Walter P Wodchis
Datos Biográficos
| ID | 1725542 |
|---|---|
| NOMBRE | Walter P Wodchis |
| NOMBRES | Walter P |
| APELLIDO | Wodchis |
| FIRMA | WODCHIS W P |
| AFILIACIONES | University of Toronto |
| ORCID | 0000-0003-2494-7031 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 112 |
| TOTAL DE CITAS | 97 |
| TOTAL COMO AUTOR | 112 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2000 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 6 |
Exploring Patient and Caregiver Work and Continuity of Care During Hospital‐to‐Home Transitions of Care in the Canadian Context
BACKGROUND: Patients and caregivers are expected to engage in work that involves both physical and cognitive tasks to manage their care and well-being during hospital-to-home transitions. Patient and caregiver work is defined as the health-related tasks they must manage, as well as the physical and cognitive effort required to complete those tasks. When continuity of care is well-supported, work for patients and caregivers may be reduced or bette…
Modernizing care coordination
Background: Seven Ontario Health Teams (OHTs), each a group of cross-sectoral health service organizations, were chosen by the Canadian province of Ontario to lead the modernization of home and community care. At the heart of this work lay the reconceptualization of care coordination, with a focus on integration. We explore how Ontario’s Ministry of Health (MOH) sought to modernize care coordination through its guidance to OHTs, OHTs’ own innovat…
Transforming Health with Integrated Care - Optimizing the Value and Impact of Research
Background: The Transforming Health with Integrated Care (THINC) research initiative aims to improve our understanding of how to implement, evaluate, adapt and/or spread and scale (share) evidence-informed integrated care policies and interventions that encompass intersectoral collaborations within and/or beyond the formal health care delivery system to advance the Quintuple Aim. THINC is led by the Canadian Institutes of Health Research’s Instit…
Pilot evaluation of a hospital-to-home care transition program in Ontario, Canada
Introduction: Health systems are facing unparalleled volumes of individuals in hospital awaiting discharge, often because patients’ homes are not amenable to their needs or immediate care supports are unavailable. Hospital-to-home care transition programs that integrate acute and community-based care delivery can ensure home environments are safe and conducive to recovery, and provide temporary intensive support until long term community care is …
Balancing standardization with local needs
Background: Seven Ontario Health Teams (OHTs), each a group of cross-sectoral health service organizations, were chosen by the Canadian province of Ontario to lead the modernization of home and community care. We explore how stakeholders across sectors experienced and negotiated the task of balancing standardization and local needs, required by this work. Approach: As part of a qualitative evaluation of OHTs’ implementation plans, we conducted se…
Evaluation of the “High Priority Communities Strategies”; Addressing Community-identified Needs in Ontario
Background: The High Priority Communities Strategy (HPCS) is an integrated community care approach focusing on the health needs of vulnerable communities in Ontario, Canada. By collaborating with health and social service organizations, HPCS aims to create programs, services, and resources that are informed by local insights and are culturally sensitive, thus enhancing access to healthcare services for their population. HPCS was initially formed …
Policy supports for integrated care
Background and objectives: Integrated care aims to coordinate the care needs of a population, particularly individuals with complex care needs, across community, primary and secondary care settings. Ontario has been pursuing a whole systems approach to integration through reorganization into Ontario Health Teams (OHTs) where hospitals, doctors, and allied health providers work as a coordinated team to provide responsive, appropriate, and efficien…
“Doing extra work and not getting extra help”
Background: During the pandemic, a "no visitors" policy was implemented across hospitals in Ontario, Canada. Without caregivers present in-hospital to support patient care (e.g., treatment decision-making, advocacy, treatment compliance, social support), there was a perceived decline in care quality. Despite existing research on the extra work required to navigate the loss of caregiver support in-hospital, there is a paucity of understanding abou…
How do policy supports enable the implementation, scale, and sustainability of integrated care programs in England, Germany, and The Netherlands? Lessons for Canada
Moral injury and the myth of resilience
The COVID-19 pandemic profoundly altered the provision, experience, and outcomes of cancer care around the globe. With untold pressures on healthcare systems as well as unprecedented disruptions to cancer care services, those working in cancer care were exposed to new and intensified morally challenging and potentially traumatic conditions. This study qualitatively explores those experiences in two hospitals located in different regions of Ontari…
Understanding policy supports for Team-Based primary healthcare models
Background: Industrialized countries are facing pressure to address the complexity of populations who experience high needs with significant costs to the health system. Interprofessional team-based care (TBC) is an essential component of integrated care strategies to respond to these complex needs. However, TBC models operate within complex policy environments that can facilitate or constrain their activities. The main goal of this project is to …
