Health Care
We have a depth of experience with various health care initiatives designed to impact system- and local-level processes to improve health outcomes for people. Our team specializes in health-related evaluation and has implemented complex summative and formative evaluations designed to involve and inform decision-making both within communities and provincially. We have worked with clients such as Health Canada, various provincial Ministries, health authorities, and non-profit organizations across BC.
We have worked extensively with Divisions of Family Practice, which are non-profit community-based groups of family physicians, to provide on the ground evaluation support for various health initiatives, including:
• Supporting the implementation and evaluation of Patient Medical Home initiatives across the province – many designed to focus on team-based care
Doctors of BC – Nurses in Primary Care Practice Case Study
This multi-phase evaluation has followed the implementation of nurses (LPNs, RNs and NPs) as they are integrated into primary care practices in Central Okanagan. The evaluation has included analysis of GP billing data, nurse shadow billing data, provider interviews, and patient focus groups. A primary learning from this evaluation is how to develop teams and effectively implement team-based care, a core component of Patient Medical Homes.
Rural and Remote Division of Family Practice – Patient Medical Home Evaluation
The Rural and Remote Division of Family Practice has implemented PMH projects in 12 communities across BC. The evaluation is designed to provide feedback to each Chapter regarding their unique project, as well as provide a collective report that summarizes the impact of the PMH work across the Division. It is intended that this information will be useful for spreading lessons learned and successes between communities, as well as informing further development of PMH/PCN in rural and remote communities.
• Designing and implementing 16 A GP for Me evaluations across the province
Doctors of BC – Local A GP For Me Evaluations
The A GP for Me project was a provincial initiative designed to improve access to primary health care services in BC. Divisions of Family Practice were tasked with developing and implementing local solutions over a period of 18 months (early 2014 to mid 2016) to achieve this goal. Our firm worked with 16 Divisions encompassing all areas of the province. Our approach to the evaluation included a developmental phase, in which we learned about each Division’s key activities and deliverables, and the development of specific methods and data collection tools to support quality improvement and evaluation. Methods (summed across all 16 projects) included conducting more than 700 physician interviews, surveying 100s of allied and community health providers as well as reviewing complex administrative datasets from the Ministry of Health and Health Authorities. The final reports for each Division included an evaluation of their project, as well as the collective contribution towards the initiative’s provincial goals. The reports also included case studies and most significant change stories that demonstrated the narrative and experiential impact on physicians, patients, and the health care system.
• Evaluation of more than 150 Doctors of BC – Shared Care and Specialist Services Committee initiatives focused on transitions in care between acute and community primary care settings and engaging specialist and family physicians, their Health Authority partners, and patients / clients
Comox Valley Division of Family Practice – Collaborative Approach to Perinatal Care Project
We completed the evaluation of the 2nd phase of the Perinatal Shared Care project in the Comox Valley, which included collecting feedback from providers and families involved, helping to develop and analyze community surveys, and exploring how aspects of the work could be sustained in the community. We gained a strong understanding of the complex and multidisciplinary care system in place to support women during the perinatal period.
Victoria Division of Family Practice – Partners in Care MHSU Project
The focus of this project was to develop group CBT-skills programs that could be delivered by family physicians. During this multi-phase project, the evaluation analysed pre-post depression (PHQ-9) and anxiety (GAD-7) scores for over 500 participants. Results from these validated scales were combined with demographic information and participant feedback on their experience with the course to provide a robust evaluation of how well the program was working, and for whom.
Other examples of our health care evaluation work includes:
East Kootenay Regional Hospital (EKRH) – Hospital Overcapacity Needs Assessment
We conducted a needs assessment to explore factors influencing overcapacity at the East Kootenay Regional Hospital (EKRH), as well as identify potential solutions. The needs assessment gathered data from multiple sources to explore the complexity of the problem from a holistic perspective. Qualitative data was collected through interviews with physicians, Interior Health Authority staff and patients, and administrative data was analyzed. As part of the project, we facilitated two engagement events with physicians, staff and key community stakeholders, to share findings and guide discussions around implementing potential changes to address the problem. The final report provided the hospital with a set of recommendations to address overcapacity, and we are continuing to work with the Medical Staff Society and the Chief of Staff to ensure these recommendations are implemented and evaluated.
