Jeannie Haggerty

• PhD
• Professor (Full) at McGill University

Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are becoming essential parts of a learning health system, and using these measures is a promising approach for value-based healthcare. However, evidence regarding healthcare professional and patient organizations’ knowledge, use and perception of P...

Background Racism has been shown to impact the health of Black persons through its influence on health care, including its expression through implicit biases in provider training, attitudes, and behaviours. Less is known about the experiences of racism in contexts outside of the USA, and how race and racism interact with other social locations and...

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...

Une relation patient-médecin à long terme n'est pas nécessaire pour l'efficacité de soin ; la continuité par épisode de soins est suffisante. Mythe L'IMPORTANCE DE LA CONTINUITÉ DANS LES SOINS DE PREMIÈRE LIGNE AU-DELÀ DE L'ACCÈS Réalité L'efficacité des services de première ligne repose en grande partie sur les connaissances et la confiance accumu...

Background The COVID-19 pandemic has required family physicians to rapidly address increasing mental health problems with limited resources. Vulnerable home-based seniors with chronic physical conditions and commonly undermanaged symptoms of anxiety and depression were recruited in this pilot study to compare two brief self-care intervention strate...

Objectives: A growing body of evidence points to persistent health inequities within racialized minority communities, and the effects of racial discrimination on health outcomes and health care experiences. While much work has considered how anti-Black racism operates at the interpersonal and institutional levels, limited attention has focused on...

Introduction: From a larger study examining policy and program information on how Canadian provinces integrate care services, this study aimed to create "priority lists" of 10-15 services that are "absolutely needed" for care integration. Methodology: A diverse group of over 50 Canadian stakeholders participated in virtual consensus-building usi...

As healthcare in Canada is provincially operated, the program innovations in one jurisdiction may not be readily known in other jurisdictions. We examine the availability of implementation-specific data for 30 innovative Canadian programs designed to integrate health and social services for patients with complex needs. Using publicly available data...

This short article captures input from patient partners on the dimensions of the research program that most resonated with them. They are passionate about wanting to see a better connection between health and social services, and they are also willing to be involved as advisors for policy directions in the same way as their involvement has become t...

The integration of care services and providers across the health-social-community continuum has helped improve the lives of many children and youth living with complex health conditions. Using environmental scan data, 16 promising multi-service programs were selected and analyzed qualitatively through a deliberative conversation approach. Descripti...

This paper describes 16 Canadian programs designed to provide integrated primary care for older adults. Publicly available data were used to identify the "what" and the "how" of integration for each program. Most programs integrated with other healthcare or medical services (vs. social services). Mechanisms of integration varied; the most common me...

This paper describes how health and social services are governed and organized across Canada for two patient groups. Governance configurations and governance proximity between primary care and priority health and social services varied markedly between provinces. While the need for integrated service delivery has been made a clear priority during t...

The First Ministers Health Accords of 2001 through 2003 (Health Canada 2006) launched the renewal of primary care toward more comprehensive care delivery models. We scanned government websites in the 10 Canadian provinces to assess how comprehensive and integrated renewal models were for health and social services in 2018. More comprehensive primar...

Comprehensive primary healthcare for patients with complex care needs requires connections to other health services, social services and community supports. This descriptive comparative policy research program used publicly available documents and informant interviews to examine progress toward integrated comprehensive care through the lens of serv...

Background Patients without a regular primary care provider – unattached patients – are more likely to visit hospital emergency departments (ED), leading to poor patient and health system outcomes. In many Canadian provinces, policy responses to improve primary care access and reduce ED utilization of unattached patients have included centralized w...

Background A pilot intervention in a participatory research programme in Québec, Canada, used telephone outreach by volunteer patient navigators to help unattached persons from deprived neighbourhoods attach successfully to a family doctor newly-assigned to them from a centralized waiting list. According to our theory-based program logic model we e...

Purpose Socially disadvantaged patients may lack self-efficacy to navigate a complex health system making them vulnerable to healthcare inequity. We aimed to develop an Index of social vulnerability that predicts increased risk of negative healthcare events (e.g. emergency hospitalization), independent of chronic disease burden. The analysis illust...

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...

