Co-developing a research plan to investigate inter-disciplinary experiences, enablers, challenges and unintended outcomes of nurse practitioner integration into primary care in Island Health

Co-lead: 

  • Darcy Ross
    Island Health

Team members: 

  • William Cunningham
    Island Health
  • Patti Telford
    Nurse & Nurse Practioners of BC
  • Zachary Matieschyn
    BC Ministry of Health
  • Christina Berlanda
    Island Health
  • Shelley Tice
    Island Health
  • Danielle Daigle
    Nurse & Nurse Practioners of BC
  • Angela Wignall
    Island Health
  • Jinelle Woodley
    Island Health
  • Steve Goodchild
    Island Health
  • Brenda Warren 
    Island Health
  • Leanne Rowand
    Main Island Health Centre
  • Lorine Scott
    FNHA

Nurse Practitioners (NPs) have practiced in BC since 2005, and are qualified to provide holistic primary care across the life span, similar to primary care physicians. Until 2018, NPs were health authority employees in salaried positions; in 2018 the MOH announced 200 new community NP positions and a contract payment structure option. Numerous contracted NP positions have since been introduced in Island Health. Integrating contracted NPs into an established primary care model traditionally provided by doctors has exposed unique challenges, opportunities and unintended outcomes. Although all stakeholders have generally worked well together, unanticipated conflicts and inefficient work flow impacts have arisen. Integrating inter-professional scopes of practice into an efficient and seamless system of innovative primary care in context of mixed expectations has been challenging. Published evidence suggests that full NP role optimization is affected by practice environments. We aim to develop a research plan to identify the enablers, challenges and unexpected outcomes, and determine how innovative processes enabling focused collaboration, clear scope of practice and improved teamwork can improve flow and access in primary care.

AIRWISE – A risk communication strategy for the prevention and early detection of respiratory illness

Co-lead: 

  • Renelle Myers 
    BC Cancer

Team members: 

  • Aleisha Fernandes
    SFU
  • Prabjit Barn
    Legacy for Airway Health
  • Stephen Lamb
    UBC, BC Cancer
  • Mohsen Sadatsafi
    RESP, UBC
  • Christopher Carlsten 
    UBC
  • Rita McCracken 
    UBC, PHC
  • Kevin Keen
    UNBC
  • Anne-Marie Nicol
    SFU, BCCDC
  • Milan Khara
    UBC, VCH
  • Pat Camp 
    UBC, HLI, PHC

Respiratory illnesses, such as asthma, chronic obstructive pulmonary disease, and lung cancer account for the leading causes of preventable deaths in British Columbia. Scientists can now identify people who are at a high risk of developing these devastating illnesses early on when it is possible to prevent, cure or slow the progression of disease. Prevention and early detection programs, however, don’t reach all members of the population equally. In addition, environmental radon and air pollution increase the risk of developing respiratory illnesses for people living in some areas of the province. This study is motivated by the need to expand the reach of prevention and early detection programs through risk communication. Our experienced team of researchers, community stakeholders, trainees, and knowledge translation specialists will define the risk information that is needed for future research and for communicating in clinical and community-based settings. Together, we will convene an advisory committee to design the first version of the AIRWISE risk communication platform and establish community coalitions to evaluate and implement it.

Eng/aging and HIV: Knowledge exchange between administrative data study and older adults living with HIV in British Columbia

Co-lead:

  • Valerie Nicholson 
    BC Centre for Excellence in HIV/AIDS

Team members: 

  • Kathleen Inglis
    SFU
  • Wayne Campbell
    AIDS Vancouver
  • Antonio Marante
    BC Centre for Excellence in HIV/AIDS
  • Patience Magagula
    Afro-Canadian Positive Network of BC
  • Silvia Guillemi
    BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Dr. Peter Centre
  • Andreea Bratu
    BC Centre for Excellence in HIV/AIDS

Since the 1980s, HIV/AIDS community groups have engaged with science to ensure that research is done with them instead of simply about them yet it is rare for communities to engage with studies using administrative health data — that is, data electronically generated at every encounter with the health care system for administrative or billing purposes. This is a collaborative project amongst researchers and people living with HIV that explores how to embody the “nothing about us without us” principle in administrative data studies to ensure ongoing authentic engagement across all HIV research. Engaging with an administrative data study called COAST at the B.C. Centre for Excellence in HIV/AIDS, we will co-develop, pilot, and evaluate a process to research the experience of aging with HIV. In B.C., over half of people living with HIV who are on treatment are over 50 years of age. People with HIV are living longer lives. Through a regular series of meetings with our research council, we aim to develop a way to leverage administrative data (COAST) to better understand the complex reality of aging with HIV that is relevant to people living with HIV, which may help improve health services and health outcomes for people living with HIV.

