Regis Blais

Université de Montréal | UdeM · Department of Health Administration

Objective In a healthcare system with finite resources, hospital organisational factors may contribute to patient outcomes. We aimed to assess the association of nurse staffing and neonatal intensive care unit (NICU) occupancy with outcomes of preterm infants born <33 weeks’ gestation. Design Retrospective cohort study. Setting Four level III NIC...

Primary Subject area Neonatal-Perinatal Medicine Background In a health care system with limited resources, hospital organizational factors such as unit occupancy and nurse-to-patient ratios may contribute to patient outcomes. Objectives We aimed to assess the association of NICU occupancy and nurse staffing with outcomes of very preterm infants...

Background. Nurses are trained to establish a trusting relationship with patients in order to create a salutogenic environment. However, in tech-heavy care settings, such as haemodialysis units, dehumanising practices tend to emerge and take root for various reasons to the potential detriment of both patients and nurses. For patients, this may lead...

Background: Chronic kidney disease (CKD) is a fast-growing cause of morbidity and mortality worldwide. Patients suffering from CKD almost always develop end-stage renal disease (ESRD) that is often treated with haemodialysis (HD). In this context, the quality of the nurse-patient relationship (NPR) plays a major role in supporting the quality of li...

In order to implement Human Caring as a framework throughout an institution, nurse educators must know how to humanistically use the power of influence. This chapter helps explain how nurse educators can politically influence their nursing school colleagues and workforce to encourage caring relationships within the institution and implement a Human...

Aim: Despite its importance in nursing, perceived quality of the nurse-patient relationship has seldom been researched. This study sought to examine and compare the quality of caring attitudes and behaviours as perceived by haemodialysis patients and their nurses. Design: This comparative descriptive study involved 140 haemodialysis patients and...

Aim(s): This quantitative study sought to explore the factors that influence positively and negatively the quality of work life (QWL) of first-line nurse managers (FLNMs) among healthcare institutions from a humanistic standpoint.Background: In Canada, the public healthcare reforms have had a considerable impact on FLNMs, which could have a negativ...

The successive reorganizations of most Western health care networks have led to constant pressure on practice conditions in nursing services administration. In addition, some studies argue that structural and managerial shortcomings due to reorganizations have severe impact on quality of work life (QWL) for frontline nurse managers (FLNMs). The pri...

The increasing complexity of home care services, pressures to discharge patients quicker, and the growing vulnerabilities of home care clients all contribute to adverse events in home care. In this article, home care staff in six programs analyzed 27 fall- and medication-related events. Classification of contributing causes indicates that patient a...

Objective: To examine the association of nursing overtime, nursing provision and unit occupancy rate with medical incident rates in the neonatal intensive care unit (NICU) and the risk of mortality or major morbidity among very preterm infants. Study design: Single center retrospective cohort study of infants born within 23 to 29 weeks of gestat...

Purpose: While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for whi...

Résumé Introduction Au Canada, les refontes structurelles et managériales au sein du réseau de la santé ont engendré une augmentation de la charge de travail des cadres gestionnaires infirmiers de premier niveau. Il appert que ces changements ont eu des effets néfastes sur la qualité de vie au travail (QVT) de ces professionnels. Objectifs de l’é...

Background Early identification of patients at who have a higher risk for the occurrence of harm can provide patient safety improvement opportunities. Patient factors contribute to adverse event occurrence. The study aim was to identify a single, parsimonious model of home care patient factors that, regardless of location and differences in home ca...

Résumé Problématique Les réorganisations successives dans le système de santé du Québec ont induit une pression énorme sur le travail des cadres gestionnaires infirmiers de premier niveau (CGIPN), ce qui a eu pour effet de nuire à leur qualité de vie au travail (QVT). Cependant, le sens attribué à la QVT par les CGPIN n’est pas encore bien connu....

Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care–associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrativ...

The successive reorganizations of most Western health care networks have led to constant pressure on practice conditions in nursing services administration. In addition, some studies argue that structural and managerial shortcomings due to reorganizations have severe impact on quality of work life (QWL) for frontline nurse managers (FLNMs). The pri...

