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Dive into the research topics where Liane Ginsburg is active.

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Featured researches published by Liane Ginsburg.


Journal of Interprofessional Care | 2005

New approaches to interprofessional education and collaborative practice: lessons from the organizational change literature.

Liane Ginsburg; Deborah Tregunno

This paper highlights a variety of issues from the organizational change literature that are especially relevant to the implementation of initiatives in interprofessional education (IPE) for collaborative practice (CP). At the level of the individual, these include the existence of strong professional cultures and the need to motivate change. At the level of the organization, context and leadership for IPE and CP are relevant. At the system level, a discussion of incremental versus radical forces for change is particularly germane. Drawing on relevant theoretical and empirical literature, we address each of these three domains and highlight lessons learned from the study of organizational change to the implementation and adoption of IPE and CP. The paper concludes with a set of key recommendations suggested for reducing the incidence of implementation failure.


Health Services Research | 2009

Advancing Measurement of Patient Safety Culture

Liane Ginsburg; Debra Gilin; Deborah Tregunno; Peter G. Norton; W. Ward Flemons; Mark D. Fleming

OBJECTIVE To examine the psychometric and unit of analysis/strength of culture issues in patient safety culture (PSC) measurement. DATA SOURCE Two cross-sectional surveys of health care staff in 10 Canadian health care organizations totaling 11,586 respondents. STUDY DESIGN A cross-validation study of a measure of PSC using survey data gathered using the Modified Stanford PSC survey (MSI-2005 and MSI-2006); a within-group agreement analysis of MSI-2006 data. Extraction Methods. Exploratory factor analyses (EFA) of the MSI-05 survey data and confirmatory factor analysis (CFA) of the MSI-06 survey data; Rwg coefficients of homogeneity were calculated for 37 units and six organizations in the MSI-06 data set to examine within-group agreement. PRINCIPAL FINDINGS The CFA did not yield acceptable levels of fit. EFA and reliability analysis of MSI-06 data suggest two reliable dimensions of PSC: Organization leadership for safety (alpha=0.88) and Unit leadership for safety (alpha=0.81). Within-group agreement analysis shows stronger within-unit agreement than within-organization agreement on assessed PSC dimensions. CONCLUSIONS The field of PSC measurement has not been able to meet strict requirements for sound measurement using conventional approaches of CFA. Additional work is needed to identify and soundly measure key dimensions of PSC. The field would also benefit from further attention to strength of culture/unit of analysis issues.


Health Services Research | 2010

The Relationship between Organizational Leadership for Safety and Learning from Patient Safety Events

Liane Ginsburg; You-Ta Chuang; Whitney Berta; Peter G. Norton; Peggy Ng; Deborah Tregunno; Julia Richardson

OBJECTIVE To examine the relationship between organizational leadership for patient safety and five types of learning from patient safety events (PSEs). STUDY SETTING Forty-nine general acute care hospitals in Ontario, Canada. STUDY DESIGN A nonexperimental design using cross-sectional surveys of hospital patient safety officers (PSOs) and patient care managers (PCMs). PSOs provided data on organization-level learning from (a) minor events, (b) moderate events, (c) major near misses, (d) major event analysis, and (e) major event dissemination/communication. PCMs provided data on organizational leadership (formal and informal) for patient safety. EXTRACTION METHODS Hospitals were the unit of analysis. Seemingly unrelated regression was used to examine the influence of formal and informal leadership for safety on the five types of learning from PSEs. The interaction between leadership and hospital size was also examined. PRINCIPAL FINDINGS Formal organizational leadership for patient safety is an important predictor of learning from minor, moderate, and major near-miss events, and major event dissemination. This relationship is significantly stronger for small hospitals (<100 beds). CONCLUSIONS We find support for the relationship between patient safety leadership and patient safety behaviors such as learning from safety events. Formal leadership support for safety is of particular importance in small organizations where the economic burden of safety programs is disproportionately large and formal leadership is closer to the front lines.


