Kerry Kuluski
Biographic Data
| ID | 4214675 |
|---|---|
| NAME | Kerry Kuluski |
| GIVEN NAMES | Kerry |
| FAMILY NAME | Kuluski |
| SIGNATURE | KULUSKI K |
| AFFILIATIONS | University of Toronto |
| ORCID | 0000-0002-6377-6653 |
| VERIFIED | Yes |
| TOTAL WORKS | 71 |
| TOTAL CITATIONS | 26 |
| AUTHOR COUNT | 71 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2012 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Moral Stressors and Command-and-Control during Healthcare Crises
Throughout the pandemic, hospitals experienced intense capacity and resource crises, driving a shift to command-and-control governance that constrained opportunities to provide person-centred care in a collaborative working environment. Patients who had completed their acute care and were awaiting transition to their next destination – known as alternate level of care (ALC) –became the target cohort for decanting and relief efforts in preparation…
Using Personas as a Tool for People-Centred Segmentation and Health Systems Planning in Ontario, Canada
Introduction: Health systems are increasingly using population segmentation for planning to organise populations into segments with similar health characteristics. However, given that these data-driven approaches rely on available data, they fail to encompass important social determinants of health, thereby making decision-making challenging. Segmentation is powerful, but little is known about how missing information could be incorporated to more…
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…
Patient Experience Data Mining Approach for Rapid Quality Improvement at Trillium Health Partners
Background: Trillium Health Partners (THP), one of Canada’s largest leading academically-affiliated health centres in Ontario, Canada, recognized a critical gap in patient experience (PE) data collection methods. Traditionally reliant on paper-based and telephone surveys, THP's approach was increasingly seen as insufficient in capturing the full diversity of patient feedback. This limitation was particularly significant within the context of inte…
The Next Frontier of People-Centred Care
Background: In the evolving landscape of integrated health systems, advancing people-centred care is crucial for fostering safe, equitable, comprehensive, and sustainable health and social care systems and services that meet community and population health needs. Patients' experiential knowledge is increasingly recognized as a complementary, valuable form of knowledge enriching professional expertise. A 2024 publication by Vincent Dumez and Audre…
Co-Designing a Virtual Patient and Caregiver Engagement Learning Series
Background: Engaging with patients and caregivers is essential to improve the quality of health care and create a more integrated experience. There is growing evidence that partnership and collaboration with patients and caregivers is essential as health systems around the world undergo reforms. To support health systems in building skills to partner, it is important that educational resources are provided along with opportunities for learning an…
Real World Examples
Background: Health systems globally are striving to be more 'person centred'- delivering care in partnership with patients and families in ways that align with their needs, preferences and values. Also, supporting people to direct and drive their own care (self-management) within enabling environments is a critical component of actioning person-centred care. This meeting joins up two Special Interest Groups: 1) Actioning Person Centred Care and 2…
“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…
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…
Advancing the Care Experience for Patients Receiving Palliative Care as They Transition From Hospital to Home (Acepath)
BACKGROUND: Although many people nearing the end of life wish to die at home, many patients experience re-hospitalisation and hospital death. No end-of-life hospital-to-home interventions have been developed with patients and caregivers, and none have been tested in Canada. Through an iterative, participatory design approach, we codesigned an intervention in partnership with potential users of the final intervention: patients, family caregivers (…
Co‐Authoring and Reporting on Lived Experience Engagement in Mental Health and/or Substance Research
INTRODUCTION: There is a move towards engaging people with lived experience and families (PWLE/F)-also referred to as PWLE/F engagement-in mental health and/or substance use research. However, PWLE/F engagement is inadequately reported on in mental health and/or substance use research papers. OBJECTIVE: To understand what PWLE/F and researchers perceive are important components to report on related to engagement in mental health and/or substance …
Best Practices Guidelines for the Engagement of People With Lived Experience and Family Members in Mental Health and Substance Use Health Research
INTRODUCTION: People with lived experience of mental health and/or substance use conditions and their families (PWLE) are increasingly engaged in research, yet rigorous guidelines for engagement are lacking. This study aims to co-design best practice guidelines to support the authentic, meaningful engagement of PWLE in mental health and/or substance use health research. METHODS: A multi-panel modified Delphi study was conducted with 61 expert pan…
The Intersection of Gender, Culture and Society for Caregivers of Older Adults Ageing in Place in Ontario, Canada
BACKGROUND: It is reported that women are more likely to be caregivers than men, experience a higher burden of care and increased emotional health sequelae as a result. Social location (a person's gender, culture, ethnicity, etc.) is known to influence caregiving experiences. However, there is limited work that draws attention to how cultural and linguistic diversity shapes the experiences and expectations of informal caregivers. OBJECTIVE: The a…
Patient Engagement in Integrated Care
This special issue endeavoured to solicit papers that were examining, advancing and ideally connecting the fields of patient, caregiver and community engagement with integrated care (defined as the connectivity between health and social care at the micro, meso or macro levels) [1]. Engagement and integrated care can be considered symbiotic: engaging with patients, caregivers with lived illness experience and community partners helps us to underst…
A qualitative study exploring hospital-based team dynamics in discharge planning for patients experiencing delayed care transitions in Ontario, Canada
Background: An increased focus has been placed on discharge planning, in order to reduce hospital length of stay and delayed discharges, and to improve continuity of care. Several benefits to team-based approaches for discharge planning have been noted; however, professional hierarchies remain. As such, challenges related to power dynamics are commonly experienced within teams who are dealing with care transitions for patients with delayed discha…
