“The right to health care. This is so fundamentally a Canadian thing. It’s an ideal that our leaders fought for and protected regardless of what political camp they were in. Health care for all is the high measure of the quality of our society. It’s compassion for each other. We can’t let it slip away to the private interest of business, greed, and money.”
s Canada’s first pre-hospital blood transfusion trial could be a ‘lifeline’ for trauma patients
We are excited to share some big news with you – starting in March, our beloved print magazine will be transitioning to an online-only format! After 35 years in print – we are going digital! While this marks the end of an era for our physical publication, we believe this opens up incredible opportunities for both you, our loyal readers, our advertisers and the Hospital News team.
By going digital, we’ll be able to bring you more timely, up-to-date news and content. No longer bound by print deadlines, we can share stories as they develop, ensuring you are in the know with relevant information whenever you need it – you will.
Additionally, this shift will allow us to bring you a wider range of content, including videos and direct links to additional resources, enhancing your overall reading experience. The convenience of accessing our magazine from anywhere – on your phone, tablet, or computer – means you’ll have the latest healthcare news at your fingertips, whether you’re at home or on the go.
We are also excited to expand our community and engage with you more directly. Our online platform will give readers easier ways to interact with us, share your feedback, and participate in conversations. With social media, we hope to create a community with ongoing dialogue sharing innovations in healthcare.
As always, our commitment to providing a forum to share best practices and developments in healthcare remains unchanged. We are confident that this new chapter will allow us to continue doing what we do best. n H
Kristie Jones Editor, Hospital News
APRIL 2025 ISSUE
EDITORIAL: March 7
ADVERTISING: Display – March 21 | Material – March 25
Monthly Focus:
Healthcare Transformation/eHealth and EHR/ Mobile Health: Programs and initiatives that are transforming care and contributing to an effective, accountable and sustainable system including virtual care. Innovations in electronic/digital healthcare, including mHealth and the Electronic Health Record (EHR).
+ ANNUAL E-HEALTH SUPPLEMENT
THANKS TO OUR ADVERTISERS
EDITORIAL: April 11
ADVERTISING: Display – April 25 | Material – April 29
Monthly Focus:
Surgical Procedures/Pain Management/ Palliative Care/Oncology: Non-invasive surgery, plastic surgery, orthopedic surgery and new surgical techniques including organ donation and transplantation procedures. New approaches to pain management and palliative care delivery. Approaches to cancer diagnosis and treatment.
+ NATIONAL NURSING WEEK SUPPLEMENT
When you visit our advertisers, please mention you saw their ads in Hospital News.
Editor Kristie Jones editor@hospitalnews.com
Advertising Representatives Denise Hodgson denise@hospitalnews.com
Publisher Stefan Dreesen stefan@hospitalnews.com
Accounting Inquiries accountingteam@mediaclassified.ca
Circulation Inquiries info@hospitalnews.com
Director of Print Media
Lauren Reid-Sachs
Helen Reilly, Publicist Health-Care Communications
Bobbi Greenberg, Health care communications
Sarah Quadri Magnotta, Health care communications
Dr. Cory Ross, B.A., MS.C., DC, CSM (OXON), MBA, CHE Vice President, Academic George Brown College, Toronto, ON
ASSOCIATE PARTNERS:
Hospital News is published for hospital health-care professionals, patients, visitors and students. It is available free of charge, accessed by our website (hospitalnews.com) and also available through our digital subscription.
The statements, opinions and viewpoints made or expressed by the writers do not necessarily represent the opinions and views of Hospital News, or the publishers.
Hospital News and Members of the Advisory Board assume no responsibility or liability for claims, statements, opinions or views, written or reported by its contributing writers, including product or service information that is advertised.
For changes in email subscriptions please send requests to info@hospitalnews.com. Hospital News does not share email information and subscriptions can be cancelled at any time.
By Olivia Lavery
Dr. Brodie Nolan’s latest study takes scientific research into the air to bring hospital-quality care where it’s needed most for patients with traumatic injuries.
Nolan, a trauma physician and scientist at St. Michael’s Hospital, a Level 1 trauma centre, and physician with Ornge, Ontario’s critical care transport and air ambulance service, is leading the Study of Whole Blood in Frontline Trauma (SWiFT Canada). He is working in partnership with Ornge, Sunnybrook Health Sciences, Canadian Blood Services, and four other lead trauma hospitals across Ontario to study the optimal method for delivering blood transfusions to patients before they arrive at hospitals.
“In an ideal world, nobody would get injured or sick outside of a hospital,” said Nolan. “But we know that is not the real world. The role of prehospital care is to bring meaningful interventions that will help save lives as close to the place and time of injury as possible.”
The current standard of care for prehospital blood transfusion is component therapy, which requires paramedics to give patients red blood cells that have been separated from other components like plasma and platelets. The SWiFT Canada study intervention involves the use of whole blood, which contains red blood cells, plasma and platelets all in one bag, on board Ornge helicopters in Toronto. Whole blood is easier to transport and store, and is effective in situations with limited resources, which could make it easier to deliver care at the site of traumatic events.
Whole blood has only recently become available for use in civilian populations, having historically been used exclusively by the Canadian Armed Forces. This is the first clinical trial looking at the use of whole blood in Canada and the first prehospital trauma transfusion study in Canada.
Nolan says that, despite trauma and severe injuries being a leading cause of death among young Canadians, research has typically been quite siloed. The goal of Nolan’s work and collaborative research like SWiFT Canada is to bridge the gap between the prehospital and in-hospital environment and leverage the interconnectivity of Ontario’s trauma system to get the best insights.
Evidence shows that patients with massive bleeding have significantly better chances of survival if they get blood transfusions early. And while having the Ornge blood-on-board program has already cut down this critical time to transfusion for patients greatly,
the goal of SWiFT Canada is to find out if there’s an even more efficient and beneficial way of doing things.
In trauma care, the first 60 minutes are considered to be the “golden hour,” the time when patients have the best chance of survival. It’s why Nolan and his colleagues at St. Michael’s Hospital call their research collective First60.
Ontario’s trauma system is unique because of the province’s geography.
As Nolan points out, 40 per cent of patients live further than a 60-minute drive to a lead trauma hospital, and 15 per cent are more than a 60-minute flight from a lead trauma hospital. Bringing in-hospital care – like blood transfusions – to these patients living
in suburban and rural communities adds a layer of health equity to a system challenged with long distances and inherent delays to accessing trauma specialists.
Nolan says that Ornge, with its ground and air transport services, is like a “lifeline” for these patients. The goal with SWiFT Canada is to make that line even stronger. n H
Tools of Change is soliciting nominations for its 2025 Landmark-designated behavior change case studies in two topic areas – (1) climate change mitigation and adaptation, and (2) sustainable transportation. We will write the case studies for the designated programs. The deadline is June 7, 2025. We are also accepting nominations for (3) building energy conservation behavior change case studies, to be reviewed and designated in 2026.
If you know of a particularly effective or innovative approach for changing related behaviours, it can even be your program, please consider nominating it. All nominations must include measured impact results.
Designation as a “Landmark” (best practice) case study through this peer selection process recognizes behavior change programs and approaches considered to be among the most successful, innovative, replicable and adaptable in the world. Designated programs gain exposure and credibility, and we prepare and post detailed
on-line program case study materials, which may help them attract customers and investors, and maintain or increase program funding.
Nominations are screened by Tools of Change staff and then the most promising are rated by peer selection panels based on a standard scoring grid. Designated programs are highlighted in our written case studies. Program organizers get a Landmark designation logo for use on websites and in electronic newsletters, providing click-through access to the program’s case study materials.
The nomination form, which can be downloaded from www.toolsofchange. com/en/landmark/ must be submitted by Friday, June 7, 2025.
To view Landmark case studies designated in past years, go to www.toolsofchange.com/en/landmark/ Tools of Change was first published as a workbook in 1994, co-authored by Jay Kassirer and Doug McKenzie-Mohr. The website, sections of which are based on the workbook, was launched in January 2000 as a
collaborative effort between Cullbridge™, the Federation of Canadian Municipalities, Health Canada, Natural Resources Canada, the International Institute for Sustainable Development, Environment Canada, and Canada’s National Round Table on the Environment and the Economy.
Founded on the principles of community-based social marketing, Tools of Change engages program planners and facilitators from around the world to share and learn from their collective experiences. Its mandate is to build the capacity for planning and implementing more successful health, safety, and environmental promotion programs.
The website currently hosts over 200 full-length case studies. An impact evaluation of site users found that most returned to the site many times, had improved their programs as a result, and had used the site to help explain and justify their ideas to colleagues and decision makers. Many had replicated ideas found on the site. n H
Irritable bowel syndrome (IBS) is a common digestive disorder that affects the intestine, causing symptoms such as abdominal pain, bloating, gas, and changes in bowel habits, including diarrhea, constipation, or both. Although this condition affects about a tenth of the global population, the underlying causes and mechanisms of IBS remain unclear. Consequently, treatments for IBS primarily focus on managing symptoms rather than addressing the root cause of the disorder.
At Tokyo University of Science (TUS), Japan, Professor Akiyoshi Saitoh and his research group have spent the past decade exploring this topic. This study published online in the British Journal of Pharmacology on December 25, 2024, discovered that a class of drugs called opioid delta-receptor (DOP) agonists may help alleviate IBS symptoms by targeting the central nervous system rather than acting directly on the intestine. This study was co-authored by Toshinori Yoshioka, a third-year PhD student at TUS.
One of the main motivations for this study was the growing evidence linking IBS closely to psychological stress. Saitoh’s group aimed to address this potential root cause by focusing on finding a novel animal model for this condition. In a study published in 2022, they developed a mice model repeatedly exposed to psychological stress – using a method called chronic vicarious social defeat stress (cVSDS) – which developed symptoms similar to a type of IBS called IBS-D. These symptoms included overly active intestines and heightened sensitivity to abdominal pain, even though their organs showed no physical damage. The cVSDS animal model involved having the subject mouse repeatedly witness a territorial, aggressive mouse defeating a cage mate, inducing indirect chronic stress.
Using the cVSDS model, the researchers sought to determine whether DOP in the brain, which is closely linked to pain and mood
ONE OF THE MAIN MOTIVATIONS FOR THIS STUDY WAS THE GROWING EVIDENCE LINKING IBS CLOSELY TO PSYCHOLOGICAL STRESS.
regulation, could serve as promising drug targets for treating stress-induced IBS. To achieve this, they performed a series of detailed experiments to observe the effects of DOP agonists on IBS symptoms and chemical signaling in the brain. Some experiments involved measuring the speed of a charcoal meal through the intestine to assess gastrointes-
tinal motility and evaluate the impact of stress or treatments on bowel movement speed, along with directly measuring neurotransmitter concentrations using in vivo brain microdialysis. This revealed that re-exposure to VSDS increased glutamate levels in the insular cortex, but these elevated levels were normalized with DOP agonists.
According to the results, the administration of DOP agonists helped relieve abdominal pain and regulated bowel movements in cVSDS mice. Interestingly, applying the DOP agonists directly to a specific brain region called the insular cortex had similar effects on IBS symptoms as systemic treatment. “Our findings demonstrated that DOP agonists acted directly on the central nervous system to improve diarrhea-predominant IBS symptoms in mice, and suggest that the mechanism of action involves the regulation of glutamate neurotransmission in the insular cortex,” highlights Saitoh. n H
Black Canadians continue to face significant barriers to accessing mental health services and supports, including cost of care, a history of systemic racism and discrimination in healthcare, personal and community experiences of racial bias, and overall lack of culturally representative and responsive mental health professionals.
The Honourable Ya’ara Saks, Alberta’s Minister of Mental Health and Addictions and Associate Minister of Health, recently announced the first recipients of the of the Promoting Health Equity: Mental Health of Black Canadians Fund. Three projects across Alberta will receive a total of $279,900 in funding to build capacity to develop and deliver programs that promote the mental health of Black people in Canada.
The work of these community-led projects enhances participants’ understanding of mental health, its determinants, and raises awareness of available mental health resources. They provide a safe and culturally relevant
“WHEN
PEOPLE FIND THE COURAGE TO ASK FOR HELP, THEY DESERVE TO BE MET BY MENTAL HEALTH SERVICE PROVIDERS WHO SEE THEM AND CAN OFFER RESOURCES THAT REFLECT THEIR REALITY.”
place where community members can access high-quality programing, resources, and supports.
