Once our PSI Knowledge Translation (KT) Fellows take off from the starting line, they make strides as they move their knowledge translation activities and research program forward. As the finish line becomes clearer in their sight, we asked our fellows some questions to share their progress thus far, and what they look forward to in the remainder of their KT Fellowship.

What are some of your accomplishments from the KT Fellowship thus far?

Publications

Since the outset of the project, I have authored/co-authored the following publications:

April 2024:

Implementation, Clinical Benefit and Safety of a D-Dimer-Focused Pulmonary Embolism Testing Pathway in the Emergency Department

Federico Germini, Fayad Al-Haimus, Yang Hu, Shawn Mondoux, Quazi Ibrahim, Noel Chan, Rick Ikesaka, Joshua Klyn, Natasha Clayton, Lehana Thabane, Kerstin de Wit

Annals of Emergency Medicine

January 2024:

The inseparability of context and clinical reasoning

Andrew Olson, Juliane E Kämmer, Ahmed Taher, Robert Johnston, Qian Yang, Shawn Mondoux, Sandra Monteiro

Journal of evaluation in clinical practice

Validating the Emergency Department Avoidability Classification (EDAC): A cluster randomized single-blinded agreement study

Ryan P Strum, Shawn Mondoux, Fabrice I Mowbray, Lauren E Griffith, Andrew Worster, Walter Tavares, Paul Miller, Komal Aryal, Ravi Sivakumaran, Andrew P Costa

PLoS One

December 2023:

GridlockED as an Intervention for Nurses (GAAIN) Study

Teresa M Chan, Nicole Bodnariuc, Nandini Nandeesha, Jennifer Kodis, Clare O’Connor, Shawn Mondoux, Alim Pardhan, Ruth Chen

The Journal of Continuing Education in Nursing

Health care utilization and outcomes of patients seen by virtual urgent care versus in-person emergency department care

SL McLeod, JE Tarride, S Mondoux, JM Paterson, L Plumptre, …

CMAJ

Development of a machine learning-based acuity score prediction model for virtual care settings

Justin N Hall, Ron Galaev, Marina Gavrilov, Shawn Mondoux

BMC Medical Informatics and Decision Making

November 2023:

Was virtual care as safe as in-person care? Analyzing patient outcomes at 7- and 30-days in Ontario during the SaRS-CoV-2 pandemic

Shawn Mondoux, Frank Battaglia, Anastasia Gayowsky, Natasha Clayton, Caillin Langmann, Paul Miller, Alim Pardhan, Julie Mathews, Alex Drossos and Keerat Grewal

Healthcare Quarterly, Longwoods

September 2023:

“It saved me from the emergency department”: A qualitative study of patient experience of virtual urgent care in Ontario

Katie N Dainty, M Bianca Seaton, Justin N Hall, Shawn Mondoux, Lency Abraham, Joy McCarron, Jean-Eric Tarride, Shelley L McLeod

PLoS One

Quantifying the escalating impact of paramedic transported emergency department visits for opioid-related conditions in Ontario, Canada: A population-based cohort study

Ryan P Strum, Shawn Mondoux, Fabrice I Mowbray, Paul Miller, Andrew Worster, Richard Ferron, Andrew P Costa

PLoS One

May 2023:

Storage conditions, sample integrity, interferences, and a decision tool for investigating unusual high-sensitivity cardiac troponin results

Matthew A Lafrenière, Vikas Tandon, Craig Ainsworth, Kazem Nouri, Shawn E Mondoux, Andrew Worster, Peter A Kavsak

Clinical Biochemistry

April 2023:

Digging into the complex problem of mental health presentations to pediatric emergency departments: a how-to guide

Shawn Mondoux, April Kam

Canadian Journal of Emergency Medicine

The COVID-19 impact and characterization on substance use-related emergency department visits for adolescents and young adults in Canada: Practical implications

Soyeon Kim, Natalie Rajack, Shawn E Mondoux, Vitor S Tardelli, Nathan J Kolla, Bernard Le Foll Journal of Evaluation in Clinical Practice

Identifying very-low-risk patients for future myocardial infarction or death Peter A Kavsak, Joshua O Cerasuolo, Mark K Hewitt, Shawn E Mondoux, Richard Perez, Hsien Seow, Craig Ainsworth, Jinhui Ma, Andrew Worster, Dennis T Ko

Canadian Journal of Cardiology

March 2023:

