Dr. Barrett is an Operations Management Professor in the HBA, MBA and EMBA programs at Ivey. Dr. Barrett’s past interactions and experiences with healthcare clinicians and administrators has largely motivated his focused interest in advancing scholarly theorization and managerial understanding of the requisite operational and organizational capabilities that underpin the productive deployment of a systematic lean management approach. His personal research focuses on the design, delivery and capture of value for and from customers through the deployment of a well-designed lean management approach.
From 2015-20, Dr. Barrett served as the Executive Director of the Ivey International Centre for Health Innovation (IICHI). At IICHI, his team of researchers focused on value based healthcare initiatives and efforts to enhance the value created and captured through systematic improvements and disruptions to the healthcare delivery value chain and for the healthcare system in totality.
Prior to completing his MBA at Ivey and embarking on a management consulting career based in Boston, David was an elite level men’s hockey coach. His unique blend of coaching, consulting and academic training enables him to apply a rare mix of skills and perspectives to problems within the operations and supply chain functional areas of a business.
Dr. Barrett is a Certified Management Accountant and a Chartered Professional Accountant. He serves as the Chair of the Research and Business Committee, the Bone & Joint Institute Western University, Co-Chair of Value Based Healthcare Canada at the Conference Board of Canada, and as a Member, Academic Thought Leadership Committee, for Kinaxis Canada.
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Barrett, D.; Sibalija, J.; Kim, R. B., 2024, "Patients’ Experiences of a Precision Medicine Clinic", Journal of Patient Experience, June 11
Abstract: The purpose of this study is to provide an overview of patients’ experiences using a precision medicine (PM) clinic that conducts pharmacogenomics-based (PGx) testing for adverse drug reactions. The study aimed to identify the features of the clinic valued most by patients and areas for improvement. A paper survey was used to collect data. Survey questions focused on patients’ perceptions of the PM testing and the overall clinic experience. Sixty-seven patients completed the survey. Quantitative data were analyzed using SPSS and frequencies were reported. Open-ended responses were coded and organized thematically. Patients reported that the clinic services increased confidence in their medication usage. Feeling respected by staff, receiving education, and quick appointments were highly valued by patients. Suggested areas for improvement included better communication from the clinic to patients, expansion of clinic services, and education for other healthcare providers. The findings demonstrate that patient experience goes beyond the clinical care provided. Current and potential future providers of PM should invest the time and energy to configure their care delivery system to enhance the patient experience.
Link(s) to publication:
http://dx.doi.org/10.1177/23743735241229384
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Begen, M. A.; Bayley, T.; Rodrigues, F.; Barrett, D., 2022, "Relative Efficiency of Radiation Treatment Centres: An Application of Data Envelopment Analysis", Healthcare, June 10(6): 1033 - 1033.
Abstract: We evaluate a number of cancer treatment centres in Ontario and determine their relative efficiency so that their performance can be compared against the provincial targets by taking into account the differences among them. These differences can be in physical and financial resources, and patient demographics. We develop an analytical framework based on a three- step data envelopment analysis (DEA) model to build efficiency metrics for planning, delivery, and quality of treatment at each centre, use regression analysis to explain our efficiency metrics, and demonstrate how our findings can inform continuous improvement efforts.
Link(s) to publication:
https://www.mdpi.com/2227-9032/10/6/1033
http://dx.doi.org/10.3390/healthcare10061033
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Subasri, M.; Barrett, D.; Sibalija, J.; Bitacola, L.; Kim, R. B., 2021, "Pharmacogenomic-based personalized medicine: Multistakeholder perspectives on implementational drivers and barriers in the Canadian healthcare system", Clinical and Translational Science, November 14(6): 2231 - 2241.
Abstract: Pharmacogenomics (PGx)-based personalized medicine (PM) is increasingly utilized to guide treatment decisions for many drug-disease combinations. Notably, London Health Sciences Centre (LHSC) has pioneered a PGx program that has become a staple for London-based specialists. Although implementational studies have been conducted in other jurisdictions, the Canadian healthcare system is understudied. Herein, the multistakeholder perspectives on implementational drivers and barriers are elucidated. Using a mixed-method qualitative model, key stakeholders, and patients from LHSC’s PGx-based PM clinic were interviewed and surveyed, respectively. Interview transcripts were thematically analyzed in a stepwise process of customer profiling, value mapping, and business model canvasing. Value for LHSC located specialist users of PGx was driven by the quick turnaround time, independence of the PGx clinic, and the quality of information. Engagement of external specialists was only limited by access and awareness, whereas other healthcare nonusers were limited by education and applicability. The major determinant of successful adoption at novel sites were institutional champions. Patients valued and approved of the service, expressed a general willingness to pay, but often traveled far to receive genotyping. This paper discusses the critical pillars of education, awareness, advocacy, and efficiency required to address implementation barriers to healthcare service innovation in Canada. Further adoption of PGx practices into Canadian hospitals is an important factor for advancing system-level changes in care delivery, patient experiences, and outcomes. The findings in this paper can help inform efforts to advance clinical PGx practices, but also the potential adoption and implementation of other innovative healthcare service solutions.