We are committed to supporting community-led projects that aim to increase equity and address the underlying determinants of mental health, including a focus on anti-Black racism. Future project receiving funding will include those that strive to strengthen or adapt mental health supports and services to meet the needs of Black communities in Canada, develop new interventions to promote positive mental health and increase access to opportunities and conditions conducive to health for all.
Having access to culturally representative care is critical to man-
aging mental health. Black-led and evidence-based projects will have a positive and sustainable impact on the mental health of Black people in Canada.
“When people find the courage to ask for help, they deserve to be met by mental health service providers who see them and can offer resources that reflect their reality. The projects funded through the Mental Health of Black Canadians Fund are dedicated to improving the mental health of its community members and moving towards better health outcomes,” says The Honourable Ya’ara Saks, Alberta Minister of Mental Health and Addictions and Associate Minister of Health. n H
Swelling caused by brain cancer is a problem that can lead to serious side effects and even death. While controlling swelling is important, a new study shows that a commonly prescribed anti-swelling drug suppresses the immune system for weeks after dosage, inhibiting the body’s ability to fight the cancer.
An international team of scientists from Canada and the United States looked at myeloid cells in brain cancer patients. These cells make up a large part of brain cancer tumours and have been shown to play a role in immunosuppression. The researchers used single-cell and spatial transcriptomics on myeloid cells from over 100 brain tumours to learn how they affect immune response
to cancer. Single-cell transcriptomics reveal how RNA is expressed in a cell, hinting at its function, while spatial transcriptomics reveals how these cells are positioned within the tissues.
The researchers discovered a consistent organization of cells within brain cancer, where each type of myeloid cell was found in specific areas tailored to its role.
Notably, they found two types of immunosuppressive myeloid cells in the tumours: one linked to areas of dead tissue while the other linked to anti-swelling therapy. In patients who had been given dexamethasone, these cells had a significantly higher immunosuppressive effect than those who had not, and the effect was stronger as the dosage increased.
Scientists then exposed otherwise non-immunosuppressive myeloid cells to dexamethasone and found that they quickly became immunosuppressive. The effect was long-lasting, remaining weeks after the drug was last given.
In some cancer patients, doctors prescribe treatments that strengthen the body’s immune response to the malignant cells, using them to fight the cancer. This study shows that dexamethasone, a drug commonly prescribed in all brain cancer patients, may be inhibiting that response, even if that drug was last given weeks before immunotherapy begins.
“Doctors should ask themselves if dexamethasone is truly needed in each case its prescribed,” says Dr. Charles
March is Kidney Health Month in Canada. If you haven’t yet considered the way your mighty kidneys impact your overall health, now is the time.Kidneys are often misunderstood and their value to overall health underestimated. Kidneys are vital organs with an important role, including removing waste from the body, helping to make red blood cells, and regulating blood pressure. Diabetes and high blood pressure are the leading causes of kidney disease, and heart disease can be both a cause and a complication for those living with kidney disease.
“Kidney disease and its many silent symptoms often go undetected until kidney function is significantly impaired,” said Elizabeth Myles, National Executive Director of The Kidney Foundation of Canada. “There is no better time than Kidney Health Month to learn more, get engaged and take action to protect your kidney health.” According to a recent Ipsos poll conducted recently on behalf of The Kidney Foundation of Canada, there is a significant gap in Canadians’ knowledge when it comes to kidneys with 55 per cent of people indicating they know nothing about kidney disease, and 52 per cent showing a lack awareness regarding the risks.
Although one-third of Canadians could correctly identify some of the kidneys’ functions, few people could identify symptoms of kidney disease.
“The Kidney Foundation’s trusted resources are a good first step to learning more about kidney health, to explore personal risk factors and to get the information you need to ask the right questions during your annual medical
exam or to consider lifestyle changes,” said Ms. Myles.
The Kidney Foundation of Canada’s supports and services aim to help those living with reduced kidney function or kidney failure to know they are not alone. “We offer a number of programs and services designed to address some of the key concerns facing patients and their caregivers every day,” said Ms.
Couturier, a neurosurgeon-scientist at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and one of the study’s lead authors. “It is important to balance the need to reduce swelling with the need for a healthy immune response. We need to start developing alternatives to dexamethasone that do not inhibit immune response in patients.”
The paper, entitled “Programs, Origins, and Immunomodulatory Functions of Myeloid Cells in Gliomas”, was published in the journal Nature on Feb. 26, 2025. It was funded by the Canadian Institutes of Health Research, Fonds de recherche du Québec – Santé, the National Institutes of Health, and the Koch Institute for Integrative Cancer Research. n H
Myles. “Programs like peer support in its many formats provides conversation with those who have lived similar life experiences, and our Kidney Community Kitchen website with recipes and cooking tips is a popular virtual stop as people navigate the complexity of dietary changes.” A first step to disease management and prevention is education. Learn more by visiting kidney.ca n H
Agroundbreaking research review led by local researchers and published in the Canadian Journal of Cardiology confirms that bed rest can speed up the aging process. “The cardiac changes we are seeing after only a few days or weeks of bed rest are similar in magnitude to multiple decades of aging,” said Carmelo Mastrandrea, PhD, MD, Postdoctoral Fellow at the University of Waterloo and a research scientist at the Schlegel-UW Research Institute for Aging (RIA) and lead author of the research review. “That means if someone’s health deteriorates and they stay in bed, we can expect aspects of
their heart function to diminish considerably, impacting the speed and ease of their rehabilitation.” This is the first time researchers have analyzed data from 38 studies to compare the cardiac changes that occur with bed rest to the typical aging process. The review was co-authored by Mastrandrea and Richard Hughson, Schlegel Research Chair in Vascular Aging and Brain Health at the RIA, and highlights two key findings: 1. Reduced cardiovascular function can occur just days into bed rest or immobility. 2. Proactive and early movement can help offset cardiac changes for people prescribed bed rest. These findings stress the importance of
upright posture and physical activity for people prescribed bed rest for various health conditions. “Bed rest reduces our ability to function, impacting our overall health with increased risk of dizziness, falling over, difficulty walking up stairs, and reduced ability to perform daily tasks,” said Mastrandrea. “Early and continuing physiotherapy and mobility for all individuals confined to bed rest will help mitigate these risks.” “Dr. Mastrandrea’s summary of the effects of bed rest and the similarities to aging extends to our research at the RIA to highlight the importance of physical activities in preventing a precipitous decline in our health,” said Hughson. n H
By Melody Keshishian
Emergency department (ED) wait times are more than just a metric – they are a reflection of the challenges and opportunities in delivering the timely, compassionate healthcare that patients need and deserve. For hospitals across Ontario, the struggle to balance rising patient volumes, staffing shortages, and limited primary care access is all too familiar.
Scarborough Health Network (SHN) is turning the tide with AcceleratED Care: A radical new experience for patients and staff that is not only reducing wait times, but changing the very nature of how emergency healthcare is delivered – including reimagining emergency department design.
“AcceleratED Care redefines the patient journey by seamlessly integrating physicians and nurses in the rapid medical examination zone to assess and initiate care efficiently for stable, mid-acuity patients,” said Dr. Elan Ambalavanar, Chief and Medical Director of the Department of Emergency Medicine at SHN.
“Grounded in our commitment to safe, compassionate care, this innovative model eliminates unnecessary wait times to provide a superior ED experience.”
SHN has already retrofitted the Birchmount and General hospital EDs to enable faster access to care. Now, SHN will become the first hospital in Canada to build an ED specifically designed to support AcceleratED Care from the ground-up, when the new Northpine ED at Centenary Hospital begins construction this year.
With AcceleratED Care, most patients are assessed by both a nurse and a physician quickly after they enter the ED, which reduces the number of times patient need to repeat their medical concerns, and enables tests and treatment options to begin earlier in their visit. But putting a physician at the front of house (known as the frontend model of care) is just one piece of the puzzle.
The AcceleratED Care experience requires transforming the very design and layout of each ED to optimize patient flow and support faster, more efficient care. In order to accommodate the front-end model, the Birchmount ED retrofit included the addition of:
• Rapid Medical Examination Rooms for immediate assessments and tests;
• Fast-Track Zones for patients with less urgent conditions to ease pressure and improve efficiency across the department; and
• Private High-Care Areas for close monitoring and faster treatment of critically ill patients.
The upgraded spaces feature more comfortable waiting areas with enough seating for families, private collaboration spaces for staff, and self-check-in kiosks to speed up the intake process and reduce front-end bottlenecks.
When SHN piloted the AcceleratED Care model at Birchmount Hospital in November 2023, it showed impressive outcomes. This pilot led to the Birchmount ED being ranked among the top five fastest EDs in Ontario each month since its launch, with initial performance indicators showing that 90 per cent of non-admitted patients were seen within two hours of arrival.
By September 2024, patients seen within 30 minutes of arrival had increased by 20 per cent.
The Deepa and Narinder Lal ED at General Hospital, which adopted AcceleratED Care in December 2024, underwent similar renovations. ED staff and leaders are now tracking improvements to wait times and the overall patient experience, anticipating data similar to that which resulted at Birchmount.
“The new AcceleratED Care experience has resulted in better overall quality of care, and prioritizes efficiency, teamwork, and staff wellness,” said Dr. Norm Chu, an emergency physician who spearheaded this model at SHN.
“Improving the workflow and reducing strain on our team are key components in ensuring that patients receive the best possible experience, while supporting staff and physicians to succeed in a busy and fast-paced environment.”
When the new Northpine ED at Centenary Hospital opens, every aspect of the facility will have been meticulously configured to support faster diagnosis, immediate treatment, and better patient outcomes.
Drawing on insights from improvements made to its sister EDs, the Northpine ED layout at Centenary will be structured to minimize unnecessary movement, ensuring that both staff and patients move seamlessly through the facility. This is not simply about adding more space – it is about creating an environment that supports efficient decision-making and a faster, easier patient journey.
“It’s incredibly rewarding to see how AcceleratED Care is improving both the patient and staff experience,” said Geleta Ansebo, Manager of Emergency Care at Birchmount Hospital.
“Our teams look forward to continually seeking opportunities for improvement to build on this initiative and propel our success.”
As the AcceleratED Care experience continues to evolve, including improving collaboration and workflow with other areas often involved in emergency care such as diagnostic imaging and mental health, SHN’s focus on designing facilities that work in tandem with care delivery will have a lasting impact on emergency care in Scarborough and beyond.
Driven by the exceptional leadership of SHN’s ED physicians and staff, these upgrades were made possible through the strong support of donors, government partners, and the local community. By creating environments that are built for faster access to care while maintaining exceptional quality, SHN is setting a new standard for emergency department design: One that puts the patient experience and safety at the forefront. n H
The transition to electronic medical records has created an unexpected challenge in health care delivery: family physicians now spend approximately 45 per cent of their clinical hours interacting with computers rather than patients. This shift has significantly impacted physician-patient interactions and contributed to increasing physician burnout.
The University of Toronto’s Department of Family and Community Medicine is addressing this through patient care innovation, implementing AI medical scribe technology supported by the Health Care Unburdened Grant program.
This initiative is part of a broader effort to address administrative burden in health care, where physicians spend about 18.5 million hours on administrative tasks each year, with 75 per cent of doctors reporting this impedes patient care.
The initiative focuses on implementing and evaluating Autoscribe, a Canadian AI-powered medical documentation solution that supports real-time transcription of patientphysician conversations.
“The first thing that happens when your clinic gets busy is you stop documenting... that’s the time when you need this the most,” explains Dr. Rajesh Girdhari (Digital Health Lead, University of Toronto), emphasizing how the technology supports health care providers during crucial moments.
“The biggest benefit of the AI scribe for me is that it has increased the quality of the patient-physician encounter,” shares Dr. Marco Lo, family physician
and member of the East Toronto Family Practice Network. “Without the stress of documentation, or deferring charting to after-hours, I can focus entirely on the patient and what they are telling me. Then, I can fully focus on generating a plan and discussing next steps. This has created a better experience for my patients, and for me as a clinician.”
“This grant for us was really just a catalyst for the whole project,” notes Dr. Rajesh Girdhari. “This is one of these products uniquely positioned to benefit patients, physicians, and the system in general.”
The two-year implementation project aims to evaluate how AI medical scribe technology can enhance patient-centered care in Ontario, while helping reduce the administrative burden of health care professionals.
The implementation of this technology comes at a crucial time, as the current documentation burden has contributed significantly to the shortage of family physicians in Ontario and a diminishing interest in family medicine among medical learners. By evaluating and supporting the implementation of Autoscribe, the initiative hopes to accelerate its adoption across health care settings, leading to substantial benefits for doctors and Ontario’s health care system.
This patient care innovation represents a significant advancement in transforming the delivery of care.
The evaluation will assess the initiative based on:
• Improvements to physician satisfaction and well-being
• Patient satisfaction
• Improvements to clinical operational efficiencies
• Reductions to clinical documentation time
• Accuracy and reliability of the AI scribe’s output
The success of this AI health care initiative relies on strong partnerships across the health care sector.
Led by the Office of Health System Partnerships in the Department of Family and Community Medicine at University of Toronto, the project brings together key health care organizations including:
•East Toronto Health Partners
• East Toronto Family Practice Network
• North York Toronto Health Partners
• North York Toronto Primary Care Network
•Scarborough Ontario Health Team
• Scarborough Family Physicians Network
•KW4 Ontario Health Team
•eHealth Centre of Excellence
•Mutuo Health Solutions
This initiative is part of a larger $10-million investment through the Health Care Unburdened Grant program, established by the Canadian Medical Association, MD Financial Management Inc. and Scotiabank® The program supports innovative initiatives across Canada aimed at enabling health care providers to focus more on what matters most –patient care.
For more information about this initiative and other supported projects, visit cma.ca/hcug and dfcm.utoronto. ca/news/primary-care-clinicians-harnessing-power-ai-scribe-technology-reduce-burnout-and-enhance n H
By Shahana Gaur
Humber River Health (Humber) remains dedicated to reducing healthcare’s environmental impact while maintaining excellence in patient care. From the outset, when Humber was built, the hospital was designed with three core vision elements in mind: lean, green, and digital. This foundational approach ensures that sustainability is embedded in every aspect of operations. Through waste reduction, infrastructure efficiency, and green clinical practices, Humber continues to lead the way in environmentally responsible healthcare.
The healthcare sector must play a crucial role in fostering sustainability, as such, Humber has implemented numerous sustainability initiatives across its operations. For example, the organization utilizes ORCA food waste digester technology to break down organic waste into liquid, diverting it from landfills and reducing greenhouse gas emissions. Food service teams prepare 80 per cent of the menu fresh on-site, vacuum-seal extra food to minimize waste, and provide reusable utensils whenever possible. Routine waste audits ensure continuous process improvements. Recycling initiatives further support Humber’s commitment to environ-
mental stewardship. The organization partners with GFL Environmental Inc. for waste management and operates an ink toner recycling program to prevent hazardous materials from entering landfills. Humber also encourages staff, patients, and visitors to bring their own reusable bags to further reduce plastic waste across its sites.
In the operating rooms, Humber participates in medical device reprocessing programs and the PVC 123 initiative, which recycles oxygen masks, tubing, and IV fluid bags - significantly reducing medical waste. The Department of Anesthesia has adopted sustainable practices by reducing the use of inhalation gases containing volatile organic compounds, cutting back on single-use plastics, and recycling IV tubing. Additionally, Humber follows a “Choosing Wisely” approach to medication waste management, ensuring that pharmaceuticals are used efficiently and reducing excess waste. As part of this effort, the organization has actively reduced the use of Desflurane, an anaesthetic gas with a high environmental footprint, in favour of more sustainable alternatives.
Humber’s Wilson site is among the most energy - efficient large urban hospitals in North America and Europe. Their lean, green, digital design includes a LEED - certified lighting program and strategic upgrades that have resulted in a 29 per cent reduction in energy use, a 34 per cent reduction in water consumption, and a 43 per cent reduction in greenhouse gas emissions compared to industry standards. Humber’s Church Campus has also made significant progress, achieving a 5 per cent reduction in energy consumption, implementing the MRI Angus predictive maintenance system to optimize equipment efficiency, and converting parking spaces into green areas for patient gardens.
“Sustainability is not just a goal – it is a responsibility,” says Jhanvi Solanki, Vice President of Clinical Programs at Humber River Health. “Every decision
made, from patient care to operational processes, considers the environmental impact. Humber is setting a new standard in green healthcare, proving that innovation and sustainability can go hand in hand.”
Humber also prioritizes sustainability in facility management by continuously evaluating and upgrading building systems to enhance efficiency. Additionally, Humber conducts regular asbestos abatement checks at older facilities to ensure a safer environment for both staff and patients while adhering to best environmental practices. These initiatives contribute to long-term sustainability by extending the lifespan of hospital infrastructure and minimizing its environmental footprint.
From a transportation perspective, the Wilson site features electric vehicle charging stations, and the organization partners with Smart Commute to encourage carpooling, cycling, and public transit use among staff. These initiatives contribute to reduced emissions and improved air quality in the Greater Toronto Area.
Humber’s environmental achievements have received significant recognition. The organization was named a 2023 Health Care Climate Action Winner by Health Care Without Harm and was awarded the Silver-Level Green Hospital Scorecard Award by the Canadian Coalition for Green Health Care. Humber was also recognized as a case study in world-class energy efficiency by Greening Health Care, ranking second among 280 international hospitals. Sustainability efforts are projected to save nearly $100 million in utility costs over the next 30 years.
In addition, Humber has led operating room waste reduction initiatives, earning the Stryker Environmental Excellence Award in Silver in 2023, and repeating success in 2024 with Gold. These efforts have resulted in
1,117 pounds of waste being diverted from landfills through medical device reprocessing in 2022. Additionally, 900 pounds of waste avoidance and $300,000 in cost savings were seen in 2023/2024, the highest in Ontario.
Humber’s Hyper-Throughput Operating Rooms further exemplify sustainability in action. These operating rooms, designed for faster and safer anterior hip replacements, have significantly reduced waste while improving surgical workflows. “Hyper-Throughput Operating Rooms break down each step within the process and evaluate its effectiveness – leaning out waste and introducing parallel processing has resulted in significant time savings,” explains Jhanvi. “This initiative not only helps tackle the surgical backlog but also aligns with Humber’s environmental sustainability goals.” The program has led to a 50 per cent reduction in waste, decreased turnover time, and lower garbage and linen usage. At Humber, a culture of continuous innovation drives these advancements, ensuring that every improvement not only enhances efficiency but also reinforces our commitment to sustainability. The lessons learned from these initiatives are being applied to other surgical areas to improve productivity and sustainability across the hospital.
Looking ahead, Humber River Health remains committed to exploring new and innovative ways to further integrate sustainability into every aspect of patient care and hospital operations. Ongoing considerations into eco-friendly medical supplies, energy-efficient equipment, and carbon offset programs will ensure that Humber continues to lead by example. By setting ambitious environmental goals and fostering partnerships with other organizations, Humber is not only making a difference, but paving the way for a greener, more sustainable future in healthcare.n H
Across Canada, emergency departments are facing an unprecedented
surge in patient volumes, stretching resources and increasing wait times. A major factor driving this congestion is the growing number of non-urgent visits – cases that could be effectively treated in primary care settings instead of the ER.
This issue has been well-documented. The latest 2025 data from the Canadian Institute for Health Infor-mation (CIHI) highlights the scale of the problem: one in seven emergency department visits in Canada are for conditions that could have been man-aged in a primary care setting. In total, this accounted for approximately 1.2 million ED visits last year, straining hospital resources and increasing wait times.
Compounding the issue, a 2024 CIHI report analysing data from the National Ambulatory Care Reporting System (2013–2014) found that 40 per cent of non-urgent ER visits take place during regular family physician office hours, suggesting that many patients are choosing emergency care despite the availability of primary care services.
To address these challenges, many hospitals are actively researching patient redirection programs to divert non-urgent cases to more appropriate healthcare settings. The goal is to redirect enough non-urgent cases to meaningfully alleviate ED wait times, but not so many that the criteria become too lenient, potentially compromising patient safety.
Montreal’s Sacré-Cœur Hospital has demonstrated that clinically validated algorithms can accurately identify patients who do not require emergency care while maintaining patient safety. In their redirection model, approximately 15 per cent of ambulatory patients were deemed eligible for redi-
rection, and the return rate was just 3 per cent – precisely the target set by researchers.
These findings underscore a critical point: the success of patient redirection hinges on the quality of the criteria used and the system’s ability to apply them accurately.
Beyonddefiningredirectioncriteria, a well-structured partner network is crucial for ensuring redirected patients receive timely care. However, establishing and maintaining these partnerships is complex, as regulations, care standards, and logistical constraints vary across regions.
Selecting the right partners and structuring clear agreements – whether with clinics, family care centers (FCCs), pharmacies, or telehealth services – is essential. Each provider has different capacities and requirements,
making expert guidance invaluable. Organizations specializing in redirection offer implementation guides, checklists, and contract templates to help hospitals build sustainable networks.
A well-designed redirection program requires scientifically validated decision-making and a strong, well-integrated healthcare network. But these are just two of the ten strategies identified by LGI Healthcare Solutions over the past decade to optimize emergency department redirection.
First implemented in Canada, LGI’s model has been successfully replicated across multiple hospitals and expanded internationally, with adoption in France and Switzerland. To date, this approach has safely redirected over 300,000 patients, demonstrating its scalability and impact on emergency care efficiency.
To learn more about these ten proven strategies and how to implement a successful patient redirection program, join the upcoming webinar, “Mastering ER Redirection: 10 Strategies from 10 Years of Experience”, on March 25th at 12:00 PM (EST).
(After March 25th, the link will direct you to the webinar recording.) n H
By Sarah Ripplinger
Walking into the Robotics and Control Laboratory (RCL), you first notice the rows of computers, many with researchers busily typing away in front of their screens. Beside desks and along the walls, robot arms and other apparatuses jut out at odd angles, some with wires cascading from them to racks of servers used to store dizzying amounts of data.
The RCL is a leading research facility in advanced machine-assisted medical applications. Headed by Vancouver Coastal Health Research Institute researchers Drs. Tim Salcudean and Purang Abolmaesumi, along with Institute for Computing, Information and Cognitive Systems director Dr. Robert Rohling, lab research focuses on medical robotics, telerobotics, ultrasound and image analysis. It is also a leading centre for image-guided diagnosis and interventions, with a goal to enhance precision medical procedures. Technologies developed at the RCL have been integrated into products sold around the world. Applications have advanced real-time video imagery of the internal structures of the body for surgical and diagnostic procedures, such as in prostate cancer care.
One of the advanced technologies investigated in the RCL is the da Vinci robotic surgical system. Using this robot, Wanwen Chen, a PhD candidate working in the lab, is making inroads in ultrasound applications in endoscopic surgery.
Chen’s software integration would make it possible to create a real-time, side-by-side view of the da Vinci’s camera video and ultrasound imagery.
The point-of-care ultrasound (POCUS) transducer selected for this approach is a compact version of larger,
traditional ultrasound machines, emitting sound waves to capture images of internal organs and tissues.
Above: Haptic feedback relayed through the expert’s controller would inform them of the pressure exerted by the non-expert’s transducer on a surface, allowing the expert to assist the non-expert in staying within an optimal range.
Left: Randy Moore, a graduate student, is collaborating with Chen on the project. His mixed reality (MR) application is creating the interface used to connect the da Vinci and ultrasound imaging technologies. While augmented reality (AR) adds layers of digital information to real-world environments, MR applications also make possible interactions between physical and digital elements.
“The same technology that we developed for use with POCUS could produce side-by-side views of da Vinci
robotic surgical system imagery with a computed tomography (CT) imaging scan or magnetic resonance imaging (MRI) scan,” notes Chen. “This advanced imaging integration offers additional layers of detail to surgeons, facilitating greater precision for enhanced patient outcomes and a reduced risk of removing excess tissue at the margins of a tumour or unintentionally coming into contact with vasculature, for example.”
Alexandre Banks, Master of Science candidate, is developing an AR hand-over-hand training system for the da Vinci technology. Banks records expert surgeons using the tool, then turns them into AR training videos. Trainees can see their own articulating arm tool at the same time as the digital overlay of the recorded one.
The tele-ultrasound prototype co-developed by David Black, a PhD
candidate working in the RCL, and Salcudean, with master’s student Ryan Yeung and several undergraduate students, could enable expert sonographers or radiologists to guide non-experts located many kilometres away in performing an ultrasound scan. An MR headset and specially designed POCUS transducer would be used by a non-expert to conduct the scan under the remote guidance of an expert.
