1
|
Ross D, Roerig M, Allin S, Marchildon G, Christenson J, Abu-Laban RB. A Global Survey of Emergency Care Clinical Networks: Discussion and Implications for Canadian Learning Health Systems. Healthc Policy 2023; 19:28-35. [PMID: 38105665 PMCID: PMC10751757 DOI: 10.12927/hcpol.2023.27235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Clinical networks (CNs) can promote innovation and collaboration across providers and stakeholders. However, little is known about the structure and operations of CNs, particularly in emergency care. As Canada advances learning health systems (LHSs), foundational research is essential to enable future comparisons across CNs to identify those that contribute to positive system change. Drawing from the results of our international survey, we provide a description of 32 emergency care CNs worldwide, including their structure, operations and sustainability. Future research should consider the context of such networks, how they may contribute to an LHS and how they impact patient outcomes.
Collapse
Affiliation(s)
- Duncan Ross
- Learning Health Systems Data Analyst, BC Support Unit Michael Smith Health Research BC, Adjunct Professor, Department of Emergency Medicine Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - Monika Roerig
- Research Coordinator, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Sara Allin
- Associate Professor, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Greg Marchildon
- Professor Emeritus, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Jim Christenson
- Professor, Department of Emergency Medicine Faculty of Medicine, University of British Columbia, Senior Medical Advisor Emergency Care BC, Vancouver, BC
| | - Riyad B. Abu-Laban
- Professor, Department of Emergency Medicine Faculty of Medicine, University of British Columbia, Interim Scientific Director, Emergency Care BC, Vancouver, BC
| |
Collapse
|
3
|
Ho K, Lauscher HN, Stewart K, Abu-Laban RB, Scheuermeyer F, Grafstein E, Christenson J, Sundhu S. Integration of virtual physician visits into a provincial 8-1-1 health information telephone service during the COVID-19 pandemic: a descriptive study of HealthLink BC Emergency iDoctor-in-assistance (HEiDi). CMAJ Open 2021; 9:E635-E641. [PMID: 34131026 PMCID: PMC8248563 DOI: 10.9778/cmajo.20200265] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND British Columbia, like many jurisdictions, has a health information telephone service (8-1-1) to provide callers with information by registered nurses and help them decide whether to attend an emergency department or primary care clinic, or manage their concern at home. We describe a new service, HealthLink BC Emergency iDoctor-in-assistance (HEiDi), that partnered physicians available by videoconferencing with 8-1-1 registered nurses to support callers. METHODS From Apr. 6 to Aug. 2, 2020, all callers to the 8-1-1 telephone service (available to anyone in BC) categorized as "seek care within 24 hours" by registered nurses were eligible for referral to HEiDi. HEiDi physicians ("virtual physicians") connected directly with callers via desktop videoconferencing software, assessed their health complaint, provided advice and suggested care disposition. We conducted a descriptive study and collected demographic characteristics, health concern and disposition determined by the virtual physician. RESULTS HEiDi virtual physicians provided 7687 consultations. Most patients (n = 4439, 57.8%) were in the 20-64 age range, and 4814 (62.9%) were female. Common health concerns were related to gastroenterology (n = 1275, 16.6%), respiratory (n = 877, 11.4%) and dermatology (n = 874, 11.4%). From the 7531 calls with available data, 2548 (33.8%) callers were advised to attempt home treatment, 2885 (38.3%) to contact a primary care physician within 1 week, 1131 (15.0%) to attend an emergency department immediately and 538 (7.1%) to attend their primary provider now. INTERPRETATION We found that virtual physicians were able to advise nearly 3 out of 4 (72.1%) patients away from in-person emergency or clinic assessment and 1 in 7 (15.0%) to seek immediate emergency department care. Virtual physicians can provide an effective complement to a provincial health telephone system.
Collapse
Affiliation(s)
- Kendall Ho
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Helen Novak Lauscher
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Kurtis Stewart
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Riyad B Abu-Laban
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Frank Scheuermeyer
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Eric Grafstein
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Jim Christenson
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| | - Sandra Sundhu
- Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC
| |
Collapse
|
4
|
Drebit S, Eggers K, Archibald C, Abu-Laban R, Ho K, Khazei A, Lindstrom R, Marsden J, Martin E, Christenson J. Evaluation of Patient Engagement in a Clinical Emergency Care Network: Findings From the BC Emergency Medicine Network. J Patient Exp 2021; 7:937-940. [PMID: 33457524 PMCID: PMC7786762 DOI: 10.1177/2374373520925721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The British Columbia Emergency Medicine Network (EM Network) has collaborated with patient partners to utilize their experiential knowledge to inform planning and implementation. Patient partners participated in several EM Network committees and initiatives. This study evaluated how patient partners and other leaders in the EM Network perceived patient engagement efforts 1 year after launch. The Public and Patient Engagement Evaluation Tool V2.0 found that there was an appropriate level of patient engagement at this early stage, an opportunity to attract more patient partners as the EM Network grows, and a need to ensure adequate resources to support more activities.
Collapse
Affiliation(s)
- Sharla Drebit
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Kim Eggers
- Patient Voices Network, Vancouver, British Columbia, Canada
| | - Chantel Archibald
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Riyad Abu-Laban
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Kendall Ho
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Afshin Khazei
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Ronald Lindstrom
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Julian Marsden
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| | - Ed Martin
- Patient Voices Network, Vancouver, British Columbia, Canada
| | - Jim Christenson
- Department of Emergency Medicine, University of British Columbia, BC Emergency Medicine Network, Vancouver, British Columbia, Canada
| |
Collapse
|
5
|
Du Mont J, Hemalal S, Kosa SD, Cameron L, Macdonald S. The promise of an intersectoral network in enhancing the response to transgender survivors of sexual assault. PLoS One 2020; 15:e0241563. [PMID: 33206636 PMCID: PMC7673577 DOI: 10.1371/journal.pone.0241563] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study explores the promise of an intersectoral network in enhancing the response to transgender (trans) survivors of sexual assault. METHODS One hundred and three representatives of healthcare and community organizations across Ontario, Canada were invited to participate in a survey. Respondents were asked to: 1) identify systemic challenges to supporting trans survivors, 2) determine barriers to collaborating across sectors, and 3) indicate how an intersectoral network might address these challenges and barriers. Descriptive statistics were used to summarize quantitative data and qualitative data were collated thematically. RESULTS Sixty-seven representatives responded to the survey, for a response rate of 65%. Several themes capturing the challenges organizations face in supporting trans survivors were identified: Lack of knowledge and training among providers, Inadequate resources across organizations and institutions, and Limited access to and availability of appropriate services. Barriers to collaborating across sectors considered important by the overwhelming majority of respondents were: Lack of trans-positive service professionals (e.g., a paucity of sensitivity training), lack of resources (e.g., staff, staff time and workload, spaces to meet), and Institutional structures (e.g., oppressive policies, funding mandates). Four ways in which a network could address these challenges and barriers emerged from the data: Center the voices of trans communities in advocacy; Support competence of professionals to provide trans-affirming care; Provide the platform, strategies, and tools to aid in organizational change; and Create space for organizations to share ideas, goals, and resources. CONCLUSION Our findings deepen our understanding of important impediments to enhancing the response to trans survivors of sexual assault and the role networks of healthcare and community organizations can play in comprehensively responding to complex health and social problems.
Collapse
Affiliation(s)
- Janice Du Mont
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shilini Hemalal
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Sarah Daisy Kosa
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, ON, Canada
| | | | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, ON, Canada
| |
Collapse
|