Papers by François Champagne
Santé mentale au Québec, 1999
This case study analyzes the implementaion of the reform of care destined to clienteles at the Pa... more This case study analyzes the implementaion of the reform of care destined to clienteles at the Pavillon Albert-Prévost. The level of implementation and the effects of the new systme have been measured and the influence of the political and structural contexts have been analyzed. At the end of the observation period, the implementation of the intervention was not yet completed but had already entailed interesting effects especially concerning access and efficiency. These effects were achieved through some mechanisms not previously planned for in the reform project. The authors have also identified several environmental facors facilitating the implementation of the reform and the realization of expected effects.
PubMed, Sep 1, 1993
Following the reform of the health care system in Quebec at the beginning of the 1970s, 32 Commun... more Following the reform of the health care system in Quebec at the beginning of the 1970s, 32 Community Health Departments (départements de santé communautaire or DSC) were created; these new organizations were administratively and physically integrated into 32 acute care hospitals throughout the province. Our study investigates to what extent variations in the implementation of DSCs and in the way they have fulfilled their mandate influence the degree of innovation of their practices. The results show that DSCs devoting greater efforts to research activities and to their relationships with other health care establishments and agencies achieve a higher level of innovation in their practices.
PubMed, Jun 9, 1984
Hospitals have traditionally relied on consulting firms to conduct large scale planning studies. ... more Hospitals have traditionally relied on consulting firms to conduct large scale planning studies. Many such "official plans" have been published with no real benefits to the organization. An alternative is to use existing resources and do the work internally. A planning process used by the Ottawa General Hospital (OGH) is outlined here. The planning process used at the OGH is significant for two reasons. It took into account multiple interests of a complex, professional organization. It recognized the need to incorporate input from members of the external environment of the hospital. This process was inspired by an approach developed in the evaluation field, the "active-reactive-adaptive" (A.R.A.) approach. The strategic planning exercise at the OGH opened lines of communication between administration and medical staff, increased awareness of planning principles, and promoted information exchange. The internally developed planning strategy was less expensive and produced information with a greater likelihood of affecting the hospital's future than a more easily ignored plan developed by outside consultants.
PubMed, 1992
This study aims at identifying determinants of satisfaction with medical care during pregnancy, a... more This study aims at identifying determinants of satisfaction with medical care during pregnancy, a topic little explored until now. 937 women from the Montreal area answered a mailed questionnaire 4 to 7 months after giving birth. Results show a high level of satisfaction with prenatal care among respondents. Multiple regression analysis reveals that information variables emerge as the main determinants of satisfaction. In fact, not having received desired information appears as the strongest predictor; information pertaining to the delivery process is most often cited by women. The other predictors are events happening during the delivery process. Contrary to findings from other studies, sociodemographic data and characteristics of the physicians do not predict satisfaction. The discussion suggests some guidelines for the measurement of satisfaction with prenatal care as well as implications for practice.
Social Science & Medicine, Jul 1, 1993
In the wake of the reform of the Quebec health care system in the early 1970s, thirty-two public ... more In the wake of the reform of the Quebec health care system in the early 1970s, thirty-two public health units (DSCs) were created. They were administratively and geographically integrated into short-term care hospitals throughout the province. This study aimed at determining: (1) the influence of environmental and organizational factors on the way in which those public health units carried out their mandate; (2) the influence of these same factors on their performance in terms of level of innovation and in terms of the fulfillment of their mandate as assessed by their main clients; and (3) the influence of their activities on their performance. Our results show that the most innovative units appear to be those that have directed a large part of their efforts toward research and that have maintained close ties with other institutions and agencies. The public health units main clients differ however on their perception of the DSCs' performance.
PubMed, Aug 10, 2023
Introduction: In Haiti, the delegation of tasks to Multi-skilled Community Health Workers (locall... more Introduction: In Haiti, the delegation of tasks to Multi-skilled Community Health Workers (locally called ASCP) is a strategy implemented by the Ministry of Public Health and Population to improve universal health coverage. Purpose of research: To contribute to the successful implementation of this strategy, this article reports on a case study of its implementation in the northern health department of Haiti. More specifically, this article provides information on the contextual factors that facilitate or hinder the implementation of task delegation to ASCP. Results: The results obtained show notable progress in the implementation of task delegation to ASCP in the northern health department of Haiti. These mainly concern the following activities: selection, training, and deployment of ASCPs, endowment of work materials, supervision, collection and analysis of data on the results obtained. In September 2019, 215 ASCPs were active in the department. This corresponds to 44.3% of the 485 ASCPs planned to cover the department’s needs. Several contextual factors hindering or facilitating the implementation of this intervention were also identified with 35 resource persons during semi-structured interviews. These relate to the planning and monitoring of the implementation of the intervention (cited by 12 out of 35 people), the institutional context (10/35), and political (17/35), structural (30/35) and environmental factors (7/35). Conclusions: This study highlights several contextual factors that need to be considered to ensure the successful implementation of the delegation of tasks to ASCP in Haiti and possibly in other contexts.
Authorea (Authorea), Jun 15, 2023
This a preprint and has not been peer reviewed. Data may be preliminary.
