Research

HPME Researcher, Ross Baker, Leads National Investigation of Adverse Events in Hospitals

Dr. Ross Baker, Associate Professor with HPME, is leading a research study that examines the frequency and nature of adverse events in Canadian acute care hospitals. Jointly funded by the Canadian Institutes of Health Research (CIHR) and the Canadian Institute for Health Information (CIHI), the study will examine the extent of adverse events, and the availability of data that could be used to track such occurrences. Dr. Peter Norton, Head of the Department of Family Medicine at the University of Calgary is co-principal investigator.

A research team in each of British Columbia, Alberta, Ontario, Quebec and Nova Scotia will examine randomly selected patient records in four hospitals to identify indications of medical or surgical adverse events. Where initial review indicates such a possibility, the charts will be examined in depth by specially trained physicians. The study, commencing in June 2002, is expected to conclude in 2004.

Similar studies in other countries have demonstrated that adverse events occur more frequently than commonly believed. A review of American studies was that issued in November of 1999 by the Institute of Medicine (IOM), entitled To Err Is Human: Building A Safer Health System. Based on these studies, the report indicated that as many as 44,000 to 98,000 people die in American hospitals each year as the result of these adverse events. Even using the lower estimate, this would make this the eighth leading cause of death in the United States -- higher than motor vehicle accidents, breast cancer or AIDS.

While many healthcare organizations track incidents and deaths, these data do not reflect the complete incidence of adverse events. Hence this research represents an important landmark study. Results from the study will be compared to other measures of adverse events developed from local reporting and administrative data to help develop more complete measures that can be used to track such events. This information will be important in identifying ways to improve patient safety and quality of care.

Research and Teaching Profiles

Faculty associated with the Department of Health Policy, Management and Evaluation (HPME) are involved in a broad range of research activities with a variety of organizations. Success of the HPME Knowledge Transfer initiative is dependent on presenting our stakeholders with a unified, clear image of the depth and breadth of Departmental expertise. To promote greater internal awareness of the knowledge developed through HPME, faculty research profiles will be included as a regular feature of this newsletter.

In this issue we feature research profiles from Ross Baker and Rhonda Cockerill:

• Ross Baker is an Associate Professor with HPME and, in July, will assume the position of Chair of the Association of University Programs in Health Administration, which represents all of the accredited masters degree programs in health administration in the US and Canada. His research interests focus on organizational factors influencing patient safety and clinical improvement, and strategies and tools for improving the use of performance information in healthcare.
  
  
• Rhonda Cockerill is a Professor and Graduate Coordinator for the Department of Health Policy, Management and Evaluation. Her research interests include development and evaluation of performance indicators for primary care; evaluation of networks of dementia care; evaluation of pharmacy provision of emergency contraception; and evaluation of HIV counseling services. She teaches in the areas of quantitative methods and program planning and evaluation.
  
  

+ + PROFILES OF THE MONTH + +

Ross Baker, PhD

Dr. Baker is an Associate Professor in HPME. His current research focuses on organizational factors influencing patient safety and clinical improvement, and strategies and tools for improving the use of performance information in healthcare. Together with Peter Norton at the University of Calgary he recently finished a survey and interview research on current patient safety activities in Canada. Ross Baker assumes the Chair of the Association of University Programs in Health Administration (AUPHA) in July 2002. He also serves as a member of the National Steering Committee on Patient Safety chaired by Dr. John Wade.

Education and Work Background

Ross Baker has an M.A. and Ph.D. from the University of Toronto and a bachelor's degree from McGill University. He taught at Dalhousie University and the University of Alberta prior to his appointment at the University of Toronto.

Research Activities

Current research includes a project funded by HEALNet on the use of digital dashboards to make strategic decisions in healthcare organizations, and a review of patient safety activities in the US, UK and Australia funded by Health Canada.

Teaching and Supervisory Responsibilities

Dr. Baker is currently supervising three students pursuing Masters and PhD degrees.

Future Research

With funding from the Canadian Institute for Health Information and the Canadian Institute for Health Research, Dr. Baker will be leading an investigation of Adverse Events in Canadian Hospitals, along with co-investigator Dr. Peter Norton, Professor and Head of the Department of Family Medicine at the University of Calgary. Through systematic review of hospital charts, the study will examine the extent of adverse events in Canadian acute care hospitals and the availability of data that could be used to support continuous monitoring and reduce these events. This is the first study of its kind in Canada and results of the study are expected to be released to the public in 2004.

+ + + + +

Rhonda Cockerill, PhD

Dr. Cockerill is a Professor in HPME specializing in program evaluation and the use of performance indicators. Her research projects involve the evaluation of a broad range of programs including networks of dementia care, pharmacy provision of emergency contraception, and HIV counseling and rehabilitation services. She also functions as the Departmental Graduate Coordinator.

Education and Work Background

Dr. Cockerill received her PhD at the University of Edinburgh. She completed a post-doctoral degree in the Department of Health Administration at the University of Alberta and worked for three years as Manager of Strategic Planning, Department of Hospitals and Medical Care, Government of Alberta prior to joining the University of Toronto. Her first position at the University of Toronto was as an evaluation consultant with the Health Care Research Unit.

Dr. Cockerill has been engaged in student funding activities, serving as a committee member for CIHR, Connaught, and Lupina Fellowship committees. She has been actively involved with the Canadian Evaluation Society and the American Evaluation Association (AEA) and currently serves on an Executive Committee of the AEA. Dr. Cockerill is also a Board member of the Anne Johnston Community Health Centre in Toronto, Canada's first barrier-free health facility.

Research Activities

Current research activities include an evaluation of a pilot project for the delivery of emergency contraception through pharmacies; development of performance indicators for primary care; an evaluation of dementia care networks; and a needs assessment of the delivery of rehabilitation services to an HIV/AIDS population.

Recently completed projects include an evaluation of the Aboriginal Healing and Wellness Strategy (AHWS) and an evaluation of the HIV/AIDS testing program.

Teaching and Supervisory Responsibilities

Dr. Cockerill is currently supervising five Masters and PhD students and is involved as a committee member on over ten additional committees. Recent graduates include Mary Lou King (Ryerson University), Pat Griffen (University of Ottawa) and Maureen Dobbins (McMaster University).

Future Research

Future research will continue to focus on the evaluation of community based programs.

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