Evaluating emergency department transfers from urgent care centres: insights for paramedic integration with subacute healthcare

Ryan P Strum, Fabrice I Mowbray, Shawn E Mondoux, Andrew P Costa

BMJ Open Quality

January 2023:

Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario

Shelley L McLeod, Shawn Mondoux, Justin N Hall, Katie Dainty, Joy McCarron, Jean-Eric Tarride, Lency Abraham, Sandy Tse, Rodrick Lim, Megan Fitzgibbon, Renee-Anne Montpellier, Leon Rivlin, Carla Rodriguez, Lisa Beck, Lianne McLean, Daniel Rosenfield, Shaun Mehta, Michelle Welsford, Cameron Thompson, Howard Ovens

Canadian Journal of Emergency Medicine

Media impact of research

December 2023

More Canadians have been using virtual care since the pandemic. Is it effective and safe? https://www.ctvnews.ca/health/new-canadian-research-suggests-virtual-care-is-effective-and-safe-1.6676  733 . Dec 7th 2023.

November 2023

McMaster study finds that virtual care is safe, being used effectively https://www.chch.com/mcmaster-study-finds-that-virtual-care-is-safe-being-used-effectively/ , Nov 27th 2023.

Medical care being delivered by phone and video is safe, concludes McMaster research

The Hamilton Spectator, Nov 27th 2023.

Prognostiq Health (previously Llif Healthcare)

As part of a larger and more concerted KT effort, and in line with the thesis put forward as part of my application for the fellowship, I have founded a company who is engaged in physician audit and feedback. The principle is to use EMR data to provide high-value feedback to clinicians with the goal of better situational awareness, improve patient care and decrease health system cost. In this way, we are engaging in the pragmatic act proposed in our application for research.

Current metrics:

• Reporting monthly emergency department practice data to over 100 MDs.
• Data holding in excess of 900,000 ED visits
• Current yearly ARR of $40,000 CAD
• Generated $380,000 CAD in seed-stage company revenue
• Over $250,000 CAD in non-dilutive business funding
• 5 employees

Newsworthy milestones:

• Prognostiq Health graduates as an alumnus from Canada’s most prestigious business incubator. We completed final selection for Creative Destruction Lab – Vancouver, Biomedical Engineering Stream in May 2024.
• Prognostiq Health is featured as a venture in the Halo Health Live 23 session. Halo Health is Canada’s only physician angel investment group, selecting among hundreds of ventures per year to find the most promising in the healthcare space.
• Prognostiq Health is selected as a feature vendor for the Digital Health Expo stage as part of the MaRS Impact Health 2024 conference. This conference features Canada’s most promosign and emergency health tech solutions.
• Prognostiq Health featured as a Beta startup company at Collision Conference 2024 in Toronto.
• Prognostiq Health selected as part of the 2024 cohort for the Canadian Entrepreneurs in Life Sciences Valley Ready (CELS-VR) program. This exposes Canadian companies to the tech ecosystem in Silicon Valley, enabling investment and market penetration.

Pending contracts – Prognostiq is poised to expand its implementation by integrating in the following health facilities:

• Newfoundland and Labrador Health Service
• Sunnybrook Health Sciences Center
• Queensway Carleton Hospital
• Royal Columbian Hospital – BC

Current impact:

• Early data from interventions has demonstrated:
  • a 10% increase in the number of patients seen per hour in participating emergency departments.
  • a 5% decrease in 72hr return rates in participating emergency departments

Media features:

• December 2022
  • IMPROVING IN-HOSPITAL PATIENT CARE USING DATA ANALYTICS
  • https://perspective.ca/improving-healthcare-st-josephs-hamilton/
• November 2022
  • McMaster Seed Fund invests $1.27 million in three startup companies
  • https://brighterworld.mcmaster.ca/articles/mcmaster-seed-fund-invests-1-27-million-in- three-startup-companies/

Please describe any challenges/barriers that you have encountered thus far and what actions were/will be taken to resolve them?

Research objectives:

• Drafting of subsequent articles is ongoing. Submission to follow
• No active issues at present.

Business objectives:

• Market penetration in healthcare takes a very long time

What are some items/deliverables that you look forward to coming to fruition in the remainder of your KT Fellowship?

A research trial with a US health center willing to pilot and try our technology. This will yield MD-centric and system centric endpoints which are likely to make us vastly more scalable in the US marketplace.

