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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

Global Research Platform

Global Research Platform

Providing access to a robust source of data on individuals with SCI creates the foundation for high-powered clinical trials and the potential to validate best practices. Such datasets become increasingly useful as more individual patients are included, and their progress monitored over time as they pass through the health care continuum from acute to community-based care. To help support this, RHI has developed a powerful web-based tool – the Global Research Platform.

What is the Global Research Platform?

A simple turn-key solution for electronic data collection, the Global Research Platform (GRP) is a secure, web-based data collection and data warehousing platform that makes the technology component easy, while increasing the quality of data collected.

As a Rick Hansen Institute innovation, GRP is designed to help accelerate research by providing an easy, flexible platform to help researchers run studies with a minimum of effort and funding. In production since 2011, GRP runs in more than 20 multi-site studies, national registries, quality improvement studies and international studies and currently includes more than 5,000 individual study participants.

International collaborations are underway with research groups in the United States, Europe, Australia, China, Israel, New Zealand and others. GRP has flexibility, usability, scalability and high security.

Learn more at www.rhigrp.net

GRP logo

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

Accreditation Standards in SCI Care

In 2012, RHI partnered with Accreditation Canada to develop comprehensive and evidence-based standards for SCI care in acute and rehabilitation settings. These standards were developed to become a vehicle for advancing consistency and reliability of SCI care across Canada, while utilizing the same accreditation process that most hospitals and rehabilitation centres already participate in. Members of RHI are working with RHSCIR facilities across Canada to participate in the SCI Standards.

Learn more about the SCI accreditation standards

RHI tools to support accreditation (you will be redirected to sci2.rickhanseninstitute.org)

Supporting Accreditation fact sheet

     
Canadian Spine Outcomes and Research Network (CSORN)

In partnership with the Canadian Spine Society, 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.

The registry includes 15 sites across Canada and data collection will be comprised primarily of participant and physician reported outcomes. Ultimately this registry will provide spine surgeons and researchers across Canada with access to current data on operative procedures and outcomes.

Learn more about 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. It also aims to cross-validate a biochemical model for classifying the initial severity of paralysis and predicting the extent of neurological recovery. The CAMPER study is being conducted at six hospitals across Canada and the US.

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. The intent is to enhance decision-making in SCI care and the allocation of limited healthcare resources and research funding to support the translation of best practices; avoid excess healthcare costs; and protect and promote the well-being of Canadians who sustain a SCI throughout the continuum.

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. Participants monitor the health of their bladder in consultation with a research nurse during weekly video-conferences. The study is currently being conducted at the Blusson Spinal Cord Centre in Vancouver, BC and St. Joseph's Healthcare London in Ontario. 

Study website (redirected to icord.org)

ISNCSCI Algorithm The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is an examination used to determine the motor and sensory impairment and severity of a spinal cord injury. The American Spinal Injury Association (ASIA) International Standards Committee is responsible for reviewing and revising the ISNCSCI to reflect current evidence. RHI's use of the ASIA International Standards is by permission of ASIA.

isncscialgorithm.com

ISNCSCI Algorithm fact sheet

   

Minocycline in Acute SCI Minocycline, an antibiotic that has been used as an acne treatment for over 30 years, has demonstrated neuroprotective properties in animal models 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 and currently includes participating hospitals in Canada and Australia.

Clinicaltrials.gov #NCT01828203

Minocycline fact sheet

   

Perinatal Interest Group Representing women with SCI, clinicians and researchers with an interest in sexuality, fertility and reproductive health, 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. The Atlas contains information on the SCI Rehabilitation Framework, rehab goals identified as a priority by people with SCI and spotlight best practice organizations across Canada.

 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. The preliminary reports (traumatic and non-traumatic) provide an overview of the results including information on demographics, frequency and impact of specific secondary complications, need for services, social impacts and quality of life.

 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. To date, the KMN initiative has trained over 300 staff in pressure ulcer best practices, initiated work in pain management, and approximately 50 staff have received “hands on” training in implementation science methodology at the six facilities throughout Canada.

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 reviews and rates the research on SCI and puts the results on the web – eliminating the need to search and screen individual databases.

scireproject.com

SCIRE fact sheet

 

 

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 ulcers 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 >

 

FEATURE STORIES

CAPI Digital graphic websiteBC Pressure Injury Prevention Initiative

RHI is hosting two interactive workshops on preventing pressure injuries for people with SCI. These two free events will be followed by an invitation-only roundtable gathering regional stakeholders to identify gaps, barriers and potential solutions to preventing community-acquired pressure injuries. More >

Cover Action Plan

Just released! Praxis Action Plan

The Action Plan was developed as a direct result of stakeholders' interest and commitment to further unify the SCI community as we work towards our collective goal of moving research into action and providing concrete solutions for people living with SCI. More >

 

 



  



OUR  PROGRAMS

Cure

 

Cure

Generating knowledge and establishing treatments that will lead to cures for paralysis after SCI

Care

 

Care

Establishing best practices to optimize and standardize care

Commercialization

 

Commercialization

Facilitating increased investment in innovative technologies

Consumer

 

Consumer

Engaging people with SCI, improving awareness and enhancing opportunities