RESEARCH SPOTLIGHT: Kingston General Hospital

Smart City + Trailblazing Research = Patient-Centred, Interdisciplinary Discovery

Large urban centres have a distinct advantage in terms of fostering critical mass of scientists working on a shared problem or within a specific discipline. But are there times when smaller is better?

At the Kingston General Hospital Research Institute, knowledge transfer takes a different route.  Kingston’s small size means proximity to everything, offering investigators unprecedented opportunities for interdisciplinary collaborations that provide a completely new perspective on their work.

An integrated, walkable research campus of universities, college and hospitals facilitates unique collaborative centres, cross-disciplinary training, and seamless integration of patient care with leading-edge research.

This activity will only increase with the opening, later this year, of the W.J. Henderson Centre for Patient Oriented Care, a multi-disciplinary hub within Kingston General Hospital. The 24/7 centre will bring together researchers, patients, trainees and treatment teams across the continuum of care, and make it easier for patients to participate in various stages of research.

“It’s much more collaborative here – Canadians have a good collaborative spirit,” says pathologist and clinician scientist Neil Renwick, who was lured to Kingston General Hospital from New York’s Columbia and Rockefeller universities.

“KGH and Queen’s are going to be very competitive because they have the proximity, the clinical expertise, the patient base, the basic science, and the vision – all of the components for exceptional translational research are here,” he says. “The hospital environment enables you to see how your research impacts real life. And I like the fact that I can walk to work.”

Collaborative research at KGH includes:

Human Mobility Research Centre: Seamlessly integrating research and patient care

Offering labs within two hospitals, meeting spaces and even a computer-assisted surgery suite, HMRC creates unique opportunities for clinicians and scientists to collaborate. “All of our research has patient-focused outcomes,” says Tim Bryant, Professor of Mechanical and Materials Engineering, Queen’s University, and co-director of the Centre. “A surgeon can come here right out of surgery with a question, such as how to improve a procedure, and then do the research or work with a scientist who can help them develop a solution,” he says. “With time, that solution may become a regular procedure for patients.”

Research Spotlight Kingston General Hospital, Human Mobility Research Centre

Collaboration and cross-disciplinary teams are the norm. Orthopedic surgeons are leveraging the biomechanical, imaging and computational modelling expertise of Dr. Michael Rainbow, Mechanical and Materials Engineering, Queen’s, to develop better approaches to treatment of wrist, shoulder, ankle and knee problems.

Dr. Daniel Borschneck, a pediatric orthopedic surgeon, and Dr. Davide Bardana, an orthopedic surgeon, are working with Queen’s chemical engineer and Centre co-director Dr. Brian Amsden on strategies for generating replacement tissue such as ligaments to treat joint injuries.

And orthopedic surgeon and shoulder specialist Dr. Ryan Bicknell is collaborating with Queen’s neuroscientist Stephen Scott to test mobility following shoulder replacement surgery using Dr. Scott’s robotic assessment system, KINARM.

KINARM: One tool, many applications

The KINARM is, in fact, a perfect example of how a research tool is being used clinically to investigate a wide range of disease and injury. This transformational technology is the world’s first robotic system for measuring, with exquisite sensitivity and precision, the effects of brain injury on an individual’s ability to perform ordinary movements and tasks. Used at more than 60 research institutions worldwide, this patented system is also in use at all three of Kingston’s hospitals by researchers exploring neurological impairments in diverse fields, including stroke, Amyotrophic Lateral Sclerosis (ALS) and Parkinson’s Disease, and even cardiac arrest, kidney failure, and major surgery.

Research Spotlight Kingston General Hospital, KINARM

Archer Laboratory: At the heart of collaboration

Dr. Stephen Archer and his team of 20 investigators in the Queen’s CardioPulmonary Unit (Q-CPU) are working to ensure a better quality of life for patients with pulmonary arterial hypertension (PAH), the obstruction of lung arteries, which can lead to fatal right heart failure. PAH patients are typically in their working years, and the disease precludes them from most forms of employment, and full participation in their lives.

This international team, in a network of six clinical trial centres across the Americas, will further define the basic mechanisms that underlie PAH, with an aim of identifying and testing possible treatments, and eventually translating these preclinical discoveries for use in patient trials.

This team approach is crucial to success, says Dr. Archer, a Tier 1 Canada Research Chair in Mitochondrial Dynamics and Translational Medicine, and head of Medicine at Queen’s University and Kingston’s hospitals. “Having preclinical basic scientists, physicians, clinical trial specialists and population health scientists collaborating under one roof ensures that Q-CPU makes significant progress towards effective treatment and cure of PAH,” he says. “It is also training clinicians and scientists to play an important role in this area of health research.”

