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Role of Policy in Best-Practice Dissemination: Informal Professional Advice Networks in Canadian Long-Term Care

  • Janice M. Keefe (a1), Lisa Cranley (a2), Whitney B. Berta (a3), Deanne Taylor (a4), Amanda M. Beacom (a5), Erin McAfee (a1), Lauren E. MacEachern (a6), Debra Boudreau (a7), Jodi Hall (a8), Genevieve Thompson (a9), Janet E. Squires (a10), Adrian Wagg (a11) and Carole A. Estabrooks (a12)...

Abstract

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 from surveys with 169 senior leaders in LTC facilities, to identify advice-seeking network structures and to select 11 follow-up interview participants. Network structures were distinguished by density, sub-group number, opinion leader, and boundary spanner distribution. Network structure was affected by ownership model in Nova Scotia and Prince Edward Island, and by regional geography in New Brunswick. Political instability within each province’s LTC system negatively affected network actors’ capabilities to enact innovation. Moreover, provincial policy variations influence advice-seeking network structures, facilitating and constraining relationship development and networking. Consequently, local policy context is essential to informing dissemination strategy design or implementation.

RÉSUMÉ

Cet article examine l’influence des politiques provinciales sur les réseaux de conseils professionnels en soins de longue durée (SLD) dans les provinces maritimes au Canada. Les impacts du modèle de propriété des établissements, de la géographie et des contextes politiques régionaux sur la diffusion des meilleures pratiques en matière de soins de longue durée ont été analysés. Des statistiques sociométriques et des sociogrammes de réseaux, calculés à partir d’enquêtes menées auprès de 169 cadres supérieurs d’établissements de SLD, ont été utilisés pour identifier les structures des réseaux de conseils et pour sélectionner 11 participants pour des entretiens de suivi. Les structures des réseaux se sont distinguées par leur densité, le nombre de sous-groupes, les leaders d’opinion et le contrôle des accès. En Nouvelle-Écosse et à l’Île-du-Prince-Édouard, cette structure dépendait du modèle de propriété utilisé, tandis que la géographie régionale était un facteur important au Nouveau-Brunswick. L’instabilité politique au sein du système de SLD de chaque province affectait la capacité d’innovation des acteurs du réseau. Les modifications des politiques provinciales influencent les structures des réseaux de conseils en facilitant ou en limitant le développement de relations et le réseautage. Le contexte politique local est un élément déterminant pour l’orientation de la conception et de la mise en œuvre de stratégies de diffusion.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Janice M. Keefe, Ph.D. Department of Family Studies & Gerontology Mount Saint Vincent University 166 Bedford Highway Halifax, NS B3M 2J6 (janice.keefe@msvu.ca)

Footnotes

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This work was supported by the Canadian Institutes of Health Research, Partnerships for Health System Improvement (MOP #318861). Additional partner funding was provided by the Nova Scotia Health Research Foundation, Alberta Innovates Health Solutions, the Michael Smith Foundation for Health Research, and Research Manitoba. We thank Pamela Fancey of the Nova Scotia Centre on Aging for coordinating the production of the manuscript and to the senior leaders throughout Maritime Canada who completed the survey and participated in the interviews.

Footnotes

References

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Keywords

Role of Policy in Best-Practice Dissemination: Informal Professional Advice Networks in Canadian Long-Term Care

  • Janice M. Keefe (a1), Lisa Cranley (a2), Whitney B. Berta (a3), Deanne Taylor (a4), Amanda M. Beacom (a5), Erin McAfee (a1), Lauren E. MacEachern (a6), Debra Boudreau (a7), Jodi Hall (a8), Genevieve Thompson (a9), Janet E. Squires (a10), Adrian Wagg (a11) and Carole A. Estabrooks (a12)...

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