NHKI Annual Research Report

ANNUAL RESEARCH REPORT

2023-2024

Knowledge Generation | Knowledge Mobilization | Capacity Building Niagara Health Knowledge Institute • 1

Table of Contents NHKI......................................................................................................................... .4 Research Output..................................................................................................... .6 Clinical Research Programs................................................................................... .7 Research Highlights................................................................................................ .8 Proud Moments...................................................................................................... 12 Advisory Committee............................................................................................... 14 Our Partners............................................................................................................ 15

“As part of the NH Strategic Plan, we embedded research and learning throughout our priorities. I’m proud to say, the NHKI has already begun transforming healthcare by providing Niagara residents access to clinical trials, and identifying opportunities to improve patient experience. Through research supported and generated by the NHKI, our physicians and clinicians are forging important partnerships with academic partners, patients and the community to advance knowledge and ultimately improve patient care.”

Lynn Guerriero, President and CEO, 2 • 2023/24 Niagara Health Annual Report

“Niagara Health has been a national leader in advocating for the inclusion of community hospitals in clinical research to improve study result generalization and equity of patient access to novel treatments through participation in clinical trials. The establishment of the Niagara Health Knowledge Institute last year is a testament to what we set out to achieve. In 2023, NH enrolled over 900 patients in 32 different clinical research studies.”

“McMaster University’s Michael G. DeGroote School of Medicine - Niagara Regional Campus is excited and proud to partner with the NHKI on individual projects, presentations, publications, and development of new streams of research to target the needs of our community and our medical education system. Together, we will strengthen our understanding of the challenges we face and find new ways to deliver healthcare and education that will benefit us all.”

Dr. Jennifer Tsang, Executive Director

Dr. Amanda Bell, Regional Assistant

and Chief Scientist, Niagara Health Knowledge Institute

Dean, Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University

Donation from McCall MacBain Foundation catalyst to launch Knowledge Institute The Niagara Health Knowledge Institute (NHKI) had been more than a decade in the making when it launched in May 2023. However, its official unveiling last year was made possible by a $4-million donation from the McCall MacBain Foundation, underscoring the community’s support and belief in the vital research and education being conducted by Niagara Health physicians and staff.

“As Niagara Health launches the Niagara Health Knowledge Institute, it is incredible to know that we have the support and commitment from the McCall MacBain Foundation,” says Andrea Scott, President and CEO, Niagara Health Foundation. “Their donation and support will leave a lasting impact on healthcare in Niagara.”

The Knowledge Institute supports the priorities in Niagara Health’s Strategic Plan including research. The NHKI will also continue leading community hospital-based research by maintaining ongoing efforts to build research capacity in other community hospitals throughout Canada.

Dr. Jennifer Tsang, a Niagara Health intensivist and the NHKI Executive Director and Chief Scientist, says launching the NHKI is another important step forward for knowledge generation.

“The partnerships between McMaster University and the Niagara Health Knowledge Institute will have significant impact on future healthcare research and, ultimately, patient care. We are thrilled to be collaborating together on this important work, and more importantly, that this type of research is happening close to home, attracting and retaining some of the best and brightest research minds.”

“Brock University places great value on our research partnership with Niagara Health.

The complementary expertise and insights shared across our institutions lead to great advances in the ways that we care for peoples’ health needs in Niagara and beyond. Brock is deeply committed to co-creating knowledge with community partners with the view of boosting health and well-being for all.”

Jonathan Bramson, Vice-Dean,

Michelle McGinn, Vice-President,

Research, McMaster University

“As we look to provide highly-skilled and knowledgeable graduates who will bolster frontline healthcare in our community, Niagara College is also proud to team up with NHKI to advance research and innovation in such a critical sector.

At Niagara College, we are focused on solutions, and this partnership promises to be a great benefit to all of Niagara.”

Marc Nantel, Vice-President, Research, Innovations & Strategic Enterprises, Niagara College

Research, Brock University

Niagara Health Knowledge Institute • 3

NHKI

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Knowledge Generation

Knowledge Mobilization

Capacity Building

The creation of new knowledge through health research.

The dissemination of new findings to maximize research impact and application.

The strengthening of organizational ability to integrate research in clinical care.