To learn more about health research at Kingston General Hospital, visit: www.kghri.ca

 

Kingston General Hospital is one of Ontario’s 24 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog. To learn more about what’s needed to support Ontario’s health research enterprise, download our Policy Platform.

RESEARCH SPOTLIGHT: SickKids

Point-of-care ultrasound leads to more efficient and accurate diagnoses in SickKids emergency

They’re calling it ‘the stethoscope of the future’. A portable technology called point-of-care ultrasound is helping doctors at The Hospital for Sick Children (SickKids) provide better and more efficient bedside care in the emergency department, and it’s having a huge impact.

Point-of-care ultrasound is used in about 25 to 30 per cent of the cases coming through SickKids’ Emergency Department. “Since using ultrasound at the bedside, I find I’m using my stethoscope less. We’re identifying medical issues more efficiently and accurately which is essentially leading to better decision-making, better care for our patients, and even a reduction in ED wait times for some patients,” says Dr. Mark Tessaro, Staff Physician in Paediatric Emergency Medicine and Research Lead in the point-of-care ultrasound program at SickKids.

Ultrasound is a safe and radiation-free medical device that uses sound waves to produce images of what’s going on inside the body.

The Paediatric Emergency Medicine point-of-care ultrasound program was launched at SickKids in 2011. The goal was to improve the care of injured and ill children through a new application of this reliable and well-established tool. SickKids is Canada’s only training centre for paediatric point-of-care ultrasound and in five years, 10 fellows have been trained and have subsequently brought their expertise and experience to other hospitals across the country and internationally.

“It helps to confirm a diagnosis much faster than before”

The applications for point-of-care ultrasound in the ED are far reaching. It enables doctors to detect internal bleeding, cardiac, and/or intestinal problems, it can uncover foreign bodies, an abscess that needs to be drained, a twisted teste or ovary, and even retinal detachment in the eye, which is very challenging to identify in children. It also helps with procedures like inserting an airway tube, or delivering an anaesthetic injection (nerve block) for example.

“There is no doubt in my mind that point-of-care ultrasound has improved the care I provide my patients. Before I began using it, I would order more tests, which later proved to be unnecessary, and spend more time doing physical exams in efforts to figure out the root problem,” says Dr. Charisse Kwan, Staff Physician in Paediatric Emergency Medicine and Education Lead in the point-of-care ultrasound program at SickKids. “It doesn’t replace the physical exam but in some ways gives us ‘magic fingers’ that enhance the physical exam and helps to confirm a diagnosis much faster than before.”

90 minutes later, 12-year-old Hannah was back on Snapchat

In mid-December, after several days of illness and an outpatient chest X-ray that suggested pneumonia, Hannah Diamond, 12, was rushed to SickKids’ Emergency Department when her fever spiked to 40 C, her lips suddenly turned blue, and she began shaking and shivering. Dr. Tessaro was working that evening, and within five minutes of Hannah’s arrival at SickKids’ Emergency Department, Dr. Tessaro told Hannah and her mom, Sari, that he’d like to do an ultrasound at the bedside to get a better picture of any potential complications that could have caused Hannah’s sudden distress. Almost immediately, Tessaro was able to rule out serious complications like fluid on the lungs, and he and the Diamond family had their answer – it was a straightforward bacterial pneumonia.

“Having a clear picture of what we were dealing with meant I didn’t need to order the usual chest X-ray, avoiding unnecessary radiation exposure for Hannah,” says Tessaro, who quickly prescribed Hannah IV antibiotics and acetaminophen.

Within 90 minutes, Hannah was back on her smartphone, texting friends about her adventure in the Emergency Department and posting photos and updates to Snapchat. About two hours later, she was discharged, and the next morning, Hannah woke up fever free for the first time in a week.

The emergency team has multiple examples of how the use of point-of-care ultrasound in the Emergency Department is improving care and has even led to quick detection of rare congenital diseases, heart conditions, and cancers that likely would have taken many emergency and specialist visits before a diagnosis was uncovered.

“As ED doctors we have a responsibility to assess patients quickly and detect problems accurately, in all areas of the body. Point-of-care ultrasound is helping us do that better,” says Tessaro.

The goal is to have virtually all SickKids staff emergency medicine physicians fully trained to use point-of-care ultrasound. Currently five are fully trained.

Drs. Tessaro and Kwan are Assistant Professors in the Department of Paediatrics at the University of Toronto.

 

SickKids is one of Ontario’s 24 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog. To learn more about what’s needed to support Ontario’s health research enterprise, download our Policy Platform.

