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10. Geriatric dementia care at Ontario Shores: A new model of care

Author

Viau, Katelynn, Yaddaden, Amel, Lussier, Maxime, Bier, Nathalie, Earle, Julie, Duff-Woskosky, Andra, Bartfay, Wally, Desai, Chaitali, Zavitz, Karen, Horsburgh, Sheri, Gamble, Brenda, Lee, Linda, Hillier, Loretta M., Patel, Tejal, Molnar, Frank, Clarke, Jo-Anne, Borrie, Michael, Cammer, Allison, Morgan, Debra, Whiting, Susan, de Vos, Maya, Henri-Bhargava, Alexandre, Votova, Kristine, Delmar, Paul, Kerchner, Geoffrey A, Wang, Guoqiao, Bateman, Randall, Klein, Gregory, Andjelkovic, Mirjana, Abi-Saab, Danielle, Bullain, Szofia, Montoya, Alonso, Fontoura, Paulo, Doody, Rachelle, Tai, Elaine, Harvey, David, Hofmann, Carsten, Ristic, Smiljana, Rehal, Sunita, Voyle, Nicola, Baudler, Monika, Verreault, Phylicia, Rousseau, François, Keller, Evelyn, Simard, Alexandra, Azouaou, Nassima, Jarboui, Manel, Talleria, Lorraine, Duguay, Johanne, Mérette, Chantale, Labbé, Annie, de Arco, Rossana Peredo Nunez, Yous, Marie-Lee, Ploeg, Jenny, Kaasalainen, Sharon, Martin, Lori Schindel, Palumbo, Mary Val, Rambur, Betty, McKenna, Lori, Voyer, Philippe, Allaire, Émilie, Li, Bing, Thaut, Michael, Yogaparan, Thirumagal, Shanmuganathan, Thirunathan, Vickneswaran, Anicha, Sriharan, Sruthy, DeMarco, Mari L., Hsiung, Ging-Yuek Robin, Best, John R., Chertkow, Howard, Gauthier, Serge, Karlawish, Jason, Feldman, Howard, Spaner, Caroline, Christie, Brian, Musteata, Stela, Gawryluk, Jodie, Hofer, Scott, Henri-Bhargava, Alex, Kenny, Rebecca, Elliot, Valerie, Kosteniuk, Julie, Chow, Amanda Froehlich, Bayly, Melanie, O’Connell, Megan E., Kortzman, August, O’Connell, Megan, Kirk, Andrew, Conn, David, Sokoloff, Lisa, Feldman, Sid, Chau, James, Moser, Andrea, Lingum, Navena, Gingrich, Shaen, Shaikh, Salma, Rabheru, Kiran, Cassidy, Keri-Leigh, Checkland, Claire, Parsons, Daria, Massie, Ariane S., Mitchell, Julie Spence, Aksenchuk, Sophia, Lindsay, Barbara, Howard, Maria, Shaw, Courtney, Armitage, Gerrard, Capstick, Andrea, McNeil, Heather, Holyoke, Paul, Vines, Chanile, Giosa, Justine, Khan, Bilal, Shultz, Mary, BEAUCHET, Olivier, Sekhon, Harmehr, Allali, Gilles, Montembeault, Maxime, Brodeur, Catherine, Macoir, Joël, Maxwell, Colleen, Maclagan, Laura, Campitelli, Michael, Yao, Shenzhen, Dharma, Christoffer, Sherin, Tracey, Hogan, David, Bronskill, Susan, Ivo, Jessica, Faisal, Sadaf, McDougall, Aidan, Bauer, Jillian, Pritchard, Sarah, Chang, Feng, Mehta, Deval, Syed, Ali, Carter, Caitlin, Sharma, Shaambhavi, Nagge, Jeff, Naglie, Gary, Stasiulis, Elaine, Yamin, Stephanie, Vrkljan, Brenda, Tuokko, Holly, Sanford, Sarah, Porter, Michelle, Polgar, Jan, Myers, Anita, Moorhouse, Paige, Mazer, Barbara, Marshall, Shawn, Gélinas, Isabelle, Crizzle, Alexander, Byszewski, Anna, Belchior, Patricia, Bédard, Michel, Rapoport, Mark, Minish, Duane, Yetman, Linda, Stephenson, Margaret, McCloskey, Rose, Agbaku, Mansa, Jarrett, Pamela, Cavanagh, Jennifer, Loncar, Adele, Demers, Vickie, Gobessi, Linda, Lodha, Vinay, Scerbe, Andrea, Astell, Arlene, DesRoches, Andrea, Panyavin, Ivan, Feltz, Nick, Wittich, Walter, Aubin, Gabrielle, Hogan, Mariah, Swaminathan, Swathi, Altschuler, Aviva, Murphy, Kelly, Guthrie, Dawn, Williams, Nicole, Campos, Jennifer, Mick, Paul, Orange, Joseph B., Pichora-Fuller, M. Kathleen, Savundranayagam, Marie Y., Phillips, Natalie A., Giroud, Nathalie, Pichora-Fuller, Kathy, Al-Yawer, Faisal, Rehan, Sana, Phillips, Natalie, Beauchet, Olivier, Niculescu, Iulia, Iaboni, Andrea, Quirt, Hannah, Penko, Marion, Tsokas, Mario, Marshall, Cecelia, Flint, Alastair, McGilton, Katherine, O’Connell, Megan E, Stewart, Norma J, Seitz, Dallas, Daku, Jean, Hack, Tracy, Hoium, Faye, Kennett-Russill, Deb, Sauter, Kristen, Holley, Joanna, Wimhurst, Christine, Katchaluba, Janet, Mitchell, Debbie, Severina, Elmira, Dallaire-Théroux, Caroline, Saikali, Stéphan, Duchesne, Simon, Sivananthan, Saskia, Mirza, Saira, Saeed, Usman, Knight, Jo, Ramirez, Joel, Stuss, Donald, Yu, Di, Swardfager, Walter, Keith, Julia, Nestor, Sean, Black, Sandra, Masellis, Mario, Joyal, Marilyne, Kotz, Sonja A., Lenglos, Christophe, Renauld, Emmanuelle, Wilson, Maximiliano A., Fecteau, Shirley, Appel, Lora, Kisonas, Erika, Appel, Eva, Bartlett, Deanna, Klein, Jennifer, Rosenberg, Jarred, Smith, Christopher, Ali, Suad, Narang, Tanya, Wiseman, Micaela, Ein, Natalie, Orchanian-Cheff, Ani, Rylett, Jane, Hogan, David B., Rockwood, Kenneth, Dixon, Roger, Sun, Winnie, Hawkins, Stacey A., Awde, Carolee, Kay, Kelly, Huntsbarger, Deana, Ferrier, Erin, Sourial, Nadia, Arsenault-Lapierre, Genevieve, McAiney, Carrie, Vedel, Isabelle, Ingram, K. Jennifer, Frank, Andrew, Sabra, Iman, Wallace, Bruce, Breau, Michael, Sweet, Lisa, Goubran, Rafiq, Knoefel, Frank, Goubran, Rafik, Stroulia, Eleni, Ault, Laura, Kecskemet, Judith, Guseva, Elena, Lungu, Ovidiu, Goldman, Sondra, Wilchesky, Machelle, Johri, Fozia, Turner, Angelese, Lavoie, Monica, Tang-Wai, David, Leonard, Carol, Graham, Naida L., Rochon, Elizabeth, Middleton, Laura, Herrmann, Nathan, Oh, Paul, Regan, Kayla, Bechard, Lauren, Lanctôt, Krista, Freeman, Shannon, Pettersen, Jacqueline, Tomasone, Jennifer, Dupuis, Sherry, Giangregorio, Lora, Ferris, Rebecca, Stultz, Tim, Mallard, Kirsten, Campbell, Elaine, Chatterjee, Atri, Mackenzie, Ian, Reinshagen, Veronica Hirsh, Ducharme, Blake, Mousavi, Ali, Gill, Sascha, Mouches, Pauline, Wang, Meng, Rajasheskar, Deepthi, MacMaster, Frank, Forkert, Nils, Smith, Eric, Ismail, Zahinoor, Varatharajah, Breni, Camicioli, Richard, Gee, Myrlene, Zwiers, Angela, Sekhon, Ramnik, Charlton, Anna, Arsenault-Lapierre, Geneviève, Ingram, Jennifer, Hawkins, Stacey, Mousavi, SeyedAli, Mackenzie, Ian