Ontario Spinal Cord Injury Research Network
In order to improve care for people with spinal cord injury (SCI), current practices must be continually re-examined to determine which are effective, new treatments and management approaches must be reviewed and tested their ability to provide cost-effective improvements in quality of life. Ontario Spinal Cord Injury Research Network (OSCIRN) harnesses the intellectual, clinical, and research resources of different clinical research centres throughout the province. The goal is to improve the evidence-base upon which clinical practice and health policy is established. OSCIRN is a collaborative network of clinicians and scientists, from five academic health science centres in the province of Ontario, working together to facilitate multi-centre clinical research from pre-hospital care, acute treatment, rehabilitation, primary care to community re-integration of individuals with a spinal cord injury. In-person meetings are held on an irregular basis. The network provides an opportunity for diverse groups to share intellectual and physical resources, benefit from infrastructural supports such as an informatics platform and centralized, web-based, multi-centre study management, and introduce cost-efficiencies in the conduct of multi-site collaborations. The network’s mandate is:
- Translational research across the continuum of care
- Integrated knowledge translation and implementation
- Integrated health economics
- Provision for investigator and industry-driven research
- Attract cutting-edge research to Ontario
Ontario Neurotrauma Foundation Summits
In the fall of 2016, Ontario Neurotrauma Foundation (ONF) hosted three summits that brought together primary care and specialist clinicians, researchers, people living with SCI as well as community partners and policy makers. The focus and audience for each summit was unique but the main objective was to address gaps, identify opportunities which could lead to innovation and improvements in care around three key health issues faced by those living with SCI: access to Primary Care, Urohealth and Neuropathic Pain. About 150 people participated in the three sessions.
The Primary Care Summit prompted further work to develop a coordinated Ontario research strategy for primary care for SCI as well as a network of primary care providers from across Ontario with interest in SCI care and research as well as the involvement of people living with SCI. Since the summit, the success of the two Kitchener-Waterloo Mobility clinics has led to a a third primary care clinic modelled on the KW example in Iroquois Falls, Ontario.
The Neuropathic Pain Summit focused on gaps in current research and informing future research and implementation priorities in area of neuropathic pain. The Canadian Best Practice Guidelines for Management of Pain in SCI have been published as a supplemental edition of the Spinal Cord journal. Following the summit, a presentation done at Canadian Pain Society Meeting and case-based workshop at the 2017 national SCI conference. A manuscript was accepted for publication in Canadian Journal of Pain. A manuscript was accepted for publication on the process and recommendations arising from the pain summit. A case-based Workshop presentation was also offered at the national SCI conference.
The Uro-Summit reviewed current gaps, opportunities and best practices and provided advise to ONF and RHI on future research and implementation priorities. In follow-up, a one-day meeting was held in the summer of 2018 to develop and endorse the guidelines developed by the Canadian Urological Association including support for publication of “Guidelines for Diagnosis, Management and Surveillance Neurogenic Lower Urinary Tract Dysfunction in Individuals with a SCI.”
Spinal Cord Injury Rehabilitation Evidence
Spinal Cord Injury Rehabilitation Evidence (SCIRE) is a comprehensive website with a set of topics relevant to SCI rehabilitation and community reintegration established by a Canadian research collaborative. SCIRE reviews, evaluates, and translates existing research knowledge into a clear and concise format to inform health professionals and other stakeholders of best rehabilitation practices following SCI. SCIRE offers two versions of the best practices, one for clinicians and one for people living with SCI.
Spinal Cord Injury Knowledge Mobilization Network
ONF, along with six Canadian rehabilitation centres, established the Spinal Cord Injury Knowledge Mobilization Network (SCI KMN). This national network has a shared goal to implement best practices in the care and treatment of secondary complications due to spinal cord injury.
SCI KMN is a community of practice with a goal to improve health outcomes for persons with spinal cord injury through what is known as implementation science or IS, which can lead to innovations in clinical practice. The SCI KMN has worked with the National Implementation Research Network (NIRN) to build expertise and capacity in Implementation Science across all seven facilities.
In October 2016 SCI KNM released Informing Implementation: A practical guide to implementing new practice as informed by the experiences of the SCI KMN. This guide leads users through the five stages of the SCI KMN Implementation Process. For each stage there are a set of activities and tools that may be used to promote effective implementation. Following a systematic and rigorous process allows users to make the process more effective and optimize outcomes.