Within Canada, we look forward to integrations across multiple new sites.

What are some things that surprised you during your fellowship thus far?

That the opportunity to have impact has presented itself both in the form of research but also in the form of direct-to-MD solutions that are changing the face of healthcare delivery in participating centers.

Once our PSI Knowledge Translation (KT) Fellows take off from the starting line, they make strides as they move their knowledge translation activities and research program forward. As the finish line becomes clearer in their sight, we asked our fellows some questions to share their progress thus far, and what they look forward to in the remainder of their KT Fellowship.

What are some of your accomplishments from the KT Fellowship thus far?

I have held my PSI Fellowship for 2 years now.  It has allowed me to continue my research program.  Some of my accomplishments in the last two years have been:

• Supporting trainees:  during this time, I have supervised 3 Master’s students, 4 PhD students, 3 medical residents and 4 postdoc fellows.  I have co-supervised a number of others.
• Mentorship:  I have had the privilege to mentor several new investigators from across Canada
• High impact publications in the European Respiratory Journal, CMAJ, Chest and Thorax
• Opportunities to transfer our knowledge to action working with the Government of Ontario, the Canadian Thoracic Society and the Lung Foundation.

Please describe any challenges/barriers that you have encountered thus far and what actions were/will be taken to resolve them?

A challenge has been hiring qualified research personnel.  We have been able to resolve this, but it caused delays.

What are some items/deliverables that you look forward to coming to fruition in the remainder of your KT Fellowship?

I look forward to seeing the results of our national, multicentre study on Respiratory Long COVID.  Long COVID is a persistence of symptoms from acute COVID infection beyond 12 weeks that is not attributed to alternate diagnoses. Studies of Long COVID have been mostly limited to people requiring hospitalization, leaving little known about its impact on the 93% of Canadians managed as outpatients.  They have also used convenience samples, small samples and/or single study locations. We have recruited a random sample of over 500 participants from the community who have had COVID to better characterize respiratory Long COVID in the population.

What are some things that surprised you during your fellowship thus far?

Not surprised, but impressed by the greater access to data there seems to be now compared to just a few years ago.  Many of my studies use large databases of people with respiratory disease.  Just a few years ago, it was very difficult to access large databases because of privacy and security concerns.  While this is still the situation when accessing Ontario health administrative data, it seems that it is becoming easier to access anonymized data from other sources.  I think this is a great trend.

Once our PSI Knowledge Translation (KT) Fellows take off from the starting line, they make strides as they move their knowledge translation activities and research program forward. As the finish line becomes clearer in their sight, we asked our fellows some questions to share their progress thus far, and what they look forward to in the remainder of their KT Fellowship.

What are some of your accomplishments from the KT Fellowship thus far?

The KT fellowship has been such an important facilitator for my research program focused on child health equity. Having dedicated funded time for research is instrumental in the progress of research and its impact.

The PSI Graham Farquharson KT Fellowship has helped support my work with Connecting Families, a randomized controlled trial evaluating the impact of income support navigation for low-income families of young children on child and parent health. There is a pressing need for effective interventions to help mitigate child poverty that can be integrated in primary care and are rigorously evaluated. The pilot phase of this trial is complete and has informed the planning for the full trial, which is also underway. A manuscript has been published reporting the experiences of families with young children experiencing financial strain. Another manuscript reporting the quantitative results of the pilot is being prepared for submission.  Recruitment for the full trial is progressing very well.

The Fellowship has also supported Innovations for Community Resilience, Equity and Advocacy (I-CREAte), a community based participatory action research team that conducts meaningful and action-oriented research to improve the health and well-being of children, families, and communities (https://www.queensu.ca/i-create/). We have completed phase 1 of Engaging Families To Build Healthy Communities, which used multiple case studies and arts based methods to examine resilience among families experiencing individual or community adversity in the context of the COVID-19 pandemic and beyond. The knowledge dissemination phase has included hosting 11 community meetings with a range of participants including community members, service organizations, government and advocacy organizations. The feedback from these meetings will be used to prepare a searchable database of community led solutions, policy briefs, and infographics, as well as peer reviewed publications and conference presentations.