Niagara Health Knowledge Institute The NHKI provides administrative and methodological support to researchers at Niagara Health to enable them to conduct studies that are first and foremost relevant to our local population in Niagara. The goal is to improve patient care and experience locally while contributing to new and improved standards of practice.

From left: Elaina Orlando, NHKI Research Manager; Jessica Thompson, NHKI Research Administrative Assistant; Kian Rego, NHKI Research Co-ordinator; Kelly Pilato, NHKI Research Co-ordinator; Dr. Jennifer Tsang, NHKI Executive Director and Chief Scientist

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LEARN MORE

e

Our Purpose

Improve patient care and experience by embedding research into clinical practice.

Our Vision

Transform healthcare through leading community hospital-based research.

Our Values

Equity • Collaboration • Continuous Learning • Innovation • Empowerment Dr. Amanda Bell, Regional Assistant Dean, McMaster University Michael G. DeGroote School of Medicine - Niagara Regional Campus; Dr. Jennifer Tsang, Executive Director and Chief Scientist, Niagara Health Knowledge Institute; Dr. Johan Viljoen; Lynn Guerriero, Niagara Health President and Chief Executive Officer; Linda Boich, Executive Vice-President, Patient Experience and Integrated Care; and Andrea Scott, Niagara Health Foundation President and CEO, cut the ribbon on the new Niagara Health Knowledge Institute.

Areas of Focus

RICH-Canada

Patient Experience

To build research capacity in Canadian community hospitals to transform healthcare across the country.

To understand and improve patient experience in healthcare and research at Niagara Health.

Care for Older Persons

Clinical Research

To advance healthcare and health service delivery for the Niagara’s aging population.

To provide Niagara Health patients access to state-of-the-art, novel therapies through participation in multicentre clinical research studies.

Niagara Health Knowledge Institute • 5

Research Output Extraordinary Caring, Extraordinary Results Grants

19%

In 2023, Niagara Health spent

Study Revenue

45%

Donations

$1.3M

36%

on research S o u rc e o f Fu n d i n g

Research Output in 2023

32

930

Clinical research studies

Patients enrolled

36

$6M+

Publications by NH researchers1

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Grant funding2

1. As primary or co-authors 2. Niagara Health researchers represented in a total of $6M+ in grant funding.

Cardiology

Clinical Research Programs

In the area of heart diseases, heart attack, irregular heart rhythm, heart failure.

Critical Care In the area of pneumonia, blood stream infection, sepsis, lung failure, kidney failure, and COVID-19.

7 Number of clinical research programs

Emergency Medicine In a wide range of acute medical conditions.

Hematology/Transfusion Medicine

12 Number of research staff

In the area of blood disorders.

Neurology In the area of ischemic stroke and bleeding stroke.

10 Number of students, volunteers and visitors

Oncology In the area of blood cancer, breast cancer, colon cancer, lung cancer, metastatic cancer.

Thrombosis In the area of arterial and venous clotting disorders.

Niagara Health Knowledge Institute • 7

Research Highlights Sharing stories, celebrating success The Niagara Health Knowledge Institute prides itself on the dedication of our members to developing and progressing research. We care about the impact of research on our patients.

These stories represent some of the milestones achieved as we work to improve access to healthcare for Niagara residents and advance knowledge for future generations.

Grant funding supports new clinical research trials at Niagara Health Research at Niagara Health received a $300,000 funding boost in 2023 from the Accelerating Clinical Trials (ACT) Canada Consortium.

The grant, spread over three years, supported the hiring of a new clinical trial research co-ordinator.

That meant being able to add more clinical trials in neurology, led by Dr. Danielle de Sa Boasquevisque, and hematology and transfusion medicine, led by Dr. Mohammad Refaei. This work will benefit patients in Niagara who may have otherwise had to travel outside the region to participate in clinical trials to receive novel treatments.

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The new research co-ordinator ensures these clinical trials run smoothly from start to finish. They are responsible for obtaining ethics approval for a study, developing contracts, screening patients and enrolling those eligible for the study, collecting clinical data, monitoring participants, closing out the study and validating the data.

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Dr. Jennifer Tsang, Executive Director and Chief Scientist, Niagara Health Knowledge Institute.

Niagara Health COVID-19 survivor participates in national study After narrowly surviving COVID-19 in 2022, Donald Kennedy used his experience to shed light on both short- and longterm outcomes of the illness in patients and their caregivers.

