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10. Factors influencing practice choices of early-career family physicians in Canada: A qualitative interview study

Author

Grudniewicz, Agnes, primary, Randall, Ellen, additional, Lavergne, M Ruth, additional, Marshall, Emily Gard, additional, Jones, Lori, additional, Rudoler, David, additional, Horrey, Kathleen, additional, Mathews, Maria, additional, McKay, Madeleine, additional, Mitra, Goldis, additional, Scott, Ian, additional, Snadden, David, additional, Wong, Sabrina T, additional, and Goldsmith, Laurie J, additional

Published
2023
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13. Primary care for individuals with serious mental illness (PriSMI): protocol for a convergent mixed methods study

Author

Grudniewicz, Agnes, primary, Peckham, Allie, additional, Rudoler, David, additional, Lavergne, M Ruth, additional, Ashcroft, Rachelle, additional, Corace, Kimberly, additional, Kaluzienski, Mark, additional, Kaoser, Ridhwana, additional, Langford, Lucie, additional, McCracken, Rita, additional, Norris, W Craig, additional, O'Riordan, Anne, additional, Patrick, Kevin, additional, Peterson, Sandra, additional, Randall, Ellen, additional, Rayner, Jennifer, additional, Schütz, Christian G, additional, Sunderji, Nadiya, additional, Thai, Helen, additional, and Kurdyak, Paul, additional

Published
2022
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23. In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada

Author

Randall Ellen, Crooks Valorie A, and Goldsmith Laurie J

Subjects
Family medicine, Canada, Unattached patients, Continuity, Attachment, Rural, Medicine (General), R5-920
Abstract

Abstract Background Most Canadians receive basic health services from a family physician and these physicians are particularly critical in the management of chronic disease. Canada, however, has an endemic shortage of family physicians. Physician shortages and turnover are particularly acute in rural regions, leaving their residents at risk of needing to transition between family physicians. The knowledge base about how patients manage transitioning in a climate of scarcity remains nascent. The purpose of this study is to explore the experience of transitioning for chronically ill, rurally situated Canadian women to provide insight into if and how the system supports transitioning patients and to identify opportunities for enhancing that support. Methods Chronically ill women managing rheumatic diseases residing in two rural counties in the province of Ontario were recruited to participate in face-to-face, semi-structured interviews. Interview transcripts were analysed thematically to identify emergent themes associated with the transitioning experience. Results Seventeen women participated in this study. Ten had experienced transitioning and four with long-standing family physicians anticipated doing so soon. The remaining three expressed concerns about transitioning. Thematic analysis revealed the presence of a transitioning trajectory with three phases. The detachment phase focused on activities related to the termination of a physician-patient relationship, including haphazard notification tactics and the absence of referrals to replacement physicians. For those unable to immediately find a new doctor, there was a phase of unattachment during which patients had to improvise ways to receive care from alternative providers or walk-in clinics. The final phase, attachment, was characterized by acceptance into the practice of a new family physician. Conclusions Participants often found transitioning challenging, largely due to perceived gaps in support from the health care system. Barriers to a smooth transition included inadequate notification procedures, lack of formal assistance finding new physicians, and unsatisfactory experiences seeking care during unattachment. The participants’ accounts reveal opportunities for a stronger system presence during transition and a need for further research into alternative models of primary care delivery.

Published
2012
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24. Volunteer First Responders for Optimizing Management of Mass Casualty Incidents

Author

Yafe, Eli, Walker, Blake Byron, Amran, Ofer, Schuurman, Nadine, Randall, Ellen, Friger, Michael, Adini, Bruria, Yafe, Eli, Walker, Blake Byron, Amran, Ofer, Schuurman, Nadine, Randall, Ellen, Friger, Michael, and Adini, Bruria

Abstract

Objective: Rapid response to a trauma incident is vital for saving lives. However, in a mass casualty incident (MCI), there may not be enough resources (first responders and equipment) to adequately triage, prepare, and evacuate every injured person. To address this deficit, a Volunteer First Responder (VFR) program was established. Methods: This paper describes the organizational structure and roles of the VFR program, outlines the geographical distribution of volunteers, and evaluates response times to 3 MCIs for both ambulance services and VFRs in 2000 and 2016. Results: When mapped, the spatial distribution of VFRs and ambulance stations closely and deliberately reflects the population distribution of Israel. We found that VFRs were consistently first to arrive at the scene of an MCI and greatly increased the number of personnel available to assist with MCI management in urban, suburban, and rural settings. Conclusions: The VFR program provides an important and effective life-saving resource to supplement emergency first response. Given the known importance of rapid response to trauma, VFRs likely contribute to reduced trauma mortality, although further research is needed in order to examine this question specifically., Peer Reviewed

Published
2018

26. The importance of informational, clinical and personal support in patient experience with total knee replacement: a qualitative investigation

Author

Goldsmith, Laurie J., primary, Suryaprakash, Nitya, additional, Randall, Ellen, additional, Shum, Jessica, additional, MacDonald, Valerie, additional, Sawatzky, Richard, additional, Hejazi, Samar, additional, Davis, Jennifer C., additional, McAllister, Patrick, additional, and Bryan, Stirling, additional

