Comparative Program and Policy Analysis Grants


Title: A Cross-Provincial Comparison of Program and Service Innovations for Patients with Multimorbidity in Interprofessional Primary Healthcare Teams (Led by BRIC NS with partners in ON, QC, and NL)
NS Research Team: Ruth Martin-Misener (Nominated Principal Investigator), Fred Burge, Janet Curran, George Kephart, Adrian MacKenzie, Emily Marshall, Tanya Packer, Ryley Urban, Mel Fracini, Grace Warner, Tara Sampalli, Erin Christian, Lynn Edwards, Elizabeth Michael, Melanie Mooney, Ashley Ryer, Larry Baxter, Kylie Peacock

More and more Canadian adults are living with more than one chronic disease or condition at the same time, especially as they get older. This creates complex health and social challenges that can be helped by a team of interprofessional primary healthcare providers. Programs for patients with multiple chronic conditions, offered by primary health care teams in Nova Scotia and Newfoundland and Labrador, will be identified and compared. Using a framework for patient-centered care developed by researchers in Quebec and Ontario, the effective elements of these programs will be identified. Team members and patients from these programs will be interviewed to map the process of care for patients. Patients with multiple chronic conditions will be surveyed to understand their experience of receiving care from these teams. The teams from all four provinces will come together to share knowledge and develop tools that could be used by primary healthcare teams, patients, healthcare administrators and researchers. The research team expects that they will identify program enhancements that could lead to improvements in quality of care for patients with multiple chronic conditions. This could enable these patients to experience better health and require less emergency and hospital care.

Title: An Inter-provincial comparison of innovative programs that help individuals and families affected by life-limiting chronic illnesses navigate end-of-life (Led by BRIC NS with partners in PEI and BC)
NS Research Team: Robin Urquhart (Nominated Principal Investigator), Grace Warner, Grace Johnston, Beverley Lawson, Cheryl Tschupruk, Juanna Ricketts

As our population gets older and the number of people living with chronic diseases rises, it will become more difficult to provide good quality care for people who live with advanced chronic disease and are approaching the end of life (EOL). Much research across Canada has shown that our healthcare systems often cannot meet the needs of these people in its current state. We need innovative ways to increase patient and family awareness of, access to, and coordination between services and supports that help people meet their needs and goals as they get closer to EOL. One potentially important approach is the delivery of community-based navigation programs that can educate patients and families, link them to critical health system and community services and supports, and support better coordination across healthcare settings. This project will identify and compare how well community-based navigation programs put in place across Canada, help individuals and families affected by advanced chronic diseases improve their access to services and supports, and achieve their EOL goals. The project will also examine how these programs can best be implemented in other places. This information will be obtained through several different ways, including surveys and interviews with people who work in the programs (e.g., nurses, navigators, managers) and use the programs (e.g., patients, family members). The information received will be used to: understand how navigation programs work, for who, under what circumstances, and to produce what types of results; and to shape recommendations about whether and how to implement such programs in other parts of our country.


Title: Integrating Paramedic Services and Primary Palliative Care to Optimize Patient Time in the Community at the End-of-Life (Led by BRIC NS with partners in BC)
Research Team: Alix Carter (Nominated Principal Applicant), Fred Burge, Andrew Travers, Judah Goldstein, Michelle Harrison, Beverley Lawson, Grace Warner, BC Research Team: William Dick, Jennifer Kryworuchko, Kimberlyn McGrail, Sabrina Wong

Led by BRIC NS member Dr. Alix Carter and partnered with BC. This project is a comparative analysis of two provinces, one with and one without the paramedics providing palliative care at home program, as it represents programmatic innovation in health care delivery. British Columbia will serve as the comparison province without a comparable program. This cross-provincial comparison has the primary objective to examine whether the Program is associated with the ability of people to stay in the community longer during the end of life, satisfying patient/family needs and using fewer hospital resources. The project also includes a formal assessment of potential to scale to a system level.

Title: Policies and program innovations that connect primary health care, social services, public health and community supports in Canada: A comparative policy analysis (Led by Quebec with partners in NS, AB, BC, MB, NB, NL, PE)
Research Team: Jeannie Haggerty (Nominated Principal Applicant), Robin Urquhart, Cheryl Tshupruk, Anne Junker, Yves Couturier, Shelley Doucet, Tara Stewart, Marilyn Barrett, Denis Roy, Leanne Currie, William  Montelpare, Jason Sutherland, Shannon Berg, Russell Dawe, Catherine Scott

Children and youth older adults with serious chronic conditions and with limited or diminishing capacity to look after themselves independently often need their primary care providers to connect them to social services, public health services and community supports. These can be services such as home care, housekeeping, education aids, income assistance, legal services and respite care. Failure to connect to needed services leads to negative experiences for patients, caregivers and health professionals alike; it also leads to poor health outcomes and health system inefficiencies. The goal of this research is to help future development of models of care that connect smoothly across health, social and community services. We will study the policies and governing structures that restrict or allow connections in different provinces and territories. Then we will identify examples of successful and unsuccessful programs that were designed to connect services so we can learn from best practices and failures. We specifically focus on what hinders information sharing across services, again looking for examples of where information flow and linkage works. Better data linkage across multiple services is good for patient care, but it will also help researchers who want to study what happens to patients. Results from the study will help various teams who are currently planning to design and study these integrated service delivery models. We believe that the findings will also be relevant to other populations with complex needs like people with mental health and substance abuse issues.