Conversations in Complexity - podcast cover

Conversations in Complexity

This is about challenges of complex care of patients with multimorbidity and patient caregiver involvement
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Episodes

Better Dementia Care: Connecting Science to Action

In this podcast, Ross Upsh ur interviews Gail Elliot about dementia care and the state of dementia care and how it can measure up to expectations that will provide the kind of care which takes into account the individual’s entirety as a human, focusing on personal narrative, brain, environment, needs, abilities and disease. In this podcast, Ross Upshur interviews Gail Elliot about dementia care and how it needs to measure up to societal expectations, providing the kind of care that takes into ac...

Feb 18, 202021 min

What it Means to be a Good Academic Citizen – Part 2

The academic research environment is changing and researchers report struggling to adapt in order to be successful. Funding shortfalls are perennial, but what systemic shifts should occur to enable researchers at all career stages to be productive and successful? Upon publishing “ Healthy research ecosystem – healthy researchers? The researcher as an organism of focus within a ‘research ecosystem ’” in Academic Matters in Fall 2019 issue, Ross Upshur and Michelle Nelson, convened to discuss them...

Dec 10, 201918 min

What it Means to be a Good Academic Citizen – Part 1

Upon publishing “ Healthy research ecosystem – healthy researchers? The researcher as an organism of focus within a ‘research ecosystem ’ in Academic Matters in mid-March 2019, Ross Upshur and Michelle Nelson, convened to critique themes from their paper and discuss a number of other academic matters not originally mentioned in the paper but have boggled the minds of many academics far and wide for a long time. In mid-March 2019, Ross Upshur and Michelle Nelson published “Healthy research ecosys...

Oct 29, 201919 min

Health Leadership Perspectives to Deploy a Seamless Integrated Care for the Older Adults in Catalonia

In this podcast, Ross Upshur, interviews Marco Inzitari, discussing the mechanisms and nuts and bolts of integrated care provided to the elderly population in Barcelona, Catalonia, Spain. Dr. Inzitari is the current President of the Catalan Society of Geriatrics and Gerontology and the Director of Intermediate Care, Research and Teaching of Parc Sanitari Pere Virgili in Barcelona. In this podcast, Dr. Marco Inzitari gives his first-hand account of the health and social care services provided to ...

Sep 06, 201922 min

“I was there for her”: A Caregiver’s Story

Gordon MacGregor, a member of the Alternate Level of Care Patient and Caregiver Council, in an interview with Ross Upshur reflects upon his personal experience taking care of his wife in a span of nearly 30 years. His experience with the health system is what thousands of patients and family caregivers undergo on daily basis. The interview highlights both positive and not so positive aspects of care and the need to take care of the instances that patients might find rather inconvenient or challe...

Jun 04, 201921 min

Striving for a Better Healthcare for the Elderly in Canada; An interview with Jane Barratt, the Secretary General of the International Federation on Ageing

Jane Barratt in an interview with Ross Upshur reflects on different aspects of elderly care and explains how it could be improved in Canada. In the interview, she gives an example of other countries and how they have been successful in laying the foundation for a more robust elderly care. In this interview, Jane Barratt, the Secretary General of the International Federation (IFA) on Ageing, describes how her interest in roams of care and allocation of services engaged her in the area of ageing a...

Feb 11, 201919 min

When All Roads Seem to Lead to Healthcare Complexity

ST: A Palliative Approach to Decision Aids to Help Improve Patients’ Medical Choices Pete Wegier in this interview with Ross Upshur discusses complexities of the end of life care and how coordination in this care setting could be optimized by the use of new communication technologies. Interestingly, his journey from computer science to cognitive psychology, to medical decision making and later to the space of palliative care has equipped Pete with tools that could help untangle some of the probl...

Nov 27, 201818 min

The Need for Intra- and Inter-sectoral Collaboration in Healthcare, in Interview with Michelle Nelson

Michelle Nelson in an interview with Ross Upshur discusses the importance of intra- and inter-sectoral collaboration in healthcare and explains how the voluntary sector could be engaged to support improved patient and family experiences and the outcomes. In a recent interview with Ross Upshur, Michelle Nelson, a Research Scientist at Research Collaboratory, Lunenfeld-Tanenbaum Research Institute, explained about her research, the importance of intra- and inter-sectoral collaboration in health ca...

Sep 18, 201813 min

Simplifying the Complexity of Palliative Care

Jeff Myers, in this interview with Ross Upshur, discusses the evolution of palliative care and the evidence that has accumulated outlining its impact on outcomes for patients, families, and systems. With early efficacy studies having focused on end-of-life experiences for patients with cancer, strong evidence now clearly delineates a role for palliative care from the time of diagnosis for any person with serious illness and their family. Serious illnesses are those that are incurable and progres...

Jul 10, 201819 min

Safer Opioid Prescribing and Non-opioid Alternatives for Chronic Pain

Abhimanyu Sud, in an interview with Ross Upshur, talks about the current opioid crisis, the challenges and the opportunities to respond to the crisis at different levels including improved prescriber education and use of evidence-based non-opioid alternatives for chronic pain. Abhimanyu Sud is the Academic Director of Safer Opioid Prescribing at Continuing Professional Development at the University of Toronto. A graduate of Yale University and the University of Toronto, he is a community-based f...