A live video feed from the non-expert’s headset-mounted camera would be fed to the expert via a video link. The expert’s haptic controller would guide the non-expert through a scan, with a digital overlay of the expert’s controller – in the form of a virtual transducer – appearing over the non-expert’s real-world environment.
“This force sensor that we developed measures changes in the magnetic field to measure transducer pressure exertion more accurately,” explains Black. “We are also investigating an option to replace the MR headset with
a smartphone app to dramatically reduce the cost of the technology.”
Tara Kemper, a graduate student, is building on prior research into an elastography system that gauges organ stiffness through vibrations. Kemper’s novel approach uses ultrasound and a vibrating board placed below a patient to quantify liver fibrosis – scar tissue – and fat, with the hopes of creating a rapid non-invasive test to detect potentially deadly fatty liver disease. n H
Above: Equipped with several rigid arms mounted with a camera, the da Vinci system enables surgeons to view real-time, three-dimensional images with depth perception capabilities. This technology enables surgeons to gauge distances between internal structures during minimally invasive procedures, such as tumour removal.
outhlake Health is leading the way in cardiac care by pioneering the use of 4D intracardiac echocardiogram (ICE) catheters, a new tool that provides real-time images of the heart for some of the most complex cardiac cases in the province. Not yet approved for regular use in Canada, hospitals must receive “Special Access” authorization from Health Canada to use the Nuvision 4D ICE catheter for specific patients. Southlake is the second hospital in Ontario and one of the first four hospitals in Canada to use this technology, building on its international reputation for ground-breaking procedures and innovative solutions.
Typically, physicians who require a 3D image of the heart use transesophageal echocardiograms (TEE), a procedure during which a thin tube is guided down the esophagus to take pictures of the heart. The Nuvision 4D ICE catheter is next generation technology. A small catheter with an ultrasound sensor is inserted from the leg into the heart to generate real-time images of the valves and other structures. This advanced technology provides higher quality, real-time images, allowing physicians to instantly see the heart in 3D so that patients who cannot use TEE can still undergo life-changing cardiac procedures that help them avoid recurrent heart failure and other complications.
“When a patient comes to Southlake for cardiac care, they’re trusting us with their hearts, a responsibility
that our team takes incredibly seriously,” said Warren Cantor, MD, Southlake Health. “Special access to cutting-edge technology like the 4D ICE catheter enables us to offer treatment options to patients who otherwise have little to no options, improving their quality of life. We are honoured to play a key role in bringing this technology to Southlake and Canada.”
• Southlake’s Regional Cardiac Program is the fourth largest comprehensive heart program in Ontario, providing advanced cardiac care close to home to thousands of patients from York Region to Muskoka, and often receiving referrals from other cardiologists throughout the province.
• Southlake is the regional hub for emergent heart attack care, meaning if a patient is having a heart attack, they’ll be brought to Southlake for treatment no matter which hospital is closest in the region.
• Southlake is known internationally for its research and innovation in cardiac care. Its recent accomplishments include becoming the first hospital in North America to successfully implanted 1,001 sutureless heart valves.
THIS ADVANCED TECHNOLOGY PROVIDES HIGHER QUALITY, REAL-TIME IMAGES, ALLOWING PHYSICIANS TO INSTANTLY SEE THE HEART IN 3D SO THAT PATIENTS WHO CANNOT USE.
Last fall, the Regional Cardiac Program at Southlake received a referral from a cardiologist in Windsor.
Their patient, Nancy Skinner, was seeking treatment for tricuspid valve regurgitation (TVR), a form of heart valve disease in which the valve between the two right chambers of the heart does not fully close. Moderate to severe TVR is a serious condition that requires treatment, including surgical valve repair or replacement, to ensure enough oxygen rich blood flows through the heart.
However, Nancy was not a candidate for surgery and complications with her heart valve prevented clear
imaging of the valve with TEE. This imaging is necessary to ensure a safe and successful procedure, and patients who cannot have TEE or have inadequate imaging with the tool are ineligible for procedures like a transcatheter tricuspid valve repair, leaving them with limited care options. Nancy and her cardiologist needed more options to address her heart disease. Undeterred, Dr. Cantor, an international expert in acute coronary syndromes, and the cardiac team at Southlake turned to global solutions in the Nuvision 4D ICE catheter.
Continued on page 16
If it’s a cause that matters, Florene is going to show up. That’s who she is—always wanting to make the world better and brighter.
As a lawyer, educator and long-standing advocate for human rights, Florene now calls Christie Gardens home, where she knows her desire to make a difference will be supported and valued.
Tireless advocate. Shining light.
“Over the last century, Southlake Health has built a proud legacy of leading edge care, close to home to save patients from travelling into Toronto,” said Derek McNally, Executive Vice President, Clinical Services and Chief Operating Officer, Southlake Health.
“Our world-class team at the Regional Cardiac Centre continues to lead ground-breaking research and techniques, ensuring patients from York Region to Muskoka, and beyond have access to the best care possible.”
With the 4D ICE catheter’s real-time imaging, Dr. Cantor was able to repair the patient’s heart valve using a minimally invasive procedure. This helped relieve the patient’s symptoms and improve her breathing. Today, she is doing much better.
“I feel like myself again,” said Nancy. “Dr. Cantor and the cardiac team at Southlake Health gave me another chance at life and went above and beyond to do so. I am so thankful for their resourcefulness in getting this new technology.”
Southlake’s Regional Cardiac Program is home to one of two Structural Heart Programs in Ontario and one of four in Canada. The program uses minimally invasive procedures to treat conditions that affect the heart’s structure, including the valves, walls, muscles, and blood vessels. Today, Southlake is one of the highest volume centres in Canada for transcatheter mitral valve repair, providing care to patients from York Region, Simcoe County, and beyond. The team at Southlake works with patients to provide the best care possible, which in some cases includes cutting-edge transcatheter procedures that are not available many in other cardiac centres.
“Southlake’s deep commitment to patients pushes our team to continuously raise the bar for leading edge cardiac care, even when that care is complex,” said Elizabeth Lalingo, Director of the Department of Cardiac Health, Southlake Health. “Every patient who walks through our doors can be confident that they’re receiving compre-
hensive care that is cutting-edge on the world stage.”
As a Level 7 Regional Cardiac Program, Southlake’s contributions to advancing cardiac care extends far beyond operating and procedure rooms. The highly skilled team of medical staff and staff provide almost every type of cardiac care, with the exception of heart transplants, to patients
who no longer need to travel far distances to Toronto. As leaders in their fields, the team actively participate in ground-breaking research and are often the first to perform leading edge procedures in Ontario, Canada and even the world. Southlake continues to collaborate with international experts to enhance cardiac care and improve patient outcomes globally. n H
V-161 targets a crucial enzyme in VRE, offering promise in combating antibiotic-resistant infections in hospital environments
V-161, a novel compound targeting the Na+-V-ATPase enzyme in vancomycin-resistant Enterococcus faecium (VRE), significantly reduces bacterial growth and colonization. A recent study has demonstrated a promising approach for fighting antibiotic resistance by identifying a compound, V-161, that inhibits a sodium-pumping enzyme critical for VRE survival under alkaline conditions in the intestine while preserving beneficial bacteria. This breakthrough offers hope for treating hospital infections and tackling the global threat of antibiotic-resistant bacteria.
The rise of antibiotic-resistant bacteria is a global health concern, with studies projecting over 10 million deaths annually by 2050 due to these resistant infections. The World Health Organization (WHO) has identified twelve critical antibiotic-resistant pathogens, including vancomycin-resistant Enterococci (VRE), such as Enterococcus faecium (E. faecium). VRE causes severe hospital-acquired infections like endocarditis and sepsis and has developed resistance to multiple antibiotics, highlighting the urgent need for new antimicrobial treatments.
In response to this crisis, a team of researchers led by Professor Takeshi Murata from the Graduate School of Science, Chiba University, Japan, has discovered a promising new compound, V-161, which effectively inhibits the growth of VRE. Their research examined a sodium-pumping enzyme found in these bacteria called Na+-transporting V-ATPase found in E. hirae, a close relative of E. faecium, used as a safer, more tractable model for studying the enzyme. The team consisted of Assistant Professor Kano Suzuki, first author from the Graduate School of Science, Chiba University; Associate Professor Yoshiyuki Goto from the Medical Mycology Research Center, Chiba University; Professor Toshiya Senda and Associate Profes-
sor Toshio Moriya from the Structural Biology Research Center, High Energy Accelerator Research Organization; and Professor Ryota Iino from the Institute for Molecular Science, National Institutes of Natural Sciences. This study, published online in Nature Structural & Molecular Biology on November 21, 2024, hypothesized that Na+-transporting V-ATPase could play a key role in the development of an antibiotic that specifically targets VRE without affecting beneficial bacteria.
Dr. Murata explains, “This enzyme helps pump sodium ions out of the cell, aiding in the survival of VRE, especially in alkaline environments like the human gut. This enzyme is absent in beneficial bacteria like lactobacilli, and while humans have a similar enzyme, it serves different functions. This makes the Na+-transporting V-ATPase in VRE an ideal target for selective antimicrobial treatments.” He further states, “We screened over 70,000 compounds to identify potential inhibitors of the enzyme Na+-VATPase. Among these, V-161 stood
out as a strong candidate, demonstrating significant effectiveness in reducing VRE growth under alkaline conditions – an environment critical for the survival of this resistant pathogen.” Following this, further studies revealed that V-161 not only inhibited the enzyme function but also reduced VRE colonization in the mouse small intestine, highlighting its therapeutic potential.
A major finding of this study was the high-resolution structural analysis of the membrane V0 domain of the enzyme, revealing detailed insights into how V-161 binds to it and disrupts the enzyme function. V-161 targets the interface between the c-ring and the a-subunit of the enzyme, effectively blocking sodium transport. This structural information is critical to understanding the workings of the compound and provides a foundation for developing drugs that target this enzyme.
Dr. Murata explains, “The findings obtained from the structural analysis could be used for the development of treatments for other refractory
bacteria and also form a basis for the development of important guidelines for future drug development.” He further adds, “We hope that the development of innovative treatments not only for VRE but also a wide range of drug-resistant bacteria will greatly advance the treatment of drug-resistant infections.”
While the results are promising, the study also notes that further research is needed to make V-161 even more effective and improve its efficacy against a broader range of bacterial strains. Despite these challenges, the findings mark a significant advancement in developing new therapeutic agents to combat VRE and other antibiotic-resistant bacteria. As part of ongoing efforts to refine V-161, the research team plans to test it against other bacterial strains to further assess its potential.
Reflecting on these results, Dr. Murata says, “We hope that these efforts will ultimately yield more effective treatments for infections caused by VRE and other drug-resistant bacteria, making a significant impact on the fields of infectious diseases and public health.” The ultimate goal is to develop a new class of antibiotics that not only complements existing treatments but may also serve as a powerful solution to combat the escalating threat of antibiotic resistance.
Dr. Takeshi Murata is a Professor at the Graduate School of Science and the Director of the Membrane Protein Research Center at Chiba University, Japan. He earned his Ph.D. in Engineering from the Tokyo University of Science in 2000. With more than 200 publications, Dr. Murata has received numerous honors, including the Young Researcher Presentation Award at the 49th Symposium of the Society for Bioenergy Research. His research primarily focuses on membrane proteins and structural studies, areas in which he continues to make significant contributions. n H
There is no question that healthcare has become more complex in the past 50 years, and with it comes risk to the patient. The “Safer Healthcare” movement recognizes these risks and advocates that we all work together, clinicians and patients alike to ensure that the benefits of care are realized and the associated risks are not. Infection Prevention and Control (IPAC) is a keystone program in every hospital and is recognized as a critical component of safe care. As IPAC Canada looks toward celebrating our 50th anniversary in 2026, we are reflecting on the support that we provide to infection control practices and patient safety.
