Volume 6 - Issue 7 by Rick Gibson
Background: Understanding and addressing the needs of frail persons is an emerging health priorit... more Background: Understanding and addressing the needs of frail persons is an emerging health priority for Nova Scotia and internationally. Primary healthcare (PHC) providers regularly encounter frail persons in their daily clinical work. However, routine identification and measurement of frailty is not standard practice and, in general, there is a lack of awareness about how to identify and respond to frailty. A web-based tool called the Frailty Portal was developed to aid in identifying, screening, and providing care for frail patients in PHC settings. In this study, we will assess the implementation feasibility and impact of the Frailty Portal to: (1) support increased awareness of frailty among providers and patients, (2) identify the degree of frailty within individual patients, and (3) develop and deliver actions to respond to frailtyl in community PHC practice. Methods: This study will be approached using a convergent mixed method design where quantitative and qualitative data are collected concurrently, in this case, over a 9-month period, analyzed separately, and then merged to summarize, interpret and produce a more comprehensive understanding of the initiative's feasibility and scalability. Methods will be informed by the 'Implementing the Frailty Portal in Community Primary Care Practice' logic model and questions will be guided by domains and constructs from an implementation science framework, the Consolidated Framework for Implementation Research (CFIR). Discussion: The 'Frailty Portal' aims to improve access to, and coordination of, primary care services for persons experiencing frailty. It also aims to increase primary care providers' ability to care for patients in the context of their frailty. Our goal is to help optimize care in the community by helping community providers gain the knowledge they may lack about frailty both in general and in their practice, support improved identification of frailty with the use of screening tools, offer evidence based severity-specific care goals and connect providers with local available community supports. Citation: Lawson B, Sampalli T, Wood S, et al. Evaluating the implementation and feasibility of a web-based tool to support timely identification and care for the frail population in primary healthcare settings.
Papers by Rick Gibson
Journal of Database Management ( …, 1996
Currently, a great deal of effort is being directed toward the development of heterogeneous datab... more Currently, a great deal of effort is being directed toward the development of heterogeneous database concepts in order to achieve system interoperability. This paper presents a conceptual model that was used in a study for developing an automatic means of translating one database structure into another with minimal human intervention. Our prototypedeveloped from this model-demonstrates the usefulness of an approach that would allow many of today's systems to be more accessible when platform, syntax or semantic changes occur. This preliminary study is limited to the automatic conversion of one specific relational database into a different, yet still relational, database format. The paper concludes with a summary of findings in order to provide a foundation for future work on the use of the proposed model as a generic, extensible framework.
Healthcare Quarterly, 2015
Recent trends show an increase in the prevalence and costs associated with managing individuals w... more Recent trends show an increase in the prevalence and costs associated with managing individuals with multimorbidities. Enabling better care for these individuals requires system-level changes such as the shift from a focus on a single disease or single service to multimorbidities and integrated systems of care. In this paper, a novel patient-centred redesign framework that was developed to support system-level process changes in four service areas has been discussed. The novelty of this framework is that it is embedded in patient perspectives and in the chronic care model as the theoretical foundation. The aims of this paper are to present an application of the framework in the context of four chronic disease prevention and management services, and to discuss early results from the pilot initiative along with an overview of the spread opportunities for this initiative.
Healthcare quarterly (Toronto, Ont.), 2013
Healthcare is in a constant state of change and evolution driven by a multitude of complex factor... more Healthcare is in a constant state of change and evolution driven by a multitude of complex factors and interactions. Consequently, organizations, teams and individuals in healthcare have to habitually realign their working relationships. Furthermore, research has shown that "working together" relationships fail in the absence of a defined framework. In this research, a novel framework and a tool kit for working together have been developed and evaluated. The framework has a formal process to articulate the intended purpose/outcome, clearly align the type of working relationship with the purpose and identify the barriers and facilitators to working relationships in healthcare.
Healthcare Quarterly, 2014
Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence ... more Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams (CHTs), that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming. In this paper, the development and implementation of the CHTs are discussed. Preliminary outcomes for the model are significant and promising. Formal and large-scale studies are planned to validate these outcomes with additional research rigour.
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Volume 6 - Issue 7 by Rick Gibson
Papers by Rick Gibson