Assessing Readiness and Sustainability for Integrated Care in Ontario, Canada with the Integrated Care Leadership Survey
The OICLS offers a brief and valid assessment of foundational aspects of multi-organizational integrated care initiatives
Within the home and community care sector, understanding the conditions fostering successful care coordination is crucial. This realist review answers
Within the home and community care sector, understanding the conditions fostering successful care coordination is crucial.This realist review answers: What conditions (contexts & mechanisms) enable care coordination to be successful (outcomes) in home and community care models
Creating Health and Wellbeing through Integrated Care
The International Foundation for Integrated Care Canada (IFIC Canada) will be hosting the second North American Conference on Integrated Care in Canada in October 2024 (NACIC24). The goal for the conference is to advance the knowledge and capability around four strategic themes to advance health and wellbeing through the advancement of integrated care. In this 90-minute workshop, we will explore and co-design the themes for the NACIC24 conference…
Leveraging a Learning Health System Approach to Integrate Care for Patients with a Hip Fracture
Background: A Learning Health System approach can provide structure and tools to blend insights from research and real-world health care operations to support implementation and delivery of integrated care. Our team has put this into practice in a large community hospital with the aim of improving the overall effectiveness of care delivery and outcomes for patients with a hip fracture.A Learning Health System is a health care ecosystem that conti…
Integrated Care and Population Health Management; two sides of the same coin
Population health management has emerged as a new buzz word to drive system reform but does it add anything to our understanding or is it just integrated care rejigged?The predecessor of IFIC (International Foundation for Integrated Care) was founded in 2000, and since that date the network advocating for Integrated Care (IC) has grown to a global movement for change. In recent years, the concept of Population Health Management (PHM) has come up …
The Impacts of Team Culture on Primary Care Teams
Background: Integrated services delivery in primary care is essential, particularly given the current challenges in primary care in Canada. Primary care teams (PCT) provide a way to facilitate integrated care. PCTs in British Columbia (BC) have evolved with widespread implementation of primary care networks, urgent and primary care centres, and community health centres. Team culture can have significant impacts on team functioning and processes, …
A provider experience survey in integrated care. Closing out the quadruple aim
Background: Capturing the provider’s experience, delivering care and provider well-being has become a major focus of health system leaders and recognized as the fourth component of the Quadruple Aim. However, tools to measure the experience of provider care are limited, with few examples in integrated care. Existing measurement is both specific to provider types/professional groups or is narrowly focused on teamwork measures. Instruments are need…
Integrating Home Care
Seven Ontario Health Teams (OHTs), each a group of cross-sectoral health service organizations collaborating to integrate care, were chosen to lead the modernization of home and community care. We explore the models key transformation ideas and report on the barriers and facilitators to implementation. The findings of this study will be of interest to people designing an implementing integrated care projects as well as evaluators and researchers …
Identifying and prioritizing recommendations to optimize transitions across the care journey for hip fractures in Canada
Background: Hip fractures are one of the most common fall-related injuries and often lead to functional decline, morbidity, and rehospitalization. After experiencing a hip fracture, patients undergo several transitions in care, both between different healthcare providers and across healthcare sectors. Care transitions can result in poor health outcomes, medication errors, readmissions, and dissatisfaction from patients and families. While a focus…
Transforming Health through Integrated Care. A Canadian collective research platform
The Canadian Institutes of Health Research (CIHR) launched a strategic research funding program called Transforming Health with Integrated Care (THINC). This initiative is a bold step forward to address the very complex challenges associated with implementing and sustaining integrated care at scale. Upwards of 100 grants have been funded to contribute to the knowledge base and the application of knowledge to improve patient and caregiver experien…
Implementation and evaluation of a novel community-based urban mobile health clinic in Toronto, Ontario
We demonstrate that in a single-payer health system, MHCs alleviate major barriers to care access for marginalized populations. Learnings provide context to the most salient factors influencing clients' decisions to seek care at MHCs and can inform how these outreach models are designed
The Integrated Care World is a Stage
