In the 1970s the Canadian health system was in the midst of a major change. The times called for improved policy research, planning and administration, and there was a need for education in health administration.
“The University of Alberta’s master of health services administration (MHSA) program was the most progressive program in Canada,” says Grace Johnston (MHSA ’74). “I felt that researchers were needed to help improve the health system, and I wanted to fill that gap.”
Johnston recognized that Canada was one of the world leaders in population-based health data, and that Statistics Canada was, and still is, an international leader in record linkage. For example, Canada has cancer registries dating back to the 1930s and Vital Statistics’ death data dates back to the 1940s. Knowing this, Johnston pursued research grounded in linkage of health administration databases.
“We needed people—researchers—with vision and creativity to maximize this potential, generate metrics, identify needs and advocate for improvements in our health system,” explains Johnston.
And Johnston did just that.
Johnston was the principal investigator for the Network of End of Life Studies and Advanced Breast Cancer Supportive Care. She is now professor emeritus in the School of Health Administration at Dalhousie University where she continues to carry out research to improve advance care planning and palliative support for those at the end of their life.
She works with others to develop population-based metrics that did not exist when she first began her palliative care research more than twenty years ago. Johnston and her team developed the methodology which was published by the Canadian Medical Association Journal in 1998. Since then, their methods have been used and adapted for national and international research, surveillance and environmental scans.
“We have remained at the cutting edge of developing new and improved methods, and their application in evaluating innovations,” says Johnston.
In 2011, her team was the first to publish a classification and regression tree analysis of the predictors of who was being enrolled in a palliative care program amongst persons dying of cancer. The team were also the first in Canada to carry out a mortality follow-back study. In 2015, they published in the Canadian Journal of Diabetes on identifying persons with diabetes who could benefit from a palliative approach. Most recently, the Canadian Journal of Aging published the team’s rules to identify frailty using administrative data, and they were just funded to use operations research to model the future need for palliative care specialists, another example of applying a cutting edge method to a palliative care challenge.
“Seeing our work being used nationally and internationally has been extremely rewarding. ”
(Last updated October, 2017)