Overview

I use qualitative research to understand the relationships between the work of health care providers and health care management. Often there is excellent medical treatment for a problem but barriers affect the provision of excellent health care. Examples of challenges include:

Communication issues between different types of health care services

Systems issues such as accessing patient information

Professional issues such as challenges in meeting patients needs

The goal is to:

Understand issues from different perspectives within the health care setting

Provide health care providers with insight and tools to overcome challenges

Assist the development of policy and procedures

Improve technological innovations to enhance the clinical setting

Research

Intoxicated Adolescents in the Emergency Department
Binge drinking in adolescents is a social problem related to adolescent development. However it is a medical issue when adolescents are brought to the Emergency Department (ED) for treatment. These adolescents are a burden on scarce hospital resources, there are no standardized recommendations for management, they are often a challenge to nurse, they arrive on weekend evenings when ancillary staff (social workers) are not available, and follow up is uncertain. We do not know whether an ED visit implies they have other mental health issues. The research study will use chart review, interviews, content analysis of policies and procedures to investigate demographics, burden on the Department, management strategies, health care providers’ attitudes, community initiatives with the aim of determining directions for future interventions to improve care while decreasing the toll on staff.

Hand over and Feedback: Issues of quality and safety in rural health care settings
In health care organizational structure lack of handover strategies, standardized data, documentation and access to medical information across jurisdictions affects patient safety, and feedback for health care providers. Feedback is essential for maintaining quality of care. Patients who are ill or injured in rural areas sometimes require transfer of care from one medical jurisdiction to another for definitive management. Each transfer is associated with changes in documentation methods and risk that important medical information will not be communicated, When patients cross medical jurisdictions it is difficult if not impossible for the primary care providers to follow up and determine whether their care was appropriate, important for quality assurance. Not only this, researchers cannot determine outcomes without consistent data. This study will use data, interviews and job shadowing. The study aims to highlight challenges and develop strategies to standardize and improve communication and consistent information to improve patient safety and quality assurance when patients move from a rural to tertiary care setting.

The On TRAC program: a decade old
Many adolescents with chronic illness who attend clinics at BC Children’s Hospital have very complex conditions requiring a significant amount of medical intervention. They face normal developmental tasks with the extra challenge of living with a disability. It is difficult to encourage the developmental transition process as the focus is often on medical issues. During this transition period teens are transferred to adult health care providers, who usually have a different health care management paradigm. On TRAC (Taking Responsibility of Adolescent Care) was developed to provide educational tools and management strategies for subspecialty health care teams who care for adolescents with chronic illness. The goal of the program is to assist staff in moving the adolescent along a transition trajectory so they are prepared for transfer to the adult health care setting by 18 years of age. This research project is a situational analysis to investigate the effectiveness of On TRAC, to understand what is considered a successful transition and transfer, and to develop recommendations (including technological tools) to improve the program.

Honours & Awards

Nominated: Excellence in BC Healthcare Award New Innovation, 2007

Hung GR. Whitehouse SR. O’Neill C. Gray AP. Kissoon N. Computer modeling of patient flow in a paediatric emergency department using discrete event simulation