School of Kinesiology and Health Science
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Browsing School of Kinesiology and Health Science by Author "6ac360523e08c154cc1ffdf0a8717c80"
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Item Open Access Patient Safety Culture (PSC) perceptions of front-line staff in acute care hospitals: Examining the role of ease of reporting, group norms of openness, and participative leadership(Wolters Kluwer, 2015-01) Grace, Sherry; Chuang, You-Ta; Ginsburg, Liane; Zaheer, ShahramBackground: Increased awareness regarding the importance of patient safety issues has led to the proliferation of theoretical conceptualizations, frameworks, and papers that apply safety experiences from high-reliability industries to medical settings. However, empirical research on patient safety and patient safety climate in medical settings still lags far behind the theoretical literature on these topics. Purpose: The broader organizational literature suggests that ease of reporting, unit norms of openness, and participative leadership might be important variables for improving patient safety. The aim of this empirical study is to examine in detail how these three variables influence frontline staff perceptions of patient safety climate within healthcare organizations. Methodology: A cross sectional study design was used. Data were collected using a questionnaire composed of previously validated scales. Findings: The results of the study show that ease of reporting, unit norms of openness, and participative leadership are positively related to staff perceptions of patient safety climate. Practice Implications: Healthcare management needs to involve frontline staff during the development and implementation stages of an error reporting system to ensure staff perceive error reporting to be easy and efficient. Senior and supervisory leaders at healthcare organizations must be provided with learning opportunities to improve their participative leadership skills so they can better integrate frontline staff ideas and concerns while making safety related decisions. Lastly, healthcare management must ensure that frontline staff are able to freely communicate safety concerns without fear of being punished or ridiculed by others.Item Open Access Quality and Variability of Cardiovascular Rehabilitation Delivery: Applying the Canadian Quality Indicators(Wolters Kluwer, 2017-11) Somanader, Deborah; Chessex, Caroline; Ginsburg, Liane; Grace, SherryPurpose: Cardiac care, including cardiac rehabilitation (CR), is most effective if it is high-quality. The aim of this study was to describe CR quality, using the recently-developed Canadian Cardiovascular Society CR quality indicators (QIs). CR site differences in quality were also assessed. Methods: Secondary analysis was conducted on an observational, prospective, multi-site CR program evaluation cohort. A convenience sample of patients from one of 3 CR programs was approached at their first CR visit, and consenting participants completed a survey. Clinical data were extracted from charts pre and post-program. Of the 30 CR QIs, 21 (70.0%) were assessable: 10 process, 9 outcome and 2 structure QIs. Results: Of 411consenting patients, 209(53.0%)completed CR. The greatest quality was observed for assessment of blood pressure (98.1%), communication with primary healthcare at CR discharge(94.2%), and patient enrollment(94.0%). The lowest quality was observed for wait time from hospital discharge (9.2%), assessments of blood glucose (42.1%), and lipid control (53.0%). Of the 7 QI s that had an established benchmark, quality for 2 (28.6%) was above the benchmark (particularly assessment of blood pressure). Significant site differences were observed in 11(64.7%) QIs. The magnitude of quality differences between sites was largest for assessment of lipid control (72.6%), assessment of blood glucose control (69.0%), and wait time in median days from referral to enrollment(30.6 days).Conclusion: There is wide variability in CR program quality, both overall and between CR sites. Quality improvement in particular aspects of CR care is required.Item Open Access Referral and use of heart failure clinics: What factors are related to utilization?(2012-07) Gravely, Shannon; Ginsburg, Liane; Stewart, Donna Eileen; Mak, Susanna; Grace, Sherry L.Background: Due to its growing prevalence, heart failure (HF) has become a major burden worldwide. HF clinics have been shown to reduce hospital readmissions, and generally have favorable effects on quality of life, survival and care costs. This study investigated the rates of referral and utilization of HF clinics, and examined factors related to program use. Methods: This study represents a secondary analysis of a larger prospective cohort study conducted in Ontario. In hospital, 474 HF inpatients from 11 hospitals across Ontario completed a survey that examined predisposing, enabling and need factors affecting HF clinic use. Clinical and demographic data were extracted from medical charts. One-year later, 271 HF patients completed a mailed survey that assessed referral to and use of HF clinics. Data were collected between the years 2006-2008 and analyses ensued in 2010. Results: Forty-one patients(15.1%) self-reported referral, and 35(12.9%) reported attending a HF clinic (85% of those referred) at 1 of 16 sites. Generalized estimating equations showed that factors related to greater program use were: having a HF clinic at the site of hospital recruitment(Odds Ratio[OR]=8.40,p=0.04), referral to other disease management programs(OR= 4.87,p=0.04), higher education(OR=4.61,p=0.02), lower stress(OR=0.93,p=0.03) and lower functional status(OR=0.97,p=0.03). Conclusion: Similar to previous research, only one-seventh of HF patients were referred and used a HF clinic. Both patient-level and health-system factors were related to HF clinic use. Given the benefits of HF clinics, more research examining how equitable access can be increased is needed. Also, the appropriateness and cost repercussions of use of multiple disease management programs should be investigated.