Additionally, the KT Fellowship has supported me in a project using electronic medical records to examine changes in the provision of preventive well child care for young children during the COVID-19 pandemic. Our team has examined changes in visit frequency, changes in growth patterns, and parent and clinician identified innovations to address access challenges during the pandemic. We have also developed methods for using natural language processing to derive breastfeeding and developmental outcomes in young children’s full charts (including narrative notes). Several manuscripts are in preparation.

What are some items/deliverables that you look forward to coming to fruition in the remainder of your KT Fellowship?

I anticipate completion of the Connecting Families study and dissemination of results to policy makers, clinicians and the academic community. This work promises to make an important contribution to evidence surrounding the effectiveness of interventions to address child poverty in primary care settings. These results have the potential to change practice and to support policy development in health services planning.

I also am working with a team conducting a systematic review of the diagnostic test properties of developmental screening tools in young children. The review will be very helpful in guiding primary care and public health practitioners in an evidence informed approach to developmental screening in young children.

What are some things that surprised you during your fellowship thus far?

Having support from PSI in this fellowship has meant that I have been able to be flexible and respond to unexpected opportunities that arise, which have the potential for significant impact.

Upon receiving their approval letters and sharing the exciting news of the award with their community, the PSI Knowledge Translation (KT) Fellows begin preparing to get settled in their place at the starting line. As they embark on their KT Fellowship journey, we asked them few questions to know them beyond their recipient biographies, as well as some notes they could pass on to future applicants.

Please use 3 words to describe how you feel as you begin your KT Fellowship.

Proud, excited, and curious (about what we will find!)

Why did you apply for the PSI KT Fellowship? How does this award align with your current research and career goals?

I applied for the Fellowship to gain valuable salary support, and because I was pursuing a project that I thought would fit well with the award opportunity. The focus on knowledge translation resonates with my work which is centered on improving the quality of care in the real world. The award is also a way to highlight my work, which is helpful for ongoing engagement of patients, caregivers, and knowledge users.

What are 3 to 5 general tips and notes you would pass on to those preparing their KT Fellowship application?

• Start early on your submission because there are a lot of documents required.
• I benefitted immensely from reviewing a colleague’s successful submission as I prepared my materials – if you know someone who was previously successful in this, I would recommend reaching out to them.
• Don’t be thrown off if there is some redundancy in the questions/materials, I found I did end up repeating myself in a few of the documents, and I guess that must have been alright because here I am.

Upon receiving their approval letters and sharing the exciting news of the award with their community, the PSI Knowledge Translation (KT) Fellows begin preparing to get settled in their place at the starting line. As they embark on their KT Fellowship journey, we asked them few questions to know them beyond their recipient biographies, as well as some notes they could pass on to future applicants.

Please use 3 words to describe how you feel as you begin your KT Fellowship.

• Empowered
• Resourced
• Valued

Why did you apply for the PSI Mid-Career KT Fellowship? How does this award align with your current research and career goals?

My application for the PSI Mid-Career KT Fellowship was motivated by my commitment to integrating social determinants of health into emergency department practices in Ontario, where I’ve witnessed the dire effects of poverty, homelessness, and other social issues on health outcomes. This fellowship aligns perfectly with my research into developing sustainable outreach programs that position outreach workers as central to effective healthcare delivery. The support from the fellowship is crucial to providing the protected time I need to do this work. Professionally, it propels my career goal of being a transformative leader in emergency medicine, advocating for systemic changes that ensure outreach workers are recognized as indispensable. Through this fellowship, I look forward to being able to secure the evidence and backing needed to advocate for policy changes that integrate and sustain outreach roles in healthcare, ultimately improving patient care and health outcomes across Ontario.

What are 3 to 5 general tips and notes you would pass on to those preparing their KT Fellowship application?

1. It is key for Knowledge Translation to involve the right people in the design, implementation and evaluation of your work and ensure that it is translated to the bedside and policy in an effective way.  You will learn the most from the patients and people with lived experience. Build your team deliberately and make sure they are compensated for their expertise.
2. Get input from all stakeholders on what the most important outcomes for them. Stakeholders include the communities who help design your treatments, interventions all the way to the people who need to sustainably fund them in the long term.
3. Get a lot of people to read your application to make sure you are communicating your work effectively. Ask them to reflect back what they think your proposal is. We get so stuck in our work that we sometimes forget to define or explain the most fundamental concepts in a grant or paper. Make it easy for the reviewers.
4. Leave time to enjoy the process. Grant proposals should be exciting to write as they essentially help you plan what you get to do in your academic work for the upcoming few years.