Nursing researcher finding ways to help improve Alberta’s health-care system

Debbie White’s life work — from a clinician in intensive care to a senior administrator — has been to find ways to improve patient safety and quality of health care in Alberta.

“I’m very interested in examining processes and structures in teams and organizations with the aim to improve outcomes,” says White, RN, PhD, a senior researcher and associate professor in the Faculty of Nursing who works closely with colleagues Dr. William Ghali and Dr. Tom Stelfox in the O’Brien Institute of Public Health and the Cumming School of Medicine.

Strategic clinical networks create opportunities to improve care

White’s current research is focused on understanding the factors that influence achievement of the goals and objectives of Alberta’s Strategic Clinical Networks (SCNs).

Alberta Health Services is a major steward of the SCNs, accountable to achieve improved health outcomes across the care continuum. These networks are interdisciplinary and include a variety of stakeholders from health professionals, researchers, policy-makers and decision-makers to patients and their families. They have been set up to develop and implement evidence-based innovations to improve patient outcomes and the experience for Albertans. Examples of SCN work include equitable access to stroke care, reduced use of inappropriate antipsychotic medication within long-term care facilities and transformation of the entire surgical experience.

“SCNs were developed based on unique patient populations or burdens of disease, and/or high intensity clinical specialties. There are 11 that are operational, surgery, cardiovascular and stroke, diabetes, obesity and nutrition, critical care, and five in various stages of planning,” says White.

White and her team have been instrumental in developing products, such as infographics and summary presentations to facilitate exchange of findings and evidence between the research team and SCN.

Collaboration is key to improving health care delivery

“Our success is in collaboration. We have a wonderful opportunity to provide feedback and work very closely with the SCN leadership and with network teams,” says White. “It is clear from Phase 1 of our study that SCN multilayer bidirectional engagement is essential to SCN success.”

Shepherding all this expertise and interest is a huge task and White’s research gets down to the nitty-gritty details such as describing structural characteristics of the SCN teams, the organizational context in which they are embedded, the levels of engagement internally and external to SCNs, knowledge translation activities and factors that enhance or challenge the SCNs in meeting their goals.

“To achieve high performance in the health system, understanding the barriers and facilitators that improve outcomes will guide Alberta and other health systems in their efforts to achieve their aims (better quality, better outcomes, better value) that will lead to sustainability,” says White.

“Things don’t get better by one person doing it,” she adds. “Alberta Health Services have established SCNs as structural mechanisms designed to involve multiple stakeholders to improve quality of care. Stay tuned to hear about the short and long-term outcomes.”