Launch of SCI Consortium brings research community together to support access to equitable heath care
Over the past two decades, the Ontario Neurotrauma Foundation (ONF) has funded and actively supported a wide variety of activities focused on research as well as implementation to advance rehabilitative care for people living with spinal cord injury (SCI).
The newly-established SCI Implementation and Evaluation Quality Care Consortium (SCI IEQCC) is now drawing together everything learned and leaders involved in two of these initiatives, the SCI Knowledge Management Network (SCI KMN) and the SCI Rehabilitation Care High Performance Indicators (SCI-High) Project. This is to ensure implementation science principles guide improvements in health care and rehabilitation for people living with SCI in Ontario.
“The Consortium provides a provincial structure, processes and measures to improve practice across the province,” says Kent Bassett-Spiers, ONF CEO who prompted the Consortium formation. “ONF is dedicated to bringing knowledge into practice, at scale. In this case the goal is equitable access to health care based on recognized best practices.”
“Dr. Kathy Craven and Dr. Dalton Wolfe (co-leads of SCI IEQCC ) were previously involved in the development of the Environmental Scan Atlas (E-Scan) in 2012 to gather information on the state of practice in SCI rehabilitation across Canada,” says Farnoosh Farahani, SCI IEQCC Evaluation Manager.
The SCI-High Project focused on advancing standards of SCI rehabilitation by establishing a framework of health indicators (structure, process and outcome) for eleven domains of care. Experts involved in the project identified these domains as key priorities in rehabilitation. They include common health issues in SCI such as urinary tract infection and tissue integrity, as well as new areas that had not been explored such as sexual health.
“The E-Scan highlighted the gaps in care as well as actions required to standardize and transform practice by 2020. This work led to the development of the SCI-High Project in 2015 and subsequently laid the groundwork of the SCI IEQCC,” says Farnoosh. “SCI IEQCC is an evolution from many different activities that have taken place to date including the E-Scan, SCI KMN, and the SCI-High Project.”
SCI KMN has focused on streamlining best practices in SCI rehabilitation in order to improve health outcomes. Using implementation science strategies and recognizing important drivers will ensure success and sustainability of results for the Consortium. The learnings of SCI KMN will facilitate the adoption of new practices and the usage of health indicators to evaluate performance across various SCI rehabilitation programs in Ontario.
“The formation of the Consortium is truly the next logical step in the process to bring key learnings regarding SCI care and rehabilitation to the forefront in key centres across the province,”Dr. Cathy Craven
In January 2019 more than 50 individuals representing various groups in SCI rehab care came together to establish the Vision and Goals for SCI IEQCC. Participants included researchers, administrative leaders from rehabilitation sites, policy makers, stakeholders, peer support volunteers, and individuals living with SCI. “It was invaluable to have people with lived experience support and guide this work and their perspectives integrated into the upcoming plans of the Consortium,” she says.
SCI IEQCC is currently focusing on implementation of six domains of care at academic health sciences centres in London, Hamilton, Toronto, Ottawa and Kingston. Sites in Thunder Bay and Windsor will also participate as they are part of the network where specialized SCI care is delivered.
“The main goal is to ensure that those who provide care and rehabilitation apply standard practices to their efforts, regardless of where they are in the province,” say Farnoosh. “There is currently a gap between the care a patient receives in hospital and the information that is available to administrators in their decision making processes.” The Consortium plans to close that gap by overseeing the collection of standard measurements and indicator data which can be used to accelerate improvements in health care.
In addition, understanding the long term outcomes of rehabilitation will allow for the evaluation of its effectiveness. “We hope to have a better understanding of what happens to patients after they leave rehab including their care needs within the community. Collecting health information at 18 months post rehab admission will allow us to examine common health issues and barriers after discharge,” Farnoosh says.
The challenge, as with any change, will be the resources to support long-term implementation of a new approach that relies on reporting, measuring, tracking and assessing outcomes. Farnoosh adds, “You can’t just implement new practices and walk away, you have to commit to ongoing evaluation in order to understand the successes gained through the change.”