Role of Policy in Best-Practice Dissemination: Informal Professional Advice Networks in Canadian Long-Term Care

Abstract

This article examines provincial policy influence on long-term care (LTC) professionals' advice-seeking networks in Canada's Maritime provinces. The effects of facility ownership, geography, and region-specific political landscapes on LTC best-practice dissemination are examined. We used sociometric statistics and network sociograms, calculated from surveys with 169 senior leaders in LTC facilities, to identify advice-seeking network structures and to select 11 follow-up interview participants. Network structures were distinguished by density, sub-group number, opinion leader, and boundary spanner distribution. Network structure was affected by ownership model in Nova Scotia and Prince Edward Island, and by regional geography in New Brunswick. Political instability within each province's LTC system negatively affected network actors' capabilities to enact innovation. Moreover, provincial policy variations influence advice-seeking network structures, facilitating and constraining relationship development and networking. Consequently, local policy context is essential to informing dissemination strategy design or implementation.

Keywords: Canadian provinces; ageing; analyse de réseaux sociaux; health system research; informal advice-seeking networks; long-term care; provinces canadiennes; recherche sur les systèmes de santé; réseaux de conseils informels; social network analysis; soins de longue durée; vieillissement.