TO: Dr. Matthew Bromwich
FROM: Children’s Hospital of Eastern Ontario
FOR: “ShoeBox Audiometry: Interactive iPad based mobile clinical audiometry”
About the Project
• Development and validation of an iPad play audiometer, the first of its kind – a clinical hearing test for children that is disguised as a video game.
• The goal of this innovation is to: improve access to clinical audiometry; diagnose hearing loss earlier and prevent the delay in language and social developmental that results from undiagnosed hearing loss.
• Previously CHEO would fly children from Iqaluit at great cost ($7,500) for a $45 test. This month, the group began screening children in Iqaluit using the ShoeBox Audiometry
• CHEO will implement a local pilot study and facilitate roll out among interested centers in Ontario.
• The outcome of this innovation may include: significant cost savings, increased patient satisfaction, better community screening, improved educational outcomes from early identification of hearing loss.

TO: Dr. Leanne Casaubon
FROM: University Health Network
FOR: “A Novel Day-Unit Care Model for TIA and Minor Stroke Patients Improves Rapid Access to Care and Satisfaction with Care”
About the Project
• Dr. Casaubon’s project, the TIA and Minor Stroke (TAMS) Unit, has transformed the care of a population at high-risk of stroke with rapid access to a comprehensive day-unit care model instead of hospital admission or waiting for an appointment at the Stroke Prevention Clinic.
• Through this project, they demonstrated that the TAMS Unit care model is feasible, acceptable to patients and staff, safe, efficient, increases patient satisfaction and allows patients to be partners in their care.
• This care model can be adopted in centres with a Stroke Prevention Clinic with modest changes to their care model, as well as other disease centres.
• This model reduces stroke risk and is more efficient.
• This model could improve system efficiencies throughout Ontario.

TO: Dr. Andrée Gruslin
FROM: The Ottawa Hospital
FOR: “Improving Placenta Health through Education and Better Prevention”
About the Project
• This Project implemented a Placenta Health Clinic which meets the needs of women at risk of placenta mediated diseases (PMD) or those who are suffering from PMD as well as those who experienced PMD in a prior pregnancy and are seeking post loss or pre-pregnancy counseling.
• This targeted clinic has improved access for those complex patients who are now seeing a specific group of specialists with unique expertise in the field.
• This clinic has improved access to care and also provided these women with specialized multidisciplinary services and permits the application of preventative measures.
• As a result, the team has documented improved perinatal outcomes.
• This new approach also resulted in high levels of patient satisfaction.

TO: Dr. Ivy Cheng
FROM: Sunnybrook Health Sciences Centre
FOR: “Implementing Wait-Time Reductions under Ontario Government Benchmarks (Pay-for Results): A Cluster Randomized Trial of the Effect of a Physician-Nurse Supplementary Triage Assistance Team on Emergency Department Patient Wait Times”
About the Project
• Dr. Cheng’s project is a randomized trial that illustrates an innovative and effective strategy to provide patient-focused care and decrease wait-times for emergency patients who are discharged without consultations. A physician-nurse supplementary team available at triage and during patient investigations permits faster institution of management programs.
• This strategy is adoptable, and easily implemented in different institutions.
• This team was demonstrated to decrease the morbidity and mortality associated with prolonged emergency department wait times, as well as increase patient satisfaction.

TO: Dr. Angel Arnaout
FROM: The Ottawa Hospital
FOR: “An Innovation in Breast Cancer Care in Ottawa: The Evaluation and Validation of a Rapid Diagnostic and Support (RADS) Clinic for Women Undergoing Assessment for Breast Cancer”
About the Project
• Breast cancer specialists at the Ottawa Hospital WBHC embarked on a new initiative to improve breast cancer care delivery by piloting a Rapid Diagnosis and Support Clinic to reduce diagnostic wait times, decrease the fragmentation of care, and maximize diagnostic resource efficiency for patients with a high probability of breast cancer.
• The results could be employed for any type of cancer for which treatments are time-sensitive and require multiple diagnostic steps.
• This multi-disciplinary approach demonstrated reductions in diagnostic wait times as well as coalesced fragmented care, and the addition of nursing support has improved patient satisfaction.

TO: Dr. Nathalie Fleming
FROM: The Ottawa Hospital
FOR: “Improved Obstetrical Outcomes for Adolescents in a Community-Based Outreach Program: A Matched Cohort Study”
About the Project
• Adolescent pregnancies are high-risk and standard obstetrical care environments may not meet the needs of adolescents.
• The investigators have established a unique adolescent outreach program in collaboration with a non-profit community service agency.
• The program includes a multidisciplinary clinic that brings ante/postpartum care to the adolescent in an adolescent–friendly environment. It is the only such community-based program in Canada.
• The project demonstrated that adolescents receiving this innovative multidisciplinary care in the community had significantly improved obstetrical and neonatal outcomes
• The team expects to disseminate their results and establish similar community outreach centers in other areas in Ontario and Canada to establish this model of care as standard for pregnant adolescents.

TO: Dr. Melanie Willows
FROM: The Royal Ottawa Hospital
FOR: “Early Intervention Opioid Outpatient Clinic: The Regional Opioid Intervention Service”
About the Project
• Opioid misuse and abuse is a major public health issue. The project developed, implemented and evaluated a regional integrative and multidisciplinary model of care for opioid detoxification and maintenance services targeted at early intervention.
• The hub and spoke partnership integrates addiction, mental health, and primary care services in the Champlain LHIN to treat opioid addiction, and provides training/ mentorship to build regional capacity to identify and treat opioid addiction.
• This approach is easily adoptable beyond the scope of one hospital. Through capacity building activities, they have been asked to provide training/mentorship to help other Canadian centres develop similar regional models of care.
• Patients can be successfully tapered off opioids and improve their mental health.
• The project has increased the regional capacity to treat opioid addiction and improved access to care.

TO: Dr. Richard Kim
FROM: London Health Sciences Centre
FOR: “Personalized Medicine at London Health Sciences Centre: Implementation of a Dedicated Ambulatory Clinic and Inpatient Consult Service”
About the Project
• The first implementation of a Personalized Medicine (PM) Clinic and Care Team in Canada as a way of providing innovative and cost-effective patient care.
• This project focused on widely prescribed drugs with risks for severe adverse drug reactions that are preventable with pharmacogenomic (PGx) testing.
• The project team observed measurable benefits in terms of reduced length of hospital stay and enhanced drug safety.
• The project shows that it is possible for a large academic medical centre to adopt and implement PM-based care.
• Kim and his team are creating the framework for adoption of this PM-model by other institutions.

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