Empowering and Accelerating Impacts of Patient-Oriented Research.

Patient partnerships require adequate planning, support and funding to mobilize knowledge and accelerate impact. We outline the themes and foreground ways in which the Engaging Multi-stakeholders for Patient Oriented-research Wider Effects and Reach teams have advanced patient-oriented research in Ontario.

Consensus statement on networks for high-quality rural anesthesia, surgery, and obstetric care in Canada.

Objective: To describe the essential components of well-resourced and high-functioning multidisciplinary networks that support high-quality anesthesia, surgery, and maternity care for rural Canadians, delivered as close to home as possible.

Composition Of The Committee: A volunteer Writers' Group was drawn from the Society of Obstetricians and Gynaecologists of Canada, the Society of Rural Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, the Canadian Association of General Surgeons, the College of Family Physicians of Canada, and the Association of Canadian University Departments of Anesthesia.

Methods: A collaborative effort over the past several years among the professional stakeholders has culminated in this consensus statement on networked care designed to integrate and support a specialist and non-specialist, urban and rural, anesthesia, surgery, and maternity work force into high-functioning networks based on the best available evidence.

PEER simplified chronic pain guideline: Management of chronic low back, osteoarthritic, and neuropathic pain in primary care.

Objective: To develop a clinical practice guideline to support the management of chronic pain, including low back, osteoarthritic, and neuropathic pain in primary care.

Methods: The guideline was developed with an emphasis on best available evidence and shared decision-making principles. Ten health professionals (4 generalist family physicians, 1 pain management-focused family physician, 1 anesthesiologist, 1 physical therapist, 1 pharmacist, 1 nurse practitioner, and 1 psychologist), a patient representative, and a nonvoting pharmacist and guideline methodologist comprised the Guideline Committee.

Mixed-Methods Evaluation of a Patient Behaviour Risk Screening, Communication and Care Planning Intervention for Hospital Settings.

Workplace violence is a common safety concern for hospital staff. The Behaviour Safety Risk Communication and Care Planning program identifies, manages and cares for patients at risk of exhibiting unsafe behaviours. This paper reports on a mixed-methods evaluation consisting of staff surveys, focus groups and open forums, screening audits, patient interviews and assessment of effectiveness measures at five hospital sites.

Review on Novel Oral Therapies for Psoriasis.

Currently, several classes of oral therapies for psoriasis are in use, in development, or in investigative stages. Standard non-biologic treatments for psoriasis, such as methotrexate, cyclosporine, and acitretin, have generally unfavorable safety profiles and are not ideal for long-term use. This review will address the safety and efficacy of existing and novel oral therapies for psoriasis that target inflammatory pathways via modulation of phosphodiesterase 4 (PDE4), Janus kinases (JAKs), sphingosine 1-phosphate (S1P), A3 adenosine receptors, and rho-associated kinase 2 (ROCK2), with an emphasis on JAK inhibitors.

Seven Ways to Inspire Innovation in the Health Technology Industry.

This article explores ways in which technological innovation can be bolstered in organizations that operate in the health technology industry. We present seven interventions at the team level (employee empowerment, servant leadership, hiring innovators, and scheduling time for innovation) and organizational level (intrapreneurship, flat management, and allowing for failure) that organizations can use to encourage and inspire innovation among employees. Given the increasingly dynamic nature of work within the health technology fields, in terms of both manufacturing processes and clinical developments, creating a culture of innovation and creativity and emboldening employees to regularly engage in such behaviors within these workplaces are critical.

Afrocentric screening program for breast, colorectal, and cervical cancer among immigrant patients in Ontario.

Problem Addressed: Black and immigrant populations across Canada have lower screening rates than Canadian-born white populations, predisposing them to increased cancer morbidity and mortality. Effective interventions are required to increase cancer screening rates among these populations.

Objective Of Program: To improve breast, colorectal, and cervical cancer screening rates at TAIBU Community Health Centre, which has a mandate to provide primary health care services to the Black and immigrant community in the greater Toronto area.

Caring for refugees and newcomers in the post-COVID-19 era: Evidence review and guidance for FPs and health providers.

Objective: To guide clinicians working in a range of primary care clinical settings on how to provide effective care and support for refugees and newcomers during and after the coronavirus disease 2019 (COVID-19) pandemic.

Sources Of Information: The described approach integrates recommendations from evidence-based clinical guidelines on refugee health and COVID-19, practical lessons learned from Canadian Refugee Health Network clinicians working in a variety of primary care settings, and contributions from persons with lived experience of forced migration.

Main Message: The COVID-19 pandemic has amplified health and social inequities for refugees, asylum seekers, undocumented migrants, transient migrant workers, and other newcomers.

Endorsement of clinical practice guidelines: Criteria from the College of Family Physicians of Canada.