R. A., Hirsh-Reinshagen, Veronica, Hsiung, Ging-Yuek. R., Gillingham, Susan M.E., Anderson, Nicole D., Alain, Claude, Georgievski, Georgi, Alfaro, Leonardo, McClenaghan, Meridith, Soares, Daniela, Matheson, Maureen, Stanoulis, Krisanne, Boyle, Daniel, Chau, Linh, Pelc, Jordan, Snash, Nadia, Byrne, Joanne, Elalouf, Karine, Alfaro, Andrea Urqueta, Johnson, Aaron, Marinier, Julie-Andrée, Kehayia, Eva, Gagné, Jean-Pierre, Murphy, Caitlin, Ellen, Ruth, Flowers, Brandi, Boulton, Karen Lee, Subotic, Arsenije, McCreary, Cheryl R., Nguyen, Amanda, Saad, Feryal, Alvarez, Ana, Beaudin, Andrew E, Pike, Bruce, Smith, Eric E, Hu, Sophie, Patten, Scott, Fick, Gordon, Sapkota, Shraddha, Mirza, Saira Saeed, Scott, Christopher J., Stuss, Donald T., Black, Sandra E., Le Blanc, Gabriella, Ducharme, Simon, Meilleur-Durand, Synthia, Lévesque, Marianne, St-Onge, Frédéric, Cunnane, Stephen, Villeneuve, Sylvia, Callahan, Brandy, Laforce, Robert, Cetin-Sahin, Deniz, Cummings, Greta G., Schuster, Tibor, Karanofsky, Mark, De Jesus, Belmir J., Cassani, Raymundo, Cecchi, Marco, Fadem, K. C., McGeown, William J., Falk, Tiago H., Chu, Charlene, Zdaniuk, Natalia, Wang, Rosalie, Ouellet, Marie-Christine, Cassivi-Joncas, Alison, Godard-Sebillotte, Claire, Rochette, Louis, Pelletier, Eric, Strumpf, Erin, Margo-Dermer, Eva, Silver, Hilah, Vafaei, Rod, Fok, Alice C, Hsiung, Ging-Yuek R., Ursenbach, Jake, Bethell, Jennifer, Neuman, Mark D, Bateman, Brian T, Hill, Andrea, Wunsch, Hannah, Ritchie, Kim, Cramm, Heidi, Aiken, Alice, Donnelly, Catherine, Goldie, Katie, Delara, Mahin, Ozzoude, Miracle, Varriano, Brenda, McLaughlin, Paula, Troyer, Angela, Bartha, Robert, Symons, Sean, Kwan, Donna, Tan, Brian, Swartz, Richard H., Saposnik, Gustavo, Tartaglia, Maria C., Ahuja, Manan, Siddhpuria, Shailee, Gormley, Jessica, Reppas, Christina, Wong, Eric, Lee, Justin, Patterson, Christopher, Walker, Jennifer, Warry, Wayne, Blind, Melissa, Allaby, Cheryl, Pitawanakwat, Karen, Zhao, Yantao, Lemieux, Andrine, Jacklin, Kristen, Crowshoe, Lindsay, Boehme, Gail, McKenna, Betty, Boyling, Elaine, Webkamigad, Sharlene, Bigeagle, Louise, Akan, Nicole, Wallace, Lindsay, Theou, Olga, Bennett, David, Darvesh, Sultan, Kirkland, Susan, Fisk, John, Andrew, Melissa, Cullen, Stephanie, Carroll, Susan, Mahon, Joel, Sarquis-Adamson, Yanina, Montero-Odasso, Manuel, Sharma, Nabina, Beaton, Derek, Roberts, Angela, Munoz, Doug, Swartz, Richard, Breen, David, Lang, Anthony, Fischer, COrrine, Fischer, Corrine, Kumar, Sanjeeve, Freedman, Morris, Finger, Elizabeth, Zinman, Lorne, Grimes, David A., Sunderland, Kelly M., Binns, Malcolm A., Strother, Stephen