Reimagining perinatal mental health services: Collaborative development of an integrated model of care

Co-lead: 

  • Michelle Carter
    Providence Health Care

Team members: 

  • Wendy Hall 
    UBC
  • Angela Russolillo
    St. Paul's Hospital
  • Brittany Bingham
    VCH Aboriginal Health
  • Christine Ou
    UBC
  • Valerie Rychel
    St. Paul's Hospital
  • Sheila Duffy
    Pacific Post Partum Society
  • Nichole Fairbrother
    UBC

Perinatal mood and anxiety disorders (PMADs) are the most common obstetrical complication in Canada, with serious implications for both the mother and infant. Untreated PMADs are associated with increased risks for poor health and social outcomes, including maternal suicide and medical complications as well as impaired infant and child development. There is increasing scientific evidence that collaboration across clinical services is essential to addressing the complex biopsychosocial needs associated with PMADs. Nevertheless, perinatal mental health (PMH) services in Canada remain fragmented, often resulting in missed opportunities to support necessary care and treatment. 

There is an immediate need to improve the access and integration of services for PMADs in BC. In an effort to narrow the evidence to practice gap, we plan to create a collaboration between clinicians, researchers and individuals with lived experience through a scientific consensus process (Delphi approach) and one-day virtual workshop. Our main objective is to develop an evidence-based, user-informed model of care to advance integrated PMH care delivery in BC and beyond.

Developing a research program on using a restorative approach to address secondary harm to patients, families and clinicians after adverse events in our healthcare system

Co-lead: 

  • Allison Kooijman
    UBCO

Team members:

  • Jo Wailing
    Victoria University of Wellington
  • Robert Robson
    Healthcare System Safety and Accountability Inc.
  • Brenda Morrison
    SFU
  • Malcolm MacLure
    UBC
  • Fiona MacDonald 
    Univresity of the Fraser Valley
  • Diane Aubin
    Diane Aubin Consulting
  • Jennifer Llewellyn
    University of Dalhousie
  • Carolyn Canfield
    UBC
  • Deb Prowse
  • Christina Krause
    BCPSQC
  • Devin Harris
    Interior Health
  • Sandi Kossey
    Canadian Patient Safety Institute
  • Jan Byrd
    Canadian Patient Safety Institute
  • Glenn McRae
    Interior Health
  • Wendy Nicklin
    International Society for Quality in Patient Care
  • David Gustafson
    Community Justice Initiatives Association
  • Alika Fontaine
    University of Alberta
  • Derek Puddester
    College of Physicians and Surgeons of BC
  • Ainsley Young
    Island Health
  • Ryan Sidorchuk
    Island Health

Patient harm in providing health services is a significant safety issue. Many efforts have been made to improve patient safety and prevent harm, however high rates of patient safety events continue. When patient harm does occur, there are negative effects for patients, families and health providers involved. Significant barriers prevent healing after harm. Patients have difficulty finding justice, health providers experience shame and self-doubt, and healthcare facilities are concerned with litigation and reputation. This disconnect between the health system (meant to heal) and the justice system (meant to punish) creates confusion for patients and health providers when medical treatment goes wrong. This process can prevent healing for both patients and health providers. A restorative approach builds relationships, shares experiences related to the harm, and focuses on fairness for individuals involved and to society as a whole. Such an approach has not yet been used in healthcare in Canada. This project brings together a team of researchers and knowledge-users to develop a program of research to address priority questions on this approach, to provide solutions for the impacts of harm for patients, families and health providers.

A collaborative project to explore COVID-19 rapid redesign and redeployment best practices and their uptake in British Columbia long-term care sector

Co-lead: 

  • David Keselman
    Louis Brier Home and Hospital

Team members:

  • Karen Neilson
    BC Ministry of Health
  • Heather Cook 
    BC Ministry of Health
  • Maura McPhee
    UBC
  • Alison Phinney
    UBC 
  • Sabina Staempfli
    UBC
  • Jennifer Stokes
    Island Health
  • Ayako Nilssen
    Island Health
  • Vicki Andersen
    Louise Brier Home and Hospital
  • Mirsad Dragic
    Louis Brier Home and Hospital
  • Keren Gersman
    Louise Brier Home and Hospital
  • Dan Galazka
    Louise Brier Home and Hospital
  • Michael Kary
    BC Care Providers Association
  • Pam Baxter 
    McMaster University

In Canada, 81% of COVID-19 deaths were in long-term care (LTC) settings. To slow the virus spread, the BC government mandated LTC sites to introduce a series of new practices and policies. For example, families and visitors were no longer allowed into LTC sites; and staff were banned from working in more than one location. In June 2020, our research team received an MSFHR grant to examine the intended and unintended consequences of these practices and policies on residents, families and staff in a ‘gold standard’ publicly funded facility with no COVID cases. We have had many interesting findings related to effective pandemic management to date, but it is unclear if these findings are applicable to other BC LTC sites.

The proposed project will bring together nearly 170 researchers and research users across 5 regional health authorities to identify best pandemic management practices and policies and to discuss strategies for their uptake. The network represents 7 key stakeholder groups including policy/advocacy, leadership and resident and family representatives. The project outcomes include recommendations for effective pandemic management in publicly funded BC LTC sites and a research advisory group to support future research.

Building a collaborative research agenda for virtual exercise and nutrition supportive cancer care in BC​

Co-lead: 

  • Alan Bates
    BC Cancer

Team members: 

  • Cheri Van Patten 
    BC Cancer
  • Stuart Peacock 
    SFU
  • Helen McTaggart-Cowan 
    SFU
  • Guy Faulkner
    UBC
  • Alina Gerrie
    BC Cancer
  • Nathalie LeVasseur
    BC Cancer
  • Rosemary Cashman
    BC Cancer
  • Kendra Zadravec
    UBC
  • G. Haukur Guomundsson
    UBC
  • Scott Lear
    SFU
  • Jeremy McAllister
    Physiotherapy Board of BC

The Nutrition and Exercise During Treatment (NEXT) Program is a long-standing collaboration (since 1999) between BCC and the UBC. In-person programming has been developed, research tested, and then offered to BCC patients. To meet evolving health needs, especially for British Columbians who live in rural and remote locations, coupled with the evolving needs for the current pandemic, we need to further develop tools to effectively shift into virtual models of care. This collaborative project will bring together a working group to plan and prioritize a research agenda to develop accessible and effective virtual (online) supportive care (exercise and nutrition programs) for people living with, and beyond, cancer in British Columbia. This collaboration will include a core working group of researchers (UBC, Simon Fraser and BCC), patient partners and people working in delivery and administration of clinical cancer care in British Columbia (Patient Partners, Allied Health Professionals, Oncologists, Nurse Practitioners, and Administrators).

Collaborating to explore complementary approaches to mental wellness and resiliency during the COVID-19 pandemic and beyond

Co-lead: 

  • Lisa Ridgway
    Patient partner

Team members: 

  • Fidel Vila-Rodriguez
    UBC
  • Aanchel Gupta
    CHEOS, UBC
  • Alberto Almeida
    St. Paul's Hospital, PHC
  • Ursula Ellis
    UBC
  • Ruth Lavergne
    SFU
  • Mariah Allyson Banal
    UBC
  • Arminee Kazanjian
    UBC

Building on the work that our team has done regarding home-based activities that can improve mental wellness during the COVID-19 pandemic, we are proposing a series of activities that will build and foster collaboration among researchers from various disciplines, people with lived experience, and experts and practitioners of various activities that have therapeutic effects on mental health. Specifically, we propose to form a collaborative group that will meet once every month to set research agenda and priorities and to plan the holding of a virtual conference in September 2021 and the preparation of a systematic plan to conduct a knowledge synthesis. The focus of both activities will be on improving mental wellness through effective self-directed activities that can be performed at home or in the community. 

Outputs from the proposed activities will be used to plan future research activities and secure funding for a knowledge synthesis that can inform current approaches to addressing mental health needs at the individual, practice, and health system levels.
 

Building on Strengths in Supported Housing and the Treatment of Mental Illness in BC

Research co-lead:

  • Julian Somers
    Simon Fraser University, At Home Project, Homeless Intervention Program, Inter-Ministry Research Initiative
Research user co-lead:

  • Darrell Burnham
    Coast Mental Health
Team members:

  • David MacIntyre
    BC Non-Profit Housing Association
  • Dominic Flanagan
    BC Housing
  • Taryn Walsh
    Ministry of Mental Health & Addiction
  • Elenore Arend
    Ministry of Public Safety & Solicitor General
  • Colin Ross
    City of Vancouver, BC Justice Summit
  • Stefanie Rezansoff
    Simon Fraser University

BC research has examined the effects of supported housing on mental illness, addiction, crime, public safety, community integration, quality of life, and total public expenditure. Local and international studies show that increased spending does not necessarily result in significant improvement for people with complex needs, and that effective interventions require specific coordinated approaches to service delivery. At present, no central source of support exists to ensure that relevant research is available to inform practices in BC.

This project will convene provincial partners who are responsible for addressing homelessness, mental illness, and addiction, and identify priorities for cross-sector coordination, implementation of best practices, and evaluation. Identified priorities will be reviewed with additional provincial stakeholders (e.g., municipal government, community-based housing & health service providers, patients & family members). Priorities and recommendations will be finalized by the project team along with recommended next steps and made available to the public via SFU web-based media and communications.

Results will inform a multi-year plan for applied research addressing housing and mental illness in BC.

Virtual Innovative health Strategies through Interdisciplinary co-Operative Network (VISION)

Research co-lead: 

Research user co-lead:

  • Thomas Noseworthy
    BC Academic Health Sciences Network (BCAHSN)

Team members: 

  • Dr. Riyad Abu-Laban
    University of British Columbia
  • Dr. Giuseppe Carenini
    University of British Columbia
  • Dr. Jim Christenson
    University of British Columbia, BC Emergency Medicine Network
  • Dr. Martin Dawes
    University of British Columbia, GenXys
  • Dr. Thalia Field
    University of British Columbia
  • Dr. Nat Hawkins
    University of British Columbia
  • Dr. Anita Ho
    University of British Columbia, Centre for Health Evaluation & Outcome Sciences
  • Dr. Richard Lester
    University of British Columbia, WelTel
  • Dr. Craig Mitton
    University of British Columbia, Centre for Clinical Epidemiology & Evaluation, VCH Research Institute
  • Dr. Panos Nasiopoulos
    University of British Columbia
  • Dr. Raymond Ng
    University of British Columbia, Data Science Institute UBC
  • Dr. Helen Novak Lauscher
    University of British Columbia
  • Dr. Frank Scheuermeyer
    University of British Columbia, St Paul’s Hospital
  • Dr. Mahsa Talebpourazad
    University of British Columbia
  • Dr. Hubert Wong
    University of British Columbia, Centre for Health Evaluation & Outcome Sciences, BC SUPPORT Unit
  • Dr. Eric Grafstein
    University of British Columbia, Vancouver Coastal Health, Providence Health Care
  • Dr. Ronald Heslegrave
    William Osler Health System
  • Dr. Deepak Kaura
    Joule Board of Directors, 1Qbit
  • Dr. Chad A. Kim Sing
    University of British Columbia, Vancouver Coastal Health
  • Dr. Douglas Kingsford
    Interior Health, BC Ministry of Health
  • Colleen McGavin
    BC SUPPORT Unit
  • Dr. Tom Noseworthy
    BC Academic Health Sciences Network
  • Dr. Don Sin
    University of British Columbia, Centre of Heart Lung Innovation
  • Dr. Sean Virani
    University of British Columbia, Canadian Heart Failure Society
  • Tina Cheng
    University of British Columbia
  • Michael Lai
    University of British Columbia
  • Sophia Ly
    University of British Columbia
  • Azzra Mangalji
    University of British Columbia
  • Ellison Richmond
    University of British Columbia

 Patient care today relies heavily on patients and caregivers coordinating their own records, leading to difficulties building comprehensive and accurate health records. Digitizing the patient journey, from using electronic records to tracking patients' health with portable sensors, are now conceivable to curate and accurately record health information and improve self-management. To begin transforming healthcare using technology-enabled healthcare approaches, commonly referred to as virtual or digital health, we need rigorous interdisciplinary research.

Virtual Innovative health Strategies through Interdisciplinary co-Operative Network (VISION) aims to advance research to develop and evaluate virtual and digital interventions in healthcare. With experienced faculty members, trainees, and research users (eg. patients, caregivers, policy makers, healthcare professionals, industry) from health, social, and natural sciences, together we can work to digitize healthcare.

Through this MSFHR grant, we will bring VISION members and experts outside of BC together to explore key areas of interdisciplinary research in digital health and convene a patient and caregiver advisory committee to guide our patient-oriented research path forward.