Published
2017
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28. Trauma 2016Characteristics of early analgesia in adults presenting with acute trauma to a level 1 trauma centre.Linking acute care to rehabilitation to determine functional outcomes for trauma patients in Canada.Accessibility to trauma centres in Oman.Identifying at-risk drivers post-trauma: a retrospective cohort study.Rates and determinants of unplanned emergency department visits and readmissions within 30 days following discharge from the trauma service: the Ottawa Hospital experience.The role of C-reactive protein measurement after traumatic injury: Can you quantify systemic inflammation? A systematic review.A retrospective examination of current clinical treatment of pediatric blunt spleen and liver injuries at a single tertiary care centre.Differential behaviour of damage-associated molecular patterns (DAMP) with allocated negative peritoneal pressure therapy in open abdomen management.Effect of a new hospital start-up on first 24 hours mortality: a long way toward trauma team-building and Advanced Trauma Life Support (ATLS) introduction. A key role for the human factor?Creating and evaluating an interrater reliability coding process in a hospital trauma registry.Weekend patterns in pediatric road traffic injuries: 10-year analysis of trauma registry data in South Africa.The impact of the acute care surgery service model on non-clinical outcomes, including health economics, delivery systems, and education: a systematic review.The economic burden and potential years of life lost from fire deaths in residential homes.A systematic review of the risks and benefits of venous thromboembolism prophylaxis in traumatic brain injury.Trauma surveillance and registry development in Mozambique: results of a 1-year study and the first phase of national implementation.Exploratory laparoscopy and cholecystectomy for penetrating throracoabdominal injury: case report and literature review.Avoiding unnecessary intubations of combative trauma patients with use of medications.Magnitude of geriatric burn injury abrogates the unwarranted optimism seen in surrogates of general ICU patients with severe illness.Sarcopenia in geriatric trauma.Experiences of older adult trauma patients discharged home from a tertiary trauma centre.The influence of spatial access to trauma care on mortality for severely injured patients in Nova Scotia.The impact of trauma case management on IVCF retrieval rates: experience from a level 1 trauma centre.1000 consecutive in-hospital deaths following severe injury: What has changed over the years?Monitoring recovery of open tibial fractures using objective functional measures with preliminary data from a combined orthoplastic research clinic.Predictability of a prehospital tool used for identification of major trauma patients.Meta-analysis on the impact of the acute care surgery model of disease-specific and patient outcomes for appendicitis and biliary disease.Pelvic pressure changes after a fracture: a pilot cadaveric study assessing the effect of pelvic binders and limb bandaging.Suspect pelvic injuries based on mechanism alone or in conjugation with physiologic parameters.Distal radial ultrasound guided fracture identification and manipulation.The predictive value of the Canadian Study of Health and Aging Clinical Frailty Scale on adverse outcomes among geriatric trauma patients.Who, what, where: a critical assessment of helicopter emergency medical services transport and transfer times on patient outcomes at two level 1 trauma centres.Is your data telling you what you think it is? An assessment of BC Trauma Registry completeness.Introducing e-FAST training to Trinidad and Tobago (TT).Resilient despite childhood trauma experiences.Prognostic value of serum procalcitonin measurements in critically injured patients: a systematic review.Application and evaluation of knowledge retention related to Advanced Trauma Care for Nurses (ATCN) course content: a preliminary study.Risk of blunt cerebrovascular injury in association with mandible fractures: pilot study at a Canadian level 1 trauma centre.Improving the documentation of the rate of arrival time for trauma team leaders through the use of low-cost interventions and awareness in a trauma centre.The reliability of DAD ICD-10-CA codes for injury reporting.Implementing an ICD-10-to-AIS 2005 crosswalk in a provincial inclusive trauma system.Compliance of tranexamic acid administration to trauma patients at a level 1 trauma centre.Intra-abdominal hypertension and mortality in critically ill patients with sepsis: a prospective observational study.Clot amplitude measurement at 10 minutes predicts blood products transfusion and hospital mortality.Variations in length of stay for major trauma across Canadian trauma centres.Evolution of guidelines for definitive emergency airway management in adult major trauma.Concussion patients in the emergency department: assessing a new triaging tool for follow-up and prompt long-term management.Pseudoaneurysm of the profunda femoris artery following blunt trauma treated by endovascular coil embolization. Review of 2 cases and relevant literature.Carotid cavernous fistula: an easily missed complication of head trauma.Development of a provincial patient episode of care.Mechanism of injury and trauma-related outcomes in the geriatric population over 10 years in the United States.The FAITH Score — early predictors of inpatient mortality in adult trauma patients.Geriatric burn patients who survive to discharge have reasonable recovery of function at 1-year follow-up.Proof of principle in a Canadian level 1 trauma centre: the use of resuscitative endovascular balloon occlusion of the aorta (REBOA).Isolated physiologic indications are associated with failure to achieve primary fascial closure in the open abdomen: an analysis of physiologic subgroups.The anticoagulated trauma patient: the Ontario experience in the era of direct oral anticoagulants.The effect of a public transit strike on a provincial trauma system.A novel device to control bleeding in penetrating cardiac injuries.Overcoming the challenge of intravenous infusion of hydrogen-enriched lactated Ringer’s: a scavenger solution for reactive oxygen species in hemorrhagic shock.ABS QE and CE performance by a general surgery program with a surgical critical care fellowship.Does the use of an RSI checklist and equipment silhouette in simulated emergency scenarios improve team performance and operational safety?Exposure to major trauma patients and safety-critical