Browsing by Author "Holodinsky, Jessalyn"

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    Cross-sectionally Exploring Proxy Usage for Historical Data Analysis: A Proof of Concept
    (2024-11-01) Adeboye, Promise Anjolaoluwa; McDonald, Sheila; Suzanne, Tough; Patten, Scott; Holodinsky, Jessalyn
    Introduction: Longitudinal cohorts routinely collect information that encompass many different aspects of the life course, but their analysis is often restricted to validated scales. Such validated scales are often routinely shifting to reflect contemporary understandings of important concepts. Such routine changes often mean that a present-day scale measuring a concept may be incomparable to a different scale measuring the same concept in previous time-points. This restriction greatly hampers the strength of longitudinal cohorts in being able to make comparisons across time points. In this problem lies an opportunity to create a method of proxy development such that the proxy would be impervious to scale evolution over time. Flourishing is a common, well-studied concept that is a good candidate for this proof of concept. This thesis explores the use of proxy measurements as an optimization procedure for longitudinal cohorts going forward. Methods: As a proof of concept, two methods were explored for proxy creation using the test concept of flourishing. Using a bootstrapped linear regression approach, the proxy models were evaluated on performance metrics. Discussion: Although the proxy models performed similarly, the interpretation of results differed per model. Through the development of a flourishing proxy based on available data, it is possible to quantify historical flourishing, such that associations can be made between that and other concepts. Due to the context of the model derivation, the coefficients of either models cannot be extrapolated to other cohorts, but the coefficients of the knowledge-driven model can be furthur validated temporally within the derivation cohort. The included variables from both proxies contribute to the conceptual understanding of flourishing, but only in this specific cohort. Conclusion: Proxy derivation methods have the capacity to increase the value-add of historically collected data. However, more evaluations and validations of both the coefficients and the derivation method are needed before this can be used as a finalized procedure.
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    Mapping Current Adult Intensive Care Unit Patient Care Rounding Practices
    (2015-04-24) Holodinsky, Jessalyn; Stelfox, Henry Thomas
    Effective communication is essential for high quality patient care; within the ICU the majority of health care provider communication occurs during patient care rounds. While several best practices for rounds have been proposed it is unclear if they are being used in Canadian adult Intensive Care Units (ICU). The objective of this thesis was to describe current rounding practices in a sample of Canadian adult ICUs. A prospective observational study consisting of a national survey and follow up interviews was undertaken. ICU rounding practices were found to be heterogeneous across the country and overall self-rated rounding quality was high, but several opportunities for improvement were highlighted. This thesis proposes five recommendations for rounding practices: defining participants and roles, managing interruptions, further study on patient and family involvement, streamlining teaching during rounds, and creating an objective metric to assess rounding quality. A structured tool for use during ICU rounds is also proposed.