The Evidence-Into-Practice awards are awarded annually by the Research and Capacity Building Department at Island Health to honour innovators from across Island Health who have successfully implemented a chance in practice, drawing on available evidence or generating their own rigorous data. This year, all three recipients of the award – the Gold, Silver, and Bronze – were awarded to South Island teams. We are doubly proud as all of the successful teams also received support from the South Island MSA.
Dr. Paul Winston, Dr. Emily Krauss, and colleagues have been working on a Rapid Triage and Diagnosis of Complex Regional Pain Syndrome (CRPS), a debilitating diagnosis resulting from a fracture, injury or surgery. The group conducted a retrospective case analysis which indicated the utility of using prednisone, a type of corticosteroid, for treatment of CRPS. They published their findings in Pain Research and Management, bolstering support for the idea that routine community clinic settings could be appropriate places for treatment of CRPS, rather than requiring specialty services or tests. Having generated this finding and published their results, the project continued by engaging with orthopedic surgeons at Rebalance MD, plastic surgery, neurology, pediatrics and Island Health administrators to develop a rapid triage process for patients experiencing regional pain after an injury. The team has found that almost all patients meeting the criteria for rapid triage have returned the functional usage of their injured limb.
A member of the review panel commended this team for their team building and knowledge translation initiative. They praised them for the creation of multidisciplinary teams to advance this work and for engaging medical students in the development and dissemination processes.
Dr. Duncan Jacks, Dr. Jacques Smit, Dr. Tristan Camus, and colleagues developed a same-day discharge program for arthroplasty surgery patients in Victoria, the Victoria Enhanced Recovery after Surgery (VERA) project. Available literature and similar programs in other sites across Canada suggested that same day discharge could be safely discharged with lower rates of complications and shorter lengths of stay. The group developed the Clinical Order Set for same day discharge as well as refined the necessary protocols for patient care, before piloting the same day discharge, testing the protocol with ten patients. All ten patients left hospital on the same day as their surgeries without complications.
A reviewer celebrated this initiative, saying “This is exciting work that addresses many of Island Health’s strategic priorities and puts emerging standards into practice. The team is commended for building cross-discipline support and engagement from early stages to ensure the project’s success and organizational backing for future sustainability”.
Dr. Elisabeth Crisci and Dr. Shauna Tierney drew on existing literature and successes in other sites for the creation of a Hospital at Home (HaH) program in Victoria. HaH is an acute care service delivery model that allows a subset of patients requiring admission to hospital to receive their care while in the comfort of their own homes. Drawing on funding support from both the South Island MSA and Health System Redesign, Dr. Crisci and Dr. Tierney formed the Hospital at Home working group, building consensus and support for a HaH pilot with Island Health, the South Island Hospitalist Department, the Victoria and South Island Divisions of Family Practice, and ultimately, the Ministry of Health. The Hospital at Home initiative was included in the Fall 2020 Provincial Plan, starting at the Victoria General Hospital.
We congratulate all these teams for their outstanding initiatives to improve patient care using the best available evidence. Each team will present a short summary of their project and answer questions from the audience in a virtual awards ceremony this Friday, November 27th from 12-1pm. Attendance is free and open to all. Please register using this link: https://www.eventbrite.ca/e/evidence-into-practice-awards-ceremony-2020-tickets-121798521657