OICR brings together health services researchers for first-ever Ontario-wide meeting
Dr. Eva Grunfeld addresses the Health Services Research Workshop.
(S. Durant)
Researchers, health care professionals and leaders in cancer care programs met in February to plan strategies for improving the way we prevent, screen, diagnose and treat cancer in Ontario.
OICR’s Health Services Research (HSR) Program held a major workshop and planning meeting on February 3 and 4 in Toronto. Hosted by Dr. Craig Earle, Director of the HSR Program and Dr. Eva Grunfeld, head of knowledge translation within the HSR Program, the workshop gave health services researchers and representatives from the health care system an opportunity to learn about OICR’s plans and start thinking about strategies to implement them. With approximately 130 participants, this was the first meeting of its kind, bringing together a multidisciplinary group of researchers, clinicians and policy makers focusing on cancer health services in Ontario.
Health services researchers use data from the health care system to improve the organization and delivery of health care. There are a number of institutes and research groups in Ontario working on health services research related to cancer. In introductory remarks at the workshop, Earle explained that OICR hopes to develop strategies that foster collaborations between these researchers to strengthen existing capacities to answer questions about cancer care, and to answer new questions that will arise as the result of new approaches to diagnosing and treating cancer and managing end-of-life care.
“One of our main priorities is to understand how we can improve the uptake of protocols and procedures that can benefit patients,” said Earle, noting that many patients are treated outside of the “cancer system.” In rural areas, patients with common cancers are often treated in part by primary care practitioners (family doctors or nurse-practitioners) and general surgeons, with specialized medical, radiation and surgical oncologists supporting them behind the scenes.
“Our other main priority is to improve the integration of health services along the cancer continuum. We know that cancer involves diagnosis and treatment, followed by either surveillance or end-of-life care. Research can help us understand how to do a better job of co-ordinating these activities so patients’ experience is smoother. In some cases, this co-ordination could also lead to better outcomes,” said Earle.
One example of this research was presented by Dr. Lisa Barbera, a researcher at the Institute for Clinical Evaluative Studies. She presented research by the Palliative Care Health Research Network describing health services usage by patients who have late-stage cancers. In these cases, physicians and the patients themselves know the cancer will be terminal. Barbera and her colleagues found that despite this knowledge, over 50 per cent of these patients die in acute care hospitals, and 40 per cent visited an emergency room in their last two weeks of life.
Researching cancer care can be very complicated. Unlike scientific projects that test hypotheses about the natural world, health services projects try to understand institutions and activities that are designed by humans. Health services researchers studying cancer are a diverse group, including primary care physicians, oncologists, nurses, statisticians and psychologists, among others. Their research strategies often blend statistical methodologies with qualitative techniques developed by social scientists.
OICR has helped recruit leading health services research talent to Ontario to improve the delivery of cancer services. Earle, a Canadian-trained oncologist, returned to Ontario last year after spending a decade at Harvard. Grunfeld, a physician and one of Canada’s foremost experts in cancer health services research, relocated to Toronto from Halifax last year.
In closing remarks, Grunfeld, emphasized the importance of thinking carefully at the planning and priority setting stages in order to derive maximum benefit from health services research and knowledge translation strategies.
“We need to identify knowledge translation opportunities that align with the priorities identified by our group in order to bring the benefits of our work to patients,” Grunfeld said. “Following this meeting, we’ll develop a report highlighting the priorities we identified. This is the first step toward creating a province-wide health services research network.”
Top ten priorities identified at the meeting
- Increasing screening participation
- Improving coordination of care and access
- Better utilization of resources near the end of life
- Improving the quality of cancer surgery in the community
- Identifying and intervening in the long-term effects of cancer survivorship
- Developing quality of care standards & benchmarks
- Evaluating different models of survivorship care
- Navigating the health system after abnormal screening tests
- Knowledge Translation: inventory and evaluation of current activities
- Assessing sociodemographic and geographic disparities affecting equitable access to quality cancer care