Les multiples restructurations organisationnelles du réseau de la santé dans la plupart des pays de l’espace francophone ont induit une pression continue sur les conditions d’exercice des acteurs œuvrant en administration des services infirmiers (ASI). Certaines études scientifiques soutiennent que les lacunes structurelles et managériales issues d...

Les multiples restructurations organisationnelles du réseau de la santé dans la plupart des pays de l’espace francophone ont induit une pression continue sur les conditions d’exercice des acteurs œuvrant en administration des services infirmiers (ASI). Certaines études scientifiques soutiennent que les lacunes structurelles et managériales issues d...

Objective: Successive reorganizations of healthcare system around the globe have placed enormous pressure on the work of nurse managers (NMs) and this has eroded their quality of work life (QWL). However, little is known about the meaning of NMs' QWL. Aim: Inspired by Watson's Human Caring Science perspective, this study aimed to describe and under...

Objective: The aim of this study is to document the enacted (actual) scope of practice (SOP) of nurses in pediatric settings in relation to education level and position. Background: Baccalaureate-prepared staff nurses routinely carry out only a fraction of the activities essential for quality of care and patient safety they have been educated fo...

Enacted scope of practice is a major issue for nursing administrators, given the potentially negative effect on accessibility, continuity, safety and quality of care, job satisfaction, and organizational costs of nurses working at reduced scope. Optimal deployment of nurses to a fuller enacted scope of nursing practice holds much promise for addres...

Objectives: This study analyzed midwifery services implementation in one region (Montérégie) of Quebec. The objectives were to determine whether services were implemented as planned and to identify factors that facilitated or impeded implementation. The aspects studied included organizational components; types of midwifery services provided; levels...

Delivering safe, quality care in the context of home care can be challenging, particularly when facing Canada’s increasing home care demand. A Pan-Canadian Home Care study was conducted and reported that home care recipients highly value continuity and coordination. This research revealed that New Brunswick’s Extra-Mural Program is highly regarded...

The purpose of the Leadership and Health System Redesign research study was to explore the leadership dynamics at play in Canadian health reform and to develop leadership capacity in the Canadian health system through applied research and knowledge mobilization. The study makes an important contribution to our understanding of how different forms o...

This paper explores the policies and practices that are needed to improve the safety of home care in light of the most recent evidence about home care safety in Canada. Four areas for policy and practice change are addressed: 1) the promotion of effective communication processes in home care through cross-sector collaboration, case management and t...

Home care demand in Canada has more than doubled in recent years. While research related to safety in home care is growing, it lags behind that of patient safety in institutional settings. One of the gaps in the literature is the study of the perceptions of home care triads (clients, their unpaid caregivers, and paid providers). Thus, the objective...

Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institu...

AimThis integrative study on safety in home care provides a synopsis of evidence in the Canadian and international literature. The objectives of this study were to: (i) develop/test a comprehensive search strategy to locate the literature on harmful incidents (previously called adverse events (AEs)) in the home care environment to track emerging ev...

Background: The occurrence of adverse events (AEs) in care settings is a patient safety concern that has significant consequences across healthcare systems. Patient safety problems have been well documented in acute care settings; however, similar data for clients in home care (HC) settings in Canada are limited. The purpose of this Canadian study...

Natural health products (NHP) are increasingly being used to supplement prescription medications (PM) and over-the-counter (OTC) products. The objective of this study was to examine patterns of overall health product use and how these patterns are associated with social and health factors. We used direct health measures data from the Canada Health...

The objectives of this study were to document the incidence rate and types of adverse events (AEs) among home care (HC) clients in Canada; identify factors contributing to these AEs; and determine to what extent evidence of completion of incident reports were documented in charts where AEs were found. This was a retrospective cohort study based on...

Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their rel...

Objective: To examine the associations of four distinct nursing care organizational models with patient safety outcomes. Design: Cross-sectional correlational study. Using a standardized protocol, patients' records were screened retrospectively to detect occurrences of patient safety-related events. Binary logistic regression was used to assess...

Over the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the d...