 

 

RESEARCH SPOTLIGHT: Hamilton Health Sciences

Discovering a Healthier, Wealthier, Smarter Hamilton through health research

Written by Renato Discenza, Executive Vice President, Strategy & Innovation, Hamilton Health Sciences

 

Renato Discenza

When change is big and dramatic, it’s not hard to miss. But when it happens in quick little bursts, it’s harder to recognize. We may notice something out of our peripheral vision, but like a scurrying creature it freezes when we turn to look. When we turn away, something moves again. But what was it? These small, incremental changes leave us thinking, “Something is different here, but I’m not sure what.”

Initially that’s the feeling I had when I started working in Hamilton. After years of working around the globe seeing some pretty dramatic change, I thought Hamilton would be a more gradual, steady environment. But lately, I’ve certainly noticed there is a shift happening in Hamilton’s economic foundation that, after years of percolating below the surface, is finally starting to permeate our city’s identity on a provincial, national, and even global scale in a very big way.

Those who know Hamilton well might always know it as “Steel Town”, but it is a more modern moniker that might be required. Healthcare has risen to the forefront of our city’s landscape. This is happening at the same time as our arts and culture and business innovation scenes are developing a maturity and sophistication of their own. An increase in a knowledge industry like healthcare, coupled with these other two shifts, can only spell positive transformation for the “Hammer”.

In my interactions, I’ve found that others are often surprised to learn that the health service and research sector is Hamilton’s largest employer, with Hamilton Health Sciences (HHS) topping the list at more than 11,000 employees. This doesn’t include our more than 800 physicians and 1300 volunteers. When we include our colleagues at St. Josephs Healthcare and McMaster’s Faculty of Health Sciences, this just adds to the prominence of healthcare as a predominate engine of Hamilton’s economic growth.

For examples of this kind of impact, watch Building a WEALTHIER Ontario: Hamilton’s Story.

Clinical care aside, the magnitude of health science research being conducted right here in our own backyard has doubled in recent years, and is receiving global acknowledgement and awards. Most recently, HHS was ranked #2 among Canada’s top research hospitals by Research Infosource, second to Toronto’s University Health Network.

This isn’t a new position for HHS. In fact, it’s the third year in a row that we’ve earned this rank.  It is a testament to the incredible pace at which our research efforts continue to grow. In 2014, HHS attracted more than $212M in research funding – a $30M increase over 2013. These results are even more remarkable when we consider the increasingly challenging fiscal environment for health research in Canada.

Our success has hinged on the incredible health infrastructure we’ve built that’s attracting top-of-class researchers. Never before have we seen such a high calibre of research expertise in our city, forming a research hub that’s the envy of health centres around the world.

And while our research is reaching more corners of the globe than ever before, we’re also having a significant impact on our community here in Hamilton. We have more than 400 researchers and 500 research staff working to solve big problems, including cardiovascular disease and cancer.

Our research teams are more than white coats – they’re physicians, surgeons and health experts. Many of them are at our patients’ bedsides every day. It’s this “bench-to-beside” approach that has us moving at full speed toward some of our city’s and country’s biggest population health problems. We are applying evidence to initiate change that will affect our community today, as well as generations to come.

Medical research is more than an academic exercise: it is part of the therapeutic pathway for many patients. The ability of residents to participate in leading research and have access to the clinicians engaged in that research means our citizens are accessing top level care. While researchers think globally, they influence outcomes locally.

While basic science research will always be important to move us ahead in delivering healthcare, we are also focussing on knowledge translation and innovation.  The time is right.  This focus on helping the patients at the bedside comes at a perfect time.  There is a significant focus now at the provincial and federal level on innovation.  Ontario has appointed a Chief Health Innovation Officer following OHIC’s The Catalyst report.  The Federal government is taking a closer look at the report from the Advisory Panel on Healthcare Innovation led by Dr. David Naylor.  At HHS we are focussing on the application of both these levers:  research and innovation.  We have the advantage of the skills and expertise in our community with a wide spectrum of partners in research excellence.  We also have the advantage of being learners and teachers.  Gaining knowledge and disseminating knowledge are cornerstones of applying innovation.

The momentum we’ve gained in the health research sector here in Hamilton is affording us opportunities like never before to create a healthier, wealthier, smarter and more sustainable community for all.  There is more coming… stay tuned.

Learn more about research at Hamilton Health Sciences.

 

Hamilton Health Sciences is one of Ontario’s 24 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog. To learn more about what’s needed to support Ontario’s health research enterprise, download our Policy Platform.

