Browsing by Author "Prevost, Chad"

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Patient experiences in rural Northern Ontario: small hospital utilization and perspectives on community paramedicine
(2019-05-07) Prevost, Chad
This thesis adhered to an integrated article format with two distinct studies focusing on the analysis of patient medical records from a rural hospital in north east Ontario (Study 1) and a cross-sectional observational investigation of patient perspectives on community paramedicine (CP) (Study 2). The aim of Study 1 was to help hospital administrators identify patients at high risk of frequent hospital resource utilization (emergency department (ED) visit or admissions) so that if appropriate, they may be redirected to alternative services available in the community. Therefore, the two main research questions for this study were: (1) Which types of patients are more prone to having repeat ED visits and hospital admissions; and (2) What types of services could better serve or help improve the health of these patients? Study 2 aimed to evaluate patient and caregiver perspectives related to their involvement in three CP programs in rural communities across Northern Ontario. There were two research questions guiding the evaluation of patient perspectives in this study: (1) How effective is CP at supporting patient-centered care; and (2) How do perceptions differ between home visit (HV) and wellness clinic (WC) patients? In Study 1, twenty-six patients met the criteria for repeat ED visits (65% female; mean age 52 years) and accounted for a total of 623 ED visits. Seventeen patients met the criteria for repeat admissions (41.2% female; mean age 73 years) and accounted for 69 repeat hospital admissions. The most common reason cited for repeat ED visits was dressing changes and the most common reason cited for repeat admissions was chronic obstructive pulmonary disease. For Study 2, 91.7% (n=55) of patients reported being satisfied with the CP services they received and 98.3% (n=59) of the patients indicated that they would recommend CP to others. Patient perspectives of CP suggest that the service model is consistent with a patient-centered framework that includes interpersonal, psychosocial, clinical, and structural dimensions. The patients also valued CP for the ease of access and the reassurance provided by the paramedics monitoring their health concerns. Our studies found that an older population with increased health needs appear acceptable towards receiving alternative health care services outside of the hospital. Based on the perspectives of patients currently enrolled in CP programs across Northern Ontario, the HV and WC services of CP appeared to be considered as an acceptable program that can provide patient-centered care in rural and northern communities. Collectively, these two studies provide important data related to the patient experience in a rural and northern health care system context. These are encouraging signs that alternative health care services, like the CP programs, can address non-urgent issues for residents of northern and rural communities in Ontario.
Perceived importance of professional competencies for admission to the College of Kinesiologists of Ontario
(2015-04-01) Prevost, Chad; Kpazaï, Georges; Attiklemé, Kossivi
Background: For more than a decade, the development of professional competencies has been at the heart of curriculum reforms in Education and Health care training worldwide. Reference documents of competencies have been developed in Australia (Brownie, Thomas, McAllister, & Groves, 2014), Canada (Boucher & Ste-Marie, 2013; Royal College of Physicians and Surgeons of Canada, 2005), United-States (Hurd & Buschbom, 2010), and in Europe (Battel-Kirk, Van der Zanden & al., 2012). In most of these reference documents, the number of professional competencies that a professional must acquire does not exceed twenty. However, in the field of kinesiology, the College of Kinesiologists of Ontario (CKO) (2013) has defined 54 professional competencies required for admittance to the College. Objective: The purpose of this research project aims to identify, from the standpoint of university instructors who teach in a kinesiology program, the professional competencies that are considered the 17 most relevant from those suggested by CKO. Methodology: Participants (N=23) were required to complete an online survey on the domain www.SurveyMonkey.com in order to determine the competencies deemed most important by them. Results: The quantitative data obtained through the use of the surveys allowed for a list of 17 competencies to be retained at the end of the study. The qualitative data provided by the participants supported and complemented the quantitative data. Conclusion: The competencies retained in this study undoubtedly represented the views of all the participants in regards to the essential competencies that a kinesiologist should be able to demonstrate upon admission to the College of Kinesiologists of Ontario.