C., Mandzia, Jennifer, Orange, JB, Tartaglia, Carmela, El Shatshat, Amna, Rao, Praveen P.N., Teves, Julia, Bodkin, R Jack, Ho, Joanne M-W, Mehdizadeh, Sina, Dolatabadi, Elham, Ng, Kimberley-Dale, Arora, Twinkle, Jizmejian, Melody, Mansfield, Avril, Taati, Babak, Levy, Jake, Savard, Melissa, Pascoal, Tharick, Soucy, Jean-Paul, Rosa-Neto, Pedro, Martins, Felicia, Waller, Shannon, Flora, Parminder, Morland, Chris, Donovan, Steve, Fels, Deborah, Desai, Shital, Boger, Jennifer, Shashtri, Karan, Persaud, Deanna, Marashi, Sheida, Nedlund, Ann-Charlotte, Mäki-Petäjä-Leinonen, Anna, Nygård, Louise, Issakainen, Mervi, ryd, Charlotta, Pan, Yuhan, Joddrell, Phil, Dove, Erica, Owens, Hollis, Park, Elly, Liu, Lili, Kaufman, David, Simonian, Natalie, Chen, Ying, Sunderland, Kelly, Fraser, Julia, Swartz, Rick, Strother, Stephen, Legrand, Diego, Roberge, Pasquale, Vanasse, Alain, Bocti, Christian, Pirrie, Lorraine, Gray, Carolyn Steele, Nippak, Pria, Coughlan, Dave, Teselink, Johannes, Hermann, Nathan, Rasquinha, Fawn, Lanctot, Krista, Webber, Jodi, Woo, Kevin, Chamoun, Elicia, Coulombe, Valérie, Sellami, Leila, Paquette-Raynard, Emmanuelle, Gardner, Sandra, van Zon, Lorraine, Moy, Sally, Sidrak, Mariam, Sternhill, Janis, Feldman, Sidney, Karuza, Jurgis, Berall, Anna, Thomas, Neil, Mattek, Nora, Riley, Thomas, Reynolds, Christina, Marcoe, Jennifer, Sharma, Nicole, Kaye, Jeffrey, Jagtap, Shreya, Rotenberg, Shlomit, Vandermorris, Susan, Anderson, ND, Dawson, DR, Chater, Catherine, Soor, Jaspreet, Ji, Xiang, Koo, Morgan, Compagnone, Jordana, Kertes, Peter, Juby, Angela, Mager, Diana, Davis, Christopher, Jay, David, Blackburn, Toni, Brocks, Dion, Lee, Hyunwoo, Wiggermann, Vanessa, Rauscher, Alexander, Lam, Kevin, Tam, Roger, Popuri, Karteek, Beg, Mirza Faisal, Jacova, Claudia, Sossi, Vesna, Bindra, Jessica, Bouvier, Liziane, Monetta, Laura, Vitali, Paolo, Martel-Sauvageau, Vincent, Godin, Judith, McNeil, Shelly, McElhaney, Janet, Laughton, Thomas, Ho, Joanne, Tung, Jennifer, Dubé, Joseph B., Lin, Tianzhen, Best, Sarah, Truemner, Julia, Sargeant, Patricia L., Borrie, Michael J., Fogarty, Jennifer, Bassi, Nimi, Di Prospero, Cynthia, Whitehead, Victor, Pilon, Randi, Wong, Timothy, Elhayek, Nada, Dasgupta, Monidipa, Davis, Daniel, ORegan, Niamh, Kröger, Edeltraut, Furrer, Daniela, Wilcheski, Machelle, Morin, Michèle, Carmichael, Pierre-Hugues, Champoux, Nathalie, Monette, Johanne, Giguère, Anik, Aubin, Michèle, Durand, Pierre, Whiteside, Jena, Mele, Bria, Merrikh, Daria, Goodarzi, Zahra, Seary, Judith Anne, Bulley, Heather, Diciacca, Allison, Esseltine, Julia, Gaiger, Erin, Jankovic, Ivana, Mackenzie, Stephanie, McBride, Meghan, Knopp-Sihota, Jennifer A., Hoben, Mathias, Poss, Jeffrey W., Rachor, Geoffrey S., Estabrooks, Carole A., and Iroanyah, Ngozi

