Isabelle Gaboury

Université de Sherbrooke | UdeS · Department of family and emergency medicine

Canada is experiencing an unprecedented primary care crisis, with 6.5 million Canadians reporting lacking a family physician, including 31% of the Quebec population. To address this problem, the province of Quebec implemented Primary Care Access Points (GAPs) to help unattached patients navigate and access primary care services while awaiting attac...

Background This study aims to describe the main type 2 diabetes mellitus (T2DM) quality improvement (QI) challenges identified by primary care teams in the province of Quebec who participated in the COMPAS + QI collaborative. Methods A qualitative descriptive design was used to analyse the results of 8 COMPAS + workshops conducted in 4 regions of...

Background Physiotherapy is effective to reduce pain and improve the quality of life of people living with chronic pain. To offer high-quality physiotherapy services, these services must be patient-centred and respond to patients’ needs. However, few studies seem to target patients’ perceived needs, whereas more studies tend to focus on needs asses...

Rationale Awareness of their standing relative to best practices motivates primary healthcare (PHC) teams to improve their practices. However, gathering the data necessary to create such a portrait is a challenge. An effective way to support the improvement of the practices of PHC teams is to simplify the availability of data portraying aspects of...

Background Access to primary healthcare services is a core lever for reducing health inequalities. Population groups living with certain individual social characteristics are disproportionately more likely to experience barriers accessing care. This study identified profiles of access and continuity experiences of patients registered with a family...

Background: This study aims to describe the main type 2 diabetes mellitus (T2DM) quality improvement (QI) challenges identified by primary care teams in the province of Quebec who participated in the COMPAS+ QI collaborative. Methods: A qualitative descriptive design was used to analyse the results of 8 COMPAS+ workshops conducted in 4 regions of t...

Background Overcrowded emergency departments (EDs) are associated with higher morbidity and mortality and suboptimal quality-of-care. Most ED flow management strategies focus on early identification and redirection of low-acuity patients to primary care settings. To assess the impact of redirecting low-acuity ED patients to medical clinics using an...

Background A train-the-trainer approach can effectively support the integration of new practice standards for health and social services professionals. This study describes the effects of an enhanced train-the-trainer program to support registered nurses and social workers working in primary care clinics in their understanding of the fundamental pr...

This project explored an interprofessional collaboration initiative at Clinique Indigo which aimed to improve comprehensive care for unattached patients in Quebec’s primary care system. Throughout the project, physicians and non-physician health professionals alike became more actively engaged in the care of patients lacking a regular primary care...

Background Understanding patients' experiences accessing primary health care (PHC) is necessary to improve service organisation. This study aims to examine individual, organisational, and contextual factors associated with patients' experience of accessing the multidisciplinary PHC clinic to which they are attached. Methods This cross‐sectional st...

Context Patient and family partners are being increasingly engaged worldwide in processes aimed at the quality improvement (QI) of healthcare services. There is also growing interest in documenting these engagement processes within organizations to share and improve them. To support the provincial implementation of this approach, the Quebec’s minis...

This multi-methods study describes the development of a pediatric rehabilitation telehealth intervention fidelity checklist, estimates its inter-rater reliability, and documents raters' implementation experience. A literature scan and expert consultation identified eighteen key behaviors and categorized them into three subdomains, measured using a...

Background: The enhancement of primary health care and the prevalence of chronic diseases are key issues worldwide, especially in Canada. As the incidence of chronic illnesses rises, they have emerged as the foremost cause of mortality worldwide. This trend has led to a surge in demand for healthcare services, placing significant pressure on primar...

Background The advanced access (AA) model is among the most recommended innovations for improving timely access in primary care (PC). AA is based on core pillars such as comprehensive planning for care needs and supply, regularly adjusting supply to demand, optimizing appointment systems, and interprofessional collaborative practices. Exposure of f...

