How to Work Collaboratively Within the Health System: Workshop Summary and Facilitator Reflection

Effectiveness in health services research requires development of specific knowledge and skills for working in partnership with health system decision-makers. In an initial effort to frame capacity-building activities for researchers, we designed a workshop on working collaboratively within the health system. The workshop, based on recent research exploring health system experience and perspectives on research collaborations, was trialed at the annual Canadian Health Services and Policy Research (CAHSPR) conference in May 2019. Participants reported positive evaluations of the workshop. However, further efforts should target health services researchers that may not be as motivated to develop skills in collaborative research. Additional attention to equipping researchers with the skills needed to work in partnerships is recommended, including approaches and materials that avoid oversimplification of complex challenges

Beyond “Two Cultures”: Guidance for Establishing Effective Researcher/Health System Partnerships

Background: The current literature proposing criteria and guidelines for collaborative health system research often fails to differentiate between: (a) various types of partnerships, (b) collaborations formed for the specific purpose of developing a research proposal and those based on long-standing relationships, (c) researcher vs. decision-maker initiatives, and (d) the underlying drivers for the collaboration. Methods: Qualitative interviews were conducted with 16 decision-makers and researchers who partnered on a Canadian major peer-reviewed grant proposal in 2013. Objectives of this exploration of participants’ experiences with health system research collaboration were to: (a) explore perspectives and experience with research collaboration in general; (b) identify characteristics and strategies associated with effective partnerships; and (c) provide guidance for development of effective research partnerships. Interviews were audio-recorded and transcribed: transcripts were qualitatively analyzed using a general inductive approach. Results: Findings suggest that the common “two cultures” approach to research/decision-maker collaboration provides an inadequate framework for understanding the complexity of research partnerships. Many commonlyidentified challenges to researcher/knowledge user (KU) collaboration are experienced as manageable by experienced research teams. Additional challenges (past experience with research and researchers; issues arising from previous collaboration; and health system dynamics) may be experienced in partnerships based on existing collaborations, and interact with partnership demands of time and communication. Current research practice may discourage KUs from engaging in collaborative research, in spite of strong beliefs in its potential benefits. Practical suggestions for supporting collaborations designed to respond to real-time health system challenges were identified

Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to “Re-imagine” Research

Background: Emerging evidence that meaningful relationships with knowledge users are a key predictor of research use has led to promotion of partnership approaches to health research. However, little is known about health system experiences of collaborations with university-based researchers, particularly with research partnerships in the area of health system design and health service organization. The purpose of the study was to explore the experience and perspectives of senior health managers in health service organizations, with health organization-university research partnerships. Methods: In-depth, semi-structured interviews (n = 25) were conducted with senior health personnel across Canada to explore their perspectives on health system research; experiences with health organization-university research partnerships; challenges to partnership research; and suggested actions for improving engagement with knowledge users and promoting research utilization. Participants, recruited from organizations with regional responsibilities, were responsible for system-wide planning and support functions. Results: Research is often experienced as unhelpful or irrelevant to decision-making by many within the system. Research, quality improvement (QI) and evaluation are often viewed as separate activities and coordinated by different responsibility areas. Perspectives of senior managers on barriers to partnership differed from those identified in the literature: organizational stress and restructuring, and limitations in readiness of researchers to work in the fast-paced healthcare environment, were identified as major barriers. Although the need for strong executive leadership was emphasized, “multi-system action” is needed for effective partnerships. Conclusion: Common approaches to research and knowledge translation are often not appropriate for addressing issues of health service design and health services organization. Nor is the research community providing expertise to many important activities that the healthcare system is taking to improve health services. A radical rethinking of how we prepare health service researchers; position research within the health system; and fund research activities and infrastructure is needed if the potential benefits of research are to be achieved. Lack of response to health system needs may contribute to research and ‘evidence-informed’ practice being further marginalized from healthcare operations. Interventions to address barriers must respond to the perspectives and experience of health leadership

"Getting a Grand Falls Job" : migration, labour markets, and paid domestic work in the pulp and paper mill town of Grand Falls, Newfoundland, 1905-1939

While it has been generally understood that domestic service was an institution of particular importance to working-class women and to middle-class householders in North America in the late 19th and early 20th centuries, we still know little about the interwar years, a period during which the occupation declined in overall importance, but still defined many women's working lives. In the 1920s and 1930s, a vast majority of women who grew up in Newfoundland's coastal communities, where household production and the family fishery remained the mainstay of the economy, spent part of their lives performing domestic tasks for pay. -- To begin to understand the historical and cultural significance of domestic service to women's lives in Newfoundland, this dissertation uses a case-study approach. It focuses on the pulp and paper mill town of Grand Falls, where there was a steady demand for domestics by mill workers and their families, the town's elite, and hotels and boarding houses during the 1920s and 1930s. One of a number of single-resource towns supported by Newfoundland's economic diversification policies of the late 19th and early 20th centuries, Grand Falls was built in the interior of the island by the Harmsworth brothers of Britain in 1905. By tracing domestics' lives and experiences from countryside to company town, into the household--as workplace--and then into their married lives, the study explores themes relating to the gendered nature of uneven development. For instance, many Grand Falls employers shared much in common with the women they hired, in terms of religion, ethnicity and social origin, which raises interesting questions about the gender and class dimensions of an employer/employee relationship that has traditionally been characterized as one of domination and subordination. It also considers that relations of gender and class within the company town were formed in conjunction with factors such as migration patterns, pre-existing concepts of the gender division of labour within household production, company paternalism, and social stratification within the workplace, the household and the town. The ways in which these factors overlapped and shaped the lives of domestics forms the backdrop of this study

Bennett, Myra

The Myra Bennett collection consists of papers both personal and professional that relate to her life as a nurse and midwife in the community of Daniel's Harbour and includes correspondence, biographical material, diares and journals.