health services delivery

Implementing and evaluating ActionADE to transform medication safety

Medications have transformed the lives of Canadians suffering from many debilitating conditions. However, medications may also cause harm. As medication use has increased, so has the incidence of adverse drug events (ADEs), harmful and unintended events related to medication use. Today, ADEs cause over 2 million emergency department visits across Canada each year, and are a leading cause of admissions. 

Preventing ADEs is not easy. Health care providers often unknowingly expose patients to the same or similar medications as ones that previously caused harm. For example: 

Primary Investigator: 
Year: 
2018

Shared decision-making at the end of life: Including the voices of people with dementia


Recent debates about palliative end-of-life (EOL) care and legalized assisted dying have stimulated new questions about EOL care for those living with dementia. However, when discussing preferences for EOL care, individuals with dementia are often excluded from the decision-making process, leaving decision making to family members and/or care providers. 

Primary Investigator: 
Award Type: 
Year: 
2017

No time for nice? Exploring the nature and influence of workplace incivility and bullying in long-term residential care

Residential care aides (RCAs) provide the majority of hands-on care for individuals in long-term residential care (LTRC). Yet, as they are situated at the bottom of the workplace hierarchy, they receive little respect or recognition for their work. In BC, LTRC workers (mainly RCAs) have the highest rates of on-the-job injury; four times higher than the provincial average and twice as high as acute care workers, due primarily to overexertion and violent or aggressive acts from residents. 

Primary Investigator: 
Award Type: 
Year: 
2017

Responding to the dual epidemics of hepatitis C and addiction in British Columbia

In British Columbia (BC), it is estimated that 78,000 people are living with hepatitis C virus (HCV), most of whom do not even know they have the disease. If left untreated, HCV can cause serious harm, including liver cancer and death. People who inject drugs (PWID) are at elevated risk of HCV infection given their exposure to various individual and environmental circumstances, such as their ongoing addiction and barriers to accessing health care.

Primary Investigator: 
Award Type: 
Year: 
2017
Health Category: 

Innovative addiction research program: Addressing polysubstance use

British Columbia (BC) faces a mental health and addiction crisis with an estimated cost of $100 million annually. In April 2016, a public health emergency was declared due to an alarming increase in opioid-related overdose deaths in recent years.

Primary Investigator: 
Award Type: 
Year: 
2017
Health Category: 

Incentivizing the delivery of sustainable care of chronic diseases in Canada: Case studies in musculoskeletal disease

Concerns about the sustainability of publicly funded health systems and the rising cost of care abound, yet there is little research that explores health care efficiency. Simple cost-saving exercises (i.e. cutting services) may risk harming patients, while more sophisticated, efficiency-saving approaches aim to provide health care at a greater benefit per unit of cost. Encouraging quality and value of health care delivery, whilst reducing waste, is also an indirect way to control health care costs.

Primary Investigator: 
Award Type: 
Year: 
2017

Opioid addiction research program to improve prescribing practices and reduce overdose

Canada is amid an opioid crisis, with six or seven deaths a day due to opioid overdose. Prescription opioid misuse can also transition to illicit opiate and intravenous drug use, substantially increasing the risk for overdose and blood-borne infections. Rates of overdose death due to counterfeit fentanyl have also risen and represent a growing crisis in most regions in Canada, with British Columbia (BC) being particularly hard hit. Half of the 800 anticipated overdose deaths for 2016 in BC are expected to involve fentanyl.

Dr. Fairbairn's research will:

Primary Investigator: 
Award Type: 
Year: 
2017
Partners: 
Health Category: 

Canada-wide comparison of patient reported outcomes by complexity of radiotherapy technique for bone metastases

Radiotherapy (RT) is a common and cost effective treatment for patients with painful bone metastases (BoM). Complex and lengthy RT courses are increasingly used for BoM, despite substantial evidence and Choosing Wisely Canada guidelines recommending the use of single fraction RT (SFRT) over lengthy courses. Reluctance to adopt SFRT is based on lack of evidence of its effectiveness in patients ineligible for trials, such as those with poor performance status and BoM complicated by fracture or neurological compromise.

