Whitney Berta

Whitney Berta
University of Toronto | U of T · Institute of Health Policy, Management and Evaluation

BSc, MBA, PhD

About

142
Publications
44,087
Reads
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3,360
Citations
Additional affiliations
February 2000 - present
University of Toronto
Position
  • Professor (Associate)

Publications

Publications (142)
Article
Background: Knowledge brokers (KB) are increasingly being employed in health care to implement evidence-based practice and improve quality of care. Middle managers (MMs) may play a KB role in the implementation of an innovative or evidence-based practice in hospitals. However, how MMs' broker knowledge in hospitals and their impact on practice has...
Article
Full-text available
Background Complex interventions are increasingly applied to healthcare problems. Understanding of post-implementation sustainment, sustainability, and spread of interventions is limited. We examine these phenomena for a complex quality improvement initiative led by care aides in 7 care homes (long-term care homes) in Manitoba, Canada. We report on...
Article
Full-text available
Background Nursing home residents require daily support. While care aides provide most of this support they are rarely empowered to lead quality improvement (QI) initiatives. Researchers have shown that care aide-led teams can successfully participate in a QI intervention called Safer Care for Older Persons in Residential Care Environments (SCOPE)....
Article
Full-text available
Improving Nursing Home Care Through Feedback On perfoRMance Data (INFORM) was a complex, theory-based, three-arm, parallel cluster-randomized trial. In 2015–2016, we successfully implemented two theory-based feedback strategies (compared to a standard approach to feedback) to increase nursing home (NH) care aides’ involvement in formal communicatio...
Article
Full-text available
Understanding of intervention sustainability processes is limited. Failure to sustain evidence-based innovations means that intended improvements are short-lived, scale-up and spread are unlikely, and real losses are incurred on research investments. We explored the sustainability of a health care aide (HCA)-led quality improvement (QI) initiative,...
Article
Full-text available
Our understanding of the post-implementation sustainment, sustainability, and spread (SSS) of complex quality improvement interventions is limited. We explored factors that influenced the SSS of a care aide-led quality improvement initiative (Safer Care for Older Persons (in residential) Environments [SCOPE]) implemented in 6 Manitoba long-term car...
Article
Full-text available
Background Numerous studies have examined the efficacy and effectiveness of health services interventions. However, much less research is available on the sustainability of study outcomes. The purpose of this study was to assess the lasting benefits of INFORM (Improving Nursing Home Care Through Feedback On perfoRMance data) and associated factors...
Article
Full-text available
Background Communities represent a highly relevant source of knowledge with regard to not only healthcare performance but also sociocultural context, yet their role in learning health systems has not been studied. Situating the learning health system as an organization, this paper explores the phenomenon of organizational learning from or with comm...
Preprint
Full-text available
Background: Nursing home residents require daily support. While care aides provide most of this support they are rarely empowered to lead quality improvement (QI) initiatives. A previous proof of principle study, called Safer Care for Older Persons in Residential Care Environments (SCOPE), demonstrated that care aide-led teams can successfully part...
Article
Full-text available
Background As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of ser...
Article
Background The context of care provided in long‐term care homes is changing, as an increasing number of older adults are entering long‐term care with advance stages of illness and higher care needs. Long‐term care homes are quickly becoming the place of death for an increasing number of older adults, despite recent literature identifying inadequate...
Article
Full-text available
Communities of practice (CoPs) are groups of people who work together on an ongoing basis and share knowledge and expertise. CoPs exist both within and outside of organizations, although extra-organizational CoPs have received less evaluation attention. The primary objective of this study was to assess the applicability of a multi-level, multiple v...
Article
Full-text available
Background Clinical guidelines informed by patient preferences are more likely to be used and widely advocated, yet research shows that few guidelines reflect patient preferences. Objective Explore how developers generate guidelines informed by patient preferences. Patient Involvement Seventeen patients were involved as interview participants. M...
Article
Full-text available
Background Clinical guidelines optimize care delivery and outcomes. Guidelines support patient engagement and adherence if they reflect patient preferences for treatment options, risks and benefits. Many guidelines do not address patient preferences. Developers require insight on how to develop such guidelines. Objective To conduct a scoping revie...
Chapter
This chapter analyses the labour market for Personal Support Workers (PSWs). It focuses on Canada as an illustrative case. The literature suggests that, while it is helpful to consider the PSW labour market as a whole from a neo-Weberian perspective, it is better thought of as a series of sub-markets – comprising the hospital, long-term care, and h...
Article
Full-text available
This article examines provincial policy influence on long-term care (LTC) professionals’ advice-seeking networks in Canada’s Maritime provinces. The effects of facility ownership, geography, and region-specific political landscapes on LTC best-practice dissemination are examined. We used sociometric statistics and network sociograms, calculated fro...
Article
Full-text available
