Introducing O'Brien Institute’s "Shaping the Future of Healthcare" series

At the O'Brien Institute for Public Health, we are privileged to work alongside some of the brightest minds in healthcare research. Our members are dedicated to advancing knowledge and developing innovative solutions that address the most pressing health challenges in Alberta and beyond.

We recognize that as Albertans, we are in unprecedented times as our healthcare system undergoes restructuring. In light of this, we are excited to launch O'Brien Institute’s Shaping the Future of Healthcare series, where we will be highlighting some exceptional researchers who are driving change and making a profound impact in the following key areas:

1. Primary care
2. Continuing care
3. Acute care
4. Mental health and addiction

Each week, we will feature dedicated members from these categories, showcasing their groundbreaking work, achievements, and the positive influence they have on our community. These individuals exemplify the O'Brien Institute’s spirit of innovation, compassion, and excellence.

Join us in celebrating these healthcare research innovators and learning more about the incredible strides they are making to improve health outcomes for all Albertans. Stay tuned for inspiring stories, insightful research, and a glimpse into the future of healthcare.

Let’s honour the people behind the progress. Together, we can foster a healthier, brighter future.

Acute Care:

Acute care is the care we receive during emergencies or while treating severe injuries or illnesses. It encompasses emergency care and medical services, surgeries, cancer care, and so on. Improving the quality of acute care Albertans receive is imperative. Learn about some of our members who are at the forefront of acute care innovations.

Dr. Aravind Ganesh: Advancing stroke care: Harnessing AI to fill treatment gaps

Dr. Aravind Ganesh, MD, is a leading expert in vascular and cognitive neurology. His clinical research focuses on understanding, preventing, and treating stroke and cognitive impairment, including related behavioural and neuropsychiatric issues. With extensive training in clinical epidemiology, imaging, trials, and mixed-methods research, Dr. Ganesh is dedicated to improving patient outcomes through innovative approaches.

Addressing gaps in stroke treatment using artificial intelligence (AI)

Through Alberta Innovates funding, Dr. Ganesh is working with a team to utilize AI and imaging innovations to solve an acute care challenge. Reperfusion therapies are common treatment for acute ischemic stroke (AIS), but they require rapid delivery to be successful. Neuroimaging is used to quickly identify AIS patients that are eligible for reperfusion therapies. However, this method of quickly identifying treatment-eligible patients is a current triage challenge for physicians who are not stroke specialists. Additionally, healthcare systems also face an efficiency challenge of auditing and resource planning for AIS care because it is hard to determine the ratio of AIS patients successfully treated versus those eligible for treatment. Dr. Ganesh will use AI technology to evaluate and improve the efficiency of tools designed to address the above challenges using real-world data. His work will also inform relevant stakeholders on how to best integrate AI tools into the point-of-care and population-level audits of successful treatment of eligible patients.

Why does this work matter?

Dr. Ganesh's AIS project aims to assess and address current gaps in stroke treatment by leveraging advanced technology to swiftly and accurately identify patients eligible for critical stroke treatments. This initiative not only proposes innovative solutions for enhancing routine care and quality monitoring but also promises to significantly advance stroke care for Albertans.

Dr. Ganesh is an assistant professor in the departments of community health sciences and clinical neurosciences. He is a member of the O’Brien Institute for Public Health, the Mathison Centre for Mental Health Research and Education, and the Hotchkiss Brain Institute.

Dr. Khara Sauro: Improving ICU outcomes for vulnerable populations and analyzing the impact of COVID-19 surgery delays

Dr. Khara Sauro, PhD, stands at the forefront of acute care research, driving advancements in patient outcomes and care strategies across Alberta. Her work is shaping a more effective and equitable healthcare system. Here’s a closer look at her research and its significance.

Vulnerable populations in ICU:

Dr. Sauro's research on critically ill patients experiencing homelessness brings to light the unique challenges faced by this vulnerable group. 

Patients experiencing homelessness who survived their initial hospitalization were more than twice as likely to visit the emergency department or be readmitted to the hospital within 30 days compared to those with stable housing. Additionally, they stayed in the hospital for an average of 10 days longer.

Her findings can inform strategies to prepare patients experiencing homelessness for discharge from the ICU to reduce healthcare resource use after critical illness and improve health outcomes. 

Impact of delaying non-urgent surgery during COVID-19:

In her CIHR-funded program, Dr. Sauro examined surgical care policies during the COVID-19 pandemic across Canada and looked at the impact of delaying non-urgent surgeries on patients and healthcare providers. 

The findings from all of these studies taken together revealed that during the COVID-19 pandemic, policies enacted to prioritize certain surgeries over others to manage the strain on healthcare resource use were different across the country. The significant reductions in healthcare resource use during the pandemic likely may have increased severe health issues for patients post-COVID-19 response and did increase distress for both patients and healthcare providers. This research highlights the critical role of policy in healthcare practice, and that innovative approaches are needed to manage surgical wait periods.

Why does this work matter?

Dr. Sauro's research addresses critical gaps in healthcare for vulnerable populations and the role policy decisions have during crises. By highlighting the unique challenges faced by ICU patients experiencing homelessness, her work advocates for tailored care strategies to reduce readmissions and emergency visits, improving outcomes for these at-risk individuals. Her study on surgical delays during COVID-19 emphasizes the importance of informed policies to manage wait times and reduce patient and surgeon distress. This evidence-based research is crucial for developing a more effective and equitable healthcare system in Alberta, ensuring better care and support for all patients.

Dr. Sauro is an associate professor in the departments of surgery, community health sciences, and oncology. She is a member of the O'Brien Institute for Public Health and the Arnie Charbonneau Cancer Institute.