procedures. Part I: risk and reliability.Impact of a prealert program for air ambulance response to major trauma patients in a provincial, inclusive trauma program: the New Brunswick experience.Impact of repeated offering of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma system.Out in the sticks and stones may break your bones, but does rurality surely hurt you? Are you more likely to die from injury in a rural area? Trauma patient health equality in New Brunswick.The timely use of tranexamic acid in trauma.What are they doing now? An SBIRT evaluation.Thrombocytosis following splenic trauma and association with venous thromboembolism: a Toronto trauma registry cohort study.Relative contraindication to percutaneous tracheostomy: Is it time to revise them?Optimization of the medical and surgical management of traumatic spinal cord injury.Investigating the implementation of acute care guidelines for spinal cord injuries.Dural sinus thrombosis after TBI: a description of current management and mortality.64-slice CT compared with MRI to clear cervical spine injury in high-risk obtunded blunt trauma patients.Traumatic injury in the oil industry.Development and implementation of quality indicators for acute care surgery.Exploring logistical reasons for leaving the abdomen open in trauma: Does surgeon workload and time of day matter?Opinions of practising surgeons regarding the appropriateness of published indications for use of damage control surgery in trauma patients: an international cross-sectional survey.Systematic review of evidence for indications for use of damage control surgery and damage control interventions in civilian trauma patients.A retrospective quality control study of goals of care designation in geriatric trauma patients.Use of the iTClamp for arrest of hemorrhage after self-inflicted injury: a utilization review.iTClamp use in anticoagulated patients.iTClamp 4-month training retention demonstrated by tactical police.The Canadian Prehospital Evidence-based Practice (PEP) Project: program description of a contemporary knowledge translation resource.State of the evidence for Emergency Medical Services (EMS) care of blunt spinal trauma: an analysis of appraised research from the Canadian Prehospital Evidence-based Practice (PEP) Project.Simulation scenarios: effective learning tool in the Think-First Injury Prevention Strategy for Youth (TIPSY).Hemostatic dressings for external bleeding: a systematic review using GRADE methodology.Tourniquet application for severe limb bleeding: a systematic review using GRADE methodology.A retrospective quality audit regarding the incidence and treatment of hypothermia in severely injured trauma patients who undergo emergent surgery.Application and validation of the Kenyatta National Hospital–University of Alberta orthopedic trauma assessment (KUOTA) tool.Data quality targets in a provincial trauma registry.Factors influencing emergency medical service response time to fatal motor vehicle crashes.Evaluating the impact of the Rural Trauma Team Development Course.Characteristics and patterns of major traumatic brain injury in Nova Scotia: a 12-year retrospective analysis.The effect of blood alcohol on outcomes in patients with major traumatic brain injury in Nova Scotia.Creating a culture of safety — pediatric emergency department injury prevention.Understanding your audience: creating an injury prevention website for teens.Complications associated with angioembolization (AE) in unstable pelvic fracture: a systemic review.Cryoprecipitate in trauma: a systemic review of its effects on reversal of trauma coagulopathy, exposure to allogeneic blood products and mortality.A 15-year review of pediatric trauma mortality: a descriptive analysis.Pediatric patients requiring urgent surgery in an adult trauma centre.DoesN-acetylcysteine (NAC) improve outcome in traumatic brain injury? A systemic review in human and animal literature.Trauma scoring systems.The timing of initiation of venous thromboembolism prophylaxis after traumatic solid organ injury: a national survey of practice.Reversal strategies for the novel oral anticoagulants (NOAC) in trauma: a systematic review of human, animal and in vitro studies.Flail chest management: a survey of Canadian traumatologists.Endovascular stenting for traumatic common iliac pseudoaneurysm as an adjunct following exploratory laparotomy in a stab injury patient.Descriptive epidemiology of all-terrain vehicle–related injuries in British Columbia’s Interior Health Authority.Characterization of pelvic bleeding in trauma: implications for research and management.Introduction of a longitudinal competency-by-design trauma rotation into a block-based surgical residency program — a solution to providing adequate trauma case volume in competency-based education.Physicians’ satisfaction with trauma system factors influencing transfer of trauma patients in 4 regional trauma systems.The natural history of traumatic central cord syndrome as compared with other incomplete cervical cord injuries.An evaluation of trauma data collection in Latin American low- and middle-income countries.Heterogeneity of truncal hemorrhage in trauma.The impact of RoTEM generated coagulation data on the early diagnosis of acute traumatic coagulopathy: a prospective study.Trauma team leader (TTL) response time to bedside: a strategy to improve documentation.The effect of Alberta’s new impaired driving legislation on motor vehicle–related trauma.Oncological emergencies in acute care surgery: an analysis of processes and outcomes.Novel hand-held hematoma detector for the diagnosis of intracranial bleeding.Acute coagulopathy of trauma following isolated brain injury: relationship between coagulofibrinolytic alterations and sym-pathoadrenal activation.A comparative study of functional fibrinogen assays using TEG and RoTEM in trauma patients.Prolonged transfer times of polytrauma patients to a level 1 trauma centre is a risk factor for PE: a retrospective cohort study.Seatbelt laws and seatbelt usage compliance — What is the correlation? Multinational comparative observation.Is the trauma team leader any good? Evidence from a discrete choice experiment.Understanding trauma in East Africa: investigating the application of a GIS-enabled trauma registry.The prevalence of alcohol-related trauma recidivism: a systemic review.Development of a hospital-wide program for simulation-based training in trauma care and management.Grade V liver trauma involving a liver allograft.Current use and complication rates of prophylactic IVC filters.

