Promoting High Quality Health Care Workplaces: Learning From Saskatchewan

1
Promoting High Quality Health Care Workplaces
Learning From Saskatchewan
Abstract
1) Web-based survey
There is a connection between quality
workplaces, retention and recruitment of health
providers, and enhanced care outcomes. Several
policy and research reports have described the
need to create high quality health care
workplaces to address ongoing human resource
sustainability in the health care system. The
purpose of this research is to explore the
development of high quality health care
workplaces in Saskatchewan and the use of key
research and policy documents to support that
development. This study has four components
1) Web-based survey 2) Content analysis
3) Focus groups 4) Descriptive model(s)    
The first component is intended to collect
lived-experience data from people working in
health care. In late 2004, more than 4000
letters of invitation were sent to those
identified by random sample in a database managed
by the Saskatchewan Association of Health
Associations. The survey hopes to encourage
participation from all geographic locations in
the province, all professions working in health
care, in rural and urban workplaces. One of the
challenges was ensuring privacy of the database
as required by The Health Information Protection
Act in Saskatchewan. A reminder letter was sent
to each of the invitees at the end of January,
2005.
Knowledge Utilization Network
2) Content Analysis
The second component is collection of relevant
documents from each of the Regional Health
Authorities. These could include annual
reports, health quality initiatives, policies,
practices and programs, minutes and
correspondence to understand the ideas or
concepts that have guided decisions, actions, and
changes in Saskatchewan health care workplaces.

• The KUN is central to the knowledge transfer and
  utilization component of this research project.
• Representatives of stakeholder groups involved in
  the health care sector were invited to
  participate in this research project from the
  beginning. Their support was requested and
  received in preparing the funding proposal to
  Health Canadas Health Policy Research Fund.
• In the months following funding approval, the KUN
  has grown to more than 50 representatives from
  professional regulatory bodies, associations,
  unions, and government agencies.
• The KUN is intended to increase ownership and
  understanding of the research and its processes
  and to provide opportunities for broad
  involvement in planning.
•  
• Most of the communication and involvement of KUN
  members will occur via e-mail, print materials,
  and telephone.
•  
• There will be two face-to-face meetings of the
  KUN to build trust and develop collaborative
  relationships.
• In April, 2005 the KUN will gather to share
  information on research progress and to provide
  feedback about what we have found.
• In December 2005, the KUN, focus group
  participants and PAC members will share the
  research findings, critique the descriptive
  models for validity and develop strategies for
  using the research findings.

Research Questions
3) Focus Groups
The third component of the research involves
Focus groups. Focus group will be conducted to
examine the barriers and the facilitators to
achieving high quality health care workplaces and
the role of specific research and policy
documents.   Focus group participants will
volunteer following completion of the survey
instrument by contacting a toll free number to
register.   A script will be prepared to ensure
consistency throughout the process. The focus
groups will be audio-taped for transcription
purposes. Additional factors mentioned in the
focus groups will become part of the data that
contribute to the next phase of the research, the
model(s) development.
What ideas have guided changes in health care
workplaces? And, what are the sources of these
ideas? How do knowledge users define
quality? What are knowledge users levels of
awareness of policy and research report
recommendations about high-quality health care
workplaces? What decisions have been made and
actions taken in Saskatchewan health care
workplaces to improve the workplace
environment? To what extent, and how, have these
changes been informed by policy and research
report recommendations? What other factors have
guided policy and decision-making about health
care workplaces? Who are the people that have
influenced decisions about health care
workplaces? According to various stakeholders,
what is currently working and why in providing
high quality health care workplaces? According
to various stakeholders, what is needed to enable
present and future improvements in health care
workplace quality?
4) Descriptive Models
The final component is the development of
descriptive models. The survey, content
analysis, and focus group information analyses
will contribute to the building of models
regarding how organizations are addressing
quality workplace issues in Saskatchewan and how
research and policy reports are influencing those
initiatives.   Facilitated discussions with the
Project Advisory Committee, the Knowledge
Utilization Network (KUN), and the Health Quality
Council Quality Improvement Network members will
assist in synthesizing the linkages between the
inputs, outputs, main outcome, and enabling and
restraining forces into descriptive
models.   Model(s) will be examined for efficacy
during the one-day facilitated stakeholder
workshop to which participants in the focus
group, the KUN, and other key stakeholders will
be invited.
Research Team Members
Project Advisory Committee
Marlene Smadu, Principal Investigator,
University of Saskatchewan\ Maureen Bingham,
Health Quality Council Lisa Clatney, Health
Quality Council Elizabeth Domm, University of
Saskatchewan Tanya Dunn-Pierce, Saskatoon
Regional Health Authority Karen Eisler,
Saskatchewan Registered Nurses Association Tom
McIntosh, Canadian Policy Research Network
SPHERU Joan Sawatzky, University of
Saskatchewan Renee Torgerson, Saskatchewan Health
P. Susan Wagner, University of Saskatchewan Jane
Fahlman, University of Saskatchewan Michelle
Bilan, University of Saskatchewan
The PAC is comprised of healthcare providers,
academics and organizational and government
representatives, all renowned in their fields.
PACs role is to guide the project, liaising
between the Research Team and the organizations
their represent. This is to ensure that the
research continues to have policy relevance to
the organizations they represent. The PAC will
also assist in the dissemination of research
results within their professional associations,
regulatory bodies and/or unions. Its members
are   Susan Antosh, Saskatchewan Association of
Health Organizations Allen Backman, University of
Saskatchewan Cheryl Craig, Five Hills Moose Jaw
Union Hospital Carole Estabrooks, University of
Alberta Norma Freeman, Canadian Nurses
Association Bernie Knorr, City Hospital,
Saskatoon Kelly Kummerfield, University of
Regina Judith Martin, Saskatchewan Labour Kathie
Paddock, Office of Nursing Policy, Health Canada
Employers need to find ways to ensure that
employees have as much control as possible over
their work hours and schedules, and the location
of their work. Alternative work arrangements
should be made as widely available on a
volunteer basis - as possible Workers should be
allowed to say no to overtime hours it should be
made easier for employees to transfer from
full-time to part-time work and vice versa
workers should receive a certain number of paid
days leave per year for childcare, eldercare, or
personal reasons
Funding support has been received from Health
Canadas Health Policy Research Program and
Saskatchewan Health. Additional information on
this research is available on-line at
http//www.spheru.ca/PDF20Files/SMADU/Healthy_Wor
kplace_Main_Page.htm