Building Capacity in Health Professionals to Conduct Quality Improvement: Evaluation From a Collaborative Interorganizational Program.

BACKGROUND: The Toronto Academic Health Sciences Network Health Professions Innovation Fellowship Program began in 2014 as a pilot initiative among 4 academic teaching hospitals in Toronto, Ontario. The purpose of the Program was to cultivate applied leadership, interprofessional collaboration, and quality improvement capacity among health professionals. PURPOSE: This article reports on the evaluation findings from the initial year as well as an update on current program status and sustainability. METHODS: A formative evaluation was conducted focused on the impact on clinical practice, participant skill development, participant experience, and cross-organizational partnerships. Data were collected through a focus group, interviews, and pre- and postsurveys. RESULTS: Data from the initial pilot showed increases in leadership practices, project management, and quality improvement knowledge, with changes in leadership practices being significant. Positive changes in clinical practice at both the individual and unit/team levels and capacity for building relationships were also reported. Since the pilot, more than 160 participants from 15 health professions and 9 organizations have participated. Several graduates have taken on leadership roles since their participation in the Program. CONCLUSIONS: Health care organizations wishing to advance academic practice may benefit from implementing a similar collaborative program to reap benefits beyond organizational silos.

Examining Nutrition Knowledge of Bariatric Surgery Patients: What Happens to Dietary Knowledge over Time?

BACKGROUND: Nutrition education is a standard of care in bariatric surgery clinical practice guidelines. Despite its known importance, no studies have documented the trajectory of nutrition knowledge over the course of the bariatric surgery process. Primary objectives included determining changes in bariatric surgery nutrition knowledge scores from the pre-surgical phase to 1-month post-surgical intervention and investigating the impact of time on nutrition education retention in bariatric patients. Secondary objectives focused on the relationship between patients' pre-operative anxiety and depression on nutrition knowledge retention. METHODS: Prior to data collection, patients attended a nutrition education class and met with a registered dietitian. One hundred and nineteen consented patients eligible for bariatric surgery completed a nutrition knowledge questionnaire, Eating After Bariatric Surgery (EABS) prior to and 1 month following bariatric surgery. RESULTS: Analyses revealed (1) patients' nutrition knowledge (measured by EABS) significantly increased from the pre-operative phase (M = 46.9; SD = 14.4) to the post-operative phase ((M = 56.9; SD = 14.1), t(118) = -8.01, p < .001); (2) time between the nutrition education class and patients' surgery significantly impacted knowledge retained; (3) patients with higher pre-operative levels of depression and anxiety had significantly lower post-operative nutrition knowledge; and (4) gender differences in terms of patients' nutrition knowledge. CONCLUSIONS: This study confirmed that dietary knowledge significantly improves following surgical intervention. Furthermore, increased time in between receiving nutrition knowledge and surgery resulted in less retained knowledge 1-month post-op. Future education interventions for bariatric surgery programs should focus on addressing these factors to optimize patient knowledge and information retention after surgery.

NursesforTomorrow: a proactive approach to nursing resource analysis.

This paper describes the background, development, implementation and utilization of NursesforTomorrow (N4T), a practical and comprehensive nursing human resources analysis method to capture regional, institutional and patient care unit-specific actual and predicted nurse vacancies, nurse staff characteristics and nurse staffing changes. Reports generated from the process include forecasted shortfalls or surpluses of nurses, percentage of novice nurses, occupancy, sick time, overtime, agency use and other metrics. Readers will benefit from a description of the ways in which the data generated from the nursing resource analysis process are utilized at senior leadership, program and unit levels to support proactive hiring and resource allocation decisions and to predict unit-specific recruitment and retention patterns across multiple healthcare organizations and regions.