Among the challenges in delivering integrated health and social care services is the need to attend to the coordination of tasks, roles, activities, and operations, while considering how these efforts are experienced by patients, carers and communities. The literature has noted an important disconnect between how providers and leaders view their efforts to coordinate service delivery, and how patients perceive these efforts on the receiving end. …
Why the US spends more treating high-need high-cost patients
One of the most pressing challenges facing most health care systems is rising costs. As the population ages and the demand for health care services grows, there is a growing need to understand the drivers of these costs across systems. This paper attempts to address this gap by examining utilization and spending of the course of a year for two specific high-need high-cost patient types: a frail older person with a hip fracture and an older person…
Case managers’ reflections of a brief case management intervention in Canada
The ideal population for this intervention are adults with mental health issues in need of system navigation, and those motivated to address their goals. Further research is needed to establish fidelity criteria
Integrating care for older people with complex needs
Case managers or care coordinators who support patient-centred collaborative care are key to successful integration in all our cases as are policies that provide funds and support for local initiatives that allow for bottom-up innovation. However, more robust and systematic evaluation of these initiatives is needed to clarify the 'business case' for integrated health and social care and to ensure successful generalization of local successes
Complexity-compatible' policy for integrated care? Lessons from the implementation of Ontario's Health Links
Complex adaptive systems (CAS) theory views healthcare as numerous sub-systems characterized by diverse agents that interact, self-organize, and continuously adapt. We apply this complexity science perspective to examine the extent to which CAS theory is a useful lens for designing and implementing health policies. We present the case of Health Links, a "low rules" policy intervention in Ontario, Canada aimed at stimulating the development of vol…
Hospitalizations for ambulatory care sensitive conditions across primary care models in Ontario, Canada
Implementing Community Based Primary Healthcare for Older Adults with Complex Needs in Quebec, Ontario and New-Zealand
The aim of this paper is to set the foundation for subsequent empirical studies of the "Implementing models of primary care for older adults with complex needs" project, by introducing and presenting a brief descriptive comparison of the nine case studies in Quebec, Ontario and New Zealand. Each case is described based on key dimensions of Rainbow model of Valentijn and al (2013) with a focus on "meso level" integration. Meso level integration is…
Organizational Context and Capabilities for Integrating Care
Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes
Variations in geographical distribution of foreign and domestically trained physicians in the United States
Organizational Context Matters
The toolkit can be used to characterize and compare organizational contexts across cases and enable comparison of results across studies. This information can enhance our understanding of the influence of organizational contexts, support the transfer of best practices, and help explain why some integrated care initiatives succeed and some fail
Shifting paradigms
Frameworks for understanding integrated care risk underemphasizing the complexities of the development of integrated care in a local context. The objectives of this article are to (1) present a novel strategy for conceptualizing integrated care as developing through a series of milestones at the organizational level, and (2) present a typology of milestones empirically generated through the analysis of four cases of integrated community-based pri…
Comparing International Models of Integrated Care
There is value to using a common template to provide guidance in international comparison of models of integrated care. We discuss the applicability of the approach to support scale and spread of integrated care internationally
A Research Program on Implementing Integrated Care for Older Adults with Complex Health Needs (iCoach)
Health and social care systems across western developed nations are being challenged to meet the needs of an increasing number of people aging with multiple complex health and social needs. Community based primary health care (CBPHC) has been associated with more equitable access to services, better population level outcomes and lower system level costs. Itmay be well suited to the increasingly complex needs of populations; however the implementa…
How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand
Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the wa…
The Integrated Care World is a Stage
Among the challenges in delivering integrated health and social care services is the need to attend to the coordination of tasks, roles, activities, and operations, while considering how these efforts are experienced by patients, carers and communities. The literature has noted an important disconnect between how providers and leaders view their efforts to coordinate service delivery, and how patients perceive these efforts on the receiving end. …
Equity Promoting Integrated Care