Implementation Science | 2007

Revisiting interaction in knowledge translation

Liane Ginsburg; Steven Lewis; Lisa Zackheim; Ann Casebeer

BackgroundAlthough the study of research utilization is not new, there has been increased emphasis on the topic over the recent past. Science push models that are researcher driven and controlled and demand pull models emphasizing users/decision-maker interests have largely been abandoned in favour of more interactive models that emphasize linkages between researchers and decisionmakers. However, despite these and other theoretical and empirical advances in the area of research utilization, there remains a fundamental gap between the generation of research findings and the application of those findings in practice.MethodsUsing a case approach, the current study looks at the impact of one particular interaction approach to research translation used by a Canadian funding agency.ResultsResults suggest there may be certain conditions under which different levels of decisionmaker involvement in research will be more or less effective. Four attributes are illuminated by the current case study: stakeholder diversity, addressability/actionability of results, finality of study design and methodology, and politicization of results. Future research could test whether these or other variables can be used to specify some of the conditions under which different approaches to interaction in knowledge translation are likely to facilitate research utilization.ConclusionThis work suggests that the efficacy of interaction approaches to research translation may be more limited than current theory proposes and underscores the need for more completely specified models of research utilization that can help address the slow pace of change in this area.


Health Care Management Review | 2007

Learning from preventable adverse events in health care organizations: development of a multilevel model of learning and propositions.

You-Ta Chuang; Liane Ginsburg; Whitney Berta

Background: Preventable adverse events represent learning opportunities. Indeed, understanding and learning from preventable adverse events are the new organizational imperatives in health care. However, health services researchers note that there is a dearth of research on learning from failure in health care and, in industry, a limited capacity to learn from incidents and failure. Purpose: We address the gap between awareness of preventable adverse events and knowledge that relates to how to respond to them effectively. We develop a multilevel model of learning and theorize factors that influence learning from preventable adverse events. Methodology: Drawing upon theories of organizational learning and organizational behavior, we develop a multilevel model of learning from failure, where perceived characteristics of the events, group composition and dynamics, and the behavioral and structural arrangements of health care organizations are proposed to play important roles. Practical Implications: Our model highlights factors that facilitate learning from failure and others that impede it. Awareness and attention to these factors can help health care managers extract learning from failures, like preventable adverse events, and may ultimately contribute to reducing the occurrence of preventable adverse events and improving quality of care.


BMJ Quality & Safety | 2013

Self-reported patient safety competence among new graduates in medicine, nursing and pharmacy

Liane Ginsburg; Deborah Tregunno; Peter G. Norton

Background As efforts to address patient safety (PS) in health professional (HP) education increase, it is important to understand new HPs’ perspectives on their own PS competence at entry to practice. This study examines the self-reported PS competence of newly registered nurses, pharmacists and physicians. Methods A cross-sectional survey of 4496 new graduates in medicine (1779), nursing (2196) and pharmacy (521) using the HP Education in PS Survey (H-PEPSS). The H-PEPSS measures HPs’ self-reported PS competence on six socio-cultural dimensions of PS, including culture, teamwork, communication, managing risk, responding to risk and understanding human factors. The H-PEPSS asks about confidence in PS learning in classroom and clinical settings. Results All HP groups reported feeling more confident in the dimension of PS learning related to effective communication with patients and other providers. Greater confidence in PS learning was reported for learning experiences in the clinical setting compared with the class setting with one exception—nurses’ confidence in learning about working in teams with other HPs deteriorated as they moved from thinking about learning in the classroom setting to thinking about learning in the clinical setting. Conclusions Large-scale efforts are required to more deeply and consistently embed PS learning into HP education. However, efforts to embed PS learning in HP education seem to be hampered by deficiencies that persist in the culture of the clinical training environments in which we educate and acculturate new HPs.


Implementation Science | 2015

Does organizational context influence the use of best practices by healthcare aides in residential long term care

Carole A. Estabrooks; Janet E. Squires; Leslie A. Hayduk; Debra Morgan; Greta G. Cummings; Liane Ginsburg; Peter G. Norton

Knowledge translation researchers in the last decade have seen a torrent of publications arguing for the central importance of organizational context in influencing implementation success. The Translating Research in Elder Care (TREC) program investigates the role of organizational context on the use of best practices, provider and resident outcomes in residential long-term care facilities (nursing homes) in three western Canadian provinces. The purpose of this presentation is to present findings from our study examining the influence of organizational context on the use of best practices by healthcare aides.


