Information Technology Sophistication in Hospitals: A Field Study in Quebec

The Quebec health sector has been experiencing a period of great turmoil over the last five years. Among other institutions, hospitals are faced with huge pressures from government funding cuts. Several empirical studies in the information systems field have shown that the use of computer-based information systems could have positive impacts on organizational performance. Many agree to say that health care institutions are no exceptions. But if one wishes to identify the effects of IT on the delivery of care, one must be able to characterize IT for operationalization purposes. The objective of this research project is twofold. Our first aim consists in developing and validating a measurement instrument of IT sophistication in hospitals. Such instrument should provide hospital managers with a diagnostic tool capable of indicating the profile of their respective institutions in regard to IT use and comparing this profile to those of other similar health institutions. In this line of thought, our second objective consists in presenting the IT sophistication profile of Quebec hospitals. Le secteur de la santé au Québec vit à l'heure des grands bouleversements. Plusieurs s'entendent à dire que les hôpitaux n'ont d'autre alternative que de faire appel aux technologies de pointe afin d'assurer un niveau de qualité des soins adéquat tout en minimisant les coûts associés à ces mêmes soins. Or, si l'on veut identifier les effets de la TI sur la performance des hôpitaux, il faut être capable de définir cette TI en tant que construit et caractériser cette dernière dans un but d'opérationalisation en tant que variable indépendante, dépendante ou modératrice dans un cadre conceptuel de recherche. Cette étude vise deux objectifs particuliers. Le premier consiste à développer un questionnaire mesurant le degré de sophistication des TI en milieu hospitalier et à le valider auprès de la population des hôpitaux québécois. Notre second objectif est de présenter, de façon sommaire, le profil des hôpitaux du Québec en matière de sophistication des TI.IT sophistication, measurement instrument, hospital information systems, Sophistication des TI, instrument de mesure, SI en milieu hospitalier

Positionnement multidimensionnel concepts, théories et applications

Le positionnement multidimensionnel permet d'estimer les coordonnées d'un ensemble d'objets dans un espace de dimension spécifiée. Ce travail se fait à l'aide de distances, de similarités ou de préférences basées sur les jugements des répondants. Ce mémoire décrit diverses méthodes n'utilisant que des données de distances ou de similarités (dissimilarités). Ces méthodes sont détaillées à l'aide d'exemples mettant en pratique la théorie. De plus, une section est réservée aux programmes informatiques spécialisés dans ce domaine de l'analyse de données. Une attention particulière est faite sur le programme ALSCAL provenant du logiciel SPSS

Les expériences vécues par les enfants de Duplessis institutionnalisés : les conséquences après plus de 50 ans

Dans cet article, les auteurs présentent les résultats qualitatifs recueillis à partir de questionnaires et d’entrevues semi-structurées destinés à documenter les expériences tant actuelles que passées des enfants de Duplessis institutionnalisés (EDI). Des exemples typiques et deux cas représentatifs sont présentés. Les résultats indiquent que les abus et la négligence subis par les EDI pendant l’enfance ont compromis leur ajustement psychosocial à long terme. Ils révèlent aussi que les EDI qui ont rapporté au moins quatre forces pendant leur enfance étaient plus susceptibles d’être protégés à l’âge adulte contre les effets négatifs de leur placement.In this article, the authors present qualitative results, derived from questionnaires and semi-structured interviews, to describe past and present experiences of the Duplessis children. Examples representative of their experience and a detailed description of two cases are provided. Results indicate that childhood abuse and negligence are related to poorer long-term psychological adjustment. The findings also demonstrate that reporting at least four strengths in childhood can have long-term protective effects.En este artículo, los autores presentan los resultados cualitativos recopilados a partir de cuestionarios y entrevistas semiestructuradas destinadas a documentar las experiencias, tanto recientes como pasadas, de los niños de Duplessis que fueron institucionalizados (EDI). Se presentan ejemplos típicos y dos casos representativos. Los resultados indican que los abusos y la negligencia sufridos por los EDI durante la infancia han comprometido su ajuste psicosocial a largo plazo. También revelan que los EDI que han reportado al menos cuatro fuerzas durante su infancia eran más susceptibles de estar protegidos en la edad adulta contra los efectos negativos de su colocación.Neste artigo, os autores apresentam os resultados qualitativos coletados a partir de questionários e entrevistas semi-estruturadas destinados a documentar as experiências tanto atuais quanto passadas das crianças de Duplessis institucionalizadas (CDI). São apresentados exemplos típicos e dois casos representativos. Os resultados indicam que os abusos e a negligência sofridos pelas CDI durante a infância comprometeram seu ajuste psicossocial a longo prazo. Eles revelam também que as CDI que relataram, pelo menos, quatro aspectos positivos durante sua infância eram mais susceptíveis de ser protegidas durante a idade adulta contra os efeitos negativos de sua internação