Over the last three decades, integrated care has emerged as an important health system strategy to improve population health while addressing the unique needs of structurally marginalised communities. However, less attention has been given to the role of integrated care in addressing issues related to inequities in health and health care. In this commentary we introduce the concept of Equity Promoting Integrated Care (EPIC) that situates integrat…
Promise and peril
Our study highlighted that stakeholder priorities and a limited understanding about public health systems influenced how reforms were implemented. Our findings support calls for modernized and inclusive governance, stable public health funding, and investment in the public health workforce, which may help inform future reforms
Rising burden of multimorbidity and related socio-demographic factors
Mapping for Conceptual Clarity
This work represents a first step towards development of a fully formed conceptual framework that includes key domains, concepts, and mechanisms of implementing integrated community-based primary health care
Measuring Integrated Care’s Reliance on Caregiver Support
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Evaluating the ‘Health Links’
Introduction: Adults with multiple chronic illnesses account for more than 75% of health care spending. Many are considered complex due to multimorbidity, high service use, and psychosocial vulnerability.Practice Change Implemented: The Health Links (HLs) are networks of multiple health and social service organizations that voluntarily partner to deliver integrated care to complex, high-cost patients in Ontario, Canada.Aim and Theory of Change: W…
Perceived value of support for older adults coping with multi-morbidity
This study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main them…
Variations in geographical distribution of foreign and domestically trained physicians in the United States
The Effect of Medicare's Prospective Payment System on Discharge Outcomes of Skilled Nursing Facility Residents
In July 1998, the Centers for Medicare and Medicaid Services (CMS) changed the payment method for Medicare (Part A) skilled nursing facility (SNF) care from a cost-based system to a prospective payment system (PPS). Unlike the previous cost-based payment system, PPS restricts skilled nursing facility payment to pre-determined levels. CMS also reduced the total payments to SNFs coincident with PPS implementation. These changes might reduce quality…
Measuring health status and decline in at-risk seniors residing in the community using the Health Utilities Index Mark 2
Cost and Quality
BACKGROUND: Although both quality and cost are important concerns for long term care (LTC) facility management and policy, the relationship between cost and quality is poorly understood. Such knowledge is necessary to guide facility management and policy action. OBJECTIVE: We sought to determine the net effect of quality on cost in LTC hospital settings. STUDY SAMPLE: A 4-year panel dataset from April 1997 through March 2002 comprising observatio…
Validating Diagnostic Information on the Minimum Data Set in Ontario Hospital-Based Long-Term Care
BACKGROUND: Over 20 countries currently use the Minimum Data Set Resident Assessment Instrument (MDS) in long-term care settings for care planning, policy, and research purposes. A full assessment of the quality of the diagnostic information recorded on the MDS is lacking. OBJECTIVE: The primary goal of this study was to examine the quality of diagnostic coding on the MDS. STUDY SAMPLE: Subjects for this study were admitted to Ontario Complex Con…
Health status utilities and the impact of pressure ulcers in long-term care residents in Ontario
LTC residents with PU had slightly though statistically significantly lower HRQOL than those without PU. Comorbidity contributed substantially to the low HRQOL in these populations. Community-weighted MDS-HSI utilities for LTC residents are useful for cost-effectiveness analyses and help guide health policy development
The Relationship of 60 Disease Diagnoses and 15 Conditions to Preference-Based Health-Related Quality of Life in Ontario Hospital-Based Long-Term Care Residents
BACKGROUND: Population-based diagnosis- and condition-specific health-related quality of life (HRQoL) scores are required for decision-making and research purposes. These HRQoL scores do not exist for hospital-based long-term care (LTC) residents. OBJECTIVE: To estimate the impact of 60 diseases and 15 conditions on caregiver-assessed preference-based HRQoL. METHODS: Residents in hospital-based LTC facilities in Ontario, Canada were identified fr…
Using the Johns Hopkins Aggregated Diagnosis Groups (ADGs) to Predict Mortality in a General Adult Population Cohort in Ontario, Canada
BACKGROUND: Administrative healthcare databases are increasingly used for health services and comparative effectiveness research. When comparing outcomes between different treatments, interventions, or exposures, the ability to adjust for differences in the risk of the outcome occurring between treatment groups is important. Similarly, when conducting healthcare provider profiling, adequate risk-adjustment is necessary for conclusions about provi…
The increasing burden and complexity of multimorbidity
The high prevalence of multimorbidity and numerous combinations of conditions suggests that single, disease-oriented management programs may be less effective or efficient tools for high quality care compared to person-centered approaches
Integrating care for older people with complex needs
