Our research entails Maximing Equitable Relationships by Collaborative University Research & insights, among providers of health care to heart and stroke patients. Our research is carried out by interdisciplinary teams at two sites Saskatoon and Halifax. These sites were chosen because they are of manageable size and yet completely distinctive in history, demographics and economy. Similarly, focusing on two leading clinical conditions reduces variations in working conditions, however, the organization of the work is distinct. We study the working environments of health care providers and resulting evaluations of quality by patients and the providers, with providers having professional perspectives on quality and patients having opinions on quality.

• Rein Lepnurm, Scientific Director (profile) (email)
• Roy Dobson, Managing Director (email)
• David Keegan, Co-investigator (email)
• Brian Brownbridge, Anesthesiology
• Mike Kelly, Neurology

For general inquiries, please email the MERCURi Research Group at mercuri.rg@usask.ca.

Related areas of inquiry

• Patient Perspectives on Quality
• Interprofessional interdisciplinary collaboration
• Measures of Performance in Health
• Systematic Outcome Mapping in Hospitals

Recent publications emerging from work

Lepnurm R, Nesdole R, Dobson RT, Peña-Sánchez JN. The effects of distress and the dimensions of coping strategies on physicians’ satisfaction with competence SAGE Open Medicine 4: DOI: 10.1177/2050312116643907 (2016).

Lepnurm R, Dobson RT, Nesdole R, Peña-Sánchez JN. Modelling Factors of physicians’ satisfaction with competence. SAGE Open Medicine 3: 2050312115613352 DOI: 10.1177/2050312115613352 (2015).

Nesdole R. Lepnurm R, Voigts D, Roberts R. Reconceptualizing determinants of health: barriers to improving the health status of First Nations peoples, Canadian J Public Health, 2014; 105(3): e209-e213.

Nesdole R, Lepnurm R, Noonan B, Voigts D. (2014) Properties of the Old-fashioned and Modern Prejudiced Attitudes towards Aboriginals Scale, Canadian Journal of Behavioural Science (http://dx.doi.org/10.1037/a0036349).

Peña-Sánchez JN, Lepnurm R, Keegan DL,Dobson RT, Bermedo-Carrasco S. Payment method as a predictor of daily distress experienced by physicians, Journal of Hospital Administration, 2014; 3(5):1-13

Peña-Sánchez JN, Lepnurm R, Dobson RT, Keegan DL. Impact of payment methods on professional equity of physicians, Journal of Hospital Administration, 2014: 3(2) doi: 10.5430/jha.v3n2p50

Peña-Sánchez JN, Lepnurm R, Morales-Asencio JM, Delgado A, Domagała A, Górkiewicz M. (2013) Factors identified with higher levels of career satisfaction of physicians in Andalusia, Spain. Health Psychology Research, doi:10.4081/hpr.2014.1527.

Peña-Sánchez JN, Lepnurm R, Bermedo-Carrasco S. Latent gender inequalities in the well-being of physicians according to payment method for practicing medicine. Journal of Hospital Administration. 2013; 2(4): 7-14.

Lepnurm, R., Dobson, R.T., Voigts, D., Lissel, M., Stamler, L.L. (2012). What matters most to patients when they assess quality of care, Journal of Hospital Administration,1(2): 7-16

Lepnurm, R., Dobson, R.T., Stamler, L.L., Persaud, D.D., Keegan, D.L. & Brownbridge, B. (2012). The contribution of work environment to nurses’ assessments of the quality of patient care. Healthcare Management Forum, 25, 70-79.

Ongoing research

We continue to believe that highly motivated providers of care are more satisfied with the performance of their duties, reporting fewer compromises in care, than less motivated providers of care. Naturally, distress, leadership and organizational culture, all affected by managerial decisions  affect quality. We also believe that patients are becoming more able to assess quality, and have the right to do so.

Based on studies of 348 providers of health care in the hospitals of Saskatoon and Halifax our models of Satisfaction with Competence explain over 70% of variance using: distress, input resources, organization, equity and interference in personal life controlling for years in practice.

Our focus has expanded to include Patient Education and now follows patients into the community asking them how knowledgeable they are about their clinical condition, how capable they are in assuming self- care responsibilities, and what their actual habits are in exercise, diet, taking of medications, and getting enough sleep. Providers of care know that recovery from heart attack and stroke does not end upon discharge from hospital, especially when patients are discharged before complete or incomplete recovery with families and community programs expected to keep patients from being re-admitted to hospital.

Patients do have a role in assessing quality; however, the challenges are ongoing to ask the correct questions with patients not being fearful that criticising their caregivers will somehow affect their care. At the same time lifestyle changes are not easy to make in a society that generates sedentary habits, consumption of processed foods with excessive sugars, starches and fats, and accumulation of material wealth at the expense of culture and the environment. Success in making these changes also affect health care providers’ satisfaction with performance of duties, but difficult to measure.

Videos

• Click here for a video simulation of a patient interview from our Managing Quality in Canadian Hospitals study.
• Click here for a video simulation of a focus group from our Managing Quality in Canadian Hospitals study.
• Click here for a short introductory video on the Managing Quality in Canadian Hospitals Study.

The Safe Water for Health Research Team was formed in April 2008 by faculty from the Colleges of Nursing, Veterinary Medicine, Arts and Science, the Toxicology Centre, and partners from the Federation of SK Indian Nations (FSIN), Health Canada, Environment Canada, the Canadian Lutheran World Relief Organization, and partnering Universities in Peru. This research team has developed further partnerships with the Global Institute of Water Security, Saskatchewan Water Security Agency, Ministry of Health, International Centre for Northern Governance and Development, First Nations Inuit Health Branch and the Water Economics, Policy and Governance Network (WEPGN).

Co-Leaders:

Dr. Lalita Bharadwaj is an Associate Professor with the School of Public Health, and Dr. Cheryl Waldner is a Professor with the Western College of Veterinary Medicine.

Theme Goal:

The long-term goal of the Safe Water for Health Research Team (SWHRT) is to build community and scholarly capacity for water and health research in rural and remote communities in SK, in order to make evidence-based decisions about water policy that will promote the health of all SK residents.

Projects to date:

• We established a Community-Based Safe Drinking Water Research Program with SK First Nations.
• We also worked with the MoH and the SK health regions to summarize and map the determinants of water quality in public water supplies too small to be regulated by the Ministry of Environment (MoE).
• The group is currently funded by CIHR : Water Regulations: Impact on First Nations health equity and promotion.  The project utilizes  a community-based participatory research approach to identify barriers to, health impacts of, and the process and capacity needs for, First Nations drinking water regulation.

The Team holds a Phase 2 Health Research Group Grant from the Saskatchewan Health Research Foundation: The goal is to investigate the geographic distribution of drinking water quality and the association with chronic disease. This project involves a PhD student (WCVM) who recently completed the CREATE iTrap program. The project also includes research aimed at understanding groundwater consumption in rural communities and the impact of risk perception on human health risk. Applications of Bayesian Methods and deterministic risk assessement are applied.  

The Ministry of Health (MOH) has partnered with this group to provide advice, guidance, educational materials and in-kind analysis of water quality of drinking water samples collected from semiprivate wells in two regions of the province.

• Funded by Health Canada, the group is also working with the Federation of Saskatchewan Indian Nations (FSIN) analyzing data collected in First Nations communities in 2006 and 2010 and a third round of sampling has been initiated this year.
• There are several other grad student projects underway with MSc (Geography and Planning and SENS), studying water quality through the trucked to cistern drinking water supply and PhD (SENS & CH&E) students, whose projects are providing key research evidence for policy decisions for recreational lake management in SK.