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SCIRE

Spinal Cord Injury Research Evidence

SCIRE New colourNew research is coming out every day on best practices for spinal cord injury care and treatment. A clinician would have to read 20 journal articles a day, 365 days a year, to keep pace with current advances in health care knowledge. For people with spinal cord injury, there is a multitude of information available on the web, but it is not always clear what information is credible.

To overcome this challenge, RHI provided funding and support for the development of SCIRE (Spinal Cord Injury Research Evidence), a collaboration of Canadian and international SCI researchers that provides up-to-date, accurate information about spinal cord injury research.

SCIRE supports SCI health care providers in their practice by rating and reviewing current best evidence, covering a comprehensive set of topics relevant to SCI rehabilitation and community reintegration. It reviews, evaluates, and translates existing research knowledge into a clear and concise format to inform health professionals of best rehabilitation practices following SCI. Since the website launched in 2009, SCIRE has established itself as a popular and credible resource, receiving an average of 100,000 visitors a year.

In late 2017, SCIRE expanded to make this same research-based information available to the broader community by writing in everyday language, providing more background information and explaining the science behind the research. SCIRE Community covers a variety of topics such as common health issues for people with SCI, current treatments and contains an extensive video and resource library. SCIRE Community is funded by RHI through the Blusson Integrated Cures Partnership.

Visit SCIRE Professional at www.scireproject.com

Visit SCIRE Community at www.scireproject.com/community 

Projects & Initiatives

Our Projects & Initiatives

In this section you will find updates on many of our latest projects and initiatives including work in translational research and best practice implementation projects. These projects and initiatives directly support our main program objectives, with many supporting more than one program. 

Learn more about our projects and initiatives:

Rick Hansen SCI Registry (RHSCIR)

A pan-Canadian registry of people who have sustained a spinal cord injury

Access to Care and Timing (ACT)

A multi-centre research study about the process of health care delivery

Global Research Platform (GRP)

A web-based data collection and warehousing platform to help accelerate research

Other Projects & Initiatives

Learn what else we are working on

Data & Technology

Data & Technology

RHI houses specialized teams in both data services and information technology in order to support projects across our network, providing an integrated approach to data- and technology-based solutions in SCI research and clinical care.

Here are a few examples of how RHI supports research and clinical care initiatives through technology and data services:

Global Research Platform (GRP) is a secure, web-based data collection and data warehousing platform that enables researchers to improve the quality of the data collected. Most notably, GRP is the technology behind the Rick Hansen SCI Registry which operates in Canada, New Zealand, Israel and China. In addition, GRP runs studies in Australia and the US.

ISNCSCI Algorithm is a free tool that helps clinicians accurately classify spinal cord injuries. The Algorithm is based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) – the most widely recognized assessment for determining a person's level of injury and impairment.

CliniQuick is a mobile electronic medical record (EMR) application designed to support real-time quality improvement in a clinical setting. Clinicians are able to enter patient information directly into a tablet or smart phone and review a summary of the treatment history and outcomes, eliminating the need to manually sort through stacks of cumbersome paper-based records.

We also provide data services for RHI-supported projects such as the Rick Hansen SCI Registry and Access to Care and Timing – from the point that data is entered into the GRP through to the point that it is analyzed for publications or summarized for reports.

The data team applies complex logic to make sense of the data, applying data and statistical analysis techniques so that researchers have the appropriate information they need to investigate a particular research question.

Other Projects & Initiatives

Other Projects & Initiatives

Below are a few more examples of translational research and best practice implementation activities that we are collaborating with other research organizations on.

Project Summary

More Information

Canadian Spine Outcomes and Research Network (CSORN)

The CSORN study tracks specific outcome measures of different surgical techniques used to treat spinal condition in the creation of a national health data registry.

> CSORN

   

Cerebrospinal Fluid Pressure Monitoring and Biomarker Validation (CAMPER)

The CAMPER study is a multi-centre clinical trial examining spinal cord perfusion pressure and biomarker analysis. The study will help establish best practice guidelines for managing the spinal cord perfusion pressure, which could minimize secondary damage as a result of acute injury and therefore improve recovery. 

Clinicaltrials.gov #NCT01279811

CAMPER fact sheet

   

Health Economics: Agenda for SCI Research in Canada RHI and the Ontario Neurotrauma Foundation are supporting the development and implementation of a health economics agenda for SCI research in Canada in order to enhance decision-making in SCI care and promote the well-being of Canadians who sustain a SCI.

Health Economics report

   

 HOME-SCI

The Home-based observations and monitoring of events related to urinary tract infections in SCI (HOME-SCI) study looks at the value of regular monitoring of bladder health by using a non-invasive monitoring system. 

