Research Location: Interior Health Authority

Co-developing system integrations and a research agenda for adverse drug event reporting and digital health at Interior Health

Over 2 million Canadians visit emergency departments each year because of adverse drug events (ADEs)—unintentional harms caused by outpatient medications. ADEs leads to over 700,000 hospital stays and cost more than $1 billion in healthcare expenses annually. These issues are especially severe in the Interior Health Authority, where an aging population and high rates of chronic diseases increase the risk of ADEs. Effective drug monitoring is essential for detecting and preventing these events. However, current reporting systems are underused due to their complexity and lack of integration with existing medical records to benefit clinical practices.

This C2 grant will enable our team at Interior Health to collaborate with researchers, healthcare providers, health system leaders, and policymakers to identify solutions and co-create a research agenda aligned with provincial health priorities using Menear’s framework of learning health system. The goal is to enhance patient safety by improving the documentation and communication of ADEs through digital innovations. This initiative not only addresses immediate local needs but also contributes to broader provincial health research goals.

Engaging rural community members in building a rural clinical trials program

This project aims to support community and patient partner engagement in the development of our rural clinical trials program. Clinical trials are an important aspect of medical research as they advance therapeutic options and improve health care outcomes. Unfortunately, most clinical trials are conducted in urban centres making results from the studies difficult to generalize in the rural setting. Additionally, people from rural communities face significant challenges when looking to participate in clinical trials. To promote equity in clinical trial access, and to create evidence to inform health care delivery in rural communities, our team is building a clinical trial program in the rural community of Cranbrook, B.C. We will develop tools, resources, and knowledge to share with other rural communities wanting to participate in clinical trials. We will work collaboratively with knowledge users such as rural patients, families, clinicians, decision makers, institutions (i.e., UBC and College of the Rockies), local Indigenous Peoples, and the Interior Health Authority to identify research priorities, guide clinical trial implementation, promote community engagement, and ensure the project is responsive to local community needs.

Seeking Rural Equity by Increasing Rural Engagement in Clinical Trials: An East Kootenay Clinical Research Program

Clinical trials play a key role in medical advances, helping to identify new treatments or improved ways to treat illnesses. Clinical trials generate information that can guide treatment decisions. By participating in clinical trials, individuals may have access to new treatment options for serious conditions. However, when clinical trials do not include people from rural areas, the knowledge generated may not be useful in rural settings. This program of research aims to help people in rural communities in the East Kootenay area have access to clinical trials. Partnerships with universities, major urban hospitals, and researchers across Canada (the Accelerating Clinical Trials Canada Consortium) will help East Kootenay Regional Hospital to build a program of research for people living in rural communities. This will enable people in the East Kootenay region to participate in certain clinical trials. Successes and lessons learned from this program will help other rural areas to build their own clinical research capacity with the goal of making clinical research in Canada more inclusive of rural populations.

Addressing equity in clinical trials: development of a rural clinical trials research program

Clinical trials are essential for the development and optimization of medical therapies. However, clinical trial access is limited in rural and small communities in Canada. This is an important health equity issue as rural populations often to not have the opportunity to access investigational therapies and clinical trial results often do not reflect the health of rural populations. This project, which is funded by the CANTRAIN Clinical Trials Training Program, Michael Smith Health Research BC, the Accelerating Clinical Trials Consortium and the Canadian Institutes for Health Research. This project aims to build a rural clinical trials program in the East Kootenay region of British Columbia. It will build develop partnerships among educational institutions, Interior Health and community organizations. A community advisory board will be developed to seek community input into the program development and clinical trial selection. The principal investigator is Dr. Denise Jaworsky who is a rural general internal medicine specialist, but this project is a collaboration among a team of researchers from Interior Health, UBC and College of the Rockies. This project aims to improve clinical trial access for populations in the East Kootenay region and develop models and best practices to support rural clinical trial access in other rural communities in Canada.

