Title: Health Care Settings and Public Policy: An International Collaborative Research Workshop June 10-14, 2002

Investigator Name: Professor Peter C. Coyte

Project Completion Date: January 2003

Research Category: Workshop

Institution: University of Toronto

Project Number: 6795-15-2001/4430006

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Summary

Overview:

In June 2002, a five-day Collaborative Workshop took place at University of Toronto, with participants from research and public policy sectors in Canada and Sweden. The Workshop consisted of four days of intensive, participant team-led seminars and a one-day public Symposium. Seminars focused on the design and conduct of research related to health care, technology, and place, and the implications of geographically dispersed health care service provision for diverse policy sectors. These include housing, social services, and international trade agreements. The objectives of the Symposium were: to showcase internationally recognized researchers' perspectives on the future of health care settings; to recognize the knowledge translation role played by decision makers in home and community care agencies and industries; and to launch the CIHR Strategic Training Program in Health Care, Technology, and Place.

Why is it Important?

Health restructuring in Canada and Sweden has increased the number and types of settings in which care is sought, delivered and received. Due to fiscal and demographic pressures, together with technological advances, globalization, and changes in social attitudes, a broad spectrum of health care is now dispersed across hospital, home, clinic, workplace, school, and "eCare" settings. Care recipients of all ages and in all states of health and disability navigate a non-linear web of care sites to access the health services they require. Understanding the unique challenges posed by geographically decentralized, technology-mediated health care order is difficult and requires collaborative effects, particularly because so many policy sectors are involved.

Objectives:

1) Through interdisciplinary and international exchange, to build knowledge pertinent to the dynamic interplay of health care, technology, and place; 2) to generate research priorities in concert with decision makers; and 3) to design and implement international studies. Anticipated outcomes:
1) enhanced research capacity to examine multi-sited, technology-mediated health care; 2) ongoing policy sector involvement in research proposals;
3) exchanges and secondments to foster cross-fertilization and knowledge transfer, and 4) more explicit attention paid to health care settings and technologies in policy development.

Recruitment:

In total, forty-three participants, representing academics, graduate students and policy makers from the two countries, were involved.

Curricula:

On the basis of the participants' expertise and interests, five Curricular Themes were developed:

• Legal, Political, and Policy Issues Pertaining to Health Care Settings;
• Health Care in Home and Community Care Settings;
• Organization and Provision of Health Care Work;
• Quality of Life and Quality of Care for Care Recipients; and
• Ethical Issues Pertaining to Health Care Settings Research, Practice, and Policy.

Participants were assigned to ten small teams (five Canadian; five Swedish). To promote boundary-crossing, the composition of each Canadian team was cross-national, cross-disciplinary, and cross-professional. In Canada, team leaders met monthly to generate best practices for interdisciplinary/interprofessional collaboration. The results of these team leader meetings were presented during the introductory session, entitled "Cross-Disciplinary Perspectives on Theory, Method, and Policy".

Special Events:

Several special events were planned to complement the daily curricular modules. Professor Ross Gray (Toronto Sunnybrook Regional Cancer Centre) presented a screening of his award-winning drama, "Handle With Care? Women Living with Metatstatic Breast Cancer". Following the screening, participants discussed the use of non-traditional media, including literature and the fine arts, in health care research and knowledge translation.

Three unique field visits were also arranged

• Introduction to assistive technologies for home and community care at The Centre for Studies in Aging (Sunnybrook & Women's College Health Sciences Centre);
• Introduction to Northern Ontario Remote Telecommunications Health (NORTH) Network, (Sunnybrook & Women's College Health Sciences Centre); and
• Introduction to the architecture of healing at The Hospital for Sick Children.

Public Symposium:

A Symposium entitled, "21st Century Health Care: "Here, There, and Everywhere" provided the capstone event for the Workshop. The objectives of the Symposium were to showcase world-class research innovation, stimulate new thinking about knowledge translation pertaining to health care settings, and launch the newly CIHR Strategic Training Program in Health Care, Technology, and Place (HCTP).

A poster presentation room was set up for participants to meet and learn about the knowledge translation and research activities of home and community care decision makers, including: The Canadian Home Care Association; the Change Foundation; Calea Home Care; ComCare Health Services; Saint Elizabeth Health Care; the Victorian Order of Nurses of Canada; and WeCare Health Services.

Exhibition space was provided for "House Calls: A Physician's Photo Essay on Home Care" by Mark Nowaczynski, M.D., Ph.D. This award-winning installation of documentary photography underscores the power of non-traditional knowledge translation initiatives in health care.

Dissemination of the Proceedings:

All documents generated through the Workshop, including reading lists and curricular materials are posted at the HCERC website. Stakeholders have been alerted to the availability of these documents via the HCERC listserv. The generosity of Health Canada in funding this event is acknowledged on the Workshop webpage.

The driving concern of the Workshop was to promote health care research and knowledge translation across academic boundaries and beyond academia. Hence, knowledge translation methods were a topic of inquiry during the Workshop. Innovative modes of dissemination (e.g. eHealth promotion; use of visual arts and drama), innovative career orientations (e.g. "researcher in residence"; "practitioner-policy analyst"; "physician-documentarian"), and the opportunities and challenges associated with communication across professions, disciplines, and regions were explored via the curricular modules, special events, and Public Symposium.

Seven months following the Workshop, integrative research and knowledge translation activities have been stimulated. Key outcomes include:

• Dissemination to pertinent audiences, including the Children and Youth Home Care Network Retreat (September 2002), the Canadian Research Transfer Network Meeting (October 2002), the Canadian Health Services Research Foundation CADRE Meeting (October 2002), and the Canadian Home Care Association Meeting (November 2002).
  
  
• Cross-professional policy analysis: Romanow Report. Ontario researcher-practitioner Karen Spalding and B.C. policy representative Brenda Canitz co-developed a submission to the Commission on the Future of Health Care in Canada. The submission, addressing the need for a national paediatric home care program, was presented at the Canadian Home Care Association Meeting.
  
  
• Cross-professional research models: Researcher-in-Residence. Decision Maker partner, Saint Elizabeth Health Care, and Post-Doctoral Researcher Wendy Young have been invited to speak at the Canadian Health Services Research Foundation concerning their researcher-in-residency program. Dr. Young was an active Workshop participant, and Saint Elizabeth participated in the poster-presentation session. The poster emphasized the role of conducting research with and within policy and practice organizations.

Cross-sectoral research collaboration: Housing Adequacy for Home Care. As a result of linkages developed at the Workshop, Canada Mortgage and Housing Corporation was invited to participate as a policy partner in developing a multi-purpose instrument to assess housing adequacy for long-term home care. This research project is led by Workshop Co-Director Peter C. Coyte, with support from the Ontario Ministry of Health and Long Term Care - Hospital Management Research Unit.

The views expressed herein do not
necessarily represent the views of Health Canada

In addition to the above summary, the full report can be accessed in the following ways:

• The print version of the full report can be obtained in the language of submission from the Health Canada Library through inter-library loan.
• An electronic version of the report in the language of submission is available upon request from Health Canada by contacting the Research Management and Dissemination Division.

This research has been conducted with a financial contribution from Health Canada's Health Policy Research Program. For permission to reproduce all or part of the research report, please contact the Principal Investigator directly at the following address: peter.coyte@utoronto.ca.

The Health Policy Research Program (HPRP) funds research that provides an evidence base for Health Canada's policy decisions. The HPRP is a strategic and targeted program with a broad socio-economic orientation and connections to national and international endeavours. The research can be primary, secondary or synthesis research, a one-time contribution to a developing research endeavour, or a workshop, seminar or conference.