Background: Integrated knowledge translation refers to researcher and research user partnerships to co-generate and implement knowledge. This type of partnership may be critical to success in increasing knowledge use and impact, but the conceptualisation of its initiation has not been fully developed. Initiating this type of partnership has proven...
Article
Full-text available
Background: This review of scholarly work in health care knowledge translation advances understanding of implementation components that support the complete and timely integration of new knowledge. We adopt a realist approach to investigate what is known from the current literature about the impact of, and the potential relationships between, cont...
Article
Full-text available
Deceased-donor renal transplant (DDRT) is an expensive and potentially risky health intervention with the prospect of improved life and lower long-term costs compared with dialysis. Due to the increasing shortage of kidneys and the associated rise of transplantation costs, certain patient groups may not benefit from transplantation in a cost-effect...
Article
As recent policy reports in Ontario and elsewhere have emphasized, most older persons would prefer to age at home. This desire does not diminish for the growing numbers of persons living with dementia (PLWD). Nevertheless, many PLWD end up in residential long-term care (LTC) or in hospital beds. While LTC is valuable for PLWD with highly progressed...
Article
Full-text available
Background: Implementation scientists and practitioners, alike, recognize the importance of sustaining practice change, however post-implementation studies of interventions are rare. This is a protocol for the Sustainment, Sustainability and Spread Study (SSaSSy). The purpose of this study is to contribute to knowledge on the sustainment (sustaine...
Article
It is well established in research, practice, and policy that unpaid caregivers (family and friends of people with care needs) experience stress in their role. Supports that have been put in place by policy planners and program developers to support caregivers may not be accessed by caregivers at all or may do little to reduce their stress. Accessi...
Preprint
Background As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums seek bridge the “di...
Article
Full-text available
Background: Health care researcher-research user partnerships, referred to as integrated knowledge translation (IKT), have been adopted on an international basis, and are an effective means of co-generating and implementing evidence into policy and practice. Prior research suggests that an initiation period is essential for establishing functional...
Preprint
Full-text available
Background: As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care...
Preprint
Full-text available
Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of se...
Preprint
Full-text available
Background: As demand and desire to “age-in-place” grows within an aging population, and new areas of need emerge, governments nationally and internationally are focusing effort and attention on innovative and integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of se...
Article
Full-text available
Background We report on the impact of two system-level policy interventions (the Long-Term Care Homes Act [LTCHA] and Public Reporting) on publicly reported physical restraint use and non-publicly reported potentially inappropriate use of antipsychotics in Ontario, Canada. Methods We used interrupted time series analysis to model changes in the ri...
Article
To ensure a safe transition of mental health patients from hospital to community settings, greater attention is being given to discharge planning. However, assessing the quality of discharge planning has been challenging due to wide variations in its definition. To facilitate evaluation of discharge planning, its meaning in the mental health litera...
Article
Full-text available
Health care organizations are leveraging machine-learning techniques, such as artificial neural networks (ANN), to improve delivery of care at a reduced cost. Applications of ANN to diagnosis are well-known; however, ANN are increasingly used to inform health care management decisions. We provide a seminal review of the applications of ANN to healt...
Data
Summary of findings. (PDF)
Data
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. (PDF)
Data
Search strategy and syntax. (PDF)
Data
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. (PDF)
Article
Full-text available
Background Interpersonal relationships among professionals drive both the adoption and rejection of consequential innovations. Through relationships, decision-makers learn which colleagues are choosing to adopt innovations, and why. The purpose of our study was to understand how and why long-term care (LTC) leaders in a pan-Canadian interpersonal n...
Article
Background Increasing demands on health care systems require patients to take on more active roles in their health. Effective self‐management has been linked to improved health outcomes, and evidence shows that effective self‐management is linked to health literacy (HL). HL is an important predictor of successful self‐management in other chronic di...
Article
Full-text available
Background: Interest in public involvement in health research projects has led to increased attention on the coordination of public involvement through research organisations, networks and whole systems. We draw on previous work using the 'health research system' framework to explore organisational actors and stewardship functions relevant to gove...
Article
Full-text available
Background: Growing interest in public involvement in health research has led to organisational and policy change. Additionally, an emerging body of policy-oriented scholarship has begun to identify the organisational and network arrangements that shape public involvement activity. Such developments suggest the need to clearly conceptualise and ch...
Article
Background: Despite emerging frameworks for quality improvement (QI) implementation, little is known about how the implementation process works, particularly in nursing home settings. A study was conducted to describe "how"' a complex frontline worker-led QI program was implemented in nursing homes. Methods: Six focus groups were conducted in Fe...
