Knowledge Translation in HealthWestern Health Sciences

Trainee Projects

Ramona Kyabaggu

Implementation of interoperable electronic health record (iEHR)

The future of health care in Canada envisages a ubiquitous, interoperable electronic health record (iEHR) capable of bridging the continuum of care and linking health care organizations across geopolitical boundaries. Implementing an iEHR in an organization’s structure and practice delivery however is a complex process with no shortage of documented cases of implementation failure serving as cautionary tales. For my thesis research, I am interested in studying the mechanisms and consequences of iEHR adoption and implementation with a particular interest in aspects of the implementation process mediated through implementation climate and its antecedents. I will use an exploratory sequential mixed methods approach, which involves quantitative mediation analysis at the organizational level and qualitative interviews with health informatics and information management professionals involved in EHR implementation efforts in care delivery settings. This research provides attention to implementation science and the non-technological factors effecting implementation that are often understudied in health informatics research and the wider body of eHealth literature. Overall, the aim of this research is to develop a substantive generative causal model that can be used to guide implementation, training and support and facilitate EHR implementation success. 

David Walugembe

Exploring variations in the implementation of a health systems level policy intervention to improve maternal health

There is a limited understanding of the observed variations in the implementation of health policy interventions as well as their reported minimal impact in reducing maternal and perinatal mortality and morbidity especially among low and middle-income countries (LMICs). Furthermore, a few studies on assessing implementation of health policy interventions to improve maternal and child health outcomes explicitly articulate their theoretical underpinning. To understand the implementation and integration of Maternal Perinatal Death Reviews (MPDRs), there is a need to look at what people actually do and how they work.Against this background, my study aims to explore the variations in the implementation of maternal and perinatal death review (MPDR) policy among selected health facilities in Uganda using the Normalization Process Theory. The specific objectives of this study are:

  • To understand how the actors involved in the implementation of MPDR policy understand and make sense of the policy (Coherence).
  • To understand how the actors engage and participate in the implementation of the MPDR policy (Cognitive participation).
  • To understand how the resources to operationalize the MPDR policy are distributed among the actors (Collective action).
  • To understand how the actors involved in the implementation of the MPDR policy reflect or appraise the effects of implementing the policy (Reflexive monitoring).

Sandy Steinwender

Use and impact of realist reviews in health care policy and decision making

Realist reviews have emerged over recent years, based on the growing need for research and “information” by policy and decision makers, to deal with complex social issues (Pawson et al, 2005).  Realist reviews aim to provide policy and decision makers with a transferable theory to understand the contexts, mechanisms, and outcomes of intervention programs.

Currently, little is known about the research impact of realist reviews for health policy and health care outcomes.  The complexities of health policy and decision-making processes make it difficult to understand the role of evidence, knowledge use and uptake (Hegger et al, 2016).  The objective of this research is to determine the use and impact of realist reviews in health care policy and decision making.  

  • Are realist reviews useful and if so, at what levels of the health system (macro/meso/micro)?
  • In what context and under what circumstances are realist reviews used by policymakers and decision makers?
  • What are the challenges and enablers to using realist reviews by policy and decision-makers?