Author

Petrie, Casey, primary, Anton, Hugh, primary, Lampron, Jacinthe, primary, Matar, Maher, primary, Alhinai, Fatma, primary, Dekirmendjian, Adriana, primary, Kirkpatrick, Andrew, primary, Magnone, Stefano, primary, McFarlan, Amanda, primary, Burstein, Brett, primary, DeGirolamo, Kristin, primary, Banfield, Joanne, primary, Margolick, Joseph, primary, Hamadani, Fadi, primary, Schmitz, Erika, primary, Muakkassa, Farid, primary, Partain, Natalia, primary, Malekpour, Mahdi, primary, Rodrigue, Nathalie, primary, Tansley, Gavin, primary, Nadeau, Rachel, primary, Harzan, Christina, primary, Morris, Rhys, primary, Majee, M. Azam, primary, Murphy, Patrick, primary, Majeed, M. Azam, primary, Cheung, Annie, primary, Nolan, Brodie, primary, Bradley, Nori, primary, Brewer, Brian, primary, Hinton, Monica, primary, Al Rawahi, Aziza, primary, Canzian, Sonya, primary, Lo, Olivia, primary, LeBreton, Mathieu, primary, Gezer, Recep, primary, Ghawnni, Abeer, primary, Xiao, Jimmy, primary, Veigas, Precilla, primary, Moore, Lynne, primary, Waller, Bentley, primary, Abourbih, Daniel, primary, Biswas, Saptarshi, primary, McMillan, Jennifer, primary, Tung, Lily, primary, Uy, Cassandra, primary, Arnold, Kristen, primary, Rice, Timothy, primary, Wood, Brendan, primary, Butler, Michael, primary, Neto, Joao Rezende, primary, Chatani, Praveen, primary, McLean, Devon, primary, Benjamin, Susan, primary, Orchard, James, primary, Woodford, Shelley, primary, Kenney, Matthew, primary, Mohamed, Safia, primary, Chesney, Tyler, primary, Morgan-Cavallaro, Marissa, primary, Dakson, Ayoub, primary, Somogyi, Dafna, primary, McCallum, Jessica, primary, Dang, Jerry, primary, Paskar, Dave, primary, Roberts, Derek, primary, Taheri, Amir, primary, McKee, Jessica, primary, Mckee, Jessica, primary, Carter, Alix, primary, Butorac, Elizabeth, primary, Jensen, Jan, primary, Alam, Asim, primary, Saleh, Zia, primary, Byrne, James, primary, Knight, Heather, primary, Kureshi, Nelofar, primary, Edwards, Jane, primary, Batey, Brandon, primary, Da Luz, Luis Teodoro, primary, Govind, Shaylan, primary, Bradford, Diane, primary, Fong, Deanna, primary, Vogt, Kelly, primary, Marchand, Mylene, primary, Al-Zubaidi, Yasir, primary, Whitman, Lisa, primary, Strauss, Rachel, primary, Menon, Matthew, primary, Tarighi, Payam, primary, Bouchard, Béatrice, primary, Olarte, Rafael, primary, Al-Masrouri, Safiya, primary, Klassen, Barbara, primary, Nakashima, Brenda, primary, Al-Shehhi, Ruqaiya, primary, Kapadia, Bhavin, primary, Lejnieks, Brandon, primary, Peng, Henry, primary, Ahmed, Mooyad, primary, Maghraby, Nisreen, primary, Singhal, Ash, primary, Hogan, Jessica, primary, Green, Robert, primary, Krouchev, Radoslav, primary, Krouche, Radoslav, primary, Chaplin, Tim, additional, Evans, David, additional, Randall, Ellen, additional, Brasher, Penny, additional, Figueira, Sonshire, additional, Waggott, Melissa, additional, Tran, Alexandre, additional, Mai, Trinh, additional, El-Haddad, Julie, additional, Al Rawahi, Aziza, additional, Doig, Christopher, additional, Easterbrook, Bethany, additional, Blinder, Henrietta, additional, Bailey, Karen, additional, Malig, Michelle, additional, Roberts, Derek, additional, Xiao, Jimmy, additional, Ball, Chad, additional, Jenne, Craig, additional, Ceresoli, Marco, additional, Manfredi, Roberto, additional, Piazzalunga, Dario, additional, Ansaloni, Luca, additional, Puhacz, Melody, additional, Louffat-Olivares, Ada, additional, Zhang, Chris, additional, Fauteux-Lamarre, Emmanuelle, additional, van As, Arjan Bastiaan, additional, Murphy, Patrick, additional, Hameed, Morad, additional, Vogt, Kelly, additional, Allen, Laura, additional, Leeper, William, additional, Parry, Neil, additional, Haut, Elliott, additional, Leslie, Ken, additional, D’souza, Karan, additional, Zhang, Jacques, additional, Rehou, Sarah, additional, Dandurand, Charlotte, additional, Sekhon, Mypinder, additional, Garraway, Naisan, additional, Gooderham, Peter, additional, Greisdal, Donald, additional, de