REACH – Urgent and Primary Care Clinic (UPCC)
We are currently conducting a formative and summative evaluation of the Urgent & Primary Care Clinic (UPCC) operating out of the Research, Education, and Action for Community Health (REACH) centre located in East Vancouver, BC. The goal of the evaluation is to provide feedback on the UPCC’s implementation and operation and to generate learnings about embedding a UPCC within a community health centre. Employing a participatory, strengths-based and developmental approach, the evaluation is responsive to changes in the UPCC’s priorities and needs as the evaluation progresses, such as capturing REACH and the UPCC’s response to the COVID-19 pandemic.
Older Adult Health and Long-Term Care
We have supported several projects designed to address the health and wellness of older adults, including community based programming and initiatives in long-term care settings. In addition, our Director of Research and Evaluation holds a Master of Gerontology degree and advocates the inclusion of older adults in research.
BC Patient Safety and Quality Council (BCPSQC) – The Call for Less Antipsychotics in Residential Care (CLeAR) Initiative
The purpose of the evaluation was to provide summative findings of the BC Patient Safety and Quality Council’s CleAR Wave 2 Initiative as a resource to the Council and its partners to inform decisions regarding quality future improvement approaches in residential care. Multiple methods were used including process mapping, case studies and monthly data reports compiled by Care Homes, Canadian Institute for Healthcare Information (CIHI) Inter-rai data and WorkSafe BC Data. Analysis included administrative data analysis, and qualitative thematic identification of lessons learned and recommendations. The final report included findings regarding the decreased use of antipsychotic medication, better teamwork and facility staff workflow and increased residential care planning for quality of life and safety of patients (see the report here: https://bcpsqc.ca/resource/clear-wave-2-final-evaluation-report/)
Doctors of BC – Long Term Care Initiative (LTCI)
The Long-term Care Initiative is a province-wide effort funded by the GPSC to support local solutions for enhanced GP Most Responsible Provider (MRP) services in long term care. We support several Divisions across the province in their Long-term care Initiative work, from providing annual reports, case studies of specific initiatives, analysis of specific best practice expectations using chart audits, and COVID-19 response evaluations. Our data sources for these evaluations have included Ministry of Health billing data, chart audits, health authority utilization data, Office of the Senior’s Advocate data and surveys, provider surveys, and interviews.
Gabriola People for a Healthy Community – Stepping Up, Stepping Out (SUSO)
This project was an arts, exercise, and education program designed for frail, isolated seniors by People for a Healthy Community on Gabriola Island and the Quadra Circle Community Connections Society on Quadra Island. Supported by a CAI Convening Grant (Winter 2016), the program delivered senior-specific arts and exercise activities using an innovative approach of training younger seniors to engage their older peers. This work demonstrates our ability to work in more isolated communities and with a focus on supporting the efforts of a smaller community-based organization.
Mental Health and Substance Use
We have experience leading evaluation projects in partnership with community agencies as well as with People with Lived and Living Experience relating to mental health and substance use. Our knowledge of health care in BC, our knowledge of community-based organizations and our use of a trauma informed perspective, has helped us to navigate complex systems but remain grounded in the community.
Vancouver Coastal Health (VCH) – Crystal Clear Peer Project
Crystal Clear was a Vancouver Coastal Health program that operated out of the Three Bridges Health Centre. The program was designed to provide long-term harm reduction education opportunities to street involved youth in Vancouver’s downtown south area. In this engagement, we designed and implemented an evaluation plan to provide longitudinal information related to the engagement and effective transfer of health information to a specific vulnerable population. The evaluation operated for three years and included both a developmental and participatory approach: street involved youth participated directly in the design and implementation of the evaluation, incorporating a unique insight that otherwise might not have readily been available. Because of this engagement, the evaluation maintained a 95% response rate to data requests from street youth over a three-year period. Upon its completion, the evaluation methodology used for this project was acknowledged by the Canadian Evaluation Society and used as the foundational piece of a National Case Competition that challenged evaluation students across Canada.
See also, Project Highlights – BC Provincial Overdose Emergency Response
Indigenous Health and Well-being
We have experience working with Indigenous peoples, in both urban and rural settings, in a variety of sectors including in health care, women’s safety, and mental health and substance use. Our team supports the Truth and Reconciliation Commission of Canada: Calls to Action, the First Nations principles of OCAP and we have taken steps to ensure our evaluation approach is informed by an understanding of the historical and structural inequities that impact the indigenous experience of health and social services.