IPAC Canada is a not-for-profit member-based organization dedicated to improving safe patient care through science-driven IPAC practices. With over 2,000 members, we operate through local chapters across the country, ensuring effective dissemination of information and resources. The organization provides education at both national and local levels, including webinars, certification support, and a website providing general information to the public with additional resources available to members. From World Hand Hygiene Day each May, to International Infection Control Week in October, IPAC Canada is poised to support our members in driving ex-
cellent practices forward. Recently, an innovative Ethical Framework, developed in Canada was provided to assist members in finding the best solutions in difficult situations. This statement was co-published by our close partners, the Association for Professionals in Infection Control (APIC) in the USA. Partnerships are an important feature of the association, as infectious organisms know no boundaries. IPAC Canada plays an active role in global partnerships, collaborating with organizations like International Federation of Infection Control (IFIC) and the World Health Organization (WHO). Annually, our hybrid education conference allows networking of members
from across the country and around the world and provides cutting-edge information to ensure our members have the most current information available to hone their practice. n H
RN BN MHA CRM CIC is President of Infection Prevention and Control Canada (IPAC Canada) – www.ipac-canada.org
enome BC is funding a set of research projects to address the risk associated with a strain of avian influenza, of the H5N1 subtype. The BCCDC is conducting the projects in partnership with the Provincial Health Officer, the Ministry of Health, the Ministry of Agriculture and Food and researchers from the University of British Columbia. The announcement comes at a critical time, with the recent detection of the first domestically acquired human H5N1 case in British Columbia.
In addition, human cases have been reported in the United States and elsewhere, most often following close contact with sick animals. While the overall risk to the general population remains low, the recent avian influenza activity and human cases underscore the urgent need to be prepared.
“These projects will use genomics to study how the H5N1 virus is transmitted, create tests to monitor for cases of H5N1, identify ways to track the virus to see how it changes, and will also develop platforms to analyze, interpret and share the data that is being gathered,” says Genome BC’s Chief Scientific Officer and Vice-President Research and Innovation, Federica Di Palma.
“We are responding to the need to stay ahead of this threat through the development and use of genomic tools to enhance testing, improve monitoring and deepen our understanding of the virus.”
This announcement concerns the launch of two genomics research projects responding to the avian influenza. One of those two projects is called
STERIS is a leading global provider of products and services that support patient care with an emphasis on infection prevention. WE HELP OUR CUSTOMERS CREATE A HEALTHIER AND SAFER WORLD by providing innovative healthcare, life sciences and dental products and services.
STERIS Healthcare’s complete focus is in the peri-operative environment. We partner to understand where you are today, create a plan together, and provide full solution sets to support the Operating Room (OR), GI / Endoscopy Suites and Medical Device Reprocessing Area (MRDA) environment. Our commitment is to help Customers solve their biggest challenges, leverage opportunities for growth, and advance the care of patients. We put the full power of our market leading solutions and our people to work every day in order to help Customers elevate patient care.
To learn more about how STERIS can help you, call STERIS Canada Sales ULC at 800-661-3937 or visit www.steris.com/healthcare-canada.
“WE ARE RESPONDING TO THE NEED TO STAY AHEAD OF THIS THREAT THROUGH THE DEVELOPMENT AND USE OF GENOMIC TOOLS TO ENHANCE TESTING, IMPROVE MONITORING AND DEEPEN OUR UNDERSTANDING OF THE VIRUS.”
the HUB and consists of a series of four sub-projects addressing various aspects of surveillance, testing and research to better understand how the virus is transmitted and how it may evolve. These research projects will:
• Investigate the possible role of wind in transmitting H5N1 within and between farms to better understand the spread of the virus
• Develop antibody tests to monitor exposure to H5N1 in human populations
• Evaluate the use of wastewater surveillance testing to provide an early warning system
• Monitor mutations in the virus to detect those with the potential to make H5N1 more adapted to humans
• Develop cross-institutional data platforms to collect, process and share the genomic data created by these projects “We know serious infections can occur and without early detection and containment there is a potential for these infections to spread,” says Dr. Linda Hoang, medical director of the BCCDC Public Health Laboratory and principal-investigator on the HUB
projects. “However, with enhanced strain-detection strategies for influenza virus already in place across BC microbiology labs, we were well placed to detect the first human case of H5N1 in BC,” adds Dr. Hoang.
“The state-of-the-art genomics capacity at the BCCDC Public Health Laboratory enabled us to conduct genetic analysis to help inform patient care and population risk.”
Avian influenza, commonly known as bird flu, is a viral disease carried by wild aquatic birds like geese and ducks that can be transmitted to poultry. Some highly pathogenic strains, such as H5N1, are deadly for birds and can spread through flocks rapidly. If an outbreak occurs on a farm, flocks must be immediately culled to try and stop the spread of the virus, resulting in significant negative impacts on food security and the economy.
Continued on page 22
Delivers gapless laminar airflow to minimize turbulence and gently guide particles away from the surgical site. MEDGLAS™ PREFABRICATED OR WALLS
Easy to clean, prefabricated glass walls are able to withstand disinfecting agents offering a better alternative than site-built drywall.
By Marlene Leung
t. Michael’s Hospital has received funding for a device that helps clinicians better treat people with diabetic foot ulcers, who face the risk of limb amputation. Notably, the MIMOSA Pro solution is the result of research that was developed at the Keenan Research Centre for Biomedical Science at Unity Health Toronto.
A team representing the Downtown East Toronto Ontario Health Team’s (DETOHT) Lower Limb Preservation Program successfully applied for Ontario Health and Boehringer Ingelheim Canada Digital Health Care Transformation Funding. The team is led by Vascular Surgeon Dr. Charles de Mestral, Senior Clinical Program Director Desa Hobbs and DETOHT Executive Director Nancy Lin.
The handheld MIMOSA Pro device uses visible, infrared, and near-infrared light to rapidly capture wound insights at the point-of-care, including: tissue oximetry, temperature, wound measurement, and a digital image. These insights enable
clinicians to see beyond what is visible to their naked eye, and better assess a patient’s wound and periwound areas.
In recent years, North America and other regions globally have been experiencing one of the most devastating outbreaks of highly pathogenic avian influenza in history. Since 2022, over 8.5 million poultry have been culled in BC, causing significant financial loss to farmers and reductions in the supply of eggs and poultry products, contributing to increased prices for these items in grocery stores.
Globally, H5N1 has already been transmitted from birds to a variety of mammals including skunks, cats and seals. Last year, a strain of H5N1crossed over from birds into cattle in the U.S. and spread from cattle-to-cattle in herds across the country. A number of human cases with mild symptoms were reported following close contact with infected cows.
Then in January, the U.S. reported its first human death from bird flu; the individual had been in close contact with sick and dead birds from a backyard flock. As more humans are exposed to the virus, and the virus spreads to other mammals, there is an increased risk that the virus may change and spread more easily from person to person.
The research builds on the relationship between the BCCDC, Ministry of Agriculture and Food, the Ministry of Health and the Provincial Health Officer to share avian influenza genomics capacity, results and information, using a One Health approach that assesses human health risks at the intersection of animal health and ecosystems. n H
Vascular Surgery Project Coordinator Javier Garay, Vascular Surgeon Dr. Charles de Mestral, Chiropodist Sreenath Rave, Vascular Surgeon Dr. Elisa Greco and Vascular Surgery Clinic RN Kirk Young.
THE HANDHELD MIMOSA PRO DEVICE USES VISIBLE, INFRARED, AND NEAR-INFRARED LIGHT TO RAPIDLY CAPTURE WOUND INSIGHTS AT THE POINT-OF-CARE.
“The MIMOSA Pro is essentially a type of wound scanner that gives clinicians information that the human eye – even the expert human eye –can’t see. It’s digital health innovation that will support our team in wound assessment and wound monitoring,” de Mestral said.
The research behind the MIMOSA Pro was developed at St. Michael’s Hospital by Plastic and Reconstructive Surgeon Dr. Karen Cross and Dr. General Leung, an engineer who led research in the hospital’s MRI department. In 2020, Cross competed at the Angels Den medical competition and won funding to push the project forward.
Since then, the MIMOSA Pro has evolved and has been approved for
clinical use both in Canada and the U.S. Cross is now the co-founder of MIMOSA Diagnostics with Leung, who also serves as the company’s chief technology officer.
“To have the MIMOSA Pro come back to St. Michael’s for use in patient care is amazing. I’m very grateful to Dr. de Mestral, and to (Vascular Surgeon) Dr. Elisa Greco who in the early days of MIMOSA had an active role in supporting us and the evolution of this technology,” said Cross.
“We spent a lot of time in their vascular surgery clinic imaging patients. It’s incredible how it’s come around full circle and is now back at St. Michael’s.”
Continued on page 24
2024 evidence published in International Journal of Infection Control by Dr. Victor Lange found Needle‑free connectors with a solid external access surface have demonstrated significantly lower CLABSI* rates vs those with a non solid access surface.1
BD® MaxPlus™ and BD® MaxZero™ Needle-free Connectors are the only connectors on the market today with this solid external surface.
Learn more about BD® MaxPlus and MaxZero™ Needle-free Connectors >
*CLABSI: Central line-associated bloodstream infection
Reference:
1 Lange VR. Use of different designed needle-free connectors: a snapshot of central venous catheter intraluminal blood occlusion and central line-associated bloodstream infection in hospitals. International Journal of Infection Control. 2024(20). doi.org/10.3395/ijiic.v20.23731
Continued from page 22
Greco agrees. “Seeing the MIMOSA from conception and early-day trials, to now being in full clinical use in our clinics is incredible. It is truly the ‘bench-tobedside’ research that Karen and I had always talked about – she was the ‘bench’ research, and I the ‘bedside’ in the clinic, for a collaborative and innovative approach to patient care,” she said.
We are SC Johnson
Professional Healthcare
As a leader in safety and skin care, SC Johnson Professional® provides healthcare facilities with the right choice of solutions to meet every need throughout the continuum of care.
Conveniently Available to: Hospitals, Long-Term Care and Retirement Homes, Primary Care Practices, and more.
Healthcare Hand and Hygiene Program
As LEADING EXPERTS IN HAND HYGIENE to support Infection Prevention Protocols our deep-rooted knowledge originates from our Deb® skin care solutions. We produce quality products that are independently tested to high standards.
The MIMOSA Pro will be used for the care of patients treated in the St. Michael’s vascular surgery clinic as part of the DETOHT’s Lower Limb Prevention Initiative, a community health program that seeks to improve
Our program includes essential products, support resources, compliance and audit tools to help optimize hand hygiene best practice according to the 4 Moments for Hand Hygiene guidelines.
Our DEDICATED COMPLIANCE TEAM work in partnership with your practice to establish and implement a 6-Stage actionled Compliance Plan tailored to the unique needs of your facility.
Interested in learning more about if your facility is driving hand hygiene compliance and understanding what solutions may be right for you? Our team of hygiene specialists can help you with an onsite audit report providing areas of opportunities and solutions. Learn more today!
www.scj.com
services for patients at risk of or with foot wounds related to diabetes and peripheral artery disease.
Diabetic foot ulcers are open sores or wounds that can develop on the feet of people with diabetes, as a result of nerve damage and poor circulation. Diabetic foot ulcers require intensive treatment usually including a combination of wound cleaning/dressings, medications and surgeries or minimally invasive procedures to improve blood flow or treat severe infection.
De Mestral said that under typical circumstances, clinicians assess a patient’s wound or foot ulcer and come up with a treatment plan. After a few weeks, the patient’s wound is re-assessed to see if the treatment is working or if more aggressive interventions are required.
He believes the MIMOSA Pro can help speed up this process by giving clinicians more certainty about the patient’s risk level and the required treatment.
“This digital health solution gives us extra information and insights that can guide us to more timely interventions, and ultimately prevent leg amputations,” he said.
Cross said it was a fortunate “collision” with Leung many years ago, that laid the foundation for MIMOSA Diagnostics. Over many coffees at a café close to St. Michael’s, the two
DIABETIC FOOT ULCERS ARE OPEN SORES OR WOUNDS THAT CAN DEVELOP ON THE FEET OF PEOPLE WITH DIABETES.
developed the MIMOSA Pro, resolved challenges and eventually perfected the technology.
“That collision was the most important thing that happened because it connected me with a person who understood the engineering piece and also the clinical piece, because he worked in the clinical environment every day,” Cross said of Leung. “He built the first prototype in his kitchen, and we tested it in my lab. That’s how MIMOSA started.”
She credits the unique research environment at St. Michael’s for bringing her and Leung together, despite their different academic backgrounds, and supporting them throughout the development phase of MIMOSA.