Subjects
Abstracts: Posters
Published
2020

12. Virtual interprofessional education to support medical laboratory technologists' participation in interprofessional collaborative practice within integrated healthcare models

Author

Gamble, Brenda, Dubrowski, Adam, Torres, Andrei, and Short, Michael

Abstract

Interprofessional collaborative practice is a key requirement for the successful implementation of integrated healthcare models. Current interprofessional education opportunities seldom include medical laboratory technologists who oversee the production of data that informs the diagnosis, treatment, and monitoring of patients. Errors in the laboratory process mostly occur in the pre-analytical and post-analytical phases, which both involve the need for collaboration between medical laboratory technologists and other healthcare providers. In this article, we introduce and describe an innovative work-integrated virtual learning experience that provides technologists with the opportunity to fully participate in interprofessional education.

Published
2023
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17. A systems approach to address the impact of second victim phenomenon.

Author

Gamble, Brenda and Gamble, Kathleen Jean

Subjects
WORK environment, MEDICAL personnel, POPULATION geography, VICTIM psychology, SYSTEM analysis, PSYCHOSOCIAL factors, HEALTH, INFORMATION resources, INTERPERSONAL relations, DECISION making in clinical medicine, PATIENT safety
Abstract

Over the last decade, second victim phenomenon (SVP) has been identified as a serious issue for healthcare workers (HCWs). Results from a 2018 survey of Canadian HCWs demonstrated that the majority of those who responded had experienced SVP and indicated that there was a lack of support in the workplace. The overall objectives of this paper are to a) heighten the awareness about SVP and its impact on HCWs and 2) to recommend an organizational/systems approach to support HCWs as second victims. This will be accomplished by first defining SVP and its relationship to patient safety. We will apply a health geography framework which incorporates the concepts of location, place, human interaction, movement and region to demonstrate the variability across care settings and the need for a systems approach to support HCWs. A human geography approaches to SVP would allow policymakers, leadership teams and managers within a health care setting to uniquely tailor their support systems to their individual contexts, which in turn will create a workplace culture of safety that builds on the organization's unique qualities. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector

Author

Landry Michel D, Hastie Robyn, Oñate Känecy, Gamble Brenda, Deber Raisa B, and Verrier Molly C

Subjects
Physical therapy, Health human resources, Workforce, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.

Published
2012
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22. Accountability through Regulation in Ontario's Medical Laboratory Sector

Author

Gamble, Brenda, Bourne, Lavern, and Deber, Raisa B.

Subjects
Interviews as Topic, Male, Ontario, Financing, Government, Social Responsibility, Quality Assurance, Health Care, Organizational Case Studies, Humans, Female, Documentation, Clinical Laboratory Services, Licensure, Research Paper
Abstract

Although the use of performance indicators for the analytical (and highly measurable) phase of the medical laboratory process has had a long and successful history, it is now recognized that the value of a laboratory test is embedded in a system of care. This case study, using both documents and interview data, examines the approaches to accountability in the Ontario Medical Laboratory Sector, noting both the challenges and benefits. This sector relies heavily on the regulation instrument, including a requirement that all medical laboratories licensed by the provincial government must follow the guidelines set out by the Quality Management Program - Laboratory Services. We found the greatest challenges exist in the pre-analytical phase (where a large portion of total laboratory errors occur), particularly the interface between the laboratory and other providers.

Published
2014

23. Mental health service utilization among demented individuals with or without mood disorders in Canada.

Author

Ackerman, Michael, Bartfay, Emma, Bartfay, Wally J., and Gamble, Brenda

Subjects
MENTAL health services, AFFECTIVE disorders, ALZHEIMER'S disease
Abstract

Aim: To assess how comorbid mood disorders were associated with health service utilization of individuals with Alzheimer's disease or other dementias in a Canadian household population. Methods: The study utilized a population-based secondary data analysis approach, using data from the Canadian Community Health Survey (CCHS) 2011-2012 annual component. Results: Mood disorders were found to be more prevalent among persons with Alzheimer's disease or other dementias compared to those without (26.7% vs 7.7%). Individuals with Alzheimer's disease or other dementias and a comorbid mood disorder were more likely to use mental health services (Adj OR: 6.58, P=0.000). Conclusion: The increased usage of health services in persons with Alzheimer's disease or other dementias and a comorbid mood disorder exhibit the importance of understanding the needs of these individuals to help shift public policy. This will aid researchers in developing and implementing improved services. [ABSTRACT FROM AUTHOR]

Published
2016
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32. Canadian Stakeholders' Views about the Boundaries of Publicly Funded Health Care: What are the Consequences for Women Caregivers?

