Capital District Health Authority Research Articles

A comprehensive simulation for wait time reduction and capacity planning applied in general surgery

This paper describes the use of operational research techniques to analyze the wait list for the Division of General Surgery at the Capital District Health Authority in Halifax, Nova Scotia, Canada. A discrete event simulation model was developed to aid capacity planning decisions and to analyze the performance of the division. The analysis examined the consequences of redistributing beds between sites, and achieving standard patient lengths of stay, while contrasting them to current and additional resource options. From the results, multiple independent and combined options for stabilizing and decreasing waits for elective procedures were proposed.

Publication bias in the medical literature: A review by a Canadian research ethics board

We reviewed the publication record of all protocols submitted to the Capital District Health Authority Research Ethics Board (REB) in Halifax, Nova Scotia, for the period 1995-1996. Because of a heightened awareness of the issue, we hypothesized that there would be less publication bias (a failure to report negative results) and a higher publication rate from completed studies, than previously reported. Closed studies were identified from the REB database. Publications were identified by the investigators, requests from sponsors, and a literature review. For each publication, we identified authors, title, journal, number of subjects enrolled, and whether or not the publication was a report of a randomized clinical trial. Comparisons were done using a Student's t test, the Chi-square statistic, or Fisher's exact test as appropriate. From the database of closed studies, 106 remained unpublished, while completed investigations resulted in 84 publications (44% publication rate). The median time to publication was 32.5 months. Publication of statistically significant results occurred in 71/84 trials. Publication of protocols submitted by departments ranged from 91% (anesthesia; 10/11) to 25% [nursing; 2/8 (P<0.05)]. Trials investigating new drugs in Phase 3 or 4 studies were more likely to be published than trials investigating agents in Phase 1 or 2 (P<0.05), and were less likely to be published if sponsored by a pharmaceutical company (P<0.05). Publication bias continues to be a problem, particularly for early phase investigative studies. Our results suggest that a different approach is required to reduce publication bias. The role that REBs and peer-reviewed journals might play requires further exploration.

Health systems planning for an influenza pandemic

District planning, in general, and influenza pandemic planning, in particular, are necessary to sustain health care organizations and systems. An extensive stakeholder process used by Capital District Health Authority (CDHA) and the Izaak Walton Killam (IWK) Health Centre involved more than 25 teams. This work resulted in a joint CDHA/IWK pandemic influenza contingency plan for public health, primary care, acute care and tertiary care services. In addition, district and business continuity planning has been enhanced.

The EXTRA Difference: Leadership Development

The development of leadership positions in nursing is paramount to strengthening the Canadian healthcare system and is one of ACEN’s priorities. National reports, such as the Romanow Report (2002) from the Commission on the Future of Health Care and the 2003 First Ministers Health Accord (Health Canada 2006), have highlighted the importance of building leadership capacities among healthcare professionals. In response to this need, the Canadian Health Services Research Foundation (CHSRF) launched the program Executive Training for Research Application (EXTRA) in 2004. EXTRA is an interprofessional two-year competitive fellowship program. Its twofold goal is to enhance the skills of Canadian healthcare executives (nurses, physicians and health administrators) to use existing research in their dayto-day decision-making and thereby increase the use of evidence-based decision-making overall. EXTRA’s accomplishments have led organizations to encourage those among their leadership ranks to take advantage of the program as one means to attain their own succession planning goals, and also to build capacity in their organizations for research literacy and use. The Halifax-based Capital District Health Authority (CDHA) has supported five EXTRA fellows and has made a commitment to continue to encourage its leadership team to participate in EXTRA. Dr. Judith Kazimirski, Vice President of Medicine for CDHA, said, “There is absolutely no question that this health authority has benefited as much from this program as have the participants themselves.” Now in its third year, EXTRA has accepted 76 fellows, one-third of whom were from nursing. The success of the fellowship is a direct result of the advantages that fellows have derived from their participation and work in EXTRA. Some benefits of EXTRA, in the participants’ own words: ACEN UPDATE

A Capital Approach: Tobacco Treatment and Cessation within Nova Scotia's Capital Health District

Inspired by Nova Scotia's comprehensive Tobacco Control Strategy and in an effort to support Capital Health's 100% smoke-free policy, the Addiction Prevention and Treatment Services (APTS) branch of Capital District Health Authority researched, designed and implemented an innovative tobacco intervention program. The success of the Capital approach, combining peer support, adult education concepts, addictions treatment knowledge, and free pharmacological aids, has sparked interest and dialogue among Canadian and American addictions professionals. The following article describes the rationale, guiding principles, key components and future directions of APTS's "To Be Tobacco Free" program.

An Invitation to Bolivia

An Invitation to Bolivia

Development and implementation of a joint breastfeeding policy: Bringing an ideal to reality

Summary The purpose of this article is to describe the barriers to creating breastfeeding friendly culture and strategies used to overcome these barriers by a tertiary level Health Centre and a Capital District Health Authority (CDHA) Public Health Services, with which the authors were affiliated. Lessons learned from this process may be a useful resource for other organizations embarking on this difficult, yet exciting journey.

Clinical Education: Challenges and Strategies

Coordinator of Affiliate Placement Service (APS), Health Professionals Education, for the Capital District Health Authority in Nova Scotia. She is the Nova Scotia member of the CAMRT Professional Practices Committee and past member of COE Radiography. Prior to her position as Affiliate Placement Coordinator, she was an educator with the QEII/Dalhousie School of Health Sciences (formerly the QE II Health Sciences Centre School of Radiological Technology).