Study website (redirected to icord.org)

   

Minocycline in Acute SCI Minocycline, an antibiotic that has been used as an acne treatment for over 30 years, has demonstrated neuroprotective properties that minimize inflammation and secondary damage to the spinal cord. This multi-centre clinical trial addresses its efficacy and safety for use in human clinical trials.

Clinicaltrials.gov #NCT01828203

Minocycline fact sheet

   

Perinatal Interest Group The mandate of this group is to initiate collaborative discussions for addressing significant gaps in knowledge and services for women with SCI.

Resources for sexual health after SCI

Learn about pregnancy and SCI

   

Rehab E-Scan Atlas

This first atlas of Canadian SCI rehabilitation enables rehabilitation providers, people with SCI and their care-givers with evidence-based data to advocate for preventive care, improved clinical care services and a reduction in regional service disparity. 

 Download a free copy

   

 

SCI Community Survey

The largest study of its kind ever done in Canada among people with SCI, the primary intent of the SCI Community Survey is to confirm the most important SCI-specific needs of Canadians with SCI and how sucessfully those needs are being met. 

 View a summary of results (preliminary analysis)

> SCICS fact sheet

 

 

SCI Knowledge Mobilization Network

SCI KMN is a community of practice that has evolved out of a national best practice implementation effort. The goal of the network is to improve health outcomes for individuals with SCI with demonstrated economic impact through implementation science leading to innovations in clinical practice. 

SCI KMN fact sheet

   

Spinal Cord Injury Research Evidence

SCIRE project is dedicated to providing up-to-date, accurate information about the effects of rehabilitation care for people with SCI. SCIRE is available in two versions - one written in everyday language for individuals with SCI and their caregivers, and one written in academic language aimed at health professionals.

scireproject.com

     
     

 

 

Translational Research & Best Practice Implementation

Translational Research & Best Practice Implementation

In order to advance the objectives of our four core programs (Cure, Care, Commercialization and Consumer), RHI supports translational research and best practice implementation activities.

What is translational research?

Translational research is a branch of medical research that attempts to more directly connect research with patient care by turning basic discoveries (developed, for instance, through multi-centre research studies) into new treatments and approaches that tackle the most pressing needs of individuals with SCI.

RHI supports and undertakes translational research studies to generate knowledge about SCI and to seek ways to improve outcomes for people with the injury. These research projects are critical to the outcomes of RHI. The Rick Hansen SCI Registry (RHSCIR) supports our translational research activities by collecting core data from Canadians with SCI during their transition through acute care, rehabilitation and community integration, and throughout their life journey. This data will be available to all participating members to engage people in relevant translational activities, and help identify gaps and priority needs.

What is best practice implementation?

Best practice implementation is the interventions, programs/services, strategies, or policies which have demonstrated desired changes through the use of appropriate, well-documented research or evaluation methodologies. They have the ability to be replicated, and the potential to be adapted and transferred. A best practice is one that is most suitable given the available evidence and particular situation or context. 

The success of cure strategies will depend on changes in practice within the existing the health care delivery system. The time to implement best practices is currently 17 years. This needs to be dramatically shortened to ensure Canadians with SCI will benefit in their lifetime.

One of our goals is to become a world leader in promoting and implementing best practices for the care of people with SCI. Within our own clinical and research network, we are uniquely positioned to influence behaviour change, and ultimately move SCI research into action.

The overall aim of RHI’s best practice implementation projects is to lead the process of improving access to and adoption of knowledge, in order to help support evidence-based decision-making in SCI care in Canada and internationally.

 

 

Accreditation Standards

Accreditation Standards

What are the accreditation standards in SCI acute and rehab care?

In 2012, RHI partnered with Accreditation Canada (AC) to develop comprehensive and evidence-based standards for spinal cord injury called the Acute and Rehabilitation SCI Standards of Care (SCI Standards), as part of AC's existing Qmentum accreditation program, which hospitals sites already participate in. Implementation of these standards through policy and practice changes will help standardize and optimize care for people with SCI in Canada.

RHI's goal is to have at least 50% of the acute and rehabilitation centres participating in the Rick Hansen SCI Registry (RHSCIR) to use the SCI Standards as part of their organizations' Qmentum accreditation site visits by the year 2018.

Accredited RHSCIR Sites Aug2017 AF

RHSCIR sites which have successfully fulfilled the SCI Standards according to Qmentum accreditation as of June 2017. For a complete list of accredited sites to date, see Status.