Link(s) to publication:
http://dx.doi.org/10.1111/cts.13083
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Sibalija, J.; Barrett, D.; Subasri, M.; Bitacola, L.; Kim, R. B., 2021, "Understanding value in a healthcare setting: An application of the business model canvas", Methodological Innovations, October 14(3)
Abstract: The business model canvas is a popular tool used to develop value-driven business models. Specific emphasis is placed on understanding what customers value and providing users with steps on how to design and deliver value for their customers. In health care, creating and delivering value for patients is an often-discussed topic, with the provision of patient-centered care becoming a standard for many health care organizations. While patients play a key role in determining value, providers are the key to delivering value. Therefore, effective health care management relies on integrating multiple perspectives from key stakeholders. This process requires consideration of the key needs that must be addressed, the resources and capabilities necessary to meet these needs, and the interests and values specific to each set of stakeholders. The business model canvas lends itself well to health care service planning as it incorporates the factors described above into the business model’s conceptualization and subsequent realization. This article outlines how the business model canvas was applied to assess the needs of physician stakeholders to help guide the expansion of a pharmacogenomic-based precision medicine clinic that conducts genetic testing for patients at risk of experiencing adverse drug reactions. The article provides a detailed description of how the business model canvas was used and adapted to understand physician’s responsibilities and challenges related to drug prescription and dosing, and how the clinic could address physician needs and create value by mapping clinic services onto physician needs and wants. Interviews were conducted with physicians and the data were analyzed following the recommendations of the developers of the business model canvas. The article examines the strengths and limitations of the business model canvas and discusses its applicability to a health care setting.
Link(s) to publication:
http://dx.doi.org/10.1177/20597991211050477
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Saxton, K. G.; Barrett, D.; Gould, L.; Sandieson, R. M.; Koivu, S.; Meyer, M. J., 2020, "Exploring Residential Models of Care for Treatment of Infectious Complications Among People Who Inject Drugs: a Systematic Review", International Journal of Mental Health and Addiction, June 18(3): 772 - 783.
Abstract: This article identifies, compares, and assesses residential models of care to treat infectious complications among people who inject drugs (PWID) through intravenous antibiotic (IV) therapy. Database searches in Ovid MEDLINE, Embase, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature Studies were performed. A Google web search was also performed. Studies published in English between 2000 and May 2017 that presented data on an out-of-hospital residential program for IV antibiotic treatment of infectious complications among PWID were included. Of the 2355 unique articles screened, 218 were reviewed in their entirety and three were included. Across the three included studies, no mortalities were reported during the study. Each study reported similar outcomes compared to in-hospital care. In the two studies reporting costs, residential care was substantially less expensive. This review indicates that residential treatment appears to be beneficial to PWID, hospitals, and the health care system.
Link(s) to publication:
http://dx.doi.org/10.1007/s11469-019-00113-1
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Siu, S.; Scarffe, A. D.; Barrett, D.; Strong, M. J.; Schulz, V.; Dixon, D. R.; Calvin, J. E., 2019, "Enhancing Physician Managerial Capabilities: Partnership between Medicine and Business", MedEdPublish, April 8(2)
Abstract: Background
Physicians are typically appointed to leadership roles within health care organizations on the basis of individual accomplishments in research, education, and/or clinical care. However, these types of achievements seldom provide the requisite management capabilities to lead within health organizations. In this manuscript, we described our initial experience in developing an in-house program to provide current and aspiring physician leaders with the managerial capabilities to enhance the quality of health care delivery within their respective organization.
Methods
In a partnership established between a Medical School and a Business School, we designed two series of weekend workshops to provide current and aspiring physician leaders with the financial capabilities to assist them in their future healthcare leadership careers. This course was then expanded to a Management Principles for Physician workshop with open enrollment to physicians at all levels. Baseline demographics and participant evaluations of each course were recorded. In the open enrollment Management Principles for Physician workshop, we examined the relationship between participant background and their course evaluations as well as their areas of interest for further training.
Results
All 3 workshops received excellent evaluations by participants. The positive impact of the open enrollment program, based on participants’ self-evaluations, was the highest in female physicians, as well as early to mid-career physicians. Additionally, physicians who do not currently hold leadership positions and those who are leading at Divisional levels were the most interested in further training in finance.
Conclusion
In summary, this series of workshops demonstrated the feasibility of an in-house physician leadership program and yielded important information for the design of future leadership development curriculum.
Link(s) to publication:
http://dx.doi.org/10.15694/mep.2019.000096.1
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