: This project describes the development and testing of the actual scope of nursing practice questionnaire. : Underutilization of the skill sets of registered nurses (RNs) is a widespread concern. Cost-effective, safe, and efficient care requires support by management to facilitate the implementation of nursing practice at the full scope. : Literat...

Antibiotic overuse and resistance have become a major threat in the last 2 decades. Many programs tried to optimize antibiotic consumption in the inpatient setting, but the outpatient environment that represents the bulk of antibiotic use has been challenging. Following a significant rise of Clostridium difficile infections, all the health care sta...

Is conformity to depression treatment guidelines associated with reduced health services costs? Aim: The objectives of this study were: (1) to assess the conformity of current treatment to the Canadian guidelines for pharmacological treatment of depression, (2) to determine whether there is a difference in costs of health care services by level of...

Background: Absenteeism among healthcare professionals constitutes a major threat to healthcare systems in Africa. However, underdeveloped information systems make it difficult to assess the problem and eventually act upon it. Objective: The objective of this study was to document the extent of absenteeism among healthcare professionals in Cameroon...

To document the opinions of the users of the Quebec Physicians Health Program (QPHP) about the services they received. Mailed questionnaire. Quebec. A total of 126 physicians who used QPHP services between 1999 and 2004. Users' overall rating of the QPHP services, their opinions about the program, and whether their situations improved as a result o...

Aim: The objectives of this study were: (1) to assess the conformity of current treatment to the Canadian guidelines for pharmacological treatment of depression, (2) to determine whether there is a difference in costs of health care services by level of conformity to guidelines and (3) to identify patients’ and treating physician characteristics th...

Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among home care clients. The purpose of this study was to assess the burden of safety problems among Canadian home care clients using data collected through the Resident Assessment Instrument - Home Care (RAI HC), and...

Healthcare-associated infections (HAIs) constitute a major safety problem. Healthcare managers need complete and valid information to fight against these infections. The purpose of this study was to develop a dashboard of indicators to help healthcare managers monitor HAIs. A pilot testing approach was used that was composed of the following steps:...

The objective of this cohort study is to describe the service utilization by clients of homeless resources in Quebec and Montreal (Canada) over a 5-year period. Participants (N = 426) were recruited from a survey conducted in 1999 about clients' utilization of resources intended for homeless people in Montreal and Quebec. Data analyzed in this stud...

Previous studies have concluded that there is significant variation in drug coverage across Canadian provinces because conventional measures of inter-rater reliability for formulary listings are low. We sought to investigate whether conventional methods are appropriate for formulary concordance measurement by testing the hypotheses that (a) convent...

The purpose of this study was to identify the nature of patient safety problems among Canadian homecare (HC) clients, using data collected through the RAI-HC((c)) assessment instrument. Problems of patient safety have been well documented in hospitals. However, we have very limited data about patient safety problems among HC clients. The study meth...

The aim of this study is to describe distinct typologies among mentally ill users of resources for homeless people, in order to inform the targeted development of mental health services to address their varied needs. Data came from a survey of clientele of resources for homeless persons in Montreal and Quebec (N = 757) and this study includes the 3...

The purpose of this paper is to compare predictors of receipt of recommended first-line pharmacotherapy in three generational cohorts of patients with new episode depression. This retrospective database cohort study included adolescent, adult and senior Quebec Public Prescription Drug Insurance Plan beneficiaries with new episode depression, who we...

With the perspective of Disability Creation Process (DCP), rehabilitation caring extends the definition of patient safety beyond physical aspects. Given that rehabilitation transforms the person holistically and solicits a humanistic approach from the caregiver, it seems inevitable that psychological, social, and spiritual standpoints must be consi...

The specific contribution of caring to patient safety has not been explicitly clarified in previous studies, particularly in rehabilitation. Considering the particular needs of patients in rehabilitation, it seems that a caring approach could have an important role in their safety. Inspired by the Quality-Caring Model of Duffy and Hoskins (2003), t...