Author

Gamble, Brenda J.

Subjects
MEDICAL care, SOCIOECONOMICS, INFORMAL sector, SMALL business, HOSPITAL & community, CAREGIVERS, PUBLIC health, HEALTH care industry
Abstract

The debate about the sustainability of Canada's health care model has focussed on updating what services should be publicly funded. Full public coverage is only guaranteed for services delivered in hospitals or by physicians. Many reports have recommended expanding public coverage to include community-based services. A national survey of 2,523 policy elites demonstrated that implementation of this policy direction will be difficult. The inability to implement policy that supports publicly financing community-based services could result in a shift of the delivery of care from the formal sector to the informal sector. Moreover, a shift of this nature will undoubtedly result in a higher reliance on the unpaid work of women caregivers. Consequently, there is a need to explore the impact that economic and social restructuring has on the well-being of women caregivers within both the formal and informal sectors. [ABSTRACT FROM AUTHOR]

Published
2007

33. Simulation Interventions for the Classroom to Support the Acquisition of Interprofessional Competencies.

Author

Gamble BJ, Graham L, Goulding HM, Moreau E, and Barth B

Abstract

Interprofessional collaboration (IPC) supports the delivery of quality and safe healthcare. The acquisition of interprofessional competencies both pre-licensure and post-licensure are key to implementing this approach in the healthcare workplace. This report documents the development and implementation of a simulation intervention to support interprofessional education (IPE) in the undergraduate classroom for pre-licensure learners. The learning activity framework includes an exposure phase (e.g., didactic classroom instruction) and an immersion phase (e.g., simulation intervention and debriefing). Details on the debriefing process are included as it is key to achieving the learning objectives. The three learning activity pilot tests (n=150) revealed that learners recognized that interprofessional competencies were an important asset to support IPC. The pilot tests identified the need for further development in order for students to make a connection with the mastery phase (i.e., clinical placement). The next steps will include the development and incorporation of formative tools to assess learners' progress, as well as a plan to evaluate the learning activity that will connect all three phases (exposure, immersion, and mastery) of the learning framework., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Gamble et al.)

Published
2021
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34. The Canada Health Act for the Twenty-First Century?.

Author

Deber R and Gamble B

Subjects
Canada, Health Care Reform, Health Policy, Health Services Accessibility legislation & jurisprudence, Health Services Accessibility organization & administration, Humans, Universal Health Insurance legislation & jurisprudence, Forecasting, Universal Health Insurance organization & administration
Abstract

As the participants in the Canada Health Act, Version 2.0 conference made clear, there is a strong case to be made that this key piece of legislation no longer captures some key challenges to managing health care in Canada. Particular issues include 'portability' across provincial/territorial boundaries, and the definition of insured services. However, the CHA is not a barrier to reform; it acts as a floor, rather than a ceiling. Health reform may thus require a combination of new legislation to set conditions for which new services should be insured, and developing mechanisms to identify priorities, ensure appropriateness, and improve efficiency, which are unlikely to be addressed through overarching legislation. The CHA should thus be maintained, recognizing that it is necessary, but not sufficient.

Published
2017

35. Ensuring accountability through health professional regulatory bodies: the case of conflict of interest.

Author

Zelisko D, Baumann A, Gamble B, Laporte A, and Deber RB

Subjects
Health Occupations economics, Health Occupations legislation & jurisprudence, Humans, Ontario, Organizational Policy, Professional Misconduct legislation & jurisprudence, Societies ethics, Societies legislation & jurisprudence, Conflict of Interest, Health Occupations ethics, Professional Misconduct ethics, Social Responsibility, Societies standards
Abstract

How do self-regulated health professions' regulatory bodies address financial conflict of interest (coi) and ensure accountability to the public? using document analysis, we examined how four ontario regulatory colleges (physicians, nurses, physiotherapists, audiologists/speech-language pathologists) defined coi and the education, guidance and enforcement they provided for coi-related issues. These colleges are upholding the mandates to define, identify and address financial coi by providing regulations or standards and guidelines to their membership; they differed in the amount of educational materials provided to their registrants and in the possible coi scenarios they presented. Although there were few disciplinary hearings pertaining to financial coi, findings for the hearings that did occur were documented and posted on the college public registers (the listing of all registered college members along with all relevant practice information), informing the public of any limitations or restrictions placed on a member as a result of the hearing., (Copyright © 2014 Longwoods Publishing.)