Case managers or care coordinators who support patient-centred collaborative care are key to successful integration in all our cases as are policies that provide funds and support for local initiatives that allow for bottom-up innovation. However, more robust and systematic evaluation of these initiatives is needed to clarify the 'business case' for integrated health and social care and to ensure successful generalization of local successes
Implementing a “Low-Rules” Provincial Integrated Care Initiative in Canada
Introduction: This study explores the implementation of "Health Links", a provincial integrated care initiative aimed at transforming care systems for high needs patients in Ontario, Canada. Launched in 2012 with 19 early adopters, there are currently 54 operational Health Links in Ontario. Each Health Link consists of multiple providers and is led by a coordinating partner such as a hospital, primary care group, or community support agency
Continuing efforts to integrate care can benefit from cross-jurisdictional comparisons
Despite its theoretical appeal, integrated care remains a new frontier for health and social care systems in many countries. A key motivation for increasing the integration of a range of health care services with socialor community-based services is the imperative to improve the patient experience, particularly for individuals with ongoing multiple and complex health care and functional needs. To meet these needs they receive care from many diffe…
The influence of gender and other patient characteristics on health care-seeking behaviour
BACKGROUND: Canadians' health care-seeking behaviour for physical and mental health issues was examined using the international Quality and Cost of Primary Care (QUALICOPC) survey that was conducted in 2013 in Canada. METHOD: This study used the cross-sectional Patient Experiences Survey collected from 7260 patients in 759 practices across 10 Canadian provinces as part of the QUALICOPC study. A Responsive Care Scale (RCS) was constructed to refle…
The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients
Organizational Context and Capabilities for Integrating Care
Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes
A person centred model for people with complex care needs
It is well known in the literature how the modern health and care systems are being oriented to launch and develop national strategies to construct and build a more comprehensive system for the people with "complex health and social care needs". Most of Chronic Care programs have been introduced proactive care management for this vulnerable population who are causing high utilization of high cost services. However a new Integrated health and soci…
Perceived value of support for older adults coping with multi-morbidity
This study investigated the perceived value of informal and formal supports for older adults with multi-morbidity from the perspectives of patients, care-givers and family physicians. Semi-structured interviews were conducted with 27 patients, their informal care-givers and their family physicians in an urban academic family health team in Ontario. Analysis was conducted using a General Inductive Approach to facilitate identification of main them…
Understanding the Attributes of Implementation Frameworks to Guide the Implementation of a Model of Community-based Integrated Health Care for Older Adults with Complex Chronic Conditions
What Works in Integrated Care Programs for Older Adults with Complex Needs? A Realist Review
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Managerial strategies for integrated care
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
Effective Organizational Leadership in the Implementation of Integrated Care; Lessons from 9 cases in the iCoach Project
Introduction: Policy makers in many countries are encouraging the development of integrated care strategies and the development of new models of integrated care. These new models require changes at a clinical or service level, organizational level and system level with strong leadership necessary at all three levels. Despite the key role of leadership in these efforts, there has been only limited study of what organizational leadership approach i…
Operationalizing Patient-Centered Integrated Care
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)
On the Margins and Not the Mainstream
Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of aging populations and their carers. Across the world CBPHC is at varying stages of evolution and no standard model exists. In order to scale up and spread successful models of care it is important to study what works well and why to support broader efforts to implement, scale-up a…
The Generation of Integration
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021
Using Information Communication Technology in Models of Integrated Community-Based Primary Health Care
Introduction: Information and communication technology (ICT) is a promising enabler to support delivery of integrated care by inter-disciplinary teams by supporting information sharing across professional and organizational boundaries; arguably a crucial aspect of successful models of integrated care. The literature suggests that there are core components of ICT functionality such as interoperability between systems, supported chronic disease man…
Health care (74 obras) · Medicine (67 obras) · Political science (56 obras) · Integrated care (48 obras) · Interprofessional Education and Collaboration (48 obras) · Computer Science (46 obras) · Nursing (41 obras) · Primary Care and Health Outcomes (40 obras) · Business (34 obras) · Chronic Disease Management Strategies (25 obras)