My research focuses on the generation of knowledge to inform and improve the care of older adults. I have led multidisciplinary research teams on several projects addressing three inter-related areas of study: 1) designing and testing interventions that enhance, maintain, or prevent loss of physical function in older adults with and without cognitive impairment; 2) developing a comprehensive understanding of the knowledge, skills and attitudes required of healthcare professionals and healthcare aides to care for older persons and their care partners, which is central to contributing to positive outcomes for these individuals with multiple and complex needs; and 3) conceptualizing, developing, and testing supportive models of supervision of regulated and unregulated staff in healthcare settings. Supportive staff supervision models form a structural element integral to promoting high quality work environments, which serve to optimize the processes and outcomes of health care. The results of my research program have led to understanding interventions that have a positive effect on patients and staff in long-term care homes and rehabilitation environments and on the development of appropriate health policies.
Nurse Practitioners supporting the workforce in long-term care homes
Study Status: completed
Institute: KITE Research Institute
Study Purpose: In this two-phase study, we focused on improving the well-being of staff in long-term care homes (LTCHs) by introducing nurse practitioner-led mini-meetings (huddles). In phase 1, we worked with LTCH leaders to develop and adapt the huddles to address the needs of the LTCH. In phase 2, huddles were implemented, and we examined their effectiveness and the implementation process.
Background: A team of international researchers provided research-based recommendations to support the well-being of staff. With LTCH’s leaders’ and staff input, one recommendation was chosen to address the challenges experienced by the LTCH. The recommendation was nurse practitioner-led huddles to support staff.
Study Methods: We followed a four-step process to develop the huddles and adapt them to the context of the LTCH. Then, huddles were implemented for 4 months. We conducted a process-outcome evaluation to examine feasibility, acceptability, sustainability, and initial efficacy. Staff participating and not participating in huddles were asked to complete surveys about their moral distress, job satisfaction, health, and support by the nurse practitioner. In addition, staff and managers participating in huddles were interviewed to discuss the implementation process.
Key Findings: The nurse practitioner carried out 48 huddles. Majority of huddles focused on resident care and staff well-being. Overall, the study found that huddles can be helpful in improving staff well-being. Staff who attended huddles felt less distress and more support. We also learned what factors contribute to the success of huddles in LTCHs.
This study shows that nurse practitioners can successfully implement programs to support staff in LTCHs. Factors affecting implementation need to be considered in by researchers working in LTCHs.
Health Conditions:
Aging (dementia, frailty, etc.), Rehabilitation Services
Understanding how transitional care programs work to meet patients’ needs
Study Status: active
Institute: KITE Research Institute
Study Purpose: We are doing a study to evaluate the care patients receive in Transitional Care Programs. The goals of the study are to:
1. Identify the services and therapies offered to patients
2. Identify if there are changes in patient's well-being
3. Learn what services and therapies help patients recover
4. Learn if patients are satisfied with their stay
Background: Many older adults experience delays in being released (discharged) from hospitals. Transitional care programs are new programs created for patients who are ready to leave the hospital but either need some extra services before going home or a place to wait for a room in a long-term care home.
Study Methods: We will interview patients or their care partners at the beginning and end of their stay at the transitional care program. In the interviews, we will ask about patients’ well-being before hospitalization, their well-being in the moment, their ability to do daily activities, and their satisfaction with the services. In addition, the patients’ medical chart will be reviewed to identify what services and therapies are provided to them during their stay and their discharge location. We will also interview program managers and staff to learn more about the services they provide.
Health Conditions:
Aging (dementia, frailty, etc.), Rehabilitation Services
External Links:
- Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
- Faculty Member, Rehabilitation Sciences Institute, University of Toronto