Primary Investigator: 
Year: 
2017
Health Category: 

Women taking charge of changing childbirth in BC

Childbearing women in Canada are speaking out about their desire for respectful maternity care. The Vancouver Foundation funded Phase 1 of our provincial, community-led participatory action research project entitled "Changing Childbirth in BC: Women exploring access to high quality maternity care". A steering group of women from different cultural and socioeconomic backgrounds worked with researchers and community agencies to study access to preferred models of maternity care and experiences of autonomy, respect, discrimination, or coercion when participating in a decision-making process.

Primary Investigator: 
Year: 
2017

TEC4Home: Telehealth for emergency-community continuity of care connectivity via home monitoring

Patients with long term medical conditions like heart failure or chronic lung diseases typically get admitted to and discharged from hospitals frequently because their conditions fluctuate. For example, one out of four patients older than 65 with heart failure often needs to return to hospital within one month of a previous emergency room or hospital stay. Today, using electronic monitors, patients can measure their own blood pressure, weight, and blood oxygen from home, and send their measurements to doctors or nurses so they can supervise the patient's state of health.

Primary Investigator: 
Year: 
2017

Addressing morbidity, mortality and health care costs among patients evaluated for addiction care in acute care settings

Substance use disorders account for a significant burden of disease among Canadians and place an enormous burden on the acute care system. The annual cost of harms associated with substance use in Canada is estimated to be approximately $40 billion, with health care being the single largest contributor. In British Columbia (BC) there is clear urgency to address this challenge, given the recent steady increase in hospitalization rates due to substance use and the unprecedented number of drug overdose deaths prompting the recent declaration of a public health emergency.

Primary Investigator: 
Year: 
2017
Health Category: 

Wealthy and healthy: Socioeconomic status (SES) and syndemics

Co-infections with sexually transmitted infections and blood borne infections (STIBBI) are common among people living with HIV. They occur because of shared risk behaviours and common social conditions. It is a significant public health issue because groups of people at high risk of acquiring and transmitting infections can spread them more readily to the broader population.

Primary Investigator: 
Award Type: 
Year: 
2015

Continuing Health Impact Assessment (CHIA) of the computer-based Drug and Alcohol Training Assessment in Kenya (eDATA K)

Tobacco, alcohol and other substance use disorders (SUD) are among the most important risk factors for the global burden of disease, with a 38 percent increase in global burden of the disease from substance use in the 20 years between 1990 and 2010, mainly driven by increased drug use (57 percent) and alcohol use (32 percent).

Primary Investigator: 
Award Type: 
Year: 
2015
Health Category: 

Socio-demographic and behavioural factors: Impact on cardiac patients' access to and outcomes from care

Dr. Mackay’s program of research aims to explore the effects of ethnicity on certain critical junctures in cardiac care: seeking treatment in an Emergency Department when having symptoms of acute coronary syndrome; decision-making regarding revascularization or other treatment for coronary artery disease; outcomes following revascularization procedures (i.e., angioplasty and coronary artery bypass surgery); and discharge from acute care of cardiac patients who have screened positive for depression.

Primary Investigator: 
Award Type: 
Year: 
2014

Addressing disparities in access to living donor kidney transplantation in South and East Asian Canadians

Kidney Transplantation is the treatment of choice for patients with end stage kidney disease. Living donor kidney transplantation ensures the timeliest transplant and offers the best post-transplant survival, making it the gold standard therapy for patients with kidney failure. Unfortunately, access to living donor kidney transplantation varies by age, socioeconomic status, and race. However, our understanding of these disparities are severely limited, particularly in Canada - therefore strategies to address these issues remain poorly characterized.

Primary Investigator: 
Award Type: 
Year: 
2014

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