Costa, Assis, additional, Yonahan, Prem, additional, Magaia, Ivandra, additional, Magun, Catarina, additional, Maripiha, Paloma, additional, Massinga, Ezio, additional, Muataco, Monica, additional, Muripa, Vania, additional, Jacobe, Mario, additional, Gupt, Shailvi, additional, Bracco, David, additional, Abou-Rizk, Cybil, additional, Prakash, Ipshita, additional, Deckelbaum, Dan, additional, Razek, Tarek, additional, Neves, Otilia, additional, Matar, Maher, additional, Mamazza, Joseph, additional, Lampron, Jacinthe, additional, Marley, Robert, additional, Horattas, Ileana, additional, Fenton, Adam, additional, Salvator, Ann, additional, Hodgman, Erica, additional, Isbell, Claire, additional, Wolf, Steven, additional, Arnoldo, Brett, additional, Kowalske, Karen, additional, Phelan, Herb, additional, Bridgham, Kelly, additional, Dove, James, additional, Blansfield, Joseph, additional, Shabahang, Mohsen, additional, Torres, Denise, additional, Wild, Jeffrey, additional, Yanchar, Natalie, additional, Schuurman, Nadine, additional, Asbridge, Mark, additional, Bowes, Matt, additional, McBeth, Paul, additional, Kirkpatrick, Andrew, additional, Grondin, Sean, additional, Kaplan, Gilaad, additional, Maggs, Sharon, additional, Bodger, Owen, additional, Pallister, Ian, additional, Naveed, Asif, additional, DeGirolamo, Kristin, additional, Van Zyl, Theunis Jean, additional, Loftus, Andrew, additional, Lygas, Anna, additional, Mahmood, Rozina, additional, Haas, Barbara, additional, Ringer, Thom, additional, McFarlan, Amanda, additional, Wong, Camilla, additional, Tien, Homer, additional, Sawadsky, Bruce, additional, Rizoli, Sandro, additional, Phillips, Andrea, additional, Ackery, Alun, additional, Lakha, Nasira, additional, Li, Jennifer, additional, Hamm, Jeremy, additional, Storey, Annika, additional, Sinanan, Alex, additional, Rozycki, Grace, additional, Ali, Jameel, additional, Alhinai, Fatma, additional, Dixon, Elijah, additional, Nanni, Jessica, additional, Chalkin, Kathryn, additional, Sorvari, Anne, additional, Horton, Lisa, additional, Barratt, Lee, additional, Blanchette, Shirley Ann, additional, Li, Yangmei, additional, Topolovec-Vranic, Jane, additional, Grushka, Jeremy, additional, Makhoul, Nicholas, additional, Keenan, Alanna, additional, Knight, Heather, additional, Thakore, Jaimini, additional, McMillan, Jennifer, additional, Robinson, Scott, additional, Williams, Dori, additional, Owen, Julian, additional, Coates, Angela, additional, Kortbeek, John, additional, Lall, Rohan, additional, Callum, Jeannie, additional, Stelfox, Henry Thomas, additional, Simons, Richard, additional, Clement, Julien, additional, Lauzier, François, additional, Nathens, Avery, additional, Turgeon, Alexis, additional, Trojanowski, Jan, additional, Meikle, Andrew, additional, Filiatrault, Lyne, additional, Tallon, John, additional, KimSing, Chad, additional, Flexman, Alana, additional, Bedi, Sukhmeet, additional, Hunt, Cindy, additional, McGowan, Melissa, additional, Ouchterlony, Donna, additional, Amin, Arpit, additional, Inaba, Kenji, additional, Haltmeier, Tobias, additional, Benjamin, Elizabeth, additional, Lam, Lydia, additional, Matsushima, Kazuhide, additional, Strumwasser, Aaron, additional, Demetriades, Demetrios, additional, Lysecki, Paul, additional, Kahnamoui, Kamyar, additional, Farrokhyar, Forough, additional, Sne, Niv, additional, Vanderbeek, Laura, additional, Holavanahalli, Radha, additional, Ryan, Colleen, additional, Schneider, Jeffrey, additional, Phan, Tam, additional, Ahmed, Najma, additional, Neto, Joao Rezende, additional, Wheatcroft, Mark, additional, Prabhudesai, Vikram, additional, Paskar, Dave, additional, Rotstein, Ori, additional, Nisenbaum, Rosane, additional, Nascimento, Barto, additional, Sholzberg, Michelle, additional, Erdogan, Mete, additional, Sealy, Beth, additional, Green, Robert, additional, Rice, Timothy, additional, Leong-Poi, Howard, additional, Pannell, Dylan, additional, Beckett, Andrew, additional, Hamam, Mohamed