May 22, 201818 min

Is There a War on Science? Philosopher Maya Goldenberg Says No

Maya Goldenberg, in an interview with Ross Upshur, talks about her academic journey from a close look at evidence-based medicine and its philosophical issues to a feminist approach to the philosophy of science. Later on, Maya will discuss her research interest in fundamental issues related to public health policy such as vaccine hesitancy. The interview culminates to a very fascinating view on the state of science in the current political world. Maya Goldenberg is an Associate Professor of Philo...

Apr 17, 201822 min

Building Capacity for Palliative Care

Sarina Isenberg, interviewed by Ross Upshur, discusses palliative care from the lens of a scientist and health researcher committed to making a difference for those who receive such care in the course of their disease. Sarina’s first experience with palliative care was at a relatively young age when two loved ones were in palliative care in the course of their terminal illnesses. Later, her studies in health-related subjects landed Sarina in palliative care study and research, which is a subject...

Jan 31, 201821 min

Looking ahead for a more Upstream Population Health; Interview with Gary Newton, Sinai Health System CEO

Gary Newton, in an interview with Ross Upshur, discusses his agenda as the Chief Executive Officer of the Toronto Sinai Health System while explaining his views on complex care and how he is trying to bring about change in Sinai Health System in Toronto. In this fascinating and candid interview, Dr. Gary Newton talks about his views towards complexity, his aha moments, his involvement in health administration, his experience of running a hospital based Division of Cardiology, the Department of M...

Oct 31, 201720 min

Demystifying the Role and Extent of e-Technology in the Management of Patients with Complex Care Needs

Carolyn Steele Gray, in interview with Ross Upshur, discusses how her academic journey shaped her perspectives in understanding patient needs, health policy, organization and provider level issues and how to use that understanding to deliver a better care. The latter, she adds, necessitates a realistic approach of how to harness e-health technologies to deliver care, especially to patients with complex care needs. Carolyn discusses how technology in health is not the silver bullet to healthcare ...

Sep 27, 201719 min

Transforming Health System Performance from a Scientist-marathoner’s Perspective

Kerry Kuluski, in interview with Ross Upshur, discusses her undertakings in her journey from being a social worker to a scientist. Her goal is to improve health system performance for people with multimorbidity and their caregivers. This is a fascinating talk as it explains how looking at data sets and trying to analyze them is not the only way to meet the needs of people, especially the ones who are “stuck in transition”. She also draws interesting parallels between marathon training and grant ...

Sep 01, 201719 min

Lessons from Elderly Care in the UK

Jon Glasby in interview with Ross Upshur, discusses his research focused on understanding and responding to “inappropriate” emergency hospital admissions of older people. In the interview, he discusses how his research took up the challenge of hospital admissions of frail older people with multiple chronic conditions and how many of the admissions could be prevented. His work expands the debate from merely one of how to allocate scarce resources in hospital settings to one of organizing better, ...

Jul 31, 201725 min

Why is it so difficult to access care for patients with multimorbidity?

Julia Ho in interview with Ross Upshur talks about her recent article “It’s a fight to get anything you need”—accessing care in the community from the perspectives of people with multimorbidity, published in the Open Access journal of Health Expectations.

Jul 12, 201721 min

The Concept of Evidence in Healthcare – Part 2

Ross Upshur further examines evidence from a scientific, philosophical and ethical viewpoint in the second part of the podcast “Concept of Evidence in Healthcare”. Throughout the discussion, he presents practical examples of how the provisional nature of evidence has played a role in justifying the practice of medicine as it has evolved over time. The talk is intriguing as is the subject itself. Some of the articles mentioned in the podcast: We need both evidence and values to navigate uncertain...

Jun 22, 201720 min

The Concept of Evidence in Healthcare – Part 1

Ross Upshur explores a very important concept in modern healthcare: "The Concept of Evidence" in this and the next podcast. He talks about evidence and what it means to base decision on evidence. He would also dig into its evolution; attempts made to orient clinical decision making to the literature; its new dimensions and hierarchy of evidence; “what it is and what it isn’t”; and how it relates to patients values and expectations; and more. Links to some of the articles mentioned in the first p...

Jun 14, 201714 min

Polypharmacy – Part 2

Ross Upshur discusses the problems with polypharmacy and looks at some proposed solutions to the problem in the second part of the two podcasts on the subject.

Jun 07, 201716 min

Polypharmacy – Part 1

Ross Upshur is examining the issues related to medications use, polypharmacy and deprescribing in patients with multiple chronic conditions in this and the next podcast. He examines some of the issues that arise in clinical practice and tries to explain the phenomenon. In the second podcast he looks at some proposed solutions to the problem.

May 31, 201719 min

An Introduction to Complexity

Ross Upshur discusses how the care of patients with multiple concurrent chronic conditions and social determinants pose substantial challenges for both primary care providers and health systems and how his research lead to the creation and implementation of an inter-professional model of care to address the issue.

Mar 30, 201715 min
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