Background: Early in the COVID-19 pandemic, efforts to decrease risk of viral transmission triggered an abrupt shift from ambulatory health care delivery toward telemedicine. In this study, we explore the perceptions and experiences of telemedicine among socially vulnerable households and suggest strategies to increase equity in telemedicine acces...

Background and purpose: Teaching clinics aim to provide patients with care that is comprehensive, high quality, and timely. Since resident presence at the clinic is irregular, timely access to care and continuity remain challenging. The two main objectives of our study were to compare the experience of timely access by patients of family residents...

Purpose Socially disadvantaged patients may lack self-efficacy to navigate a complex health system making them vulnerable to healthcare inequity. We aimed to develop an Index of social vulnerability that predicts increased risk of negative healthcare events (e.g. emergency hospitalization), independent of chronic disease burden. The analysis illust...

Background: Pilot interventions were implemented in five different regions within a Canada-Australia participatory research programme to improve access to primary healthcare for vulnerable populations. In Québec, Canada, a telephone outreach program used volunteer patient navigators to help unattached persons from deprived neighbourhoods attach suc...

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...

Background Current dimensions of the primary health care research (PHC) context, including the need for contextualized research methods to address complex questions, and the co-creation of knowledge through partnerships with stakeholders – require PHC researchers to have a comprehensive set of skills for engaging effectively in high impact research...

Background: Effective shared decision-making in pediatric surgery requires clarity regarding which surgical outcomes are most important to patients and their families, and how they prefer to receive the information. Despite how essential this is for effective risk communication, little is known about the communication needs and preferences of patie...

Background: The aim of this work was to show the feasibility of providing a comprehensive portrait of regional primary care performance. Methods: The TRANSFORMATION study used a mixed-methods concurrent study design where we analyzed survey data and case studies. Data were collected in British Columbia, Ontario and Nova Scotia. Patient's Medical...

Introduction Timely access is one of the cornerstones of strong primary healthcare (PHC). New models to increase timely access have emerged across the world, including advanced access (AA). Recently in Quebec, Canada, the AA model has spread widely across the province. The model has largely been implemented by PHC professionals with important varia...

Background Inequitable access to primary health care (PHC) remains a problem for most western countries. Failure to scale up effective interventions has been due, in part, to a failure to share the logic and essential elements of successful programs. The aim of this paper is to describe what we learned about improving access to PHC for vulnerable g...

Background and Aims Multi‐stakeholder partnerships offer strategic advantages in addressing multi‐faceted issues in complex, fast‐paced, and rapidly‐evolving community health contexts. Synergistic partnerships mobilize partners' complementary financial and nonfinancial resources, resulting in improved outcomes beyond that achievable through individ...

Background Primary healthcare is the main entry to the health care system for most of the population. In 2008, it was estimated that about 26% of the population in Quebec (Canada) did not have a regular family physician. In early 2017, about 10 years after the introduction of a centralized waiting list for patients without a family physician, Québe...

Partnerships are an important mechanism to tackle complex problems that extend beyond traditional organizational divides. Partnerships are widely endorsed, but there is a need to strengthen the evidence base relating to claims of their effectiveness. This article presents findings from a mixed methods study conducted with the aim of understanding p...

Objective: This study documents the adoption of telehealth by various types of primary healthcare (PHC) providers working in teaching PHC clinics in Quebec during the COVID-19 pandemic. It also identifies the perceived advantages and disadvantages of telehealth. Method: A cross-sectional study was conducted between May and August 2020. The e-sur...

In primary health care, multi-stakeholder partnerships between clinicians, policy makers, academic representatives and other stakeholders to improve service delivery are becoming more common. Literature on processes and approaches that enhance partnership effectiveness is growing. However, evidence on the performance of the measures of partnership...

Aims We describe an innovative research protocol to: (a) examine patient‐level longitudinal associations between nurse staffing practices and the risk of adverse events in acute care hospitals and; (b) determine possible thresholds for safe nurse staffing. Design A dynamic cohort of adult medical, surgical and intensive care unit patients admitted...

Background: Primary healthcare is the main entry to the health care system for most of the population, even for specialized care. In 2014, it was estimated that about 25% of the population in Quebec (Canada) did not have a regular primary healthcare provider. In 2017, after the introduction of a centralized waiting list to enroll unattached patient...