Serhan, additional, Qiu, Liqun, additional, Leung, Chung, additional, Semprun, Carlos, additional, Goh, Cynthia, additional, Loo, Richard, additional, Júnior, Schubert Pereira, additional, Santos, Eduardo, additional, Ramjist, Joshua, additional, Pennell, Christopher, additional, Harris, Loren, additional, French, James, additional, Fraser, Jacqueline, additional, Benjamin, Susan, additional, Atkinson, Paul, additional, Hogan, Ann, additional, Watson, Ian, additional, Cormier, Cathy, additional, Chisholm, Allison, additional, Pishe, Tushar, additional, Emer, Benoit Phelan of, additional, Hussein, Zahra, additional, Chia, Tze L., additional, Isa, David, additional, Mnatzakanian, Gevork, additional, Colak, Errol, additional, Acuna, Sergio A., additional, Veigas, Precilla, additional, Najmeh, Sara, additional, Khalil, Maria Abou, additional, Hopkins, Brent, additional, Fata, Paola, additional, Khwaja, Kosar, additional, Brandman, David, additional, Thibault-Halman, Ginette, additional, Christie, Sean, additional, Bethune, Allison, additional, Da Costa, Leo Dante, additional, McLaughlin, Patrick, additional, Kanji, Hussein D., additional, Lester, Erica, additional, Sun, Warren, additional, Dykstra, Mark, additional, Fawcett, Vanessa, additional, Widder, Sandy, additional, Tsang, Bonnie, additional, Lawless, Bernard, additional, Marshall, John, additional, Zygun, David, additional, Faris, Peter, additional, Bobrovitz, Niklas, additional, McKee, Ian, additional, LaPorta, Tony, additional, Molaff, Alan, additional, Tan, Edward, additional, Jensen, Jan, additional, Greene, Jennifer, additional, Goldstein, Judah, additional, Cook, Jolene, additional, Petrie, David, additional, Swain, Janel, additional, Dana, Fidgen, additional, Travers, Andrew, additional, Cain, Ed, additional, Faulkner, Kayleigh, additional, Paramalingam, Vasuki, additional, William, Adrian, additional, Zideman, David, additional, Singletary, Eunice, additional, Bradley, Richard, additional, Reilly, Michael, additional, Olarte, Rafael, additional, Laflamme, Claude, additional, Okutoyi, Paul, additional, Almansoori, Khaled, additional, Saleh, Abdullah, additional, Hawes, Harvey, additional, Hogan, Jessica, additional, Kromm, Julie, additional, Menon, Matthew, additional, Jaramillo, David Gomez, additional, Mason, Stephanie, additional, Fenerty, Lynne, additional, Walling, Simon, additional, Clarke, David B., additional, Batey, Brandon, additional, Stewart, Tanya Charyk, additional, Merritt, Neil, additional, Edwards, Jane, additional, Estrada-Codecito, Jose, additional, Dey, Chris, additional, Moahammed, Ayman, additional, Dawson, Janice, additional, Smith, Jennifer, additional, McKenzie, Suzanne, additional, Bhatti, Junaid, additional, Martinez, Rocio, additional, Shangguan, Erin, additional, Mahiri, Kevin, additional, Gray, Daryl, additional, Moffat, Brad, additional, Da Luz, Luis Teodoro, additional, Paskar, David, additional, Faidi, Samir, additional, Nagarakanti, Nishan, additional, Wilson, Heather, additional, Howell, Brianne, additional, Rurka, Zonia, additional, Bouwsema, Cindy, additional, Garzon, AnaMaria, additional, Chan, Robert, additional, Scharfenberger, Angela, additional, Evans, Chris, additional, Shermann, Jill, additional, Mian, Oxana, additional, Bado, Joaquin, additional, Strauss, Rachel, additional, Alam, Asim, additional, Smith, Tyler, additional, Walsh, Margaret, additional, Masales, Cathy, additional, Drake, Brian, additional, Joos, Emilie, additional, McConnell, Yarrow, additional, Rhind, Shawn, additional, Peng, Henry, additional, Barbosa, Ramon, additional, Min, Arimie, additional, Di Battista, Alex, additional, Shiu, Maria, additional, Baker, Andrew, additional, Iqbal, Sameena, additional, Mo, David, additional, O’Hara, Nathan, additional, Hengel, Ross, additional, Nunn, James, additional, Minor, Samuel, additional, Hartlen, Kathy, additional, Joos, Emile, additional, Hsiao, Marvin, additional, and Brown, Ross, additional

