layers was synthesized with a high-pressure, high-temperature technique. The compound, with chemical formula Hg(2)Ba(2)-Y1-xCaxCu(2)O(8-delta), contains a double HgO layer with structure similar to that of rock salt. The prototype compound Hg(2)Ba(2)YCu(2)O(8-delta) is an insulator.