 

 

End of Award Update – December 2024

 

Results

This project laid the foundation for the development of a rural clinical trial program in Cranbrook, BC. We have hired and trained a clinical research coordinator and engaged over 15 students (nursing and medical) in this project. We have begun to establish the infrastructure and policies necessary to conduct clinical trials in the East Kootenay Region. We have also started the site initiation process to bring two clinical trials to Cranbrook. We hosted a two-day workshop on Indigenous Peoples’ engagement in research in partnership with Michele Sam (Ktunaxa scholar), Stephanie Obara (nursing instructor) and College of the Rockies. This workshop was funded by the Canadian Race Relations Foundation.

 

Impact

While we are not quite ready to enroll participants in clinical trials in our community, we expect to be able to do so in the next few months.

Our work was presented at the recent Rocky Mountain Internal Medicine Conference by internal medicine resident, Sabrina Martini (born and raised in Cranbrook), where it won an award for best quality improvement poster:

Martini S, Stewart Q, Jaworsky D, Keefer S, Curran J, Hawe N, Obara S, Sam M, Siemens J. Building Clinical Research Capacity in Rural Communities: Developing a Clinical Trial Program in the East Kootenays. Rocky Mountain Internal Medicine Conference. Rocky Mountain Internal Medicine Conference, Canmore, November 14-15, 2024

 

Potential Influence

The goal of this project is to develop, implement and study a rural clinical trial program so that we can create tools to support other rural communities to build clinical trial programs. Ultimately, it will help to address geographic inequities in clinical trial access.

 

Next Steps

Our next steps are to:

  • Continue to build or rural clinical trial program
  • Engage more health professionals in clinical trial training
  • Build a community advisory board so that community members can inform priorities and guide the program
  • Use an implementation science lens to study barriers and facilitators to rural clinical trials.

Implementing a restorative approach in long term care to heal and learn from the harms of COVID-19

This Health System Impact Fellowship is co-funded by CIHR, Michael Smith Health Research BC, and the Interior Health Authority (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.

 

It has become increasingly common that aging members of our population require healthcare services to support them. Many Canadians spend their final years in long-term care (LTC) facilities as a result. LTC facilities have been under scrutiny in recent years with respect to quality of care and inadequacy of resources, along with concerns about their increased privatization. The COVID-19 pandemic exposed the vulnerabilities of the state of LTC facilities across Canada. There is broad acknowledgement that improvements must be implemented to make the experience and safety of residents of LTC facilities better.

 

Our intended research is interested in understanding the experiences of harm that residents, family members, and healthcare workers have encountered, particularly those during the COVID-19 pandemic. This proposed project will aim to listen to the stories of patients, families and healthcare workers who have been adversely affected by restricted visitation policies, the loss of residents, and burnout, as a way to better understand the context of LTC, to facilitate a Restorative Community of Care for healing, and to learn from these situations to inform subsequent action.

 

This initiative will be facilitated using a restorative approach and will be comprised of three phases: listening to understand, planning for future actions, and reporting and evaluating the results of this process. A restorative approach is a principle-based approach that fosters a relational way of thinking and being and is carried out through facilitated dialogue with the intention of speaking openly about the harm experienced and to work together to heal from that harm and to learn from the past to improve the future. This approach supports respect, dignity and mutual care and concern between people, communities, healthcare providers, and the health system.

 

Source: CIHR Funding Decisions Database

Advancing anti-colonial implementation science and knowledge translation with the xacqanaǂ itkiniǂ (Many Ways of Working on the Same Thing) research team

xacqanaǂ itkiniǂ (Many Ways of Working on the Same Thing) is a long-term working relationship between Ktunaxa First Nation, Interior Health, University of Victoria, and University of British Columbia – Okanagan. Over the last three years, the xacqanal itkinil team developed a new approach to research that is led by Ktunaxa peoples and reflects Ktunaxa culture. We tested this approach in Ktunaxa communities by hosting a series of gatherings and land-based activities, where community members shared their vision for a healthy community. The team recently received a five-year CIHR Project Grant to build off the first phase of the partnership to work towards Ktunaxa Nation’s vision for a healthy community. We will work with community partners to co-design and implement interventions (i.e. programs, policies, practices), with the aim of transforming the culture of the health system to better serve Indigenous peoples and the wider population. This fellowship will directly contribute to monitoring and evaluating the interventions and their implementation to understand what is working well, what challenges are encountered along the way and how they are addressed, as well as how this work can be carried forward into the future.