Published
2016
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30. In search of attachment: the experiences of chronically ill women transitioning between family physicians in rural Ontario

Author

Randall, Ellen Cameron

Abstract

Most Canadians receive basic health services from family physicians who play an important role in chronic disease management. Canada, however, has an endemic shortage of family physicians and consequently, a large population of unattached patients. Physician scarcity is particularly acute in rural regions, leaving patients transitioning between family physicians at risk for not readily finding a new doctor. To ensure patient-centred solutions to this barrier to care, policymakers need to inform their responses with an understanding of the patient experience. This qualitative study explores the experiences of chronically ill, rurally situated Canadian women transitioning between family physicians with the goal of providing insight into how the system supports these patients. The study reveals the presence of a multi-phase transitioning trajectory. Participants’ accounts indicate that efforts to attach to a regular family physician were hindered by the lack of available doctors and by gaps in system support within each transitioning phase.

Published
2012

31. Community perceptions of risk factors for interpersonal violence in townships in Cape Town, South Africa: A focus group study.

Author

Makanga, Prestige Tatenda, Schuurman, Nadine, and Randall, Ellen

Subjects
INTIMATE partner violence, ALCOHOLISM, CELEBRITIES, CLERGY, CRIMINALS, FOCUS groups, POVERTY, RESEARCH funding, CRIME victims, CULTURAL values, SOCIAL attitudes, THEMATIC analysis, DATA analysis software, DESCRIPTIVE statistics
Abstract

Interpersonal violence is a major contributor to the burden of disease globally, and in South Africa, it is the leading cause of injury. There is an emerging consensus that the development of actionable policy and effective prevention strategies for interpersonal violence requires an understanding of the contextual matters that elevate risk for interpersonal violence. The objective of this study was to explore community perceptions of risks for interpersonal violence in five townships in Cape Town, South Africa, with high rates of violence. Focus group discussions were conducted with community members to identify key factors in that contributed to being either a perpetrator or victim of interpersonal violence. The ecological framework was used to classify the risk factors as occurring at individual, relationship, community or society levels. Some of the risk factors identified included alcohol abuse, poverty, informality of settlements and cultural norms. Differences in how each of these risk factors are expressed and experienced in the five communities are also elucidated. This approach enabled the collection of contextual community-based data that can complement conventional surveillance data in the development of relevant community-level strategies for interpersonal violence prevention. [ABSTRACT FROM AUTHOR]

Published
2017
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32. How do family medicine residents and early career family physicians talk about comprehensiveness in primary care?

Author

Randall, Ellen, Grudniewicz, Agnes, Rudoler, David, Goldsmith, Laurie, and Lavergne, Ruth

Subjects
*RESIDENTS (Medicine), *FAMILY-work relationship, *PRIMARY care, *FAMILY medicine, *PHYSICIANS, *WOMEN physicians
Abstract

Context: There is growing concern that delivery of primary care is becoming less comprehensive and that new family physicians may be moving away from comprehensiveness as the cornerstone of their approach to care. However, understanding what is meant by "comprehensiveness" is key to ascertaining the current state of primary care delivery. Objective: To report on how family medicine residents and early career family physicians describe comprehensiveness in primary care. Study design and analysis: Thematic analysis of interview data from the main qualitative strand of a broader mixed-methods study exploring early career family practice patterns. Setting: Canadian family medicine in British Columbia, Ontario, and Nova Scotia. Population studied: Family medicine residents (n=31) and family physicians in their first 10 years of practice (n=63). Results: Participants described comprehensiveness in multiple, rich, and varying ways. These descriptions reflected two general views of comprehensiveness: one centred on operational dimensions of care delivery and one centred on philosophy of care. Operational descriptions focused on services offered, patient population, care settings, and delivery models. Some operational descriptions were unidimensional (e.g., services offered), while others included multiple care dimensions (e.g., services, settings, and patient population). Philosophy of care descriptions centralized the patient, viewing comprehensiveness as care that considered the "patient as a whole"--looking at a person in their entirety, rather than only their presenting conditions, and rendering care that best meets their broader needs. Cutting across these two views of comprehensiveness are considerations of context (e.g., urban/rural) and whether comprehensiveness is considered at the level of the patient, population, individual clinician, or team. Conclusions: Participants' descriptions of comprehensiveness revealed that some view it primarily in terms of care components (e.g., services, populations), while others view it as a philosophy of care. Regardless of the lens, participants' descriptions portray comprehensiveness as nuanced, variable, and sensitive to practice and patient population contexts. Understanding how residents and clinicians think about comprehensiveness is important for policymakers and educators seeking to support ongoing delivery of comprehensive primary care. [ABSTRACT FROM AUTHOR]

Published
2023

34. The importance of informational, clinical and personal support in patient experience with total knee replacement: a qualitative investigation

Author

Goldsmith, Laurie J, Suryaprakash, Nitya, Randall, Ellen, Shum, Jessica, MacDonald, Valerie, Sawatzky, Richard, Hejazi, Samar, Davis, Jennifer C, McAllister, Patrick, and Bryan, Stirling

Subjects
musculoskeletal diseases, surgical procedures, operative, musculoskeletal system, 3. Good health
Abstract