He and his wife and caregiver, Denise, joined a national study aimed at better understanding outcomes of the COVID-19 virus, and predictors of those outcomes. Donald was one of seven Niagara Health patients in the University Health Network study that followed 2,000 patients and caregivers from the provinces hit hardest by the virus: Quebec, Ontario, Alberta and British Columbia. The final results of the study are being worked into a research paper for publication.

LEARN MORE Denise and Donald Kennedy.

Results of summer student’s study could change how translational research is performed Research findings by summer student Vanessa Gyorffy should revolutionize community hospitals’ ability to participate in research that involves the study of patient blood samples.

Gyorffy found that blood biomarkers were stable even when the plasma was stored for up to 72 hours at room temperature.

“This is great because for community hospitals that don’t have access to research labs, they can ship these samples to a central processing site and thus can still be involved in research studies,” she says.

Gyorffy’s work was made possible by funding from the COVID-19 Network of Clinical Trials Networks.

Vanessa Gyorffy, Student, McMaster University.

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Kailee Morrison, Research Co-ordinator.

Thrombosis research co-ordinator wins national award Madelyn Law, Director, Quality, Patient Safety and Risk.

New director knows power of healthcare research As Niagara Health’s new Director of Quality, Patient Safety and Risk, Madelyn Law will look at innovations in health services and how best to implement them. She’ll also work with her team and NHKI researchers to determine how research done here and elsewhere can improve the quality of care Niagara Health provides, “thinking about it through a lens of evidence to practice and aligning it with the Strategic Plan to enhance safe and quality care.”

After less than a year on the job, Kailee Morrison was named Research Co-ordinator of the Year by the Canadian Venous Thromboembolism Network in 2023. “In the year Kailee’s been here, we’ve opened five clinical trials. We’re now recognized in the Canadian thrombosis research community as a major player, and Kailee has been instrumental in the thrombosis research program becoming so successful,” says Dr. Blair Leonard, Director of Niagara LEARN MORE Health’s Thrombosis Service.

“What have we learned from research that we can put into practice and how can my team support frontline staff to help implement that?

How do we implement, sustain and spread improvement across the system?” she says.

Law is on a two-year secondment from Brock University where she founded and directed the Interprofessional Education for Quality Improvement Program, which engages community partners, including Niagara Health, and students to improve the quality of health LEARN MORE services through research.

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Dr. Eric K Nguyen, Radiation Oncologist.

Niagara Health employee’s curiosity spurs critical patient fall research When Virginia Pullar noticed an unusually high number of patients falling in the hospital during the early part of the COVID-19 pandemic, she investigated further.

Then the Co-ordinator in Decision Support, Pullar, worked with the Niagara Health Falls Committee, using data from the Incident Reporting System (IRS) to determine the number of patient falls.

The committee expected to see a significant drop in falls, given fewer people came to the hospital during the pandemic’s first wave. But data showed an uptick in patient falls.

Pullar and the Falls Committee theorized that visitor restrictions and reduced patient contact and supervision may have impacted the number of patients falling. Their most important conclusion was the need for a rapid response and adaptability to unpredictable situations, particularly those that could arise during a pandemic.

Virginia Pullar, Manager, Enterprise Analytics.

Findings from the project were published in the Journal of Patient Safety in 2022. Pullar also earned the Staff Research Award in 2023 for her enterprising work.

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Niagara Health cancer doctor’s research finds specialized radiation treatment poses few risks of side effects Radiation Oncologist Dr. Eric Nguyen compiled the largest body of data about undue side effects using stereotactic body radiation therapy (SBRT) to treat both primary lung cancer and metastatic disease in the lungs, and found that SBRT can be used with a low risk of toxicity or complications, even when treating multiple tumours at once.

He also further established SBRT as an effective option that can delay disease progression in metastatic cancer patients with multiple lung tumours, while confirming the therapy can be used more aggressively and be curative for primary lung cancer lesions.

Dr. Nguyen’s findings will help cancer doctors throughout the world make better informed decisions about their patients’ treatment plans, especially those with multiple tumours.

“It just provides more options when treating this group of patients,” Dr. Nguyen says.

