Larry, an idealistic young policy analyst, dreams of achieving change from the inside. On his quest to find a cure for ER crowding, he encounters poorly designed structures, misconceived improvement projects, managerial stonewalling, political posturing, and the ghost of Tommy Douglas. Can Larry save the system?
A digital micro-series of 11 bite-size episodes, Larry... is an all-singing, all-dancing, all-evidence-informed romp through the healthcare bureaucracy.
When not writing musicals, Sara Kreindler conducts health-systems research at the University of Manitoba. Prior to her faculty appointment, she spent eight years as a researcher with the Winnipeg Regional Health Authority. The non-hummable version of some of Larry’s adventures can be found in the following articles:
From the Western Canadian Patient Flow (WeCanFlow) Study
Kreindler SA, Schull MJ, Rowe BH, Doupe MB, Metge CJ. Despite interventions, emergency flow stagnates in urban Western Canada. Healthc Pol 2021; 16(4): 70-83. doi: 10.12927/hcpol.2021.26498
Kreindler SA, Star N, Hastings S, Winters S, Johnson K, Mallinson S, Brierley M, Nicholson Goertzen L, Anwar MR, Aboud Z. "Working against gravity": The uphill task of overcapacity management. Health Serv Insight 2020; 13: 1-6. doi: 10.1177/1178632920929986
Kreindler SA, Hastings S, Mallinson S, Brierley M, Birney A, Tarraf R, Winters S, Johnson K, Nicholson Goertzen L, Anwar MR, Aboud Z. The "hard, relentless, never-ending" work of focusing on discharge: a qualitative study of managers' perspectives. J Health Org Manag 2021 [epub ahead of print]; doi: 10.1108/JHOM-04-2021-0132
Kreindler SA, Aboud Z, Hastings S, Winters S, Johnson K, Mallinson S, Brierley M. How do health systems address patient flow when services are misaligned with population needs? A qualitative study. Int J Health Policy Manag 2021 [epub ahead of print]; doi: 10.34172/ijhpm.2021.36.
Prior Work on Patient Access and Flow
Kreindler SA. The three paradoxes of patient flow. BMC Health Serv Res 2017; 17:481. doi: 10.1186/s12913-017-2416-8
Kreindler SA. Six ways not to improve patient flow. BMJ Qual Saf 2016; 0: 1-7. doi:10.1136/bmjqs-2016-005438
Kreindler SA, Cui Y, Metge CJ, Raynard M. Patient characteristics associated with longer emergency department stay: a rapid review. Emerg Med J 2016;33(3):194-9. doi: 10.1136/emermed-2015-204913
Kreindler SA. Policy strategies to reduce waits for elective care: A synthesis of international evidence. Br Med Bull 2010; doi: 10.1093/bmb/ldq014.
Kreindler SA. What if implementation is not the problem? Exploring the missing links between knowledge and action. Int J Health Plann Manag 2016; 31(2): 208-226. doi: 10.1002/hpm.2277
Kreindler SA. Planning without action and action without planning? Examining a regional health system's efforts to improve patient flow, 1998–2013. Int J Health Plann Manag 2018; 33:e333–e343.
Primary Care and Physician–System Relations
Kreindler SA, Metge C, Struthers A, Harlos K, Charette C, Bapuji S, Beaudin P, Botting I, Katz A, Zinnick S. Primary care reform in Manitoba, Canada, 2011-15: Balancing accountability and acceptability. Health Policy 2019; 123(6): 532-537. https://doi.org/10.1016/j.healthpol.2019.03.014
Kreindler SA, Struthers A, Metge CJ, Charette C, Harlos K, Beaudin P, Bapuji SB, Botting I, Francois J. Pushing for partnership: Physician engagement and resistance in primary care renewal. J Health Org Manag 2019; 33(2): 126-140. https://doi.org/10.1108/JHOM-05-2018-0141
The show also draws on other literature, though with no intent to provide a comprehensive survey of health policy issues.
Larry Saves Healthcare is also the topic of research on the potential of arts-based knowledge translation. Details and publications will be posted here when available.