Background: Total knee arthroplasty (TKA) is the most frequently performed joint replacement surgery in North America. Patient perspectives on TKA have been investigated in various ways, including finding as many as 20% of TKA patients are dissatisfied with their surgical outcomes. Understanding the patient experience with TKA broadly and in relation to patient satisfaction is a key gap in existing literature. Methods: We report on the qualitative component of a mixed methods prospective cohort study examining patient experience and satisfaction post-TKA for adults in British Columbia, Canada. Data collection consisted of 45 in-depth interviews about individuals’ knee surgery experiences conducted eight months after surgery. Analysis consisted of thematic coding by multiple coders. Results: Participants’ descriptions of their TKA experiences were primarily concerned with support, or the provision of aid and assistance. Support was insufficient when their expectations of support were not met; unmet support expectations led to an overall negative TKA experience. Support operated in three key domains: (1) informational support, (2) clinical support, and (3) personal support. Key sources of informational and clinical support included pre-optimisation clinics, surgeons, and physiotherapists. Key topics for informational support included pain, pain management, and recovery trajectories. Personal support was provided by family, friends, other TKA patients, employers, and themselves. Conclusions: Patient needs and expectations for support are shaped both before and after TKA surgery. Patients with an overall positive TKA experience had improvement in their knee pain, stiffness or functioning post-TKA, had their major expectations and needs for support met during their TKA recovery, and believed that any significant future expectations or needs for ongoing support would be adequately met. In contrast, patients with an overall negative TKA experience had at least one major expectation or need for support not met during their TKA recovery, even in cases where they had good TKA outcomes. Suggested interventions to improve the experience of persons receiving TKA include an expanded patient navigator model, revised pre-surgery educational materials, particularly around pain expectations and management, and comprehensive sharing of other patients’ TKA experience.

35. Revisiting patient satisfaction following total knee arthroplasty: a longitudinal observational study

Author

Bryan, Stirling, Goldsmith, Laurie J, Davis, Jennifer C, Hejazi, Samar, MacDonald, Valerie, McAllister, Patrick, Randall, Ellen, Suryaprakash, Nitya, Wu, Amery D, and Sawatzky, Richard

Subjects
3. Good health
Abstract

Background: Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada. Earlier Canadian work reported 1 in 5 TKA patients expressing dissatisfaction following surgery. A better understanding of satisfaction could guide program improvement. We investigated patient satisfaction post-TKA in British Columbia (BC). Methods: A cohort of 515 adult TKA patients was recruited from across BC. Survey data were collected preoperatively and at 6 and 12 months, supplemented by administrative health data. The primary outcome measure was patient satisfaction with outcomes. Potential satisfaction drivers included demographics, patient-reported health, quality of life, social support, comorbidities, and insurance status. Multivariable growth modeling was used to predict satisfaction at 6 months and change in satisfaction (6 to 12 months). Results: We found dissatisfaction rates (“very dissatisfied”, “dissatisfied” or “neutral”) of 15% (6 months) and 16% (12 months). Across all health measures, improvements were seen post-surgery. The multivariable model suggests satisfaction at 6 months is predicted by: pre-operative pain, mental health and physical health (odds ratios (ORs) 2.65, 3.25 and 3.16), and change in pain level, baseline to 6 months (OR 2.31). Also, improvements in pain, mental health and physical health from 6 to 12 months predicted improvements in satisfaction (ORs 1.24, 1.30 and 1.55). Conclusions: TKA is an effective intervention for many patients and most report high levels of satisfaction. However, if the TKA does not deliver improvements in pain and physical health, we see a less satisfied patient. In addition, dissatisfied TKA patients typically see limited improvements in mental health.

36. Where to enhance rural palliative care? Developing a spatial model to identify suitable communities most in need of service enhancement

Author

Schuurman, Nadine, Martin, Michael E, Crooks, Valorie A, and Randall, Ellen

Subjects
3. Good health
Abstract

Background: In Canada, access to palliative care is a growing concern, particularly in rural communities. These communities have constrained health care services and accessing local palliative care can be challenging. The Site Suitability Model (SSM) was developed to identify rural “candidate” communities with need for palliative care services and existing health service capacity that could be enhanced to support a secondary palliative care hub. The purpose of this study was to test the feasibility of implementing the SSM in Ontario by generating a ranked summary of rural “candidate” communities as potential secondary palliative care hubs. Methods: Using Census data combined with community-level data, the SSM was applied to assess the suitability of 12 communities as rural secondary palliative care hubs. Scores from 0 to 1 were generated for four equally-weighted components: (1) population as the total population living within a 1-h drive of a candidate community; (2) isolation as travel time from that community to the nearest community with palliative care services; (3) vulnerability as community need based on a palliative care index score; and (4) community readiness as five dimensions of fit between a candidate community and a secondary palliative care hub. Component scores were summed for the SSM score and adjusted to range from 0 to 1. Results: Population scores for the 12 communities ranged widely (0.19–1.00), as did isolation scores (0.16–0.94). Vulnerability scores ranged more narrowly (0.27–0.35), while community readiness scores ranged from 0.4–1.0. These component scores revealed information about each community’s particular strengths and weaknesses. Final SSM scores ranged from a low of 0.33 to a high of 0.76. Conclusions: The SSM was readily implemented in Ontario. Final scores generated a ranked list based on the relative suitability of candidate communities to become secondary palliative care hubs. This list provides information for policy makers to make allocation decisions regarding rural palliative services. The calculation of each community’s scores also generates information for local policy makers about how best to provide these services within their communities. The multi-factorial structure of the model enables decision makers to adapt the relative weights of its components.

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