Although realist evaluation (RE) requires multiple data collection methods, qualitative interviews are considered most valuable and are most frequently used. The guiding principles of RE may limit the emergence of new Context–Mechanism–Outcome (CMO) configurations by evoking particular underlying mechanisms. This paper proposes a new method for con...

Objectives Evidence suggests that healthcare quality improvement (QI) projects are more successful when decision-makers are involved in the process. However, guidance regarding the engagement of decision-makers in QI projects is lacking. We conducted a scoping review to identify QI projects involving decision-makers published in the literature and...

Objectives The advanced access model is highly recommended to improve timely access to primary healthcare (PHC). However, its adoption varies among PHC providers. We aim to identify the advanced access profiles of PHC providers. Design A cross-sectional study was conducted between October 2019 and March 2020. Latent class analysis (LCA) measures w...

Background Shared decision-making is an imperative in chronic pain care. However, we know little about the decision-making process, especially in primary care where most chronic pain care is provided. We sought to understand decisional needs of people living with chronic pain in Canada. Methods Informed by the Checklist for Reporting Of Survey Stu...

Background Access to primary healthcare services is a core lever for reducing health inequalities. Population groups living with certain individual social characteristics are disproportionately more likely to experience barriers accessing care. This study identified profiles of access and continuity experiences of patients registered at team-based...

Background: Effective healthcare innovations are often not scaled up beyond their initial local context. Lack of practical knowledge on how to move from local innovations to large-system improvement hinders innovation and learning capacity in health systems. Studying scale-up processes can lead to a better understanding of how to facilitate the sca...

Background Juvenile idiopathic arthritis (JIA) is a common pediatric rheumatic condition and is associated with symptoms such as joint pain that can negatively impact health-related quality of life. To effectively manage pain in JIA, young people, their families, and health care providers (HCPs) should be supported to discuss pain management option...

Purpose: The purpose of this study is to explore the acceptability of a telerehabilitation intervention provided to parents of children with motor difficulties. Material and methods: Sixteen parents of children were purposefully recruited to participate in semi-structured interviews aimed at assessing the acceptability of the telerehabilitation...

Introduction : À ce jour, la césarienne demeure une chirurgie majeure afin de réduire les risques de mortalité foetale et maternelle. Toutefois, entre 11 et 15 % des nouvelles mères développeront des douleurs et des complications, dont certaines seraient attribuables à la cicatrice. Quelques solutions thérapeutiques existent pour le traitement des...

Since 2012, implementation of the advanced access model in primary care has been highly recommended across Canada to improve timely access. We present a portrait of the implementation of the advanced access model 10 years after its large-scale implementation across the province of Quebec. In total, 127 clinics participated in the study, with 999 fa...

Background: eConsult is a model of asynchronous communication connecting primary care providers to specialists to discuss patient care. This study aims to analyze the scaling-up process and identify strategies used to support scaling-up efforts in four provinces in Canada. Methods: We conducted a multiple case study with four cases (ON, QC, MB,...

Aim: To explore the use and implementation of teleconsultations by primary care nurses in the context of the COVID-19 pandemic. Background: Teleconsultation use increased rapidly during the COVID-19 pandemic. Its implementation has been documented for physicians and specialists, but knowledge is still limited in nursing practice. Design: A seq...

Objective: This study aims to present a proof of concept of a dashboard on a set of indicators of access to primary healthcare (PHC) based on electronic medical records (EMRs). Methods: This research builds on a multi-method design study including (1) a systematic review, (2) a pilot phase and (3) the development of a dashboard. Results: Eight...

Objective: This study aims to explore differences in access to care as experienced by patients registered in team-based primary healthcare clinics according to their social vulnerability profile. Method: A total of 1,562 patients from four team-based primary healthcare clinics completed an e-survey conducted between June and November 2021. The s...

Introduction The 2021 Action Plan for Pain from the Canadian Pain Task Force advocates for patient-centred pain care at all levels of healthcare across provinces. Shared decision-making is the crux of patient-centred care. Implementing the action plan will require innovative shared decision-making interventions, specifically following the disruptio...