Healthier, Wealthier, Smarter Health Research Showcase

Imagine a world…

  • Where a virus is used to cure cancer

  • Where stem cells are used to cure blindness

  • Where medicine is delivered directly into the brain  

These breakthroughs are already underway. Researchers across Ontario’s 24 research hospitals are making discoveries that will truly change and improve millions of lives. They’re driving the future of healthcare, improving patient outcomes and increasing system efficiency, all while cultivating our knowledge-based economy. Collectively, CAHO hospitals help make Ontario healthier, wealthier, and smarter.

A Live-Tweet Look at Some of Ontario’s Latest Health Research Discoveries

To demonstrate the breadth, depth, and impact of the health research being done across CAHO hospitals, we hosted a showcase at Queen’s Park on March 2, 2016. In the room and on social media, people were buzzing with excitement about the world-class health research on display. Some 20 Members of Provincial Parliament and many of their staff got an inside look at 25 research projects from across Ontario—and so did the #onHWS community on Twitter. Thanks to the 200+ people who joined the conversation during our live-tweet, #onHWS was trending at #4 in Canada!

We were honoured to have Parliamentary Assistant to the Minister of Research and Innovation, Daiene Vernile, speak about the value of Ontario’s health research enterprise. “Scientific advancement fuels our knowledge economy,” said Ms. Vernile. Our health research showcase demonstrated that fact first hand, and we’ve included just a few highlights here. Want the full impact? We captured the entire showcase on Storify, and encourage you to read through to get a glimpse of the incredible health research happening across Ontario.

Healthier Wealthier Smarter Health Research Showcase   retinal scan     The Ottawa Hospital, BioCanRX oncolytic viral therapy manufacturingHHS palliative careHealthier, Wealthier, Smarter health research showcase

 

Stay tuned to #onHWS for more research and patient stories from across Ontario, and CAHO member hospitals. To learn more about why health research matters for Ontario and how you can support it, download the Healthier, Wealthier, Smarter Policy Platform and check out our other blog posts and videos.

RESEARCH SPOTLIGHT: St. Joseph’s Healthcare Hamilton

Towards a Wealthier City: Impactful, Innovative Health Research at St. Joseph’s Healthcare Hamilton

By Dr. Jack Gauldie, Vice-President Research, St. Joseph’s Healthcare Hamilton

With a strong history of medical leadership and a legacy of transforming patient care around the world, Hamilton hospitals are transforming the city through innovation, research and scientific discovery.

St. Joseph’s Healthcare Hamilton was founded in 1890 with a promise and vision to provide compassionate patient care to those who need it most. Since that time, our hospital and research enterprise has evolved to not only make our province healthier and smarter, but also wealthier.

Our affiliation with McMaster University and close relationship with Hamilton Health Sciences has created opportunity for our research to impact the city as a whole through collaborative research that produces innovative diagnostics, treatments and medication. For examples of this kind of impact, watch Building a WEALTHIER Ontario: Hamilton’s Story.

From the laboratory bench to the patient’s bedside, health research and patient care go hand-in-hand. Within our institution, researchers have made ground-breaking discoveries in the areas of lung disease, kidney disease, infectious disease and mental health.

As the centre for a number of international clinical trials, the research we do helps keep Canadians healthier – resulting in fewer visits to the emergency department and an improved quality of life.

Developing new treatments for pulmonary fibrosis, asthma and allergies has saved the lives of thousands of Canadians – and has helped thousands more to breathe easier every day. International testing of new treatments for kidney disease has the potential to affect nearly 1.3 million Canadians who suffer from moderate to severe forms of kidney disease.

Working closely with our industry partners presents opportunity to commercialize the research discoveries created within our hospital. From the development of portable devices that can diagnose infectious diseases in only 20 minutes, to the creation of a video game that helps teenagers to recognize the signs and symptoms of psychosis, research at St. Joseph’s Healthcare Hamilton creates economic change while succeeding in its primary goal of improving patient care.

Innovation has taken many forms. St. Joseph’s Health System has succeeded in developing a new, integrated model of patient care that was successfully tested at St. Joseph’s Healthcare Hamilton.

This pioneering Integrated Comprehensive Care project provides patients with a continuity of care that stretches across each step in the patients’ journey, from hospital to home, and provides a new holistic patient experience for the 21st century. Winning a Canadian leadership award for innovation in improving outcomes, the success of the Integrated Comprehensive Care project has resulted in the province beginning to adopt this model across Ontario.

By working together with our colleagues across Hamilton as well as the patients that we serve, research at St. Joseph’s Healthcare Hamilton works to make Ontario a healthier, wealthier and smarter place for everyone.

Learn more about research at St. Joseph’s Healthcare Hamilton.

 

St. Joseph’s Healthcare Hamilton is one of Ontario’s 24 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog. To learn more about what’s needed to support Ontario’s health research enterprise, download our Policy Platform.