Vancouver Native Health Society – Aboriginal Diabetes Awareness Prevention and Teaching Program (ADAPT)
The ADAPT program of the Vancouver Native Health Society, funded by Health Canada, was designed to provide culturally appropriate peer-based learnings related to health and diet. The program provided services to First Nations populations living in Vancouver’s Downtown Eastside. As part of the program’s design, a core operational set up curriculum was adapted from the University of Victoria’s Centre for Aging to support a community kitchen (Red Fox Feasting Community Kitchen), gardening initiative and exercise program. The program utilized a peer-based learning model and operated for several years. Our assessment of this program involved working closely with staff and program participants in the development and implementation of a comprehensive evaluation.
Vancouver Native Health Society – Aboriginal Diabetes Awareness Prevention and Teaching Program (ADAPT)
The ADAPT program of the Vancouver Native Health Society, funded by Health Canada, was designed to provide culturally appropriate peer-based learnings related to health and diet. The program provided services to First Nations populations living in Vancouver’s Downtown Eastside. As part of the program’s design, a core operational set up curriculum was adapted from the University of Victoria’s Centre for Aging to support a community kitchen (Red Fox Feasting Community Kitchen), gardening initiative and exercise program. The program utilized a peer-based learning model and operated for several years. Our assessment of this program involved working closely with staff and program participants in the development and implementation of a comprehensive evaluation.
Education and Training
We have experience evaluating a wide variety of education and training programming offered by government agencies, non-profit organizations, schools, universities. We also have significant experience engaging with youth at various levels and have worked with youth to develop and implement evaluation plans that are both relevant, safe and utility based.
BC Real Estate Association – Education Program Evaluation
The BC Real Estate Association has engaged our firm to develop and implement an evaluation of their education programming – including their Legal Update and APC programming. As part of the development of the evaluation plan, we reviewed existing documentation including existing regulations and the Real Estate Services Act. Additionally, our team conducted interviews with industry stakeholders from across the province – including a sample of Council and Board members. The interviews were used to identify key evaluation questions and inform the development of indicators. Evaluation efforts for this review are currently underway.
BC Real Estate Association – Education Program Evaluation
The BC Real Estate Association has engaged our firm to develop and implement an evaluation of their education programming – including their Legal Update and APC programming. As part of the development of the evaluation plan, we reviewed existing documentation including existing regulations and the Real Estate Services Act. Additionally, our team conducted interviews with industry stakeholders from across the province – including a sample of Council and Board members. The interviews were used to identify key evaluation questions and inform the development of indicators. Evaluation efforts for this review are currently underway.
Social Determinants of Health
We have worked with numerous housing and food providing agencies that work with vulnerable and marginalized populations. We have significant experience in evaluation related engagements and recognize the importance of creating and maintaining creative processes that are strategic, collaborative and inclusive for vulnerable populations.
Mom2Mom Child Poverty Initiative Society – Mom2Mom Program
The mission of Mom2Mom is to improve the lives of families isolated by poverty through strength-based relationships and by creating opportunities. We conducted a 2-year evaluation of Mom2Mom at an organizational level that was both participatory and developmental, which allowed us to build on learnings as they occurred. The methodologies included interviews with key stakeholders (including Board members and client moms), surveys, as well as a review of documents and administrative data. Findings suggested that Mom2Mom is operating in a way that is consistent with its strategic direction. We worked closely with the staff and clients to identify program strengths and challenges and put forward three key recommendations. Outcome data indicated that the organization positively impacted its participants within three focus areas: meeting basic needs, building community and trusting relationships, and connecting women and children to opportunity.
Vancouver Coastal Health (VCH) – Vancouver Food Bank Community Angels program
Funded by in part by Vancouver Coastal Health, the Vancouver Food Bank Community Angels program is designed to collect food from local restaurants, grocery stores, farms and other private sector sources and distribute it to food programs operated by social service organizations throughout Vancouver. For this program, we designed an evaluation process to assess how the program was operating relative to its stated goals and objectives and provide an understanding of program impacts in the community, challenges and developmental opportunities.