A lack of participation by practitioners is thought to be a potential cause of the low utilization of evaluation results. Some authors suggest that the use of participatory evaluation can break down existing barriers and resistance by reinforcing interest, the willingness to participate and the propensity for evaluation. This article focuses on par...

The contribution of nurses’ caring approach to patient safety in a rehabilitation setting : an innovative study The specific contribution of caring to patient safety has not been explicitly clarified in previous studies, particularly in rehabilitation. Considering the particular needs of patients in rehabilitation, it seems that a caring approach c...

Background and Objectives: Nosocomial infections (infections acquired from healthcare services) constitute a major challenge for modern healthcare systems. Healthcare managers need complete and valid information to make the appropriate decisions to fight these infections. Unfortunately, this information is often scattered or simply lacking. The pur...

This study aims to analyze whether the interval from hospital admission to surgery may be used as a surrogate of the actual gap from fracture to surgery when investigating in-hospital hip fracture mortality. After analyzing 3,754 hip fracture admissions, we concluded that those intervals might be used interchangeably without misinterpretation bias....

Up to 50% of adverse events that occur in hospitals are preventable. Language barriers and disabilities that affect communication have been shown to decrease quality of care. We sought to assess whether communication problems are associated with an increased risk of preventable adverse events. We randomly selected 20 general hospitals in the provin...

Suboptimal medication treatment of asthma has been reported. More specifically, short-acting beta 2-agonists are overused, while inhaled corticosteroids are underused. This can be related in part to poor adherence by patients to the prescribed regimen and to professionals' failure to comply with practice guidelines. Feedback seems to have an effect...

The objective of this article was to evaluate the use of the Charlson comorbidity index (CCI) to predict inpatient death in Ribeirão Preto, São Paulo State, Brazil. 54,680 hospitalizations from January 1996 to December of 1997 were analyzed. Two International Classification of Diseases adaptations of CCI were compared, and the 30 clinical condition...

Background: The gold standard method to assess hospital adverse events (AEs) is retrospective chart review. A cheaper alternative is incident reports (IRs) routinely used by hospitals to note adverse outcomes or accidents experienced by patients. Yet little is known about the value of IRs to detect AEs. Objectives: To assess the proportion of AEs m...

To verify the validity of self-reported data on service use from clients with mental or substance abuse disorders in Montreal and Quebec services for homeless individuals. To compare the self-reported data from the Enquête chez les personnes itinérantes (Fournier, 2001) on health service use with official data from Quebec health services (MEDECHO a...

This study used Pescosolido's network episode model to examine mental health service utilization among impoverished people accessing resources for the homeless in Canada's universal health care setting. The sample consisted of 439 people who met DSM-IV criteria for affective or psychotic disorders who were assessed as part of a larger study of reso...

Although physiotherapists (PTs) are one of the health professionals most involved in the treatment of back pain, their practice patterns have not been well studied. The study objectives were to identify the practice patterns of PTs treating workers suffering from acute/subacute back pain, with and without radiating pain below the knee, and to asses...

Through a mail survey in 1991, we compared the opinions of 597 physicians practicing obstetrics, 723 maternity care nurses, and 70 midwives from the province of Quebec, Canada, about selected maternity care issues, including the practice of midwifery. Results showed that divergent points of view existed between and within the three groups on many m...

This study aimed to determine the associations between guideline-concordant pharmacotherapy for depression and the use of health services in the year following diagnosis. This population-based, retrospective cohort study examined Quebec drug plans between 1999 and 2002. We included beneficiaries aged 18 to 64 years who were newly diagnosed with an...

Objective This study aimed to determine the associations between guideline-concordant pharmacotherapy for depression and the use of health services in the year following diagnosis. Method This population-based, retrospective cohort study examined Quebec drug plans between 1999 and 2002. We included beneficiaries aged 18 to 64 years who were newly...

The objectives of the current study were: to compare the predictive capacity of the original Charlson comorbidity index (CCI), the CCI with new assigned diagnostic codes and estimated weights, and a new developed comorbidity index in a Brazilian population; and to study the effect of the number of comorbidity diseases recorded on the predictive cap...

