Understanding the relationships between people and their health care systems and providers

Our network of health services researchers design, interpret and report on evaluations of clinical practice, the organization and delivery of health care, quality and safety of health services, spending and costs of care. The team is experienced with linking health service use to patients’ and families’ outcomes to evaluate the efficiency, effectiveness, and quality of care.

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About the Program

Our network of health services researchers design, interpret and report on evaluations of clinical practice, the organization and delivery of health care, quality and safety of health services, spending and costs of care. Our team is experienced with linking health service use to patients’ and families’ outcomes to evaluate the efficiency, effectiveness, and quality of care in collaboration with a wide range of clinical experts.

Examples of Our Projects

Health services and outcomes research activities span quantitative methods and qualitative research with patients and families. Current activities link population-based administrative datasets to measure perioperative care, while other activities measure patients’ perceptions regarding their shared decision-making.

Improving Care in the ICU

PHC researchers reduced the number of routine chest x-rays at St. Paul’s Hospital’s Intensive Care Unit (ICU), saving an estimated $27,000 a year and reducing patient exposure to harmful x-rays. The team, which included CHÉOS investigators Drs. Peter Dodek, Najib Ayas, and Hubert Wong implemented a quality improvement intervention that included education and computer order entry that proved to be effective in reducing the number of chest x-rays without having a negative impact on patient outcomes or processes of care. The study was published in BMJ Quality and Safety and was reported on by The Vancouver Sun.

Increasing Access to Hospitals by Changing Financial Incentives

  • New pricing approaches for bundled payments: Leveraging clinical standards and regional variations to target avoidable utilization (Link)
  • Moving from volume to value with hospital funding policies in Canada (Link)
  • Pricing hospital care: Global budgets and marginal pricing strategies (Link)
  • Re-allocating Cancer Surgery Payments for Alternate Level of Care in Ontario: What are the Options? (Link)

Coronary Revascularization: A tool for evidence-based, individualized, shared decision-making (CR-Decide)

CR-Decide is a qualitative study that aims to develop an evidence-based, individualized, decision-making tool to support shared decision-making (SDM) between patients and physicians during treatment selection for stable coronary artery disease (CAD). Once the tool has been built, the study will then focus on integrating it into routine clinical care.

Led by PIs CHÉOS Scientist Dr. Karin Humphries and Dr. Colleen Norris, CR-Decide will engage over 150 stable CAD patients and cardiovascular health care professionals across B.C and Alberta in focus group sessions and interviews in order to assess the importance of different prognostic information, to prioritize relevant clinical and health-related quality of life outcomes, and to discuss potential implementation strategies.

Current evidence suggests that patients’ and physicians’ preferences, with respect to treatment options and prioritization of outcomes, differ. The study, therefore, endeavours to address this discrepancy by facilitating the inclusion of patient preferences in treatment decision-making.

Read more about the project here.

Measuring Self-reported Health While Waiting to Access Surgical Treatment

  • The health of patients on the waiting list: Opportunity to improve health in Canada? (Link)
  • Patient-reported outcomes and surgical triage: A gap in patient-centred care? (Link)
  • Addressing the Mental Health of Canadians Waiting for Elective Surgery: A Potential Positive Post-Pandemic Legacy (Link)
  • Surgical Wait List Management in Canada During A Pandemic: Many Challenges Ahead (Link)

Improving Patient Outcomes

  • Health and quality of life among a cohort of patients having lateral internal sphincterotomy for anal fissures (Link)
  • Incisional Hernia Repair Surgery Improves Patient-Reported Outcomes (Link)
  • Using postoperative patient-reported outcomes to predict ankle arthroplasty and arthrodesis revision (Link)
  • Do Pre-operative Patient-reported Outcomes Predict Hospital Length of Stay for Surgically treated End-Stage Ankle Osteoarthritis Patients? (Link)
  • A cost-utility study of laparoscopic cholecystectomy for treatment of symptomatic gallstones (Link)