To assess the views of health care providers and managers in the NWT regarding primary health care in the community in general and issues related to medical travel in particular.
A survey questionnaire will be filled out by the respondent, who has a choice of mailing in a paper copy or completing online. The survey is anonymous – information on name, the community of residence, age and sex is not collected. However, Part A of the survey records the type of work, professional affiliation and years of employment. Part B focuses on the existing air ambulance system, and measures respondents’ perception of prompt response time, easily accessible clinical advice, and cordial and effective inter-professional communication. Part C is adapted from the Attributes of Primary Health Care: Provider Survey designed by the Canadian Institute for Health Information and focuses on providers’ scope of practice and professional satisfaction. The survey was designed in consultation with NWT Health staff. At their request, the survey is kept short to reduce respondent burden.
Standard statistical analyses of cross-sectional studies will be conducted. These will primarily be descriptive rather than causal. The survey will be conducted immediately upon approval (pre-implementation) and will be repeated 3 and 6 months post-implementation of the new system Med-Response.
The list of individuals to be contacted will be established in consultation with NWT Health staff. The sampling frame will consist of (1) the entire cadre of community health nurses who work in the community health centers, (2) primary care physicians in regional hospitals who visit the communities and care for patients from those communities and emergency room physicians who receive patients transferred from the communities, and (3) health services managers within NWT Health and regional health authorities with responsibility in primary health care and planning, evaluation and policy staff. The ongoing consultation will determine the full scope of the survey and if there would be stratification by community size, remoteness [air distance/travel time to a hospital] and sub-regions within NWT.
Data collected by the survey will be kept in the Statcan branch Research Data Centre (RDC) located within the Institute for Circumpolar Health Research (ICHR) in Yellowknife. ICHR has an affiliation agreement with the University of Toronto to support university research in the North. The branch RDC was built to the specification of Statcan with full compliance with privacy and data security requirements. At the conclusion of the study, a copy of the dataset will be provided to NWT Health for comparison with future surveys that it may decide to conduct outside the scope of the research project. The original dataset will be deleted from the ICHR RDC computer.
The study will allow local health care providers and medical travel administrators to provide input into changes that will take place in the medical travel system. Provider perspectives on the medical travel system will be collected in survey format before and after implementation of a Government-led intervention to assess the impact of the intervention from the provider's point of view. The provider survey is part of a larger study that aims to determine the effectiveness and efficiency of the new medical travel intervention. The findings will be shared with the NWT Department of Health and Social Services, and ultimately residents of NWT will benefit from an improved medical travel system, receiving prompt and appropriate care, and potentially reduced separation from families and friends. The overall goal of improving quality of care will have widespread social benefits also. Economic savings by GNWT and the health authorities will enable scarce resources to be allocated to other socially important issues.
Results will be presented to the GNWT Department of Health and Social Services, regional health authorities, and professional associations of healthcare practitioners in the territory.
The fieldwork for this study was conducted from December 5th to December 31st, 2014.
- Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study. Young, SK and Young, TK. Int J Circumpolar Health. 2016; 75: 10.3402/ijch.v75.32159. (open access)
- Delivering more equitable primary health care in Northern Canada. Young, TK and Chatwood, S. CMAJ November 13, 2017 189 (45) E1377-E1378; DOI: https://doi.org/10.1503/cmaj.170498 (paid access)