Background: Improving access to primary health care is among top priorities for many countries. Advanced Access (AA) is one of the most recommended models to improve timely access to care. Over the past 15 years, the AA model has been implemented in Canada, but the implementation of AA varies substantially among providers and clinics. Continuous q...

Introduction The aim of this study was to quantify the amount of deterioration in hearing and to document the trajectory of hearing loss in early identified children with unilateral hearing loss (UHL). We also examined whether clinical characteristics were associated with the likelihood of having progressive hearing loss. Methods As part of the Mi...

Background Juvenile idiopathic arthritis (JIA) is a common pediatric rheumatic condition and is associated with symptoms such as joint pain that can negatively impact health-related quality of life. To effectively manage pain in JIA, young people, their families, and health care providers (HCPs) should be supported to discuss pain management option...

Introduction: Attachment to a primary care provider is an important component of primary care as it facilitates access. In Québec, Canada, attachment to a family physician is a concern. To address unattached patients' barriers to accessing primary care, the Ministry of Health and Social Services mandated Québec's 18 administrative regions to imple...

The advanced access (AA) model is among the most recommended innovations for improving timely access in primary health care (PHC). Originally developed for physicians, it is now relevant to evaluate the model's implementation in more interprofessional practices. We compared AA implementation among family physicians, nurse practitioners, and nurses....

Introduction Chronic pain represents a major health issue, affecting the physical and mental health of approximately one in five people worldwide. It is now widely recognized that health professionals should use interventions that meet the needs of people living with chronic pain. Therefore, physiotherapists should attend to patients’ perceived nee...

Background: Deformational plagiocephaly can be prevented in many healthy infants if strategies are implemented early after birth. However, despite efforts to disseminate accurate information, parental adherence to evidence-based prevention strategies is a challenge. To date, factors-barriers and facilitators-influencing parental adherence to strat...

How We Work Together - The Integrated Knowledge Translation Research Network Casebook

The purpose of this study was to describe the acceptability of a stroke telerehabilitation platform from the perspective of both patients and therapists. Two public rehabilitation centers participated in a pilot telerehabilitation trial. A theoretical framework was used to conceptualize acceptability. Semi-structured individual interviews with pati...

Introduction: Despite strong evidence supporting interprofessional collaboration (IPC) and the documented need for collaborative practice in primary health care (PHC), initiatives to promote IPC in rural and remote PHC facilities have not been extensively studied. The purpose of this paper was to map interprofessional education (IPE) and interprofe...

As we are emerging out of the Pandemic, we have a unique opportunity to leverage on the lessons learned from the pandemic in fostering the healthcare transformation through innovation and IPECP. To capitalize on this opportunity and in a collaborative effort, the InterprofessionalResearch.Global (IPR.Global), the American Interprofessional Health C...

Background: Having a regular family physician is associated with many benefits. Formal attachment - an administrative patient-family physician agreement - is a popular feature in primary care, intended to improve access to and continuity of care with a family physician. However, little evidence exists about its effectiveness. In Quebec, Canada, wh...

Background: The advanced access model was developed 20 years ago and has been implemented in several countries. We aimed to revise and operationalize the pillars and subpillars of the advanced access model based on its contemporary practice by profes- sionals in primary health care. Methods: This multimethod sequential study was informed by a liter...

Objective The aim was to improve distressing patient-reported outcomes (PROs) that persisted in RA patients with clinically controlled inflammation (controlled RA). Methods In a pragmatic pilot study, we offered mindfulness-based stress reduction (MBSR), a group intervention, to controlled RA patients who had high (≥16) Centre for Evaluation Studi...

Purpose: The main objective was to assess the feasibility of conducting a full randomized controlled trial (RCT) to test the effectiveness of the OA Go Away (OGA) behavioural intervention on adherence to prescribed exercise, level of physical activity, goal attainment, and health outcomes, and to determine the acceptability of the OGA. The OGA is a...

