28 Result(s)
within
Jean-Frederic Levesque
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Article
Open AccessImplementation of large, multi-site hospital interventions: a realist evaluation of strategies for develo** capability
This study presents guidelines for implementation distilled from the findings of a realist evaluation. The setting was local health districts in New South Wales, Australia that implemented three clinical impro...
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Article
Open AccessAudit and feedback to reduce unwarranted clinical variation at scale: a realist study of implementation strategy mechanisms
Unwarranted clinical variation in hospital care includes the underuse, overuse, or misuse of services. Audit and feedback is a common strategy to reduce unwarranted variation, but its effectiveness varies wide...
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Article
Open AccessFrom data to practice change – exploring new territory for atlases of clinical variation
Despite decades of atlas production and use within multiple healthcare systems, and consistent reporting of geographical differences in the utilisation of services, significant levels of clinical variation per...
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Article
Determinants of long-term unplanned readmission and mortality following self-inflicted and non-self-inflicted major injury: a retrospective cohort study
To describe the characteristics of major injury and identify determinants of long-term unplanned readmission and mortality after self-inflicted and non-self-inflicted injury to inform potential readmission scr...
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Article
Open AccessImproving access to primary health care: a cross-case comparison based on an a priori program theory
Inequitable access to primary health care (PHC) remains a problem for most western countries. Failure to scale up effective interventions has been due, in part, to a failure to share the logic and essential el...
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Open AccessAvoiding unnecessary hospitalisation for patients with chronic conditions: a systematic review of implementation determinants for hospital avoidance programmes
Studies of clinical effectiveness have demonstrated the many benefits of programmes that avoid unnecessary hospitalisations. Therefore, it is imperative to examine the factors influencing implementation of the...
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Article
Open AccessDoes healthcare inequity reflect variations in peoples’ abilities to access healthcare? Results from a multi-jurisdictional interventional study in two high-income countries
Primary healthcare services must respond to the healthcare-seeking needs of persons with a wide range of personal and social characteristics. In this study, examined whether socially vulnerable persons exhibit...
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Article
Open AccessEnvisioning the future of clinical analytics: a modified Delphi process in New South Wales, Australia
Clinical analytics is a rapidly develo** area of informatics and knowledge mobilisation which has huge potential to improve healthcare in the future. It is widely acknowledged to be a powerful mediator of cl...
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Open AccessCombining patient, clinical and system perspectives in assessing performance in healthcare: an integrated measurement framework
The science of measuring and reporting on the performance of healthcare systems is rapidly evolving. In the past decade, across many jurisdictions, organisations tasked with monitoring progress towards reform ...
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Article
Open AccessWhat matters to people with chronic conditions when accessing care in Australian general practice? A qualitative study of patient, carer, and provider perspectives
Research underpinning the patient experience of people with chronic conditions in Australian general practice is not well developed. We aimed to ascertain the perspectives of key stakeholders on aspects of pat...
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Article
Open AccessExploring variation in low-value care: a multilevel modelling study
Whether patients receive low-value hospital care (care that is not expected to provide a net benefit) may be influenced by unmeasured factors at the hospital they attend or the hospital’s Local Health District...
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Article
Open AccessOrganizational interventions improving access to community-based primary health care for vulnerable populations: a sco** review
Access to community-based primary health care (hereafter, ‘primary care’) is a priority in many countries. Health care systems have emphasized policies that help the community ‘get the right service in the rig...
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Article
Open AccessThe impact of primary care reform on health system performance in Canada: a systematic review
We aimed to synthesize the evidence of a causal effect and draw inferences about whether Canadian primary care reforms improved health system performance based on measures of health service utilization, proces...
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Article
Open AccessEquity of access to primary healthcare for vulnerable populations: the IMPACT international online survey of innovations
Improving access to primary healthcare (PHC) for vulnerable populations is important for achieving health equity, yet this remains challenging. Evidence of effective interventions is rather limited and fragmen...
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Article
Open AccessEffect of family medicine groups on visits to the emergency department among diabetic patients in Quebec between 2000 and 2011: a population-based segmented regression analysis
Family Medicine Groups (FMG) were introduced in Quebec in 2002 to re-organize primary care practices and encourage inter-professional service delivery. We measured visits to the emergency department (ED) for a...
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Article
Open AccessPortrait of rural emergency departments in Québec and utilization of the provincial emergency department management Guide: cross sectional survey
Rural emergency departments (EDs) constitute crucial safety nets for the 20 % of Canadians who live in rural areas. Pilot data suggests that the province of Québec appears to provide more comprehensive access ...
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Open AccessThe impact of primary healthcare reform on equity of utilization of services in the province of Quebec: a 2003–2010 follow-up
In 2003, the Quebec government made important changes in its primary healthcare (PHC) system. This reform included the creation of new models of PHC, Family Medicine Groups (e.g. multidisciplinary health teams...
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Article
Open AccessQuality of work life of rural emergency department nurses and physicians: a pilot study
Information about recruitment and retention factors and quality of work life (QWL) in rural emergency departments (EDs) is limited. A pilot study was used to determine the feasibility of a large-scale study of...
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Article
Minimal evidence of response shift in the absence of a catalyst
Individuals with chronic conditions experience fluctuations in health status and thus may experience response shift. We sought to test the hypothesis that response shift effects would be non-significant among ...
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Article
Open AccessImpact of Québec’s healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up
Healthcare reforms initiated in the early 2000s in Québec involved the implementation of new modes of primary healthcare (PHC) delivery and the creation of Health and Social Services Centers (HSSCs) to support...