To identify predictors of receiving psychoactive medication and receiving recommended first-line pharmacotherapy in individuals with newly diagnosed late-life depression. We undertook a retrospective database cohort study of 5258 beneficiaries of the Quebec provincial health insurance plan between 1999 and 2002. Subjects were aged 65 to 84 years an...

Physical therapy often is used in the management of work-related low back pain (LBP). Little information, however, is known about the types of interventions used by physical therapists in the management of this condition. The objective of this study was to describe the interventions used by physical therapists in the treatment of workers with acute...

The purpose of this study was to identify determinants of use of psychoactive medication and receipt of selective serotonin reuptake inhibitors (SSRIs) among adolescents with a diagnosis of new-onset depression. A population-based retrospective cohort study was conducted among 447 adolescents enrolled in the Quebec drug plan who had new episodes of...

Purpose: Physiotherapists often use continuing education (CE) courses to acquire new knowledge, but little is known about the types and combinations of CE courses attended. The objective of this study was to describe the CE “profiles” of physiotherapists who treat individuals with work-related back pain. Methods: Physiotherapists answered a self-ad...

Little is known about how physicians' knowledge of and attitudes to practice guidelines for stable angina may influence their implementation. To explore the association between physicians' demographics, their knowledge, and opinions about stable angina and their self-reported adherence to guideline recommendations. Questionnaire-based survey. We su...

La Loi canadienne sur la santé (LCS) a été promulguée en 1984 pour assurer que tous les Canadiens puissent bénéficier de services de santé en temps opportun et sans égard à leur situation financière, selon des principes d'accessibilité, d'intégralité, de transférabilité, d'universalité et de gestion publique. Au cours des dernières années, le manqu...

Research into adverse events (AEs) has highlighted the need to improve patient safety. AEs are unintended injuries or complications resulting in death, disability or prolonged hospital stay that arise from health care management. We estimated the incidence of AEs among patients in Canadian acute care hospitals. We randomly selected 1 teaching, 1 la...

Can we accept the statistics provided by the Ministry of Health, which uses large computerized databases? Through MEDECHO, the Ministry provides to hospital managers, reports cards on different interventions. These reports compare different hospitals performances. Surgeons involved in the process hesitate to accept this information. Using the resul...

Can we accept the statistics provided by the Ministry of Health, which uses large computerized databases? Through MEDECHO, the Ministry provides to hospital managers, reports cards on different interventions. These reports compare different hospitals performances. Surgeons involved in the process hesitate to accept this information. Using the resul...

Performance assessment in health services is essential. The comparison of performance indicators requires the use of risk adjustment strategies. The objective of this paper was to assess variations in clinical performance, measured by hospital mortality and length of stay, between private and public hospitals, while taking into account the hospital...

Public agencies responsible for implementing health care policies often adapt and disseminate clinical practice guidelines, but the effectiveness of mass dissemination of guidelines is unknown. Aim: To study the effects of guideline dissemination on physicians' prescribing practices for the treatment of stable angina pectoris. Randomized controlled...

A avaliação de desempenho dos serviços de saúde é essencial. A comparação de indicadores de desempenho requer o uso de estratégias de ajuste de risco. O objetivo deste artigo é avaliar variações no desempenho clínico, mensurado pela mortalidade e pelo tempo de permanência, entre hospitais públicos e privados, levando em conta diferenças nas caracte...

The purpose of this study was twofold: 1) to determine whether publicly funded mental health services and resources available in 4 large regions in the province of Quebec were distributed according to the mental health needs of children aged 6 to 14 years and 2) to assess whether the variations in mental health services and resources across the 4 r...

To evaluate the potential advantages and limitations of the use of the Brazilian hospital admission authorization forms database and the probabilistic record linkage methodology for the validation of reported utilization of hospital care services in household surveys. A total of 2,288 households interviews were conducted in the county of Duque de C...

There is good evidence for the use of antiplatelet, beta-blocker and lipid-lowering drugs in the treatment of ischaemic heart disease, but few data on how these medications are used in treating stable angina pectoris. We examined prescription profiles for a sample of patients aged > or =65 years with stable angina, to compare the profiles to local...