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…
Family Caregivers as Care Integrators
Introduction: Practice guidelines and professional competencies recommend including family caregivers as true/valued partners in care teams, but care teams find it difficult to integrate family caregivers into the healthcare team. We define family caregivers broadly as caregivers, carers, unpaid or informal caregivers, care partners, chosen family, friends, or neighbors who support people who need care for mental and/or physical illnesses, disabi…
Putting Person Centred Care into Action
Health systems globally are striving to advance the quintuple aim of better patient and caregiver experience, better provider experience, better population health, lower cost (or better value for what we spend) and a focus on equity. One of the most neglected and least understood parts of this framework is improving patient and caregiver experience. Person centred care – care that sees a health service user as a full person with individual desire…
Actioning integrated person-centred care
Background: Globally, healthcare organisations are grappling with how to improve patient experience - a vital aspect of care quality. Patients and caregivers can play a critical role in identifying person-centred ways to improve experience. However, organisations tend to only learn from their experiences using a singular approach (e.g., patient experience surveys), do not consistently act on what they learn, or share back the actions they take. T…
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…
Facilitating patient and care partner voicing in healthcare
Background: How can healthcare organizations create the conditions for patients and care partners (family and friends who provide support to patients) to feel safe voicing or speaking up about their care preferences and concerns while receiving care? While health systems globally increasingly recognize the critical value of feedback and information shared by patients and care partners during care episodes; patients and care partners often hesitat…
Advancing the Care Experience for patients receiving Palliative care as they Transition from hospital to Home (Acepath)
BACKGROUND: Returning home from the hospital for palliative-focused care is a common transition, but the process can be emotionally distressing and logistically challenging for patients and caregivers. While interventions exist to aid in the transition, none have been developed in partnership with patients and caregivers. OBJECTIVE: To undergo the initial stages of codesign to create an intervention (Advancing the Care Experience for patients rec…
‘Safety is about partnership’
INTRODUCTION: Creating safer care is a high priority across healthcare systems. Despite this, most systems tend to focus on mitigating past harm, not creating proactive solutions. Managers and staff identify safety threats often with little input from patients and their caregivers during their health encounters. METHODS: This is a qualitative descriptive study utilizing focus groups and one-to-one interviews with patients and caregivers who were …
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. …
Co-designing implementation strategies to promote remote physical activity programs in frail older community-dwellers
Background The “AGIL Barcelona (AGILBcn)” community-based integrated care program is a multicomponent healthy aging intervention for frail older adults. In this context, the present study aimed to identify implementation strategies to optimize the accessibility, acceptability, and adaptability of mobile health (mhealth) interventions to enhance physical activity in frail older adults, and to prioritize action points according to their importance …
Community Care for People with Complex Care Needs
Meeting the needs of the population who require health and social care requires time to develop authentic relationships, broadening the membership of the care team, communicating across sectors, co-locating health and social care, and addressing the barriers that prevent providers from engaging in these required practices
What is Important to Older People with Multimorbidity and Their Caregivers? Identifying Attributes of Person Centered Care from the User Perspective
Attributes of good care extend beyond disease management. While our findings include activities that characterize these attributes, further research on implementation barriers and facilitators is required
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…
Are Patient and Carer Experiences Mirrored in the Practice Reviews of Self-management Support (Prisms) Provider Taxonomy
Patient and carer data mapped to provider activities. The taxonomy was not explicit on provider relationships and engagement with, or separate support needs of, patients and carers
Home care or long-term care? Setting the balance of care in urban and rural Northwestern Ontario, Canada
The objective of the study was to determine the extent to which community care packages could be provided at a lower cost than facility-based long-term care (LTC) for 864 individuals on the LTC waiting list in urban and rural parts of Northwestern Ontario, Canada. A sequential mixed methods design was used entailing a retrospective chart review, the formation of case vignettes, the creation of community care packages with an 'expert panel' of car…
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. …
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…
Life Interrupted
A growing number of individuals require health services to manage multiple chronic conditions (i.e., complex chronic disease), yet little is known about their experience. The purpose of this study was to investigate the impact of complex chronic disease on the lives of individuals receiving hospital care. Ninety-five participants were interviewed between February and June 2011 and shared their views on how illness impacted their lives. Interviews…
Home care or long-term care? Setting the balance of care in urban and rural Northwestern Ontario, Canada
The objective of the study was to determine the extent to which community care packages could be provided at a lower cost than facility-based long-term care (LTC) for 864 individuals on the LTC waiting list in urban and rural parts of Northwestern Ontario, Canada. A sequential mixed methods design was used entailing a retrospective chart review, the formation of case vignettes, the creation of community care packages with an 'expert panel' of car…
The care delivery experience of hospitalized patients with complex chronic disease
