What Really Matters

Bringing Evidence to Care: How the Pediatric Rehabilitation Sector is Adopting Evidence-Based Best Practices

Ontario is home to global leaders in childhood disability research who are doing foundational work in areas including cerebral palsy, autism, and concussion care. The Ontario Association of Children’s Rehabilitation Services (OACRS) hopes to leverage this world-class resource by bringing together researchers, clinicians, patients and families to facilitate the dissemination and adoption of top research evidence across the province, elevating care and improving health outcomes for the nearly 80,000 children and youth with special needs that they serve. With support from their pediatric rehabilitation partners at OACRS, Holland Bloorview Kids Rehabilitation Hospital has applied for a Health System Research Fund to support this work.  

Research supported by the Health System Research Fund has transformed care in the past, and has the promise to do so again in the future. This is just one example.

Kids walking to school together in winter boy with drum

 

It’s not an overstatement to say that Children’s Treatment Centres are beacons of light for the children and youth with special needs that they serve, and for their families. The centres deliver a broad range of assessments, diagnoses, treatments and programs in a variety of care settings to nearly 80,000 children and youth in rural and urban communities across Ontario.

For a little girl with cerebral palsy who lives and plays in Timmins, that means she doesn’t have to miss class to make the three-hour trip to Sudbury, or the eight-hour trip down to Toronto for her appointments. Instead, her mom can drive her up the street to the Cochrane Temiskaming Children’s Treatment Centre, one of Ontario’s 21 Children’s Treatment Centres that comprise the Ontario Association of Children’s Rehabilitation Services (OACRS).

Working towards a world in which all children and youth have the best opportunity to reach their potential, OACRS has brought together patients, families, clinicians and researchers from across the pediatric rehabilitation sector to support the Holland Bloorview Kids Rehabilitation Hospital on a Health System Research Fund proposal that will help to ensure all Children’s Treatment Centres—whether rural or urban—have the right tools to offer high-quality, evidence-based care.  Their collective aim is to bring research evidence into clinical care in Ontario’s 21 Children’s Treatment Centres. From the perspective of Ontario’s Patients First agenda, this collaborative work will not only help strengthen links within the sector, but it will ensure that children and youth with disabilities are receiving consistent and accessible community care.

 

Leveraging Ontario’s world-class researchers in pediatric rehabilitation

“The world’s leading researchers in the pediatric rehabilitation sector are right here in our own backyard, at Holland Bloorview Kids Rehabilitation Hospital’s research institute and the CanChild Centre for Childhood Disability Research at McMaster University,” said Jennifer Churchill, CEO of OACRS. “OACRS members saw a significant opportunity to build system capacity by collaborating with research institutes and adopting research evidence across our network to improve and standardize care for our clients.”

In May, 2015, a group of more than 50 clients, families, clinicians and researchers from all 21 Children’s’ Treatment Centres, Holland Bloorview’s research institute and McMaster’s CanChild Centre came together for a 1-day summit in order to collectively reach consensus on initial priority research areas.

“The goal was to make connections and share the latest research evidence, set research priorities for the sector, and mobilize knowledge translation activities to move priority evidence into care across the province,” said Dr. Shauna Kingsnorth, Evidence to Care Lead at Holland Bloorview Kids Rehabilitation Hospital, a proud member of OACRS.

At the summit, Dr. Kingsnorth presented the Evidence to Care (EtC) integrated knowledge translation framework and its success in delivering the Chronic Pain Toolbox, an evidence-based best practice product to assist clinicians in their efforts to accurately assess chronic pain in children with disabilities, especially those with cerebral palsy.

 

Boy in wheelchair sharing laugh with his therapist

 

Seeing the system-wide value not only of the Chronic Pain Toolbox, but of the EtC framework, the sector agreed that the EtC team was the right group to take on the challenge of building knowledge translation and exchange capacity across Children’s Treatment Centres in order to standardize care and adopt evidence-based best practices.

Our “How it works” infographic at the end of this article shows how the Evidence to Care framework successfully delivered the Chronic Pain toolbox. To learn more about the Chronic Pain Toolbox, click here.

 

Bringing evidence to care across Ontario’s childhood rehabilitation sector

“Our sector is now at the point where we have strong connections between clinicians, patients and families, and researchers,” said Churchill. “With a little fire power, we will be able to nurture those connections and establish channels for knowledge translation and best practice adoption across Ontario.”

With commitment from the pediatric rehabilitation sector, the EtC team and OACRS are ready to move forward in a partnership to implement the EtC knowledge translation and exchange framework and best practice products—including the Chronic Pain Toolbox—in all 21 Children’s Treatment Centres.  In 2015/16, OACRS and other partners supported the EtC team on submitting a knowledge translation proposal to the Health System Research Fund to accomplish this work. Other health sector partners, including the Pediatricians Alliance of Ontario and the Health System Quality & Funding Branch of the Ministry of Health and Long-Term Care, have shared interest in becoming knowledge users of this project.

“I see the impact that research evidence can have on improving the lives of children with disabilities every day at Holland Bloorview,” said Dr. Tom Chau, Vice President of Research at Holland Bloorview Kids Rehabilitation Hospital. “It’s our hope that the EtC team and OACRS will work together to share key learnings with each other and with those in related sectors to enhance a joint vision that fosters equity and promotes the best available research evidence in childhood disability.” The Health System Research Fund application is a key vehicle through which OCARS hopes to fuel this ambition.

As CEO, Churchill’s passion for this work and commitment to clients and to system improvement is palpable and inspiring. “As always in healthcare,” she said, “it all comes down to the patient and family.  Families tell us that they want their children to participate in all aspects of life—school, sports, travel, birthday parties—all of it.  Children’s Treatment Centres help to make this a reality for our kids and families across Ontario, and that’s why is it so important to continually improve by sharing our research knowledge to provide the best possible care.”

 

This research is one example of how the many voices across the pediatric rehabilitation sector are contributing to a healthier, wealthier, smarter Ontario. To learn more about OACRS, click here.

 

How it works- adopting best practices with the Evidence to Care framework

­­­