LEARN MORE

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November 2022 McCall MacBain Foundation donation that helped establish the NHKI.

April 2023 Vanessa Gyorffy awarded COVID-19 NoN undergraduate summer student scholarship to study the impact of delayed biosample process on sample quality.

October 2023 Recruitment of Research Administrative Assistant Jessica Thompson dedicated to support administrative work and graphic design.

d u o r P

ts n e om

September 2023 Recruitment of NHKI Research Co-ordinators Kian Rego and Kelly Pilato dedicated to the improvement of research in community hospitals.

M

November 2023 Establishment of Hematology/ Transfusion Medicine Research Program with Dr. Mohammad Refaei as lead.

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May 2023 Official launch of the Niagara Health Knowledge Institute and appointment of Dr. Jennifer Tsang as Executive Director and Chief Scientist.

October 2023 Kailee Morrison received the CanVECTOR Thrombosis Research Co-ordinator Award.

Honouring success, inspiring growth

June 2022

ACT funding awarded to support a full-time clinical research co-ordinator for three years at NHKI.

July 2023 Dr. Eric Nguyen led the publication of a study on the predictors of pathologic fracture and local recurrence following stereotactic body radiation therapy to 505 non-spine bone metastases.

September 2023 COVID-19 NoN funding to establish Critical Care Research Program at the Niagara Falls Hospital with Dr. Natasha Ovtcharenko as lead.

November 2023 Launch of CCIRNet Toolkit co-created by Dr. Jennifer Tsang that helps other community hospitals build and sustain research programs.

August 2023 Establishment of the Neurology Research Program with Dr. Danielle de Sa Boasquevisque as lead.

November 2023 Kian Rego awarded COVID-19 NoN graduate student scholarship.

December 2023 COVID-19 NoN funding to support Critical Care Research Program at St. Catharines Hospital with Dr. Erick Duan as lead.

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Advisory Committee NHKI Advisory Committee Members Harpreet Bassi Co-Chair, Executive Vice-President, Strategy and Communications, Interim Executive Lead, Research and NHKI, Niagara Health

Dr. Jennifer Tsang Co-Chair, Executive Director and Chief Scientist, Niagara Health

Linda Boich Executive Vice-President, Patient Experience and Integrated Care, Niagara Health

Dr. Satish Chawla Executive Vice-President, Medical, Chief of Staff, Niagara Health

Sonali Kohli Executive Vice-President, Digital Transformation, Chief Information Officer, Niagara Health

Heather Paterson Executive Vice-President, Clinical Operations, Niagara Health

Dr. Linda Lee Co-Chair, NHKI Research Subcommittee, Niagara Health

Charity Beland, Manager, Indigenous Health Services and Reconcilliation, Niagara Health

Denise Kennedy Patient Partner, Niagara Health Engagement Network

Hedy McGarrell Patient Partner, Niagara Health Engagement Network

Jonathan Bramson Vice-Dean, Research, McMaster University

Michelle McGinn Vice-President, Research, Brock University

Dr. Amanda Bell Regional Assistant Dean, Niagara Regional Campus, Michael G. DeGroote School of Medicine, McMaster University

Mark Nantel Vice-President, Research, Innovation and Strategic Enterprises, Niagara College

“Collaborative research at Niagara Health involves co-ordination among the institution and its researchers and its community. This combination of varied types of expertise and experiences provides the basis for advances in healthcare in general, with direct relevance to patients, caregivers and the Niagara community.”

Hedy McGarrell, Patient Partner, Niagara Health Engagement Network

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Our Partners Thank you to our partners

Thank you to our funding partners Niagara Health Foundation

Physicians’ Services Incorporated Foundation

McCall MacBain Foundation

Canadian Institutes of Health Research

Canadian Critical Care Trials Group

Accelerating Clinical Trials Consortium

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Community hospital-based research depends on the generosity of the local community, academic partners, and institutional donations. For more information on how to support research in your community, scan the QR code to visit our website or contact the research office.

Jessica Thompson, NHKI Research Administrative Assistant jessica.thompson@niagarahealth.on.ca Elaina Orlando, NHKI Research Manager elaina.orlando@niagarahealth.on.ca Dr. Jennifer Tsang, NHKI Executive Director and Chief Scientist jennifer.tsang@niagarahealth.on.ca

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