Article
Purpose The purpose of this paper is to examine how the design and implementation of learning models for performance management can foster continuous learning and quality improvement within a publicly funded, multi-site community hospital organization. Design/methodology/approach Niagara Health’s patient flow performance management system, a lea...
Article
Full-text available
Background: Our overarching study objective is to further our understanding of the work psychology of Health Support Workers (HSWs) in long-term care and home and community care settings in Ontario, Canada. Specifically, we seek novel insights about the relationships among aspects of these workers' work environments, their work attitudes, and work...
Article
Full-text available
Background: Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. Main text: A seminar series on syste...
Article
Background: Turnover in healthcare is a serious concern, as it is contributes to the global nursing shortage and is associated with declines in quality of care, patient safety, and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. Purpose: The purpose of this study is to increase under...
Article
Setting priorities for health services is a complex and value laden process. Over the past twenty years, there has been considerable scholarly attention paid to strengthening fairness and legitimacy using the prominent ethical framework, Accountability for Reasonableness (A4R). A variety of case studies applying A4R have advanced our conceptual und...
Article
Although it has long been recognized that employees' workplace affective commitment can be directed at a variety of foci, theory and research on this multifocal perspective remain underdeveloped, possibly due to the lack of a short, yet comprehensive measure. The purpose of the present study was to assess the psychometric properties of a newly deve...
Article
Health Support Workers (HSWs) provide up to 80% of care to residents and clients in the long-term care (LTC) and home and community care (HCC) sectors but have received little research attention compared with the regulated professions. The authors explore similarities and differences in the work psychology of HSWs employed in LTC and HCC settings....
Article
Full-text available
Background The past fifteen years have been marked by large-scale change efforts undertaken by healthcare organizations to improve patient safety and patient-centered care. Despite substantial investment of effort and resources, many of these large-scale or “radical change” initiatives, like those in other industries, have enjoyed limited success –...
Article
RÉSUMÉ Cet article examine les facteurs associés à l’inscription sur une liste d’attente pour une place en établissements de soins de longue durée en Ontario (Canada). L’analyse a été réalisée à partir de données collectées avec l’Instrument d’évaluation des résidents - Services à domicile (RAI-HC) dans le Réseau local d’intégration des services de...
Article
Full-text available
The Advice Seeking Networks in Long Term Care Study used social network analysis to understand the informal advice networks of senior leaders in Canadian long term care (LTC), with the goal of using this knowledge to inform future efforts to more effectively disseminate quality improvement innovations. In this abstract we describe one main componen...
Article
The Advice Seeking Networks in Long Term Care Study used social network analysis to understand the informal advice networks of senior leaders in Canadian long term care (LTC), with the goal of using this knowledge to inform future efforts to more effectively disseminate quality improvement innovations. In this abstract we describe one main componen...
Article
Purpose Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new sur...
Article
Full-text available
Background Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada’s long-term care sec...
Article
Background: Work attitudes have been associated with work productivity. In health care, poor work attitudes have been linked to poor performance, decreased patient safety, and quality care. Hence, the importance, ascribed in the literature, of work that clearly identifies the relationships between and among work attitudes and work behaviors linked...
Article
Identifying how nursing care directly affects patients is essential to improving care quality, reducing costs, and determining nursingʼs contribution to overall organizational performance. This scoping review examined methods used for developing nursing process health care indicators. Key concepts and sources of evidence were identified to lay a fo...
Article
As recent policy reports in Ontario and elsewhere have emphasized, most older persons would prefer to age at home. This desire does not diminish for the growing numbers of persons living with dementia (PLWD). Nevertheless, many PLWD end up in residential long-term care (LTC) or in hospital beds. While LTC is valuable for PLWD with highly progressed...
Article
Our commentators have emphasized three crucial issues which we think align and reinforce the key strategic pillars that we have identified as guides to the development of dementia strategies. First - how we conceive dementia matters: broader conceptualizations, which move beyond dementia as an illness, to dementia as a social responsibility and mat...
Article
Health literate discharge practices meet the health literacy needs of patients and families at the time of hospital discharge and are associated with improved patient outcomes and reduced readmission. A Delphi panel consisting of nurses, other health care providers, and researchers was used to develop a set of indicators of health literate discharg...
Article
Aim: The aim of this scoping literature review was to examine and summarize the factors, context, and processes that influence work motivation of health care workers. Methods: A scoping literature review was done to answer the question: What is known from the existing empirical literature about factors, context, and processes that influence work...