Published
2014

36. Accountability in the City of Toronto's 10 long-term care homes.

Author

Wyers L, Gamble B, and Deber RB

Subjects
Aged, 80 and over, Attitude of Health Personnel, Documentation, Female, Government Regulation, Health Facility Administrators, Homes for the Aged economics, Homes for the Aged organization & administration, Humans, Interviews as Topic, Long-Term Care economics, Long-Term Care organization & administration, Male, Nursing Homes economics, Nursing Homes organization & administration, Ontario, Patient Safety standards, Private Sector, Public Sector, Quality of Health Care organization & administration, Quality of Health Care standards, Homes for the Aged legislation & jurisprudence, Long-Term Care legislation & jurisprudence, Nursing Homes legislation & jurisprudence, Patient Safety legislation & jurisprudence, Quality of Health Care legislation & jurisprudence, Social Responsibility
Abstract

Long-term care (LTC) residential homes provide a supportive environment for residents requiring nursing care and assistance with daily living activities. The LTC sector is highly regulated. We examine the approaches taken to ensure the delivery of quality and safe care in 10 LTC homes owned and operated by the City of Toronto, Ontario, focusing on mandatory accountability agreements with the Local Health Integration Networks (LHINs). Results are based on document review and seven interviews with LTC managers responsible for the management and operation of the 10 LTC homes. One issue identified was the challenges associated with implementing new legislative and regulatory requirements to multiple bodies with differing requirements, particularly when boundaries do not coincide (e.g., the City of Toronto's Long-Term Care Homes and Services Division must establish 10 different accountability agreements with the five LHINs that span into the City of Toronto's geographic area)., (Copyright © 2014 Longwoods Publishing.)

Published
2014

37. Accountability through regulation in Ontario's Medical Laboratory Sector.

Author

Gamble B, Bourne L, and Deber RB

Subjects
Clinical Laboratory Services economics, Clinical Laboratory Services legislation & jurisprudence, Documentation, Female, Financing, Government, Humans, Interviews as Topic, Licensure, Male, Ontario, Organizational Case Studies, Quality Assurance, Health Care methods, Clinical Laboratory Services standards, Quality Assurance, Health Care standards, Social Responsibility
Abstract

Although the use of performance indicators for the analytical (and highly measurable) phase of the medical laboratory process has had a long and successful history, it is now recognized that the value of a laboratory test is embedded in a system of care. This case study, using both documents and interview data, examines the approaches to accountability in the Ontario Medical Laboratory Sector, noting both the challenges and benefits. This sector relies heavily on the regulation instrument, including a requirement that all medical laboratories licensed by the provincial government must follow the guidelines set out by the Quality Management Program - Laboratory Services. We found the greatest challenges exist in the pre-analytical phase (where a large portion of total laboratory errors occur), particularly the interface between the laboratory and other providers., (Copyright © 2014 Longwoods Publishing.)

Published
2014

38. Where Are Ontario's Respiratory Therapists Working?

Author

Gamble B, Daniels F, Deber R, Laporte A, and Isaac W

Abstract

Registered respiratory therapists (RRTs) aid in the diagnosis and treatment of respiratory illness and cardiopulmonary disorders, conditions that are increasingly being managed in settings other than the hospital sector. However, analysis of a longitudinal data set of Ontario's RRTs (2,903) from 1996 to 2007 demonstrates that the majority of RRTs work full-time in the hospital sector, where retention is high. Despite a policy direction encouraging the shift of the site of care from the hospital sector to the community/home, this has had little impact on where RRTs work, raising the question of who is providing respiratory services in the community.

Published
2011

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