Multiple Case Study Evaluation of Postsecondary Bridging Programs for Internationally Educated Health Professionals
The objective of this research is to analyse pathways for internationally educated health professionals (IEHPs) who have formal educational backgrounds in their chosen professions, but do not have the required educational, professional, or language requirements to enter their professions in Canada. To help bridge gaps identified through professional assessment processes and transition IEHPs into professional practice, postsecondary programs have been developed at several Canadian colleges and universities to meet the specific educational needs of professionals educated in other countries. The project involves multiple case study evaluation of six postsecondary bridging programs in three professions with identified workforce shortages (Medical Radiation Technology, Physiotherapy, and Medical Laboratory Technology). This project will be supported by a combination of funding requested from HEQCO ($70,000) and funding provided by the university researchers, both cash ($27,500) and in kind ($13,600).
"Source" Country Perspectives on the Migration of Highly Trained Health Personnel: Causes, Consequences and Responses (2010-2014)
This research will address the causes, consequences and responses of source countries to the migration of their highly trained health personnel. This will include a focus on doctors, nurses and health care managers and educators. The countries that are going to be examined specifically include the Philippines, India, South Africa, and Jamaica. Data will be gathered about who is migrating, how they are migrating and to where, and at what some of the consequences have been of the migration of highly trained health personnel from these countries using a variety of indicators considered important by those actually within the countries being studied. Finally, some of the responses to minimize the negative consequences will be examined highlighting some useful examples that could be implemented across these and other countries experiencing similar problems. This topic should be of interest to those in Canada because it is one of the countries that these personnel are migrating to and we should understand the consequences this has for countries of origin. Further, this information will help to ensure that Canada meets its international obligations to improve situations in countries from which it benefits from highly skilled migration.
On the Move (2006-2011): The Migration of Internationally Educated Health Professionals into Canada, the U.S., the U.K., and Australia
Description: Although health care workers have long been nationally and internationally mobile, there has been little study of the global patterns of migration of healthcare workers and the factors influencing their success in securing work in their field. For this study, Canada will be compared with other high income 'destination' countries, including the United States, the United Kingdom and Australia. A specific focus will be on the effects of policy and decision-making processes and regulatory environments on the migration of physicians, nurses, and midwives into these four countries. Through interviews with key stakeholders and analysis of the social, political and economic forces shaping migration and health policy, important solutions to health human resource crises will be uncovered and key policy instruments identified that best meet health care needs and better use the health care skills of immigrants.
On the Move: Employment-Related Geographic Mobility in the Canadian Context. As part of this large SSHRC funded Partnership Grant, Lois Jackson (Dalhousie) and I will be leading the Nova Scotia health worker mobility portion of the study. The key objectives of the Nova Scotia subcomponent of this project, The Employment-Related Geographic Mobility of Professional and Paraprofessional Healthcare Workers:
A process and outcome evaluation of a multifaceted intervention strategy to reduce caesarean section rates in a low risk population (2011)
Description: This project brings together a team with a wide range of practice and research expertise who will focus specifically on evaluating an intervention strategy that involves several dimensions aimed at women, their maternity care providers and the maternity care policies in the community hospital with the goal of reducing C-section rates. The study will involve collecting data on the C-section rate before the intervention strategy was implemented, during the implementation process and after a certain length of time after implementation. From this we will analyze the impact of the intervention strategy. We will also interview women and their maternity care providers to better understand what did and did not work through the implementation process. This will enable us to better inform other hospitals interested in developing similar strategies. The research we propose to undertake here is timeline because the c-section rate in Canada has been increasing without clear clinical reasons. We hope our findings will help to create a more sustainable and appropriate system of maternity care for women experiencing low-risk pregnancies and birth.
Pushing for the Best Choice features this research project.
The Health Council of Canada is reporting on innovative health care practices, policies, programs and services so they can be adopted elsewhere in Canada. Their goal is to support the identification, sharing, and uptake of innovative practices that have demonstrated to strengthen Canada's health care system. The MSH-CARES: Markham Stouffville Hospital CAesarean section Reduction Strategy is a featured innovative health practice. Click here to access.
Time from Home to Hospital Birthing Facilities: An investigation of distance, healthcare professional and risk of an adverse outcome
The risk of an adverse birth outcome introduced by distance from the mother's residence to the nearest hospital offering emergency obstetric services is of concern in Ontario as well as in Canada. An arbitrary 30 minute rule has been informally but commonly applied as a guideline for decisions about distance, birthing location and appropriate provision of care, but the legitimacy of that rule has been extensively challenged. With approximately 24% of Canadian births to women living in small communities or rural areas and with fewer rural hospitals offering specialized birthing support, distances for those women are increasing. This study will explore the association between distance from home to hospital, the healthcare professional assisting the birth and adverse birth outcomes. Obstetrician/gynecologist, family physician, and midwifery assisted births will be evaluated. Research will include all births in Ontario for 2009 through 2012. To date, research has largely focused on birth outcomes, particularly mortalities, in relation to distance to a hospital. Our analysis will explore levels of association between adverse outcome, kind of assisting healthcare professional, distance to and level of birthing facility which should address a substantial gap in Canadian and international research.
Pan Canadian Health Human Resources Knowledge Exchange Network (2011-2014)
The bulk of the costs to our health care system can be attributed to the people who deliver the services - or what is referred to as health human resources. Despite the proportion of the costs associated with who delivers health care and how they do it, there is very little coordination of what we know and don't know in this area. These funds will enable the development of a network of those doing research in this area and those who would benefit from this knowledge. The network will span across Canada and make some of the most promising practices known to key knowledge users in both English and French. The key areas of focus at the outset includes the areas of
Innovative Models of Care for a Transformed Health Care System. In partnership with Jeffrey Turnbull and Sioban Nelson, co Chairs of this Canadian Academy of Health Sciences Assessment, we are undertaking a major assessment of Canada’s health care system, to examine configurations of health care providers and respective scopes of practice. This research was identified as a priority given the current widespread challenges around accessibility and quality of care for many Canadians. It is believed that system-level, patient-oriented solutions to address these challenges can be derived from transformative care models and the efficient use of health human resources. To date there has been no comprehensive analysis of the knowledge and skills required among health care providers to meet the needs of current population health demands, let alone those of the future. This assessment will be informed by three components: