The overall aim of this project is to address gaping holes in how musculoskeletal pain is served in BC emergency departments. We will develop and pilot the Musculoskeletal Comprehensive and Response in Emergency (MSK CARE) clinic in emergency departments in the Fraser Health Authority. This type of clinic diverts patients to a MSK practitioner for triage and management. Similar clinics are running successfully in Australia and Canada (Montréal, Quebec City, Kingston, Calgary, Sherbrooke). In BC, there are no similar clinics like the MSK CARE clinic, despite these types of clinics delivering “shorter wait times, happier patients and expert care.” We will measure whether the MSK CARE clinic can (1) reduce the amount of time patients spend waiting in emergency departments, 2) successfully re-direct (‘divert’) patients from the emergency departments, and (3) is an acceptable and feasible model of care. The findings will be shared through research publications, webinars, café scientifique, and infographics. The findings from this project can provide one solution to assist in tackling overcrowding in the Fraser Health emergency departments and improve access to primary care for all people with musculoskeletal pain in this region.
Research Location: Fraser Health Authority
Post-intensive care clinical and functional outcomes in adults with sarcopenia.
Sarcopenia is a condition of weakness and a low amount of muscle in adults. Out of the hospital, adults with sarcopenia have more difficulty walking, higher hospitalization rates, and a lower life expectancy. When these adults are admitted to the hospital and need life support in an intensive care unit, sarcopenia can lower how far they can walk and may lower the chances of survival. However, the research on sarcopenia in the intensive care unit is minimal and there is limited guidance on its assessment and management. This research program aims to increase the knowledge of 1) the features of sarcopenia; 2) the influence of sarcopenia on survival, hospital discharge, and post-intensive care weakness; and 3) nutrition and physical therapies that may effectively be used to improve outcomes in adults with sarcopenia who are admitted to an intensive care unit and require life support. This research’s results will be shared widely among the intensive care community as we expect this research to inform how international intensive care clinicians assess and treat adults with sarcopenia. This research can also be used to develop future clinical trials on therapies targeted to adults with sarcopenia in the intensive care unit.
Establishing a Patient-Centred Collaborative Research Model to Inform Research Priority Setting within Fraser Health’s Mental Health and Substance Use Services Program
The Mental Health and Substance Use (MHSU) program at Fraser Health recently formed a research unit to provide strategic oversight and direction for the conduct of research. In order to foster a collaborative model that considers the perspectives of people with lived;living experiences (PWLLEs) in the identification of MHSU’s research priorities, we aim to convene a diverse group of PWLLEs, clinicians, and researchers. We will work with BC SUPPORT Unit and a patient engagement expert to facilitate the recruitment of diverse PWLLEs. These PWLLEs will work closely with two clinicians and the Research Lead to form the priority setting group and set a research agenda for the program. The group will meet monthly for a 9-month period to discuss and prioritize research ideas and ad-hoc requests submitted to the research unit. Following the initial 9-month period, we will conduct interviews with members to evaluate the priority setting process, including potential barriers and facilitators to PWLLE engagement. The proposed activities will act as a proof-of-concept model for patient-centred research and priority setting at MHSU, with the potential for continued, long-term adoption by the MHSU leadership team if found to be successful.
Creating a roadmap for critical care nursing retention
Nurses specializing in critical care handle the most severe cases in hospitals. Typically, they undergo additional training beyond their initial four-year nursing education to work in intensive care units (ICUs). During the COVID-19 pandemic, shortage of ICU-trained nurses led to non-ICU-trained nurses having to care for these patients. Anecdotal evidence suggests following the pandemic, many ICU-nurses have resigned because they experienced significant moral distress due to feeling unprepared to provide safe and ethical care. This has worsened the shortage of ICU-trained nurses particularly at Abbotsford Regional Hospital.
The federal Chief Nursing Officer released a toolkit on nursing retention, but its recommendations are broad, thus tailoring to suit specific practice environments is needed. We propose this convening and collaborating grant to bring together ICU-trained nurses and managers to brainstorm strategies tailored to retain ICU-trained nurses. We will develop an evidence-informed, nurse centred implementation research roadmap to support the recruitment and retention of ICU-trained nurses within Fraser Health, with a specific focus on Abbotsford Hospital due to its rural location and unique challenges.
Empowering Integrated Care for Healthy Aging: Co-developing a Collaborative Plan with South Asian and Chinese Communities for Inclusion and Equity
In 2021, 20.3% of BC’s population was 65 and older. Our older population is expected to grow to 25% in 2041 – a super-aged society. An integrated and inclusive care approach is needed for diverse and complex needs of older people to promote healthy aging for all. Fraser Health has implemented two regional initiatives to support healthy aging: social prescribing and the frailty pathway. Meanwhile, half of the population in the Fraser Health region are visible minorities, and 60% of the population are South Asian and Chinese. To ensure a culturally inclusive integrated care model, this project will bring health practitioners, community partners, policymakers, South Asian and Chinese older adults, and families together to discuss research priorities that can empower communities and increase health system capacity. Utilizing Appreciative Inquiry and WHO’s Integrated Care for Older People (ICOPE) methodology, we will co-plan two citizen workshops to build shared visions and collaborations across sectors. Collectively, all partners will identify strengths, potentials, and actionable strategies to enable research collaborations for an inclusive integrated model of senior care.
Preventing the Next Fracture: Expanding Access to Fracture Liaison Services across British Columbia
Broken bones (fractures) occurring in older adults after minor injury are a frequent result of osteoporosis and can negatively affect quality of life, independence and even result in death. One fracture often leads to more fractures. Treatment can prevent future fractures but less than 20% of Canadians receive these treatments after a fracture. Our research aims for all older adults in British Columbia (BC) to receive prevention treatments after a fracture. Research shows that Fracture Liaison Services (FLS) is the best way to achieve this aim. In FLS, a health provider educates patients and starts prevention treatments while the orthopedic team cares for the fracture. Our research answered: How to develop FLS in BC and adapt it in different situations? What policies ensure everyone can benefit, recognizing factors such as language, culture, geography and gender? We developed and tested FLS at one BC hospital and then spread this successful FLS model to two new hospitals. We are now studying how to spread FLS in BC. Our goal is to ensure that older adults have equal access to FLS to reduce repeat fractures, to improve quality of life and maintain independence and decrease related health costs.
CANTRAIN & Michael Smith Health Research BC Internship/Practicum for Clinical Research Professionals Program 2023-24
Sherry Sandhu is a research assistant in the Department of Addiction Medicine and Substance Use Services at the Fraser Health Authority. She supports a research program called ‘Rahi’, which means ‘a companion along a path’ in Panjabi and Hindi. The principal investigator leading the project is Dr. Nitasha Puri, an addiction medicine physician and medical lead at the Roshni Clinic which is an addictions clinic tailored for the South Asian population in the Fraser Health region. Rahi aims to develop and test the feasibility of a culturally resonant intervention to treat substance use disorder among Panjabi men in British Columbia’s Lower Mainland. The first phase of this BC-based project was to design an intervention and was co-led and co-created with people who have lived and living experience using substances (PWLLE). As the team prepares for the next phase of testing the intervention, Sherry was awarded with a unique opportunity to gain clinical research that she can bring back to her team. Sherry was one of two recipients in BC to win the CANTRAIN & Michael Smith Health Research BC Internship/Practicum for Clinical Research Professionals Program 2023-24. The clinical research internship program is an initiative of the Canadian Consortium of Clinical Trial Training (CANTRAIN), a national platform funded by the Canadian Institutes of Health Research (CIHR). Michael Smith Health Research BC is a proud partner of CANTRAIN’s clinical research internship program. Sherry will use the important clinical research skills she gains through this award, to guide her team as they go on to test this community-led intervention. This research will be vital in changing the landscape of culturally tailored health care for South Asians across BC.
End of Award Update – September 2025
Results
After the CANTRAIN internship, Sherry led the writing of a protocol for a pilot feasibility trial of a 16-week group intervention for Panjabi men with substance use disorder and their family caregivers, which was designed entirely by people with lived and living experience.
Impact
The most profound value of the Rahi research program lies in its impact on PWLLE, research team members, and the local Panjabi diaspora in Surrey, BC, on whom the project has bestowed the essence of community, belonging and continues to highlight the need for compassionate companions in recovery and life.
Potential Influence
Our work sets precedent in integrating anti-racist and anti-oppressive practice to engage people with lived and living experience from racialized populations in leading community designed interventions using culturally informed methods.
Although our work is focused on people of Panjabi ancestry, we believe it is generalizable to other racialized men with SUD or other mental health issues, that are often struggle with similar structural contexts as described in our qualitative explorations including but not limited to: immigration stressors, toxic patriarchy, and acculturative stress. As such, the proposed project has potential for profound impact for across Canada.
Next Steps
The next steps of this project are to pilot the 16-week group intervention called, the “Rahi Care Program” in a feasibility study. Other than that, our team is focused on sharing the insights gleaned from the co-design process of the project with the larger community. Using an integrated knowledge translation approach, our dissemination efforts are guided entirely by the lived experience of the peer researchers on our team.
Development of a Culturally Resonant Clinical Intervention to Support South Asian (SA) Men who use Substances
Substance use disorder is a growing chronic disease in Canada, with increasing harms. Racialized South Asian (SA) men living in the Lower Mainland have been shown to be particularly vulnerable to the harms of alcohol and opioid use, with many struggling to access support due to a variety of systemic and intrinsic barriers. Ensuring that research users are engaged as equal partners alongside researchers, the team will have shared leadership between SA men who use substances, health service providers, community organization representatives, and researchers. The goal of the project is to design an evidence-informed, culturally resonant intervention to support SA men who use substances, as well as identify next steps for further research and study of culturally resonant interventions. This will be completed during 5 collaborative meetings between the team and various stakeholders, guided by an experienced facilitator who will use an anti-racist approach to facilitation. Overall, this initiative will produce a culturally resonant intervention designed by researchers and research users and an agenda for future research that embodies anti-racist ideas and centres the experiences and ideas of SA men who use(d) substances.
Health Equity in the Digital Age: Enhancing Virtual Care for South Asians in British Columbia
Three in four South Asians in British Columbia live within the Fraser Health (FH) region. South Asians in Canada experience higher rates of chronic disease compared to the general Canadian population. These health disparities may be due, in part, to the ways in which social and environmental factors impact health and contribute to health inequities.
Virtual care services involve the delivery of health services through remote technologies (e.g., telephone, video calls, internet). Virtual care has the potential to improve healthcare access for marginalized populations; yet, South Asians in Canada are less likely to use virtual care services. They also face significant barriers in accessing culturally appropriate services. There is a need to develop and implement more equitable policies and virtual care services to improve access and reduce disparities.
This study aims to understand the barriers to, and facilitators of, virtual care services faced by South Asians in the FH region to help inform the development of more equitable and accessible virtual care solutions within FH.
Developing a Toolkit and Evidence Summaries to Disseminate an Evidence-based Resource Guide for Healthcare Provider to Incorporate Person-Centered Measures into Recovery Planning
This project builds on two other projects about how healthcare providers can include person-centred assessment tools (such as quality of life) into practice. These tools allow for the voice of persons living with mental illness and substance use to be in the driver seat of their recovery planning. This joint project is being carried out in Fraser Health community mental health centers. We will complete two activities in collaboration with practice and patient partners. First, we will develop a toolkit for clinical leaders to prepare healthcare providers to use person-centred assessment tools for shared decision making and person-centred recovery planning. Also, we will create evidence summaries and learning resources for managers/leaders to further assist providers to use these tools and to lessen any barriers to change. These activities will help with the ongoing usage of person-centred assessment tools by persons served and providers. The goal is to make use person-centred assessment tools to provide mental health and recovery services that focus on the needs of persons, which ultimately improves health outcomes of British Columbians.