OBJECTIVE: This study investigated what is important in care delivery from the perspective of hospital inpatients with complex chronic disease, a currently understudied population. PARTICIPANTS AND SETTING: One-on-one semi-structured interviews were conducted with inpatients at a continuing care/rehabilitation hospital (n = 116) in Canada between February and July 2011. DESIGN: The study design was mixed methods and reports on patient characteris…
Life Interrupted
A growing number of individuals require health services to manage multiple chronic conditions (i.e., complex chronic disease), yet little is known about their experience. The purpose of this study was to investigate the impact of complex chronic disease on the lives of individuals receiving hospital care. Ninety-five participants were interviewed between February and June 2011 and shared their views on how illness impacted their lives. Interviews…
The electronic Patient Reported Outcome (ePRO) Tool
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
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…
“It's a fight to get anything you need” — Accessing care in the community from the perspectives of people with multimorbidity
BACKGROUND: There is a growing interest in redesigning health-care systems to better manage the increasing numbers of people with multimorbidity. Knowing how patients experience health-care delivery and what they need from the health-care system are critical pieces of evidence that can be used to guide health system reforms. OBJECTIVE: The purpose of this study was to understand the challenges patients with multimorbidity face in accessing care i…
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…
Community Care for People with Complex Care Needs
Meeting the needs of the population who require health and social care requires time to develop authentic relationships, broadening the membership of the care team, communicating across sectors, co-locating health and social care, and addressing the barriers that prevent providers from engaging in these required practices
What are the Facilitators and Barriers to Integrated Health and Social Care in the Community? Insights from Care Providers
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
Functional Limitations Experienced by Older Adults with Complex Care Needs and Its Impact on Access to Community Based Health and Social Care
Introduction: Multimorbidity is often combined with functional limitations among older adults. It is therefore important to ensure the built and social environment encourages older adults to safely age while maintaining independence. Previous findings have focused on the impact of the built environment as a barrier to an active lifestyle, but not specific to accessing community-based health and social care (CHSC). We propose to investigate the im…
Are Patient and Carer Experiences Mirrored in the Practice Reviews of Self-management Support (Prisms) Provider Taxonomy
Patient and carer data mapped to provider activities. The taxonomy was not explicit on provider relationships and engagement with, or separate support needs of, patients and carers
Are patient and carer experiences mirrored in the Practice Reviews of Self-Management Support (PRISMS) provider taxonomy
Introduction: Patient self-management support is a central component of care for long term conditions and for integrated care. Patients and their carers are the final arbiter of whether support for self-management has been effective. We sought to validate a new 14-item taxonomy (Practical Reviews in Self-Management Support - PRISMS) of provider activities that support patient self-management.Methods: We interviewed 74 patients and family carers i…
The Unmet Needs of Patients and Carers within Community Based Primary Health Care
Introduction: Community Based Primary Health Care (CBPHC) is positioned as the foundation of integrated health systems, intended to support broader goals of population health and health system sustainability. CBPHC moves beyond traditional primary care (a physician visit) to team based care that spans organizational boundaries (such as primary care clinics + community care services). At the core of CBPHC are patients and their informal carers (fa…
What Factors Influence Patient and Carer Engagement in Community Based Primary Health Care? Insights from People with Complex Care Needs and their Carers
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
Building a Framework for Caregiver Co-Design and Implementation
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)
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…
Barriers to engaging in end-of-life communication in advanced illness management
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)
Patient and caregiver experience with delayed discharge from a hospital setting
How does it feel to be a problem? Patients’ experiences of self‐management support in New Zealand and Canada
BACKGROUND: The impact of long-term conditions is the "healthcare equivalent to climate change." People with long-term conditions often feel they are a problem, a burden to themselves, their family and friends. Providers struggle to support patients to self-manage. The Practical Reviews in Self-Management Support (PRISMS) taxonomy lists what provider actions might support patient self-management. OBJECTIVE: To offer providers advice on how to sup…
‘The Future is Probably Now’
BACKGROUND: Earlier end-of-life communication is critical for people with heart failure given the uncertainty and high-risk of mortality in illness. Despite this, end-of-life communication is uncommon in heart failure. Left unaddressed, lack of end-of-life discussions can lead to discordant care at the end of life. OBJECTIVE: This study explores patients' and caregivers' understanding of illness, experiences of uncertainty, and perceptions of end…
Realist-informed rapid-cycle evaluations for integrated care programs
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)The IJIC 20th Anniversary Issue was published in 2021
Person-centered and 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)
What is important to people with multimorbidity and their caregivers? Identifying attributes of person centred primary health care from the user perspective
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)
Understanding transitions of care in older adults with hip fractures
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)
"She was just lying in bed for three days" The experiences of caregivers of patients who are stuck in hospital
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)
Medicine (45 works) · Health care (44 works) · Nursing (36 works) · Psychology (33 works) · Computer Science (29 works) · Political science (27 works) · Chronic Disease Management Strategies (20 works) · Integrated care (20 works) · Interprofessional Education and Collaboration (17 works) · Qualitative research (16 works)