Abstract Background Achieving equity of access to primary healthcare requires organizations to implement innovations tailored to the specific needs and abilities of vulnerable populations. However, designing pro-vulnerable innovations is challenging without knowledge of the range of possible innovations tailored to vulnerable populations’ needs. To...

Background: Primary healthcare services must respond to the healthcare-seeking needs of persons with a wide range of personal and social characteristics. In this study, examined whether socially vulnerable persons exhibit lower abilities to access healthcare. First, we examined how personal and social characteristics are associated with the abilit...

Background A 2018 review into continuity of care with doctors in primary and secondary care concluded that mortality rates are lower with higher continuity of care. Aim This association was studied further to elucidate its strength and how causative mechanisms may work, specifically in the field of primary medical care. Design and setting Systema...

Background: Timely access in primary health care is one of the key issues facing health systems. Among many interventions developed around the world, advanced access is the most highly recommended intervention designed specifically to improve timely access in primary care settings. Based on greater accessibility linked with patients' relational co...

Background: Patient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as o...

Context: In Quebec, centralized waiting lists were created to reduce the large number of patients unattached to a family physician (25% of the population) as these patients are more likely to have unmet needs and visit the emergency room (ER). However, disadvantaged patients are more likely to have trouble navigating the health system and waiting l...

Context: From 2014 to 2018, Quebec’s health system underwent major reforms. During this tumultuous time, a partnership of decision-makers, providers, researchers and community representatives attempted to implement an innovation to improve access to primary healthcare for vulnerable patients, as part of a participatory action research program. Whil...

Context: Unattached patients – who do not have regular family doctor – often rely more on emergency departments to access care. Formally attaching patients to a family doctor is a common feature of patient-centered medical homes in North America and has been recommended as a way to reduce emergency department visits. In Quebec, Canada – where 21% o...

Aim To conduct advanced psychometric analysis of Primary Care Assessment Tool (PCAT) in Tibet and identify avenues for metric performance improvement. Background Measuring progress toward high-performing primary health care can contribute to the achievement of sustainable development goals. The adult version of PCAT is an instrument for measuring...

Introduction Access to primary healthcare (PHC) has a fundamental influence on health outcomes, particularly for members of vulnerable populations. Innovative Models Promoting Access-to-Care Transformation (IMPACT) is a 5-year research programme built on community-academic partnerships. IMPACT aims to design, implement and evaluate organisational i...

Background Polypharmacy carries the risk of adverse events, especially in people with multimorbidity. Objective To investigate the prevalence of polypharmacy in community-dwelling adults, the association of multimorbidity with polypharmacy and the use of medications for primary prevention. Methods Cross-sectional analysis of the follow-up data fr...

Almost one-fifth of Botswana's population is infected with HIV. The Inter-Ministerial National Structural Intervention Trial is a trial to test the impact on HIV rates of a structural intervention that refocuses government structural support programs in favor of young women. Ensuring that the intervention reaches all vulnerable young women in any g...

This review aims to summarize the progress of patient evaluation studies focusing on primary health care (PHC) in China, specifically in relation to survey instruments and implementation issues. Eligible studies published in English or Chinese were obtained through online searches of PubMed and China National Knowledge Infrastructure. A descriptive...

The primary health care quality factors determining patient satisfaction will shape patient-centered health reform in China. While rural public clinics performed better than hospitals and private clinics in terms of patient perceived quality of primary care in China, there is little information about which quality care aspects drove patients’ satis...

Background In Botswana, one fifth of the adult population is infected with HIV, with young women most at risk. Structural factors such as poverty, poor education, strong gender inequalities and gender violence render many young women unable to act on choices to protect themselves from HIV. A national trial is testing an intervention to assist young...

Background Organizational Participatory Research (OPR) seeks organizational learning and/or practice improvement. Previous systematic literature reviews described some OPR processes and outcomes, but the link between these processes and outcomes is unknown. We sought to identify and sequence the key processes of OPR taking place with and within hea...

Aim To describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources. Background A pan-Canadian mechanism for common measurement of the impact of prim...

Objectives To examine: 1) whether patient characteristics predict perceived self-management support (usefulness of information and collaborative care planning) by primary care providers after six months, and 2) the association between perceived self-management support and patient activation at 6 months Methods We conducted a secondary analysis amo...

