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Centre for Health Economics and Policy Analysis


Seminars resume with a look at a tool for implementing innovation

21 Dec 2015

CHEPA’s first seminar of 2016 takes place on Weds. Jan 20 and features health systems researchers Dr. Merrick Zwarenstein and Dr. Archna Narula presenting The NOSE TO TAIL TOOL- a new deliberative approach to facilitating successful development, implementation and scale up of healthcare innovations.

Zwarenstein, MBBCh, MSc,PhD, is Director of the Centre for Studies in Family Medicine and Director of Research, Department of Family Medicine, at Western University. Narula, MD, CCFP, MHP, is a family physician and Adjunct Assistant Clinical Professor, DFM in McMaster’s Department of Family Medicine. She is also a Researcher at the Centre for Studies in Family Medicine at Western, where she works under Zwarenstein’s supervision developing the tool.

The presentation, which was rescheduled from last September, draws from evidence suggesting many promising health service delivery innovations are piloted in such a way that they fail to scale to all eligible jurisdictions, resulting in many missed opportunities. Meanwhile, others are implemented and spread without clear evidence of their appropriateness, acceptability or effectiveness.

Zwarenstein notes that fields of study known variously as Knowledge TranslationDissemination or Implementation research have grown over recent decades to understand this and related problems, generating new journals and theories but generally producing only academic activities.

In this seminar, Zwarenstein and Narula present a potential tool for achieving the goals of evidence-based implementation and scale-up on the ground, in collaborations between innovators, end users and decision makers.

Zwarenstein trained at the Karolinska Institute in Sweden, the London School of Hygiene in the UK and Witwatersrand University Medical School in South Africa, working as a family physician before turning to research and teaching.

He was the principal investigator for a network of Canadian health services and policy researchers focusing on overcoming limitations to the use of randomized trials in support of policy decision-making. This group has developed a new guideline for the design of pragmatic randomized trials. This guideline, which forms part of the internationally recognized Consolidated Standards on Reporting of Randomized Trials (CONSORT) statement, has influenced the way they are described and published.

He developed new uses for routine administrative databases in Ontario for large-scale implementation and rigorous evaluation of quality of care interventions. He is the principal investigator for four randomized trials, covering all Ontario primary care physicians, of knowledge translation interventions. These studies will establish greater certainty around the use of printed educational messages, a widely used approach to changing physician behaviour, providing guidance for Ministries of Health on how to achieve physician behaviour change for improving quality of care.

Narula is a family physician who provides services at the Shelter Health Network in Hamilton providing primary care services to the homeless or marginally housed and who have complex health and social needs; and at the Wise Elephant FHT in Brampton where she provides full scope primary care and low risk obstetrical care.

She is an Assistant Clinical Professor with McMaster’s Department of Family Medicine where she has been involved with the development of the global health curriculum and also provides teaching/supervision to medical students and residents.

Her research interests include how to optimize healthcare services for marginalized populations and how to implement change at a healthcare systems level

The seminar will be held on WedsJan. 20 in CRLB-119, from 12:30- 1:30 p.m. All are welcome. The seminar will be available remotely for those unable to attend.

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