“There is an appetite for entrepreneurial activity at St. Michael’s that is different,” she said. “There’s a focus on translating the science, so it’s not science for the sake of science, but science that’s having a real-world impact.” n H
Marlene Leung works in communications at Unity Health.
www.scjp.com
ive years after the start of the pandemic, experts from the MUHC, the Montreal Children’s Hospital and The Institute share their significant experiences and lessons learned. Through their testimonies, scientific advances and innovative efforts, they tell us how they have risen to the challenges of treating the sick, protecting the most vulnerable and fighting COVID-19. Discover an overview of their crucial contributions in this unprecedented fight.
In the spring of 2020, Dr. Lucie Opartny, then Assistant Deputy Minister at the MSSS, quickly set up the COVID-19 Clinical Steering Committee to help hospitals prepare effectively for the pandemic. Since January 2023, she has been President and Executive Director of the MUHC.
A former intensivist, Dr. Jason Shahin has vivid memories of that period when caregivers, despite their fear, showed up every day at the intensive care unit to care for the sickest patients. Now director of intensive care at the MUHC, Dr. Shahin also mentions that ECMO treatment, an advanced respiratory support method, has proven to be a crucial tool in the fight to save severely ill and life-threatening COVID-19 patients.
For infectious disease specialist Dr. Don Vinh, the pandemic can be summed up as a duality that he describes as Beauty and the Beast. “Beauty” symbolizes the remarkable advances in the scientific field. “The Beast,” on the other hand, embodies the challenges of the health crisis, including that of educating the population with the need to explain health measures and fight against disinformation.
At the height of the pandemic, the MUHC Technical Services team, led by Pierre-Marc Legris, converted more than 200 rooms to negative pressure, set up screening and vaccination clinics to protect employees, but also to serve the community. Housekeeping has been stepped up, with increased frequency and rigorous disinfection of spaces to maintain high standards of hygiene.
Drs. Earl Rubin, Jesse Papenburg and Marie-Astrid Lefebvre are pediatric infectious disease specialists at the Montreal Children’s Hospital (MCH) and have been treating children with COVID-19. They can also discuss the impact the pandemic had on other illnesses in children.
As the person responsible for Infection Prevention and Control at the MCH, Dr. Lefebvre was also at the forefront of implementing health measures in a hospital during a pandemic.
Dr. Mylène Dandavino, Head of the Medical Inpatient Services at the MCH, was responsible for managing the hospitalization unit that received COVID-19 patients at the MCH. She also took care of reassigning doctors when the pandemic broke out.
Under the supervision of Dr. Tanya Di Genova, Pediatric Intensivist and now Associate Director of Professional Services, the MCH took in adult patients to relieve the Royal Victoria Hospital and the Montreal General Hospital, whose beds were all occupied. Thus, 13 critically ill adults aged 27 to 75 were treated by MCH intensivists, while nine others were treated by general pediatricians.
From the start of the pandemic, Drs. Todd Lee and Emily McDonald have done remarkable work to offer clinical trials to non-hospitalized patients with COVID-19. As of March 2020, as access to hospitals was restricted, the two experts developed innovative methods to conduct “contactless” clinical trials with patients self-isolating at home. They led the first randomized controlled outpatient trial in Canada for COVID-19 in which a patient was enrolled. Together with other colleagues from the Institute and other Canadian and American institutions, they tested hydroxychloroquine, ciclesonide and fluvoxamine, publishing their results in major medical journals. They also evaluated the cost and effectiveness of different outpatient treatments.
Dr. Don Vinh has been working with a group of international researchers to understand why some people are more vulnerable to COVID-19. They have found that about 15 per cent of patients whose lives are threatened by COVID-19 have one thing in common: a defect in the activity of type I interferons (IFNs), molecules of the immune system that normally have powerful antiviral activity. Dr. Vinh has also conducted a study to determine the factors that put an elderly person at risk of developing severe COVID-19 symptoms and medical complications that can lead to life-threatening illness.
Jonathon Campbell led studies that looked at the effectiveness and costs of strategies for screening and controlling the transmission of the virus among at-risk groups. Along with other colleagues from The Institute, he also studied the effectiveness of saliva tests compared to nasopharyngeal swabs. Dr. Cédric Yansouni and his colleagues have identified interventions to significantly improve the accuracy of rapid SARS-CoV-2 antigen detection tests by untrained individuals, and have contributed to the evaluation of these tests for approval for self-testing in Canada. Dr. Abhinav Sharma, for his part, worked on digital contact tracing applications and digital screening strategies, establishing recommendations to promote their adoption and the protection of privacy.
Several researchers have evaluated the effectiveness of vaccines in certain vulnerable populations, such as Dr. Rita Suri (for dialysis patients), Dr. Sasha Bernatsky (for people suffering from immune-mediated inflammatory diseases (IMID) such as rheumatoid arthritis, inflammatory bowel disease, psoriasis) and Dr. Cecilia Costiniuk (for people living with HIV) and Dr. Don Vinh (for the frail elderly living in CHSLDs, and for (non-HIV) immunocompromised patients). n H
component found in all fungi may provide a shield against flu-related lung damage, according to a new study.
A team of scientists led by Maziar Divangahi, a Professor in McGill’s Faculty of Medicine and Health Sciences and Senior Scientist at the Research Institute of the McGill University Health Centre, demonstrated that beta-glucan, administered to mice before their exposure to influenza, can reduce lung damage, improve lung function and lower the risk of illness and death.
Beta-glucan is found in all fungi, including mushrooms and yeast, as well as grains like oats and barley. The scientists discovered that a unique structure of this component can boost defences against pathogens.
While most research focuses on stopping the virus from replicating, this study explored how to regulate the body’s immunity to infection,
new research study from the BC Centre for Excellence in HIV/AIDS (BCCfE) shows that people with HIV (PWH) in British Columbia, Canada are now living much longer than just a few decades ago, but gains in life expectancy for women with HIV are significantly lower than men’s.
The study, published in The Lancet Public Health today, shows that both sexes have seen substantial increases in their life expectancy since 2012, when a province-wide expansion of the BC-CfE’s Seek and Treat for Optimal Prevention of HIV/AIDS Program (STOP HIV/AIDS) led to intensified HIV testing, treatment and engagement in care.
While the total life expectancy for males with HIV in BC aged 20 rose from 44 years old in the period 1996-
a concept known as “disease tolerance.” The researchers discovered that beta-glucan significantly enhanced flu survival rates by modulating immune responses and preventing severe lung inflammation, a common cause of fatality.
These results, published in Nature Immunology, highlight beta-glucan as a promising therapy for influenza and other emerging viral pathogens, said the scientists, adding future research will explore whether the findings can be applied to humans.
“It is remarkable how beta-glucan can reprogram certain immune cells, such as neutrophils, to control excessive inflammation in the lung,” said first author Nargis Khan, who conducted this research as a postdoctoral fellow at McGill and is now an Assistant Professor at the University of Calgary.
“Neutrophils are traditionally known for causing inflammation, but
Maziar Divangahi, Nargis Khan and Jeffrey Downey co-authored a new study on influenza.
beta-glucan has the ability to shift their role to reduce it,” added co-first author Kim Tran, who recently completed her Ph.D. at McGill.
Most flu-related deaths aren’t caused by the virus itself, but by an overreaction of the immune system, said the researchers. This suggests the true danger lies in the host’s own immune response. However, how the immune system becomes so imbalanced remains poorly understood.
“Beta-glucan is found in the cell walls of all fungi, including some that live in and on our bodies as part of the human microbiome,” explained Divan-
gahi. “It is tempting to hypothesize that the levels and composition of fungi in an individual could influence how their immune system responds to infections, in part because of beta-glucan.”
With flu season underway and the looming threat of bird flu (H5N1), developing effective therapeutic strategies for respiratory diseases is more critical than ever, he added.
The research was funded by the Canadian Institutes of Health Research.
“B-Glucan reprograms neutrophils to promote disease tolerance against influenza A virus” by Nargis Khan, Kim Tran and Maziar Divangahi et al., was published in Nature Immunology. n H
2001 to 68 years old in the period 2012-2020, the life expectancy of females with HIV rose from 42 years old in 1996-2001 to 61 years old in 20122020. Life expectancy at age 40 and 55 also remained lower among females than males. Meanwhile, the sex gap in life expectancy at ages 20 and 40 increased over time.
BC-CfE researchers also found that females with HIV were at a 33 per cent higher risk of death from non-communicable diseases such as kidney, liver, and lung disease than males with HIV, even after taking into account sex differences in age, socio-economic status, and historic HIV-related immunodeficiency.
“The good news is that both men and women with HIV today are living longer and healthier lives, thanks to the safe and effective HIV treatments
that are widely available in British Columbia at no cost to patients,” said Dr. Katherine W. Kooij, lead author of the study. “When we initiated this study, we hypothesized that the gap in life expectancy between BC men and women living with HIV would narrow over time, as HIV treatment and care became universally accessible. Instead, the gap grew. We suspect that this discrepancy is driven by an unequal burden on women due to adverse socio-structural factors including barriers to accessing healthcare, unemployment, poverty, unstable housing, stigma, and discrimination.”
In the BC study population, females more often resided in less affluent neighbourhoods. For instance, approximately 12.3 per cent of females (versus 7.1 per cent of males) lived in Vancouver’s Downtown Eastside, a
low-income inner-city neighbourhood with high levels of unemployment, housing instability, mental illness, and substance use. Moreover, females more often reported injection drug use as a transmission risk factor and more often met the definition for substance use disorder. These factors explain some of the higher mortality observed among females.
Meanwhile, a large Canada-wide study found that women with HIV more often reported lower income, food insecurity, poor social supports, and discrimination than women without HIV. Females with HIV may also be disproportionally affected by the ongoing drug toxicity and poisoning crisis, which has decreased life expectancy among all PWH in BC but more so among women with HIV.
Continued on page 28
By June Kaminski
As Canada advances its climate action agenda, the health care sector is making strides to reduce its carbon footprint. One major initiative leading the charge is the threeyear Preparing Canada’s Health Care Buildings for Net-Zero project by the Canadian Coalition for Green Health Care, made possible with an investment from the Government of Canada’s Low Carbon Economy Implementation Readiness Fund. This project aims to accelerate the readiness of the Canadian health care workforce and leadership to undertake climate change mitigation initiatives that will reduce greenhouse gas (GHG) emissions from health care buildings such as hospitals, health centres, clinics and long-term care homes while promoting long-term sustainability.
Hospitals and other health care buildings are among the most energy-intensive facilities in Canada. These institutions operate around the clock, requiring vast amounts of energy for heating, cooling, ventilation, lighting,
Continued from page 26
and medical equipment. Additionally, health care facilities are responsible for substantial GHG emissions due to anesthetic gases, medical waste, and fossil fuel-dependent infrastructure. Recognizing the need for urgent action, this project focuses on tangible, evidence-based strategies that will enable health care facilities to transition toward net-zero operations. Over three years, the initiative will help health institutions learn to measure their baseline emissions, implement low-carbon technologies, and adopt greener operational practices.
The project includes several interconnected elements designed to create a comprehensive roadmap for decarbonization:
To reduce emissions, health care organizations must first measure their current impact. The project will provide training on tools such as ENERGY STAR Portfolio Manager and RETScreen to help health care professionals assess and monitor their carbon footprint. Webinars and case studies
The new BC-CfE study, titled Life expectancy and mortality among males and females with HIV in British Columbia in 1996–2020: a population-based cohort study, aimed to compare trends in life expectancy between females and males with HIV in BC, Canada since 1996, when BC’s universal healthcare system began providing free highly effective antiretroviral therapy [ART] to all British Columbians living with HIV. A better understanding of the sex gap in life expectancy and its determinants are vital to designing targeted programs to
improve life expectancy among people living with HIV.
“While we undertake that work, women must be provided with supports such as low-barrier care, better housing and community connection to address the negative disparity we are seeing in their health outcomes,” added Dr. Kooij. “These findings also stress the importance of screening and preventative measures for non-communicable diseases among females with HIV. The life expectancy gap between men and women living with HIV should be narrowing, not getting worse.” n H
will further illustrate best practices in emissions reduction.
To facilitate the shift toward sustainable energy use, the project will provide case studies, fact sheets, toolkits, articles, videos, and webinars on various low-carbon technologies, including heat pumps, solar energy, and electrification strategies. Additionally, guidance on securing funding for low-carbon upgrades will be made available to health care organizations. A Low Carbon Energy Networking Hub has been initiated to meet monthly to discuss important ways to develop customized low-carbon energy plans for any health care facility.