Authorea (Authorea), Jun 15, 2023
Canadian Journal of Education, 1991
American Journal of Preventive Medicine, 1985
This paper examines the relationship between mortality and ruralness in the state of Georgia. In ... more This paper examines the relationship between mortality and ruralness in the state of Georgia. In 1979, the rural Standardized Mortality Ratio (SMR) for deaths from all causes was significantly higher than expected when compared to statewide levels, while the urban SMR was significantly lower (p < 0.01). Of the 13 leading causes of death, 9 had rural SMRs significantly higher than expected, while only homicide had a significantly greater urban SMR (p < 0.01). Although much of the rural/urban difference in overall mortality is attributed to the fact that the rural population is older, figures adjusted for age and race still reveal that the rural death rate is significantly higher than the urban rate (p < 0.01). Furthermore, there are several specific differences when analyzed by cause of death, age, and race that remain unexplained. Specific rural health problems include congenital anomalies, motor vehicle and other accidents, heart disease, and cerebrovascular disease. Specific urban health problems include homicides and cancer. In addition to metropolitan status, a second indicator of ruralness, county population size, was used to analyze the data and produced similar results. As county population size increases, the total mortality decreases. [Am J Prev Med 1985;1(1):22-29] Urbanization has long been recognized as being associated with higher death rates while rural living has been regarded by many as part of the "good life." This characterization of cities as unhealthy places 1 probably came about in the first days of modern public health practice when inhabitants of urban areas were particularly vulnerable to the great epidemic diseases which were then the leading causes of death. Higher death rates in urban areas have also been demonstrated for coronary heart disease, 2-4 deaths from all causes, 4 , 5 and particularly for cancer. 6-12 Recently however, census data have been used by government agencies 13 and other organizations as evidence that most rural populations are vulnerable to a high incidence of modern chronic diseases, because they are poorer, less educated, and older. Recent studies have reported higher infant From the
Pratiques et organisation des soins, 2012
Distribution électronique Cairn.info pour CNAMTS. Distribution électronique Cairn.info pour CNAMT... more Distribution électronique Cairn.info pour CNAMTS. Distribution électronique Cairn.info pour CNAMTS. La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit. Article disponible en ligne à l'adresse Article disponible en ligne à l'adresse https://www.cairn.info/revue-pratiques-et-organisation-des-soins-2012-2-page-131.htm Découvrir le sommaire de ce numéro, suivre la revue par email, s'abonner... Flashez ce QR Code pour accéder à la page de ce numéro sur Cairn.info.
Éthique & Santé, Dec 1, 2011
In international and national HIV/AIDS policies, free and informed consent is recognized as one o... more In international and national HIV/AIDS policies, free and informed consent is recognized as one of the major components of testing programs. For pregnant women, free and informed consent means that they should get information on prevention of mother-to-child transmission (PMTCT), understand them and make an independent choice after weighing the risks and advantages. However, no PMTCT program looked into the issue of consent. The objective of this paper is to explore the free and informed nature of pregnant women's consent with regard to testing and their rationale for accepting to be tested. We used data collected within the framework of the analysis of the creation of the PMTCT program in Benin. This analysis is based on multiple case studies that covered six maternity homes selected from 56 operational sites. For the specific analysis of consent, we used both survey data and qualitative research data. Apart from three cases of secret testing, the free nature of the consent to the test is respected on the PMTCT sites. Twenty-nine cases of refusal were recorded. The reasons put forth by most pregnant women include the fear of a positive test and its consequences on family life in 55.2% of cases and the expectation of their husbands' agreement or disagreement in 27.6% of cases. On the whole, the consent was free on all the sites but its informed nature is less respected.
Using Knowledge and Evidence in Health Care, 2004
Quality & safety in health care, 2010
To develop search strategies for identifying papers on patient safety in MEDLINE, EMBASE and CINA... more To develop search strategies for identifying papers on patient safety in MEDLINE, EMBASE and CINAHL. Six journals were electronically searched for papers on patient safety published between 2000 and 2006. Identified papers were divided into two gold standards: one to build and the other to validate the search strategies. Candidate terms for strategy construction were identified using a word frequency analysis of titles, abstracts and keywords used to index the papers in the databases. Searches were run for each one of the selected terms independently in every database. Sensitivity, precision and specificity were calculated for each candidate term. Terms with sensitivity greater than 10% were combined to form the final strategies. The search strategies developed were run against the validation gold standard to assess their performance. A final step in the validation process was to compare the performance of each strategy to those of other strategies found in the literature. We develo...
Using Knowledge and Evidence in Health Care, 2004
... and state power and thereby threatened scientific autonomy and objectivity (Baritz, 1960), an... more ... and state power and thereby threatened scientific autonomy and objectivity (Baritz, 1960), and some opposed the use of scientific knowledge for rational planning and soci-etal reconstruction because of fears that it upset the natural order of things (Collins &amp; Makowsky, 1972). ...
Journal of Public Health Policy, 1986
ABSTRACT
Health Services Management Research, Jul 1, 1991
This article presents the results of a study on the introduction of sessional fees remuneration f... more This article presents the results of a study on the introduction of sessional fees remuneration for physicians working in Quebec long-term care hospitals. More generally, this research was concerned with the determinants of the capacity of an organization to implement an innovation. Both a political and a structural model of analysis were empirically probed. We found strong support for the political model and moderate support for the structural model. This article contributes to the understanding of the relative contribution of structural and political determinants in the implementation of changes in organizations.
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Papers by François Champagne