Objective: To refine the process for endorsement of guidelines and establish the expectations of the College of Family Physicians of Canada (CFPC) regarding the quality and relevance of clinical practice guidelines targeting family physicians and their patients.

Composition Of The Committee: Initially, a group of 6 CFPC staff and selected College members reviewed the previous process for endorsement with the aim of providing a new direction, if needed. The work was then assumed by the Guideline and Knowledge Translation Expert Working Group, a purposefully selected group of 9 family physicians from across Canada with expertise in research, evidence, guidelines, knowledge translation, and continuing professional development and education.

Nurturing a culture of curiosity in family medicine and primary care: The Section of Researchers' Blueprint 2 (2018-2023).

Objective: To describe Blueprint 2 (2018-2023), the 5-year strategic plan launched in 2018 by the Section of Researchers (SOR), as well as its guiding principles and the process used to develop it.

Composition Of The Committee: Blueprint 2 was co-created by many stakeholders from across Canada and led by the SOR Council (SORC). The process started with an external, commissioned program evaluation in 2017 of the effect of the first SOR Blueprint (2012-2017).

Implementing Advance Care Planning Tools in Practice: A Modified World Café to Elicit Barriers and Recommendations from Potential Adopters.

This paper reports findings from a modified World Café conducted at a palliative care professional conference in 2019, where input on tools to support advance care planning (ACP) was solicited from healthcare practitioners, managers and family members of patients. Barriers to ACP tool use included insufficient structures and resources in healthcare, death-avoidance culture and inadequate patient and family member engagement. Recommendations for tool use included clarification of roles and processes, training, mandates and monitoring, leadership support, greater reflection of diversity in tools and methods for public engagement.

Activating Patients and Families to Improve Palliative Care: The Waiting Room Revolution.

We need to support and educate palliative care specialists and generalist providers, especially family physicians, on how to integrate an early palliative care approach into care for those with a serious illness. However, there are very few care providers compared to the number of patients and caregivers in society. To increase access to palliative care at a population level, we need a waiting room revolution, one where patients and families shift from being passive to being active in shaping their experience with serious illness.

Top 2020 studies relevant to primary care: From the PEER team.

Objective: To summarize high-quality studies for 10 topics from 2020 that have strong relevance to primary care practice.

Selecting The Evidence: Study selection involved routine literature surveillance by a group of primary health care professionals. This included screening abstracts of high-impact journals and EvidenceAlerts, as well as searching the American College of Physicians Journal Club.

Multimorbidity in Canadians living in the community: Results from the Canadian Longitudinal Study of Aging.

Objective: To determine the mean number of chronic diseases in Canadians aged 45 to 85 years who are living in the community, and to characterize the association of multimorbidity with age, sex, and social position.

Design: An analysis of data from the Canadian Longitudinal Study on Aging. The number of self-reported chronic diseases was summed, and then the mean number of chronic health problems was standardized to the 2011 Canadian population.

THE DEPRESSION INVENTORY DEVELOPMENT SCALE: Assessment of Psychometric Properties Using Classical and Modern Measurement Theory in a CAN-BIND Trial.

The goal of the Depression Inventory Development (DID) project is to develop a comprehensive and psychometrically sound rating scale for major depressive disorder (MDD) that reflects current diagnostic criteria and conceptualizations of depression. We report here the evaluation of the current DID item bank using Classical Test Theory (CTT), Item Response Theory (IRT) and Rasch Measurement Theory (RMT). The present study was part of a larger multisite, open-label study conducted by the Canadian Biomarker Integration Network in Depression (ClinicalTrials.

Developing and Implementing a Patient Behaviour Risk Screening, Communication and Care Planning Intervention for Hospital Settings.

Workplace violence prevention of patient behaviours is a primary safety focus in hospital settings. In response to provincial mandates, a multi-site tertiary care hospital system developed the Behaviour Safety Risk Communication and Care Planning Program. Components include patient risk screening, communication tools and care plans that outline mitigation strategies.

Shortages of Palliative Care Medications in Canada during the COVID-19 Pandemic: Gambling with Suffering.

Patients with serious illnesses such as cancer, advanced organ failure, dementia and COVID-19 rely on medications to alleviate suffering from uncontrolled symptoms. Numerous actual or threatened shortages of key medications used to provide palliation have been reported during the COVID-19 pandemic. This article explores the nature of these shortages, factors that have contributed to them and strategies to mitigate them.

Physician Initial Assessment Times Based on CTAS Scores: Are We Meeting the Recommendations?

The Canadian Triage and Acuity Scale prioritizes patient care in the emergency department (ED) by setting recommendations for physician initial assessment (PIA) times. However, adherence to the recommended PIA times may not be possible due to increasing ED visits, overcrowding and patient boarding in the ED. We conducted a retrospective review of adult patients who visited four community EDs from January 2016 to December 2017 and found that the overall compliance with the recommended PIA times was low.