BMJ Quality & Safety | 2014

‘Not another safety culture survey’: using the Canadian patient safety climate survey (Can-PSCS) to measure provider perceptions of PSC across health settings

Liane Ginsburg; Deborah Tregunno; Peter G. Norton; Jonathan I Mitchell; Heather Howley

Background The importance of a strong safety culture for enhancing patient safety has been stated for over a decade in healthcare. However, this complex construct continues to face definitional and measurement challenges. Continuing improvements in the measurement of this construct are necessary for enhancing the utility of patient safety climate surveys (PSCS) in research and in practice. This study examines the revised Canadian PSCS (Can-PSCS) for use across a range of care settings. Methods Confirmatory factor analytical approaches are used to extensively test the Can-PSCS. Initial and cross-validation samples include 13 126 and 6324 direct care providers from 119 and 35 health settings across Canada, respectively. Results Results support a parsimonious model of direct care provider perceptions of patient safety climate (PSC) with 19 items in six dimensions: (1) organisational leadership support for safety; (2) incident follow-up; (3) supervisory leadership for safety; (4) unit learning culture; (5) enabling open communication I: judgement-free environment; (6) enabling open communication II: job repercussions of error. Results also support the validity of the Can-PSCS across a range of care settings. Conclusions The Can-PSCS has several advantages: (1) it is a theory-based instrument with a small number of actionable dimensions central to the construct of PSC; (2) it has robust psychometric properties; (3) it is validated for use across a range of care settings, therefore suitable for use in regionalised health delivery systems and can help to raise expectations about acceptable levels of PSC across the system; (4) it has been tested in a publicly funded universal health insurance system and may be suitable for similar international systems.


BMJ Quality & Safety | 2015

Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey

Patricia Doyle; Elizabeth G. VanDenKerkhof; Dana Edge; Liane Ginsburg; David H. Goldstein

Background Quality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees. Methods The Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012. PS dimension scores were compared across learning settings (classroom and clinical) and year in programme. Results Sixty-three percent (255/406) of medical students and 32% (141/436) of postgraduate trainees responded. In general, both groups were most confident in their learning of clinical safety skills (eg, hand hygiene) and least confident in learning about sociocultural aspects of safety (eg, understanding human factors). Medical students’ confidence in most aspects of safety improved with years of training. For some of the more intangible dimensions (teamwork and culture), medical students in their final year had lower scores than students in earlier years. Thirty-eight percent of medical students felt they could approach someone engaging in unsafe practice, and the majority of medical students (85%) and postgraduate trainees (78%) agreed it was difficult to question authority. Conclusions Our results suggest the need to improve the overall content, structure and integration of PS concepts in both classroom and clinical learning environments. Decreased confidence in sociocultural aspects of PS among medical students in the final year of training may indicate that culture in clinical settings negatively affects students’ perceived PS competence. Alternatively, as medical students spend more time in the clinical setting, they may develop a clearer sense of what they do not know.


BMC Health Services Research | 2015

Understanding nurses’ and physicians’ fear of repercussions for reporting errors: clinician characteristics, organization demographics, or leadership factors?

Evan S. Castel; Liane Ginsburg; Shahram Zaheer; Hala Tamim

BackgroundIdentifying and understanding factors influencing fear of repercussions for reporting and discussing medical errors in nurses and physicians remains an important area of inquiry. Work is needed to disentangle the role of clinician characteristics from those of the organization-level and unit-level safety environments in which these clinicians work and learn, as well as probing the differing reporting behaviours of nurses and physicians. This study examines the influence of clinician demographics (age, gender, and tenure), organization demographics (teaching status, location of care, and province) and leadership factors (organization and unit leadership support for safety) on fear of repercussions, and does so for nurses and physicians separately.MethodsA cross-sectional analysis of 2319 nurse and 386 physician responders from three Canadian provinces to the Modified Stanford patient safety climate survey (MSI-06). Data were analyzed using exploratory factor analysis, multiple linear regression, and hierarchical linear regression.ResultsAge, gender, tenure, teaching status, and province were not significantly associated with fear of repercussions for nurses or physicians. Mental health nurses had poorer fear responses than their peers outside of these areas, as did community physicians. Strong organization and unit leadership support for safety explained the most variance in fear for both nurses and physicians.ConclusionsThe absence of associations between several plausible factors including age, tenure and teaching status suggests that fear is a complex construct requiring more study. Substantially differing fear responses across locations of care indicate areas where interventions may be needed. In addition, since factors affecting fear of repercussions appear to be different for nurses and physicians, tailoring patient safety initiatives to each group may, in some instances, be fruitful. Although further investigation is needed to examine these and other factors in detail, supportive safety leadership appears to be central to reducing fear of reporting errors for both nurses and physicians.

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