Green Teams play a pivotal role in fostering a culture of sustainability within health care facilities. The project supports the creation of these teams at the grassroots, corporate, and systems levels by providing guidance, resources, and case studies showcasing successful sustainability initiatives. By leveraging the collective expertise of health care professionals, green teams will drive internal change and increase awareness of low-carbon practices. A Green Team Networking Hub has been launched, where interested health care professionals can gather to share information and best practices.
One of the most potent greenhouse gases used in health care is nitrous oxide, commonly used in anesthesia. The project focuses on identifying leakage points in centralized nitrous delivery systems and implementing strategies to reduce emissions. Educational resources, policy guidance,
articles, a Nix the Nitrous web portal (greenhealth care.ca/nix-the-nitrous/) and webinars will support health care facilities in phasing out or minimizing their nitrous oxide use.
Pressurized MDIs, widely used for respiratory conditions, contribute significantly to health care-related emissions due to their reliance on hydrofluorocarbons (HFCs) as propellants. This initiative promotes the substitution of MDIs with more sustainable alternatives, where clinically appropriate, encouraging best practice prescribing, and reducing inhaler waste, through fact sheets, articles, and webinars tailored for primary care clinics and hospitals. A Clinics Networking Hub will also be organized to explore all the project initiatives within primary care and other health care clinic settings.
As Canada works toward its climate goals, health care professionals, leaders, and facility managers must take an active role in driving sustainability. This project provides a readiness roadmap for achieving net-zero health care buildings and serves as a catalyst for widespread change. By embracing these strategies, Canada’s health care sector can lead by example, demonstrating that high-quality patient care and environmental stewardship go hand in hand. The time for action is now – health care professionals can contribute to a healthier planet by championing sustainability within their institutions.
This article was submitted by The Canadian Coalition for Green Health Care.
The Project overview and deliverables are at: https://greenhealth care.ca/ net-zero-ready. n H
June Kaminski is Project Coordinator, Preparing Canada’s Health Care Buildings for Net-Zero project.
irtual reality (VR) rehabilitation offers children with hemianopia, a condition that results in partial vision loss, a novel way to restore visual perception. Until now, other strategies such as immunotherapy with bevacizumab, have been unsuccessful.
Researchers at UHN’s Donald K. Johnson Eye Institute (DKJEI) are
changing how children with vision loss are treated.
In this revolutionary trial, virtual reality (VR) rehabilitation conducted at home with remote support from doctors significantly improved visual perception – the ability to process and interpret visual information within the field of view – in children with hemianopia.
This approach is both innovative and more accessible than traditional methods. Hemianopia is a type of blindness that causes a child to lose vision in part of their field of view, either on the left or right side. This type of vision loss is permanent for about 60 per cent of children who develop it after having a type of brain tumour, such as an astroglial tumour.
Though hemianopia poses a significant barrier to normal intellectual and social development, rehabilitation for it – called vision loss rehabilitation, or visual rehab – is not standard postbrain cancer treatment.
The DKJEI team evaluated a special VR program designed to help children with hemianopia regain visual perception in the affected part of their eyes.
isha Raji overcame a lot in her first few weeks in Canada, from adjusting to living alone after growing up in a bustling household of five siblings to navigating the complexities of a once-in-a-lifetime pandemic, all while learning to build a robot on the fly for her PhD. But she says that paled in comparison to her biggest challenge: surviving her first winter.
Toronto’s weather is notoriously fickle. It can be 12 degrees one day and snowing the next – or sometimes both in the same day. Whereas her homeland of Ogun State in Nigeria is rarely dips below 20 degrees.
“I thought I was losing my mind,” said Raji, a KITE trainee and fifthyear PhD candidate at the University of Toronto’s Institute of Biomedical Engineering.
Raji is recounting her journey to KITE as part of the International Day of Women and Girls in Science (Feb. 11), an annual awareness event organized by the United Nations that aims to promote equal access and participation for women and girls in the fields of Science, Technology, Engineering and Mathematics (STEM).
“I hope by sharing my story I can inspire more women to enter STEM,” said Raji. “Everyone knows it’s a male-dominated field and from the outside, it can seem a bit daunting but once you get in you’ll see that the challenges are surmountable and you’re just as good as your male peers.”
As part of her innovative research, Raji is shifting the paradigm of robotic rehabilitation by developing software –
and at times building hardware–for a robotic arm that provides therapy for individuals with upper extremity impairment (arms, shoulders, wrist, and hand) as a result of stroke and spinal cord injury.
The arm presents 3D-printed everyday objects such as a mug, phone, or credit card at various positions and angles within a patient’s reach for them to grab. Eventually, the robot presents these objects outside of their comfort zone. Therapists can work simultaneously with the robot, fostering an integrated rehabilitation experience.
“[Raji’s] research will allow therapists and robots to work together in an unprecedented way, making it possible to integrate the strengths each of them offers during rehabilitation,” said Raji’s
PhD supervisor and KITE scientist Dr. Cesar Marquez-Chin.
Raji’s ultimate goal is to make this robotic arm portable and accessible worldwide. The arm would not only help patients do exercises but it would use data to tell them how they’re progressing in their rehabilitation journey and adapt the exercises to their abilities.
“My grandma is the reason why I got into this field. When I was 13 years old she suffered a stroke. For the rest of her life she depended on my uncle and his family to do anything, eat, get out of bed, or just put on clothes,” said Raji.
“Seeing how she suffered and the toll it took on my uncle inspired me to build devices that could help individu-
als with stroke live a better life and be less dependent on the people around them.”
After completing her PhD, Raji hopes to enter the medical technology industry and use the expertise she’s gained here to help stroke survivors in her hometown.
Raji didn’t need to take a 8,892-km voyage across the world to pursue her dreams.
She could have easily stayed in her hometown and studied at the University of Ilorin – where her father is a professor – or chosen a field where she wouldn’t be one of the only women in her classes. But where’s the fun in that?
“These challenges are what makes life interesting and beautiful,” said Raji. n H
The program, called 3D-MOT IVR, uses audiovisual stimulation to help participants track objects across both the affected and unaffected portions of their visual field.
Remarkably, the study found that as few as six weeks of 20-minute sessions, every other day, led to sustained and noticeable improvements in functional vision. The team believes the improvements they observed could be even more significant with longer rehabilitation periods.
These results suggest that VR-based therapy, such as 3D-MOT IVR, is a promising new approach to visual rehabilitation. This new approach could make vision rehab more accessible by allowing children to do therapy at home while receiving remote support, removing the barrier of having to travel to a clinic without compromising efficacy, safety, or adherence.
In recognition of how impactful this work is in the realm of pediatric
IN THIS REVOLUTIONARY TRIAL, VIRTUAL REALITY (VR) REHABILITATION CONDUCTED AT HOME WITH REMOTE SUPPORT FROM DOCTORS SIGNIFICANTLY IMPROVED VISUAL PERCEPTION –THE ABILITY TO PROCESS AND INTERPRET VISUAL INFORMATION WITHIN THE FIELD OF VIEW – IN CHILDREN WITH HEMIANOPIA.
brain tumour research, senior authors
UHN’s Dr. Michael Reber and SickKids’s Dr. Eric Bouffet were awarded the Meagan Bebenek Foundation
Award for Medical Excellence for this trial.
Further studies like this one could not only help redefine standards of care,
but also redefine what life with hemianopia – or, more accurately, what life with less visual impairment – looks like for survivors of pediatric brain cancer. n H
The first author of this study is Dr. Mariana Misawa, clinical fellow in the Department of Ophthalmology and Vision Science at the University of Toronto.
APRIL FOCUS: Healthcare Transformation/ eHealth and EHR/Mobile Health:
MAY FOCUS: Surgical Procedures, Pain Management, Palliative Care and Oncology: Non-invasive surgery, plastic surgery, orthopedic surgery and new surgical techniques including organ donation and transplantation procedures. New approaches to pain management and palliative care delivery. Approaches to cancer diagnosis and treatment.
NATIONAL NURSING WEEK SUPPLEMENT
ANNUAL E-HEALTH SUPPLEMENT Programs and initiatives that are transforming care and contributing to an effective, accountable and sustainable system including virtual care. Innovations in electronic/digital healthcare, including mHealth and the Electronic Health Record (EHR). Nursing Heroes Supplement & Nursing Heroes Awards
Advertising Booking Deadline March 21st
Material Deadline March 25th
For more info email advertising@hospitalnews.com
Advertising Booking Deadline April 25th
Material Deadline April 29th
For more info email advertising@hospitalnews.com
JUNE FOCUS: Precision Medicine and Genomics, Pharmacy and Medication, Research: Developments in the field of personalized medicine. Innovative approaches to fund-raising and the role of volunteers in healthcare. An examination of safe and effective use of medications in hospitals including medication management. ANNUAL PHARMACY SUPPLEMENT
Advertising Booking Deadline May 23rd
Material Deadline May 27th For more info email advertising@hospitalnews.com
St. Joseph’s
Care London is taking giant strides in the science of rehabilitation and movement, with direct benefit to patients
St. Joseph’s is setting a longtime vision into motion.
“Five years ago, we had a vision of leveraging our long history and expertise in providing innovative rehabilitation treatments to improve the lives of people with mobility needs on a larger scale,” says Roy Butler, President and CEO of St. Joseph’s Health Care London (St. Joseph’s). “That dream has come to life.”
While experts at St. Joseph’s had the knowledge, innovative spirit and passion to achieve the vision, they needed a partner who shared the same enthusiasm.
William and Lynn Gray answered that call. With their generosity and ground-breaking investment, The Gray Centre for Mobility and Activity was created.
“Lynne and I are very pleased with the steady forward advancement of the centre’s mission since its establishment just a few short years ago,” says Bill Gray. “The innovative thinking and idea generation that seeks new solutions to the issue of mobility have really taken root. We hoped that The Gray Centre would have an impact on care ... and it has.”
“We’ve watched the development of The Gray Centre with enormous pride and are pleased to have our name associated with it, and the excellence it stands for,” adds Lynne Gray.
Established in 2020, The Gray Centre at St. Joseph’s Parkwood Institute is a regional hub focused on researching leading-edge treatments and interventions in mobility and activity. The centre’s unique model of linking research and care allows researchers to work side-by-side with clinicians, patients, and caregivers to uncover optimal methods for maintaining mobility throughout a person’s life.
“Scientists at The Gray Centre are leading the way in integrating technology and solutions in care to better understand how we can enhance each patient’s treatment plan to im-
THE REHA-STIM MEDTEC FLOAT SYSTEM AT ST. JOSEPH’S PARKWOOD INSTITUTE ENABLES PATIENTS WITH MOBILITY LIMITATIONS TO WALK, SUPPORTED, WITHOUT FEAR OF FALLING. THEY “FLOAT” IN A CONTROLLED ENVIRONMENT USING A COMBINATION OF ROBOTICS, BODY-WEIGHT SUPPORT AND REAL-TIME FEEDBACK.
prove their functionality and ability to move,” says Butler.
More than 50 ongoing rehabilitation research projects at Parkwood Institute are exploring areas such as spinal cord and traumatic brain injury rehabilitation, pain, outcomes for amputees, virtual exercise and cognitive behavioral therapy, gait analysis as a measure of dementia progression, and stroke rehabilitation and recovery.
The Gray Centre is a catalyst and connector for these projects by investing in cutting-edge technology, providing seed grants, embedding researchers from Western University, leveraging clinical expertise, attracting worldclass researchers and translating new knowledge into clinical practice by training students and clinicians, and fostering sustainable practice change.
More than $1.3 million granted through St. Joseph’s Health Care
Foundation has advanced work at The Gray Centre over the past year. From researcher support to new equipment such as two transcranial magnetic stimulators, a portable handheld ultrasound and several sensored mats for gait assessment donors have stepped up to advance this work.
At the helm of The Gray Centre is Siobhan Schabrun, PhD, a world-renowned neuroscientist and the inaugural William and Lynne Gray Research Chair in Mobility and Activity. Thanks to a partnership with Western University’s Faculty of Health Sciences and Schulich School of Medicine & Dentistry, donor funding for the chair made through St. Joseph’s Health Care Foundation was matched, creating a $5-million endowed position.
Schabrun’s innovative research benefits people suffering from chronic pain. With a focus on non-invasive
brain stimulation techniques to enhance neuroplasticity and improve mobility and activity outcomes, she and her team are, in essence, retraining the brain’s pain response. This innovative work bridges the gap between neuroscience and rehabilitation, offering new hope for individuals with musculoskeletal and neurological conditions. Originally trained as a physiotherapist with a PhD in neuroscience from the University of Adelaide in Australia, Schabrun has attracted more than $15 million in competitive research funding and written or contributed to more than 140 scholarly publications.
