Asymptomatic carriers of COVID-19 in a confined adult community population in Quebec: A cross-sectional study.

Several countries have undertaken social distancing measures to stop SARS-CoV-2 spread. Asymptomatic carriers' prevalence is unknown and would provide essential information on hidden viral circulation. In our cross-sectional study, 1.82% of 330 asymptomatic confined individuals living in the community carried SARS-CoV-2 despite no contact with declared cases, raising concerns about unnoticed transmission.

Interprofessional collaboration: development of a tool to enhance knowledge translation.

PURPOSE: Interprofessional collaboration (IPC) is a complex and multidimensional process in which different professionals work together to positively impact health care. In order to enhance the knowledge translation and improve rehabilitation practitioners' knowledge and skills toward IPC, it is essential to develop a comprehensive tool that illustrates how IPC should be operationalized in clinical settings. Thus, this study aims at developing, validating and assessing the usefulness of a comprehensive framework illustrating how the interactional factors should be operationalized in clinical settings to promote good collaboration. METHODS: This article presents a mixed-method approach used to involve rehabilitation stakeholders (n = 20) in the development and validation of an IPC framework according to a systematic seven-phase procedure. RESULTS: The final framework shows five types of practices according to four components: the situation of the client and family, the intention underlying the collaboration, the interaction between practitioners, and the combining of disciplinary knowledge. CONCLUSION: The framework integrates the current scientific knowledge and clinical experience regarding the conceptualization of IPC. It is considered as a relevant and useful KT tool to enhance IPC knowledge for various stakeholders, especially in the rehabilitation field. This comprehensive and contextualized framework could be used in undergraduate and continuing education initiatives. Implications for Rehabilitation The framework developed integrates the current scientific knowledge and clinical experience regarding the conceptualization of interprofessional collaboration (IPC) that is relevant to the rehabilitation field. It could be used in undergraduate and continuing education initiatives to help learners understand the multidimensional and dynamic nature of IPC. It could be useful to support practitioners and managers from the rehabilitation field in their efforts to optimize collaborative practice within their organization.

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PROBLEM ADDRESSED: A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. OBJECTIVE OF THE PROGRAM: The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. PROGRAM DESCRIPTION: Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. CONCLUSION: The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

Organizational analysis of Canadian supported employment programs for people with psychiatric disabilities.

Supported employment (SE) is widely considered to be the most effective intervention for helping people with psychiatric disabilities integrate into the competitive workforce. While fidelity to principles and standards of evidence-based SE, i.e., the Individual Placement and Support model, is positively associated with vocational outcomes, studies have revealed significant heterogeneity in SE programs implemented in Canada. This qualitative study thus aimed to shed light on organizational and contextual factors influencing SE implementation in three Canadian provinces (British Columbia, Ontario and Quebec). The study adopted several key concepts from the field of organizational studies (e.g., coalitions, archetypes, isomorphism) to guide data collection and analysis. Overall, 20 SE programs provided by 15 different agencies were examined. Findings revealed that agencies' exposure to different institutional pressures, their interactions and relationships with other groups and organizations, as well as their values, beliefs and ideologies played determining roles in shaping the evolution of SE services in each province.

Patients' perceptions of the quality of care after primary care reform: Family medicine groups in Quebec.

OBJECTIVE: To evaluate how a primary care reform, which aimed to promote interprofessional and interorganizational collaborative practices, affected patients' experiences of the core dimensions of primary care. DESIGN: Before-and-after comparison of patients' perceptions of care at the beginning of family medicine group (FMG) implementation (15 to 20 months after accreditation) and 18 months later. SETTING: Five FMGs in the province of Quebec from various settings and types of practice. PARTICIPANTS: A random sample of patients was selected in each FMG; a total of 1046 participants completed both the baseline and follow-up questionnaires. MAIN OUTCOME MEASURES: Patients' perceptions of relational and informational continuity, organizational and first-contact accessibility, attitude and efficiency of the clinic's personnel and waiting times (service responsiveness), physician-nurse and primary care physician-specialist coordination, and intra-FMG collaboration were assessed over the telephone, mostly using a modified version of the Primary Care Assessment Tool. Additional items covered patients' opinions about consulting nurses, patients' use of emergency services, and patients' recall of health promotion and preventive care received. RESULTS: A total of 1275 patients were interviewed at the study baseline, and 82% also completed the follow-up interviews after 18 months (n = 1046). Overall, perceptions of relational and informational continuity increased significantly (P < .05), whereas organizational and first-contact accessibility and service responsiveness did not change significantly. Perception of physician-nurse coordination remained unchanged, but perception of primary care physician-specialist coordination decreased significantly (P < .05). The proportion of participants reporting visits with nurses and reporting use of FMGs' emergency services increased significantly from baseline to follow-up (P < .05). CONCLUSION: This reorganization of primary care services resulted in considerable changes in care practices, which led to improvements in patients' experiences of the continuity of care but not to improvements in their experiences of the accessibility of care.