Background Most patients diagnosed with a small renal mass (SRM) are treated with definitive treatments such as surgery or thermal ablation. Given that some SRMs are benign or have low metastatic potential, active surveillance seeks to reduce the overtreatment and the potential complications. Active surveillance is an alternative that is being incr...

BACKGROUND Children with disability face long wait times for rehabilitation services. Prior to the pandemic, telehealth adoption was low across most rehabilitation settings, including pediatrics. As a result of the pandemic restrictions, pediatric therapists were asked to rapidly shift to using telehealth without previous experience and often minim...

Background: Children with disability face long wait times for rehabilitation services. Before the COVID-19 pandemic, telehealth adoption was low across pediatric rehabilitation. Owing to the COVID-19 pandemic restrictions, pediatric therapists were asked to rapidly shift to telehealth, often with minimal training. To facilitate the behavior change...

Objectives: A majority of women and families wish that their babies be breastfed. However, too many still receive insufficient or inappropriate initial care from health professionals (HPs) who have limited breastfeeding (BF) competencies. We investigated barriers and potential solutions to improve the undergraduate training programs for various HP...

BACKGROUND This applied research project aims to evaluate an interactive digital patient/primary care professional platform designed specifically to improve medication adherence, an important issue in efficient healthcare. It is estimated that more than 1.3 million Quebecers do not adhere to their treatment as prescribed. By ensuring better treatme...

Background: Adherence to care plans is a major issue in health care systems. Improved adherence has several potential benefits such as ensuring treatment effectiveness and control of chronic diseases. There is currently a lack of tools to maximize treatment adherence in an integrated manner, that is, covering multiple aspects of patients' health c...

Diverse challenges arise with research involving people with communication disorders while using remote methods for data collection. Ethical and methodological issues related to the inclusion of people with communication disorders in research, specifically qualitative research, are magnified by communication challenges specific to remote communicat...

Objective Cognitive-behaviour therapy (CBT) is a research-supported treatment for anxiety disorders. Transdiagnostic CBT protocols have been recently developed to manage multiple anxiety disorders. The efficacy of transdiagnostic CBT is directly dependent on acceptability as perceived by patients and health care providers. In this study, we sought...

Aims: The purpose of this scoping review was to explore the available literature and identify gaps regarding the acceptability of telerehabilitation interventions provided by pediatric physical therapists and occupational therapists. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) framewor...

Background The implementation of evidence-based innovations is incentivized as part of primary care reform in Canada. In the Province of Québec, it generated the creation of interprofessional care models involving registered nurses and social workers as members of primary care clinics. However, the scope of practice for these professionals remains...

Few addiction treatment options are available in Arctic Canada, leading many Inuit to seek treatment programs in southern cities. We conducted a case study to understand what contributes to a culturally safe experience for Inuit in a mainstream addiction rehabilitation centre in Southern Canada. We carried out more than 700 hours of participant obs...

Children with unilateral or mild bilateral hearing loss are increasingly identified in early childhood. Relatively little is known about how hearing loss affects their developmental trajectory or whether it contributes to parenting stress for these parents. This study aimed to examine child behavior and parenting stress in parents of children with...

Introduction: Access to public rehabilitation services for patients with non-urgent conditions - which suffer mainly from musculoskeletal disorders - is problematic around the world. Remote rehabilitation services are recognized as effective means to increase accessibility. Patient acceptability is an important element in the successful implementa...

Introduction: Management of chronic obstructive pulmonary disease (COPD) remains a challenge in primary care and multiple barriers can limit implementation of COPD guidelines. Since 2016, a quality improvement (QI) collaborative, called COMPAS+, has been implemented across the province of Quebec (Canada) to support improvement of chronic disease m...

Mémoire Projet loi 11

Primary Health Care (PHC) teams are an important component of the health system – particularly in terms of integrating care for vulnerable patients living with complex health and social needs. Over the last two decades, PHC teams have been implemented in different forms across Canadian provinces and territories. This article explores the health car...