The newest advancement is a first-in-Canada and a marvel of medical engineering that is transforming options in rehabilitation research and practice. The Reha-Stim Medtec FLOAT system at St. Joseph’s Parkwood Institute enables patients with mobility limitations to walk, supported, without fear of falling. They “float” in a controlled environment using a combination of robotics, body-weight support and real-time feedback. The device has a harness attached to a robotic arm, which adjusts the level of support based on the patient’s movements. Sensors provide continuous feedback for maximum learning and greatest benefit to physical therapists and patients alike. The FLOAT system has shown significant improvements in patients’ mobility, balance and overall functional independence.
“Innovative equipment like the new FLOAT System is an example of the type of innovation that does not exist anywhere else in Canada,” says Bill Gray. “The real-life application of technologies like this are what The Gray Centre is intended to be about.” Through the combined efforts of dedicated professionals, cutting-edge technology and philanthropist partners, St. Joseph’s Gray Centre has combined vision with passion and is transforming lives, one step at a time. n H
cientists at The Hospital for Sick Children (SickKids) have discovered a way to stop tumour growth before it starts for a subtype of medulloblastoma, the most common childhood malignant brain cancer.
Brain cancer presents a unique set of challenges for researchers – by the time a person experiences symptoms, the tumours are often so complex that the fundamental mechanisms driving the tumour growth are no longer easy to identify. A research team led by Dr. Peter Dirks is working to combat this challenge for sonic hedgehog (SHH) medulloblastoma.
In a new study published in Nature Communications, the researchers identify that a protein is responsible for the waking up of ‘sleeping’ stem cells and driving SHH medulloblastoma tumour formation and regrowth. By blocking this protein and preventing the stem cells from waking, the study demonstrates what could be a pivotal treatment strategy for the cancer, utilising cutting-edge genomic approaches in combination with functional experiments in a preclinical model.
“Our findings offer a novel strategy to target cancer stem cells, providing hope for more effective treatments against aggressive brain tumors,” says Dirks, Senior Scientist in the Developmental, Stem Cell & Cancer Biology program and Chief of the Division of Neurosurgery.
The research team began by examining cellular transitions that drove the development of SHH medulloblastoma tumours. They found that early in tumour development and after conventional treatments, a protein called OLIG2 would activate ‘sleeping’ stem cells, causing them to divide and grow into a tumour.
CT-179 treatment administered prior to tumour formation blocks their growth.
“There is order to how the cancer initiating stem cells undergo fate changes to form tumours. We can target an early transition event and intercept the entire process – essentially stopping the cancer in its earliest form,” says first author Dr. Kinjal Desai, a postdoctoral researcher in the Dirks lab.
During these transitions, the researchers uncovered a key window during which tumour progression could be blocked. By combining a previously established treatment with a small molecule called CT-179, which disrupts the OLIG2 protein, the research team were able to target the residual stem cells left after treatment and prevent them from re-awakening, effectively preventing tumour relapse.
Similarly for early-stage SHH medulloblastoma, CT-179 prevented the tumour from forming and significantly increased survival rates in the preclinical model.
Together with additional preclinical models in a study published simultaneously in Nature Communications from colleagues at Children’s Healthcare of Atlanta and QIMR Berghofer Medical Research Institute in Australia, the findings showcase what could be an effective new treatment for SHH medulloblastoma, as well as other brain cancers including diffuse intrinsic pontine glioma (DIPG).
The study complements recent research from the Dirks Lab in Nature,
Above: This diagram shows how tumours regrow after traditional therapy, verus this fate transition therapy which blocks tumour regrowth.
which describes the early stages of glioblastoma development. While future research will expand these findings into clinical trials for patients, particularly among those being monitored for relapse, the Dirks lab, part of the Arthur and Sonia Labatt Brain Tumour Research Centre (BTRC), is excited for the diagnostic potential this discovery presents.
“At SickKids, we’re already genetically testing every child’s brain cancer to inform their diagnosis and treatments – our study goes beyond genetic testing to precision biology,” says Dirks. “I am excited for a future where
this ‘magic bullet’ for early treatment could be combined with diagnostic tests to potentially prevent the cancer from developing at all.”
This study is funded by Canadian Institutes of Health Research (CIHR), Ontario Institute for Cancer Research, Terry Fox Research Institute, Canadian Cancer Society, Cancer Research UK, Stand Up to Cancer, Jessica’s Footprint Foundation, Hopeful Minds Foundation, b.r.a.i.n.child, Meagan Bebenek Foundation, Garron Family Cancer Centre, the Bresler family, and SickKids Foundation. n H
In early April of 2020, Lori Chen felt a lump in her breast while she was in the shower. The Toronto-based pharmacist was 36 years old and had a two-and-a-half-year-old son, and it was early in the pandemic, when much of the world was in lockdown.
She cried for days.
Lori decided to focus on her family and the things that were within her control. She started chemotherapy, underwent a mastectomy and began to feel that her life would soon return to some semblance of normal.
That was until an echocardiogram in October 2020 revealed that she was in imminent danger of heart failure.
Lori, who had no symptoms of heart disease, says this new diagnosis was even scarier than discovering she had breast cancer.
“When I thought of heart failure, I pictured my grandmother who had swollen ankles and trouble walking up stairs,” she says. “I didn’t have anything like that. I was in shock.”
Lori had always known that her cancer treatment could affect her heart, but now she was facing the reality of that risk.
Cancer treatment–related cardiotoxicity is damage to the cardiovascular system caused by otherwise life-saving approaches to combat the disease.
“Surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy – all of these are related to some form of cardiovascular toxicity,” says Dr. Dinesh Thavendiranathan, an international expert in the field of cardio-oncology and part of the team that cared for Lori at UHN’s Peter Munk Cardiac Centre, home to the largest cardiotoxicity clinical program in Canada.
Treatment aside, many cancer patients are also at a higher risk of developing cardiovascular disease due to shared risk factors, such as smok-
CANCER TREATMENT–RELATED CARDIOTOXICITY IS DAMAGE TO THE CARDIOVASCULAR SYSTEM CAUSED BY OTHERWISE LIFE-SAVING APPROACHES TO COMBAT THE DISEASE.
ing, obesity and inflammation, he says. Cardiotoxicity can manifest as high blood pressure, valve problems, inflammation and damaged blood vessels.
If left untreated, it can lead to heart failure. But the outcomes are good when patients are identified early, Dr. Thavendiranathan says.
The research he led has helped his team develop screening strategies, including new biomarkers, 3-D echocardiography, myocardial strain imaging and cardiac MRI methods.
“We have screening strategies. We have solutions,” Dr. Thavendiranathan says. “We have cardiologists with expertise in this. And we know that cardiotoxicity can be treated.”
Awareness, on the part of both doctors and patients, is crucial because symptoms of heart damage, from severe fatigue and shortness of breath to heart palpitations, are also side effects of cancer treatment that can easily be missed.
Surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy — all of these are related to some form of cardiovascular toxicity,” says Dr. Dinesh Thavendiranathan, an international expert in the field of cardio-oncology and part of the team that cared for Lori Chen at UHN’s Peter Munk Cardiac Centre, home to the largest cardiotoxicity clinical program in Canada.
And there are also patients such as Lori, who are asymptomatic. Fortunately, she was being closely monitored and her failing heart function was discovered during an echocardiogram. Lori’s oncologist immediately referred her to Dr. Thavendiranathan.
“Surveillance, early detection and long-term follow-up with cancer patients allows us to pick up subtle changes to the heart so that we can intervene,” Dr. Thavendiranathan says.
In the past, when cancer patients were diagnosed with heart damage, their cancer therapies would simply be stopped.
“There’s nothing more devastating than that,” he says. “As a cardio-oncologist, it’s about understanding both the oncology and the cardiology components and providing a balanced consultation, so that you’re not just saying ‘stop the cancer therapy.’”
"It's helpful to feel that you're not all alone trying to figure it out, knowing that you have people who are experts in their field, who are compassionate, who pay attention, who don’t rush you," says Lori Chen, pictured with her family, who learned in October 2020 she was in imminent danger of heart failure following cancer treatment earlier that year. "I felt incredibly supported." (Photo: UHN Foundation)
Dr. Thavendiranathan and his team started Lori on cardiac therapy, introducing medications to reduce the strain on her heart.
“We were able to continue the heart medications while she received the rest of her cancer treatment, so there was no interruption to her treatment at all,” he says. “Her heart function improved and she recovered nicely.”
Dr. Thavendiranathan also supported Lori with relaxation techniques and an exercise plan.
“The exercise piece is important because during cancer therapy, patients often feel as though they have no control over anything,” he says. “The one thing they can control that can improve their cardiovascular outcomes is exercise.”
While most cancer centres might have a single cardiologist on staff, the Peter Munk Cardiac Centre is unique in that it’s a non-cancer centre with five cardiologists dedicated to cardio-oncology patients. The centre trains more cardiologists, cardiovascular surgeons and vascular surgeons than any other hospital in Canada.
Specialized cardiac care continues long after a patient’s cancer treatment has ended. In Lori’s case, that included monitoring throughout a post-cancer pregnancy.
Before her breast cancer diagnosis, Lori had been trying to get pregnant. She was able to freeze some of her eggs
before starting chemotherapy, but her IVF treatment was unsuccessful.
Lori had almost resigned herself to the fact that she would have only one child when she discovered she was pregnant in July 2022. Although she was excited, Lori worried that her heart might not be able to handle it.
“If a patient develops cardiotoxicity and then becomes pregnant, her risk of developing heart failure is about one in three,” Dr. Thavendiranathan says. “We instituted a surveillance program, which included conducting an echocardiogram each trimester.”
Fortunately, Lori’s heart function remained stable and her son, Theodore, was delivered safely in March 2023.
“Throughout my pregnancy I didn’t feel as though I could celebrate until the baby was actually born,” she says. “It was an amazing moment of ‘he’s here!’ I had been focused on this goal for so long and it was just super exciting.”
Lori credits the entire team at the Peter Munk Cardiac Centre for getting
her through every anxious moment, from diagnosis to delivery room.
“It’s human nature to jump to the worst-case scenario when you get a diagnosis like cancer or heart failure,” she says. “It’s helpful to feel that you’re not all alone trying to figure it out, knowing that you have people who are experts in their field, who are compassionate, who pay attention, who don’t rush you. I felt incredibly supported.”
Normally, Lori would have continued taking heart medications for the rest of her life. But, last summer, Dr. Thavendiranathan approached her about joining a clinical trial to determine whether patients like her could withdraw their heart-failure therapy once they’d recovered their heart function.
“I wanted to help, so I chose to participate,” she says.
In addition to being a clinician, Dr. Thavendiranathan is at the forefront of much of the research conducted in the Ted Rogers Cardiotoxicity Prevention Research Program at UHN’s Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research.
Its research is largely funded by donors who are as inspired by the possibility of innovation and medical breakthroughs as Dr. Thavendiranathan himself. He and his team recently identified three biomarkers linked to heart dysfunction in the blood of breast cancer patients that could help in the future development of targeted therapies.
Data collected from patients at the Peter Munk Cardiac Centre over the last decade also shows the lasting impact of its specialized care.
“It’s encouraging to see that with careful surveillance and treatment, we can prevent the development of future heart failure so that when patients have completed their cancer therapy, they can lead a wholesome life,” Dr. Thavendiranathan says.
People shouldn’t have to live every day thinking about their cancer because they’ve been left with cardiovascular disease, he says.
“To have been able to prevent the worst outcomes of Lori’s heart failure so that she can continue on with her work, take care of her children and have a good quality of life – that’s tremendously satisfying.” n H
Do you have employees or retirees not covered by the hospital's benefits?
HCP is a voluntary group plan designed for your part-time, casual, contract and temporary employees and retirees. All you have to do is communicate the opportunity to your employees and we handle the rest, including enrollments, premium collection, and claims administration.
It's really that easy!
Get
Plan offerings for your employees:
Three benefit packages available (Signature, Supreme & Standard)
Signature Package (Life, LTD and ADD&D ONLY) for those who already have health benefits through a spouse or other group plan
Competitive extended health plans & two optional dental plans
BONUS $1000 LTD offering for eligible employees under 35