Répercussions d’une enfance vécue en institution : le cas des Enfants de Duplessis

Les conséquences négatives d’un placement en institution sur les enfants ont été documentées, mais aucune étude n’a porté sur les orphelins et les enfants placés une fois devenus adultes. Au Québec, les Enfants de Duplessis offrent un témoignage poignant des répercussions à long terme d’une enfance vécue en institution. Les histoires recueillies auprès de 40 hommes et 41 femmes ayant grandi en institution à l’époque de Duplessis font état d’un nombre élevé d’abus et d’expériences adverses, incluant les agressions physiques, psychologiques et sexuelles. Le milieu était peu stimulant et offrait peu d’opportunités de développer des relations d’attachement positives et significatives. Lorsqu’ils sont appariés et comparés à des adultes provenant de l’enquête Santé-Québec, les Enfants de Duplessis devenus adultes rapportent plus de problèmes de santé liés au stress et une détresse psychologique plus importante. Nos résultats indiquent également que les personnes ayant disposé de peu de ressources et d’aptitudes personnelles dans l’enfance sont les plus affectées par les expériences adverses.Whereas the immediate consequences of institutionalized placements on children have been documented, no study has investigated adults who were raised in orphanages or institutions. In Quebec, les enfants de Duplessis offer a unique testimony of the long term consequences of an institutionalized childhood. Stories collected from 40 men and 41 women who grew up in institution in Duplessis’era indicate a high number of abuse and aversive experiences, including physical, psychological and sexual aggressions. In addition, the environment was poor in stimulation and opportunities to develop positive attachment relationships with adults. When matched and compared to adults from the Santé-Québec survey, les enfants de Duplessis report a higher number of health problems associated with stress and more psychological distress. Moreover, our results indicate that those who had fewer strengths and aptitudes in childhood are the most affected by unfavourable experiences.Se han documentado las consecuencias negativas del ingreso de los niños a una institución, pero ningún estudio trata acerca de los adultos que fueron internados cuando eran niños o quedaron huérfanos. En Quebec los niños de Duplessis son un testimonio desgarrador de las repercusiones a largo plazo de una infancia vivida en una institución. Las historias recopiladas de 40 hombres y 41 mujeres que crecieron en una institución en la época de Duplessis constatan el número elevado de abusos y experiencias adversas, incluyendo agresiones físicas, psicológicas y sexuales. El medio era poco estimulante y ofrecía pocas oportunidades de desarrollar relaciones de apego positivas y significativas. Al emparejarlos y compararlos a los adultos provenientes de la encuesta de Salud Quebec, los niños de Duplessis, quienes ya son adultos, reportan más problemas de salud relacionados al estrés y un desasosiego psicológico más importante. Nuestros resultados indican también que las personas que disponen de pocos recursos y aptitudes personales en su infancia son las más afectadas por las experiencias adversas.As conseqüências negativas de uma internação em instituição sobre as crianças foram documentadas, mas nenhum estudo foi realizado sobre os órfãos e as crianças internadas quando já se tornaram adultas. No Quebec, as “crianças de Duplessis” testemunham de maneira profunda das repercussões a longo prazo de uma infância vivida em instituição. As histórias recolhidas junto a 40 homens e 41 mulheres que cresceram em instituição na época do governo de Duplessis relatam um alto número de abusos e de experiências adversas, incluindo agressões físicas, psicológicas e sexuais. O meio era pouco estimulante e oferecia poucas oportunidades de desenvolver relações de apego positivas e significativas. Quando eles foram colocados lado a lado e comparados aos adultos vindos da pesquisa de Santé-Québec, as “crianças de Duplessis” que se tornaram adultas sofrem mais de problemas de saúde ligados ao estresse e a uma depressão psicológica mais importante. Nossos resultados indicam igualmente que as pessoas que dispuseram de poucos recursos e aptidões pessoais na infância são mais afetadas pelas experiências adversas

Advancing laboratory medicine in hospitals through health information exchange : a survey of specialist physicians in Canada

