• Project Profiles
  • NICU Feeding Practices
  • Approaches to Public Health Nursing
  • HKN Gap Analysis
  • Evidence Literacy Project
  • Assessing Patient Complexity
  • Early Identification of Autism
  • Measuring Quality Care
  • Young Adults in Long-Term Care
  • Reducing Medication Errors
  • Making Exercise Sticky
  • Stroke Guidelines
  • Driving Change in Mental Health
  • Help for New Mothers
  • Mentoring Makes a Difference
  • Pay-for-Performance
  • Good Care is About People
  • Working Better Together
  • Health Technology Assessment
  • Looking at the Link between Pain and Aggression
  • Reviewing Determinants of Health
  • End of Life Care Decisions in Focus
  • Rural Health Service Delivery
  • Looking at Organizational Problems
  • Integrating Evaluation with Planning
  • Rural Health Needs
  • Suicide Prevention
  • Student Health
  • Hepatitis A Immunity Project
• Participant Profiles
• Knowledge Infostructure
• Celebrating the Legacy

Assessing Patient Complexity in the Inner City

While doing her residency in community medicine at the University of Alberta, Dr. Deena Hinshaw worked part-time as a family physician at the Boyle McCauley Health Centre in Edmonton's inner city. "Working at the centre involves a different way of practicing medicine and serving a different population," she explains. "The centre's mandate is to serve those who have difficulty accessing services elsewhere. We work in teams that include nurses, counselors, physicians, social workers and therapists. The model is based on the fact that our patients are complex in their biological, psychological and social needs."

But just what does "complex" really mean?  Is there a solid, objective measure of complexity that would be useful in relation to the patients seen at the Boyle McCauley Health Centre? That was the question Dr. Hinshaw asked for her SEARCH VI local project. Besides identifying a tool to assess the complexity of patients, it was hypothesized that the tool could be used as an outcome measure to evaluate the impact of the care provided to individual patients.

Dr. Hinshaw's research identified the INTERMED tool, a bio-psycho-social-system complexity matrix developed by European researchers. INTERMED's value in the primary care setting is not clear because the vast majority of research has been done in hospital and outpatient settings. However, Dr. Hinshaw has developed key contacts with a research team in Minnesota that is currently testing INTERMED in primary care. As she moves on to post-residency training in geriatrics, she hopes the Boyle McCauley Health Centre will be able to follow up on the Minnesota research.

"For me professionally, the major impact of SEARCH was seeing how 'do-able' research really is. Many of my colleagues tend to think that research is something only specialized people can do. SEARCH gave me a different perspective on the possibilities for research and how it can be incorporated into front-line or close-to-front-line practice. I'm very grateful for that."