How the standards were created

In a joint effort with RHI, AC set up a national Spinal Cord Injury Advisory Committee to assist in the development of the SCI Acute and Rehabilitation Accreditation Standards. The Advisory Committee consisted of experts in the field of SCI across the continuum of care. The Standards were piloted in four Canadian centres:

  • Glenrose Rehabilitation Hospital, AB (Rehab)
  • Ottawa Hospital, ON (Acute and Rehab)
  • Capital Health, Halifax, NS (Acute and Rehab)
  • Saint John Regional Hospital, NB (Acute)

SCI Standards at a glance

The SCI Standards are comprised of criteria with three different levels of priority:

  • Required Organizational Practices (ROPs) address critically important patient safety areas, requiring specific tests of compliance to demonstrate evidence-based practices. ROPs are defined by AC as essential practices (e.g. assessment and management of pressure injuries or medication reconciliation) that must be in place at the time of the site visit, and are subject to a formal follow-up if not met. ROPs have the greatest impact on an organization's overall accreditation award.
  • High Priority criteria relate to other important themes of safety, ethics, risk management and quality improvement (e.g. training of team members on proper and safe use of equipment, devices and supplies used in SCI services). High Priority criteria that are unmet at the site visit may be subject to a formal follow up, at the discretion of AC. 
  • Other criteria usually pertain to enabling systems within the organization that allow clinical teams to perform well on ROPs and High Priority criteria (i.e. having access to the right resources, physical space and information systems).

Supporting hospitals with their accreditation process

RHI is working to encourage and support SCI centres to adopt the SCI Standards as part of their organizations' existing Qmentum process. Accrediting centres with the new SCI Standards will help ensure that individuals with SCI across Canada are receiving the same level of quality care at any SCI centre.

Standardization of care benefits not only patients, but also the health care system overall by reducing unintended variation in care that is not driven by evidence-based practice, thereby making more effective use of resources, improving patients' health outcomes, and reducing the burden on the healthcare system. This project will encourage centres to adopt best practices and policies that reflect the current state of knowledge and evidence-based best practices for SCI care.

RHI has developed a strategy to spread the adoption of the SCI Standards between 2014 and 2018. This strategy consists of a multi-phased approach including promotion and advocacy of the standards to SCI centres, development of practical tools and resources to aid in implementation of the practices described in the standards, and fostering a community of practice to celebrate and share successes. An AC Toolkit -- available on RHI's clinical resource site SCI2 -- has been developed to help support organizations with implementation of the SCI Standards. The toolkit includes an accessible library of resources that clinicians and policy makers can use to change practice (e.g. clinical practice guidelines, pre-printed orders), and frequently asked questions regarding the accreditation process.

Status

Congratulations to the following facilities who have successfully completed the SCI Standards review as part of their Qmentum accreditation process (as of November 2016).

Facility

Standards

Date Completed

Queen Elizabeth II Health Sciences Centre, Halifax Infirmary Acute Nov 2013
Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehab Centre Rehab Nov 2013
Hôpital du Sacré-Coeur de Montréal Acute Apr 2014
London Health Sciences Centre, Victoria Hospital Acute Nov 2014
Toronto Rehab, Lyndhurst Centre Rehab Nov 2014
Hamilton General Hospital Acute Jun 2015
Hamilton Regional Rehabilitation Centre Rehab Jun 2015
Winnipeg Health Sciences Centre Acute and Rehab Apr 2016
Foothills Medical Centre Acute and Rehab May 2016
Glenrose Rehabilitation Hospital Rehab May 2016
Vancouver General Hospital Acute Sept 2016
GF Strong Rehabilitation Centre Rehab Sept 2016
Ottawa Hospital Rehabilitation Centre Rehab May 2017

More information

For more resources, information and toolkits to support the adoption of the SCI Standards, see RHI’s clinical resource website (SCI2) at sci2.rickhanseninstitute.org/accreditation-canada and download our one page fact sheet.

 

 

The Rick Hansen Institute is a Canadian-based not-for-profit organization that drives innovation in spinal cord injury research and care. We strive to improve the lives of people living with SCI in Canada and around the world.

Learn more >

LATEST NEWS

 MG 3650 cleanSpinal Cord Injury Fund announced

A new spinal cord injury endowment fund has been set up at the Vancouver Foundation to support the Rick Hansen Institute's mission to advance research and implement best practices that will improve the quality of life for individuals who live with spinal cord injury.

UFREE teamUpdate on the RHI-Hebrew University BioDesign Partnership

Guided by RHI, the Hebrew University of Jerusalem and RHI-sponsored researcher, Dr. Yaron Blinder, two teams that participated in the one-year BioDesign Program developed solutions for common complications that affect people with SCI.

funding oppRick and Amanda Hansen Fellowship - applications now open

In partnership, the University of Toronto, the Rick Hansen Institute and the Ontario Neurotrauma Foundation are pleased to provide a two-year postdoctoral fellowship made possible by the support of the Government of Ontario. 

More News