This chapter focuses on North American (NA) participatory health research (PHR), particularly with organizations. We begin by presenting the definition of PHR put forth by NA leaders in 1995 and, then, sketching the contributions of those who have led the field since, developing, promoting, and advocating for PHR in Canada and the United States. We...

Objective: To describe the demographic characteristics, health, and health care experiences of adult patients in primary care waiting rooms in Quebec, and to determine which pillars of the Patient's Medical Home (PMH) are a priority to align primary care practices with the PMH model. Design: Baseline survey of a prospective cohort study using se...

Context: Significant reforms are needed to improve healthcare system performance in Quebec. Even though the characteristics of high-performing healthcare systems are well-known, Quebec's reforms have not succeeded in implementing many critical elements. Converging evidence from political science models suggests stakeholders' preferences are centra...

Background: Concordance refers to shared characteristics between a clinician and patient, such as ethnicity or language. The purpose of this study was to examine whether patient-clinician concordance is associated with patient-reported continuity of care (relational, informational and management) and patient-reported impacts of care (quality and e...

Healthcare systems performance is the focus of intense policy and media attention in most countries. Quebec (Canada) is no exception, where successive governments have struggled for decades with apparently intractable problems in care accessibility overall, poor performance, and rising costs. This article explores the underlying causes of the disco...

4th Annual McGill Family Medicine Research Symposium in Montreal

Introduction: Health inequities persist in Canada and the United States. Both countries show differential health status and health care quality by social characteristics, making zip or postal code a greater predictor of health than genetics. Many social determinants of health overlap in the same individuals or communities, exacerbating their vulne...

Introduction: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options...

Background In health, organizational participatory research (OPR) refers to health organization members participating in research decisions, with university researchers, throughout a study. This non-academic partner contribution to the research may take the form of consultation or co-construction. A drawback of OPR is that it requires more time fro...

Background In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients’ rating of three primary care se...

Background: Various data sources may be used to document the presence of chronic medical conditions. This study examined the agreement between self-reported and health administrative data. Methods: A randomly selected cohort of participants aged 25-75 years recruited by telephone from the general population of Quebec reported on the presence of...

Objectives To validate 2 new patient-reported measures of self-management support from health professionals for mood and emotional problems. Methods The sample comprised primary care patients with chronic physical conditions and co-morbid depressive symptoms enrolled in a randomized trial of telephone coaching of a depression self-care interventio...

Introduction: Recruitment and retention of healthcare staff are difficult in rural communities. Poor quality of work life (QWL) may be an underling factor as rural healthcare professionals are often isolated and work with limited resources. However, QWL data on rural emergency (ED) staff is limited. We assessed QWL among nurses and physicians as pa...

Most highly developed economies have embarked on a process of primary health care (PHC) transformation. To provide evidence on how nations vary in terms of accessing PHC, the aim of this study is to describe the extent to which barriers to access were experienced by adults in Australia compared with other countries. Communities participating in an...

Objective Primary care services form the foundation of modern healthcare systems, yet the breadth and complexity of services and diversity of patient populations may present challenges for creating comprehensive primary care information systems. Our objective is to develop regional-level information on the performance of primary care in Canada. Me...

Sources: Main bibliographic databases (Medline, Embase, CINAHL) and team members' personal files. Study selection: One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the 'Patient Centered Access to Healthcare' conceptual framework (dimensions and outcomes...

Objective. To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario’s health sub-systems. Materials and methods. The financing and organization models were characterized using secondary data.Costs were calculated using theWHO/SHA methodology.Healthcare...

Background: Evidence-based indicators of quality of care have been developed to improve care and performance in Canadian emergency departments. The feasibility of measuring these indicators has been assessed mainly in urban and academic emergency departments. We sought to assess the feasibility of measuring quality-of-care indicators in rural emerg...

Background: Settings affect estimation of multimorbidity prevalence. Multimorbidity prevalence was reported to be substantially higher among family practice-based patients than in the general population, but prevalence estimates were obtained with different methods and at different time periods. The aim of the present study was to compare estimate...

Objective: A small number of patients frequently using the emergency department (ED) account for a disproportionate amount of the total ED workload and are considered using this service inappropriately. The aim of this study was to identify prospectively personal characteristics and experience of organizational and relational dimensions of primary...

Plausibility of the assumption that the relationship between predictor and ED use was similar for both years. (DOCX)