Grant: Health System Impact Fellowships - PostDoc Western Canada 2 year

The phrase "no decision about me without me" (Coulter, 2011) is central to the changes taking place within community rehabilitation programs in Alberta Health Services (AHS). Like many health systems, AHS is moving toward better patient engagement in healthcare practice and policy. Shared decision-making (SDM) is essential to patient engagement and patient-centred care. SDM recognizes patients and their values as the centrepiece around which healthcare should be planned. AHS has developed a new model for how care will be delivered in community rehabilitation that prioritizes collaborative goal setting, co-created transition planning from hospital to community, and holistic partnerships between clients, providers and community. AHS has established a program of learning and evaluation to support the system change to this new model for care delivery. The program is called Innovation Collaboratives. My research will examine facilitators and barriers to the implementation of this new care delivery model, and the Innovation Collaboratives supporting it. Using an ethnographic design, information will be gathered from rehabilitation clients and providers. This information will describe perceptions and experiences of shared decision making, patient engagement, quality of life and functional status at 2 time points. Qualitative interviews will be conducted for in-depth understanding. A feasibility study will be done first. It will clarify which community rehabilitation clinics are best suited for this study and make sure the survey instruments are reliable in this population. AHS will get a tool at research completion to aid in transforming the study findings into effective training modules and policy positions on SDM. This knowledge translation tool will be pilot-tested in community rehabilitation clinics with upcoming Innovation Collaboratives. This research project will help AHS expand their new model of care for community rehabilitation to improve SDM.