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Purpose: Slow changes in older adults' health status are often not detected until they escalate. Our aim was to understand if e-technology can enhance the safety and quality of older adult care by detecting changes in health status early.Methods: E-technology was implemented with 30 seniors in an assisted living facility. We used wireless devices to monitor blood pressure, oxygen saturation, weight, and hydration. This 1-year feasibility study included: a readiness assessment, procuring devices, developing an alert software, training staff, and weekly monitoring for several months.Results: Analysis of service utilization data showed no significant differences in number of emergency or hospital visits between the intervention and control group. Qualitative data suggested residents were satisfied with the e-technology. Among staff, several saw value in weekly monitoring, however staff emphasized the need for devices to be suitable for older adults.Conclusion: It is imperative that researchers work with facilities to ensure there is value-added in implementing new technology. Staff feedback helped fine-tune devices, training materials, and measurement process. It took longer than anticipated to procure suitable devices, set up the software, and recruit residents, thus limiting data collection. Future studies should dedicate more time to implementation and propose longer timelines. [ABSTRACT FROM AUTHOR]

Purpose: This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. Methods: We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals' scope of practice. Results: Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. Conclusion: These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice. [ABSTRACT FROM AUTHOR]

This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process., (Copyright © 2017 Longwoods Publishing.)

There are limited evaluations of the impact of knowledge translation (KT) activities aimed at addressing practice and policy gaps. We report on the impact of an interactive, end-of-grant KT event. Although action items were developed and key stakeholder support attained, minimal follow-through had occurred three months after the KT event. Several organizational obstacles to transitioning knowledge into action were identified: leadership, program policies, infrastructure, changing priorities, workload and physician engagement. Key messages include: (1) ensure ongoing and facilitated networking opportunities, (2) invest in building implementation capacity, (3) target multi-level implementation activities and (4) focus further research on KT evaluation., (Copyright © 2016 Longwoods Publishing.)