Dr. Michelle Grinman: Transforming acute health care delivery and driving quality improvement

Dr. Michelle Grinman, MD, is a dedicated general internal medicine specialist, health services researcher and leader in quality improvement in General Internal Medicine. In her roles as Section Deputy Chief for General Internal Medicine at the University of Calgary and the Scientific Director of the Hospital Medicine Section for the Medicine Strategic Clinical Network in Alberta Health Services, she focusses on supporting hospital providers to optimize their workflows and relationships, in order to improve their experience, efficiency and care delivery. Her research focuses on developing transformative healthcare service delivery models to improve access to healthcare for vulnerable populations and to contribute to system sustainability. Many of these care models incorporate technologies and virtual care that enhance care delivery or enable broader outreach. Among the care models that she has implemented in Canada are the Integrated Long-Term Care Program in Toronto, various Hospital at Home programs in Alberta, and more recently, the Long-COVID Inter-Professional Outreach Program in Calgary. She also conducts research testing the feasibility of incorporation of various types of technology into clinical practice (e.g., continuous vital signs monitoring and point of care ultrasound) to support the use of such tools in reaching rural and remote communities.

Dr. Grinman’s work is committed to optimizing patient care through integration, capacity and relationship building, as well as use of technologies to enhance care delivery.

Transforming acute care delivery through patient- and community-focused care models

Dr. Grinman led the conceptualization and implementation of the Virtual Home Hospital (VHH) program, which follows a hybrid model to provide hospital-level care to patients in the comfort of their homes. In this program, a hospital-based team of doctors, nurses, and pharmacists work with a home-based team of community paramedics to provide a range of healthcare services to patients in their homes. Since its establishment in 2018, the program has spread to a second site and served over 1,200 patients. This program has been found to be safe, improve patient satisfaction, and to reduce the use of acute care services in a 6-month period. Through this work, she has become a national and international leader in the Hospital at Home community, leading the Canadian Hospital at Home Working Group to create Canadian HAH research and policy content in order to support this emerging model of care in Canada. 

Dr. Grinman, in collaboration with Dr. Okrainec from the University of Toronto, is leading a research team working to adapt and implement the Integrated Care Pathway (ICP) model first launched in Toronto in 2019. This community-focused model aims to improve continuity of care for hospitalized patients as they transition between hospital and their health home. Through the ICP, Dr. Grinman and her team are developing a way to systematically screen patients for vulnerability or unmet needs, with a streamlined pathway to connect them with the resources to meet those needs as best as possible. This system redesign aims to leverage current services, creating a more seamless and supportive experience for patients as they leave hospital, and aiming to improve the efficiency of hospital allied health teams conducting case management.

Why does this work matter?

Dr. Grinman’s research introduces innovative approaches to acute care, integrating services that address patient and community needs. Her work results in significant benefits, including reduced hospital admissions, cost and improved patient satisfaction. Through her system lens, she leads diverse initiatives that enhance the quality, outcomes, and value of healthcare for both patients and providers.

Dr. Grinman is a clinical associate professor in the Department of Medicine, Deputy Section Chief for General Internal Medicine at the University of Calgary, and Scientific Director of the Hospital Medicine Section at Alberta Health Services. She is a member of the O'Brien Institute for Public Health.

 

Dr. Tyrone Harrison: Using prediction tools to reshape our acute care system

Dr. Tyrone Harrison, MD, PhD, is a clinician and assistant professor in the departments of medicine and community health sciences at the University of Calgary. As a kidney specialist and researcher, his work focuses on care for people with chronic kidney disease (CKD) and hospital readmissions. Through his research, Dr. Harrison is addressing key challenges related to kidney disease care and hospital readmissions within our acute care system.

Improving care for people with kidney disease

Dr. Harrison and his team found that Albertans with CKD undergo surgery up to 16 times more than those with normal kidney  function, including surgeries unrelated to CKD. They also found that people with CKD were at a high risk of major cardiac events or death within 30 days of surgery, although this risk was not the same for all patients. Dr. Harrison and his team tested the performance of recommended risk prediction tools for accurately predicting these outcomes and found that they did not perform well for the patient group. They then developed novel risk prediction tools that performed better and are now in the process of testing the tools in other jurisdictions with the aim of integrating them into our province-wide clinical information system, Connect Care.

Additionally, Dr. Harrison and his team are currently investigating the relevance of post-surgery outcomes like cardiac events or deaths to people with CKD, which have been studied for many populations but are not clearly priorities for people living with CKD. Dr. Harrison’s research focus on understanding the outcomes prioritized by people with CKD and predicting the risk of those outcomes will allow him and others to develop better ways to care for these patients.

Developing tools to prevent hospital readmissions

Hospital readmissions are another major issue within our healthcare system because of the additional burden this places on patients and our acute care facilities that are already under tremendous strain. Existing prediction tools for assessing risks of readmission for patients have design limitations that limit their clinical usability and lead to a high risk of bias when designing and selecting models. Dr. Harrison  is collaborating with a group of researchers to co-design a prediction framework and then develop a prediction tool using state-of-the-art modelling to address the limitations that current readmission prediction tools have.

Why does this work matter?

Dr. Harrison is using his expertise to solve some major issues in our acute care system. By investigating the risks that people with CKD are exposed to, Dr. Harrison is able to reshape the care they receive to optimize their health outcomes. Additionally, his focus on predicting unplanned hospital readmissions using better prediction tools may allow health care providers to make better, more informed decisions on the care they provide to patients, leading to optimized patient outcomes and less strain our healthcare system.

Dr. Harrison is an assistant professor in the departments of medicine and community health sciences. He is a member of the O’Brien Institute for Public Health and the Libin Cardiovascular Institute.