Background: Laboratory testing occupies a prominent place in health care. Information technology systems havethe potential to empower laboratory experts and to enhance the interpretation of test results in order to bettersupport physicians in their quest for better and safer patient care. This study sought to develop a better understanding ofwhich laboratory information exchange (LIE) systems and features specialist physicians are using in hospital settings toconsult their patients’laboratory test results, and what benefit they derive from such use. Methods: As part of a broader research program on the use of health information exchange systems for laboratorymedicine in Quebec, Canada, this study was designed as on online survey. Our sample is composed of 566 specialist physicians working in hospital settings, out of the 1512 physicians who responded to the survey (response rate of 17%).Respondents are representative of the targeted population of specialist physicians in terms of gender, age and hospital location.Results: We first observed that 80% of the surveyed physicians used the province-wide interoperable electronic health records (iEHR) system and 93% used a laboratory results viewer (LRV) to consult laboratory test results and most (72%) useboth systems to retrieve lab results. Next, our findings reveal important differences in the capabilities available in eachtype of system and in the use of these capabilities. Third, there are differences in the nature of the perceived benefits obtained from the use of each of these two systems. Last, the extent of use of an LRV is strongly influenced by the ITartefact itself (i.e., the hospital’s LRV available capabilities) while the use of the provincial iEHR system is influenced by its organizational context (i.e. the hospital’s size and location). Conclusions: The main contribution of this study lies in its insights into the role played by context in shaping physicians’ choices about which laboratory information exchange systems to adopt and which features to use, and the different perceptions they have about benefits arising from such use.One related implication for practice is that success of LIE initiatives should not be solely assessed with basic usage statistics

F.A.R.O.G. FORUM, Vol. 5 No. 7

https://digitalcommons.library.umaine.edu/francoamericain_forum/1019/thumbnail.jp

Onchocerciasis prevalence, human migration and risks for onchocerciasis elimination in the Upper Mouhoun, Nakambé and Nazinon river basins in Burkina Faso.

Historically, the whole of Burkina Faso was considered to be endemic for onchocerciasis (except a small area in the far north of the country) with prevalence rates 60-80%, but all endemic areas were included in the World Health Organisation Onchocerciasis Control Programme, which operated a system of vector control by larviciding beginning in 1974. In Burkina Faso larviciding had been phased out by 1989 when it was considered that onchocerciasis had been reduced to levels below the transmission breakpoint (and any residual infections would disappear without further intervention). There was never any mass drug administration against onchocerciasis in Burkina Faso, except in the Bougouriba and Comoé river basins (from 1996 and 2011 to present respectively) because in each of these two areas there was a resurgence of infection, and in parts of the Nakambé River basin and Sissili River basin from 1992 to 1998. However, mass drug administration with ivermectin was also phased in across the whole country starting in 2000 using ivermectin against lymphatic filariasis and is currently being phased out (depending upon the epidemiological parameters). In this publication we report a new epidemiological survey for onchocerciasis which was carried out in 2014 in the Upper Mouhoun, Nakambé and Nazinon river basins in Burkina Faso to evaluate the prevalence and intensity of infection of onchocerciasis. A total of 11,195 people from 61 villages were examined across these three river basins, and onchocerciasis prevalence by skin-snip was below 5% in all villages, below 1% in 57 villages (93% of 61 villages) and zero in 47. In the 14 villages with positive skin snips, prevalence figures ranged from 0.31% to 3.50%. During the survey 31 infected individuals were found. All of them were Burkinabé, of whom 30 had a recent history of residence in Côte d'Ivoire (with a range of 0.5 to 73 microfilariae per skin-snip from two snips per person) and only one had no history of migration and presumably had an autochthonous infection (mean of 0.5 microfilariae per skin snip from two snips). According to parasitological indicators listed by the World Health Organization African Programme for Onchocerciasis Control in 2010, the situation for onchocerciasis was considered to be satisfactory in all three river basins and probably below the transmission threshold, in which case the disease should disappear naturally without the need for further intervention in the absence of continuing immigration. However, the results clearly indicate that infected persons coming from endemic zones of Côte d'Ivoire are settling in small communities which are otherwise nearly free from onchocerciasis in Burkina Faso. They are thus a source of continuing re-introduction of the parasite into the basins and could be a risk for the achievement of onchocerciasis elimination in all three basins. This would justify the continuation of periodic epidemiological surveys to monitor the possible recrudescence of the disease, and entomological (vector) surveys should be undertaken to assess and monitor the residual transmission