BC Housing – Evaluation of the Program Areas in the Social Housing Agreement between the Canada Mortgage and Housing Corporation (CMHC) and the British Columbia Housing Management Commission
This evaluation focused on understanding how effective current housing initiatives were in meeting the requirements of the federal and provincial agreement. This involved reviewing each of the 13 portfolio areas designed to address housing needs in BC. The study was also mandated to conduct a cross-jurisdictional review of similar initiatives from across Canada, as well as internationally. This cross-jurisdictional review included online literature, policy, and legislation reviews as well as key informant interviews with subject matter experts from across jurisdictions. This provided a comparative analysis that resulted in recommendations relating to models of best practice.
Howe Sound Women’s Centre Society – Status of Women Blue Print Project
For this project, our team worked with the Howe Sound Women’s Centre Society to develop and implement an evaluation of their Status of Women Blue Print Project. The project identified access challenges in second stage housing services for women and designed supports to address isolation and mental health concerns of women living in or fleeing unsafe environments. The evaluation involved creating a safe and supported environment for women in the program to share their stories and identify needs.
MOSAIC – Employment and Settlement Needs Assessment
In 2014, we were involved studying employment and settlement needs and assessing the effectiveness of new online learning tools for MOSAIC. This involved surveying more than 1500 MOSAIC clients, and conducting nearly a dozen focus groups in different languages throughout the Lower Mainland to supplement information gleaned from the surveys. A key component of this work was to specifically look at employment barriers faced by program participants as well as identify areas of opportunity to address employment needs. Subsequent to this work, our team developed and implemented a web-based data collection and monitoring tool for new online education programming developed by MOSAIC.
Mom2Mom Child Poverty Initiative Society – Mom2Mom Program
The mission of Mom2Mom is to improve the lives of families isolated by poverty through strength-based relationships and by creating opportunities. We conducted a 2-year evaluation of Mom2Mom at an organizational level that was both participatory and developmental, which allowed us to build on learnings as they occurred. The methodologies included interviews with key stakeholders (including Board members and client moms), surveys, as well as a review of documents and administrative data. Findings suggested that Mom2Mom is operating in a way that is consistent with its strategic direction. We worked closely with the staff and clients to identify program strengths and challenges and put forward three key recommendations. Outcome data indicated that the organization positively impacted its participants within three focus areas: meeting basic needs, building community and trusting relationships, and connecting women and children to opportunity.
Vancouver Coastal Health (VCH) – Vancouver Food Bank Community Angels program
Funded by in part by Vancouver Coastal Health, the Vancouver Food Bank Community Angels program is designed to collect food from local restaurants, grocery stores, farms and other private sector sources and distribute it to food programs operated by social service organizations throughout Vancouver. For this program, we designed an evaluation process to assess how the program was operating relative to its stated goals and objectives and provide an understanding of program impacts in the community, challenges and developmental opportunities.
BC Housing – Evaluation of the Program Areas in the Social Housing Agreement between the Canada Mortgage and Housing Corporation (CMHC) and the British Columbia Housing Management Commission
This evaluation focused on understanding how effective current housing initiatives were in meeting the requirements of the federal and provincial agreement. This involved reviewing each of the 13 portfolio areas designed to address housing needs in BC. The study was also mandated to conduct a cross-jurisdictional review of similar initiatives from across Canada, as well as internationally. This cross-jurisdictional review included online literature, policy, and legislation reviews as well as key informant interviews with subject matter experts from across jurisdictions. This provided a comparative analysis that resulted in recommendations relating to models of best practice.
Howe Sound Women’s Centre Society – Status of Women Blue Print Project
For this project, our team worked with the Howe Sound Women’s Centre Society to develop and implement an evaluation of their Status of Women Blue Print Project. The project identified access challenges in second stage housing services for women and designed supports to address isolation and mental health concerns of women living in or fleeing unsafe environments. The evaluation involved creating a safe and supported environment for women in the program to share their stories and identify needs.
MOSAIC – Employment and Settlement Needs Assessment
In 2014, we were involved studying employment and settlement needs and assessing the effectiveness of new online learning tools for MOSAIC. This involved surveying more than 1500 MOSAIC clients, and conducting nearly a dozen focus groups in different languages throughout the Lower Mainland to supplement information gleaned from the surveys. A key component of this work was to specifically look at employment barriers faced by program participants as well as identify areas of opportunity to address employment needs. Subsequent to this work, our team developed and implemented a web-based data collection and monitoring tool for new online education programming developed by MOSAIC.