title: Evaluation of a changed model of care delivery in a Canadian province using outcome mapping.
abstract: BACKGROUND
  Collaboration between the Nova Scotia Department of Health and Wellness, the province's District Health Authorities (DHAs) and the Izaak Walton Killam (IWK) Health Center led to the development and implementation of a new collaborative model of patient-centered care delivery in the province.
  
  
  OBJECTIVE
  The objective was to determine the effectiveness of the initiative in arriving at the envisioned care model by investigating its impacts (if any) on patient, system, and providers outcomes.
  
  
  METHODS
  A repeated surveys study design with mixed methods in an outcome mapping framework was used to measure process and outcome indicators for patients and families, providers, and the system.
  
  
  RESULTS
  Almost all outcomes at the patient and family, provider, and system level improved following the implementation of the model, and these effects were stronger on units where the model was more fully implemented.
  
  
  CONCLUSIONS
  The efforts of the province, DHAs and IWK to improve patient care through the new care model have been successful. This evaluation is unique in the broad range of indicators it incorporates. Comprehensive monitoring and evaluation of health system changes is critical to system effectiveness.
authors.affiliation: Dalhousie University-WHO Collaborating Centre on Health Workforce Planning & Research, Halifax, Nova Scotia, Canada.
authors.forename: Gail
authors.initials: G
authors.lastname: Tomblin Murphy
authors.forename: Adrian
authors.initials: A
authors.lastname: MacKenzie
authors.forename: Rob
authors.initials: R
authors.lastname: Alder
authors.forename: Cindy
authors.initials: C
authors.lastname: Cruickshank
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009674:Nova Scotia; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018802:Patient-Centered Care / Q000458:organization & administration*
keywords: health system evaluation; health system transformation; model of care; outcome mapping