RCN Research Grants foster collaboration while improving outcomes for patients
Improving the quality of care for cancer patients takes team work. “Clinical problems are not unique to individual hospitals; we can learn from each other,” explains Dr. Ari Meguerditchian, Program lead for the RCN’s Cancer Quality & Innovation Program. “The goal of the RCN Research Grants is to stimulate innovation, collaboration and a network approach to problem solving.”
Last fall, the RCN awarded six research grants, totalling $550,000. Selected projects aim to impact cancer care quality, helping the network to improve the provision of care, increase survival rates, and reduce the burden of cancer.
They are also fostering an unprecedented level of collaboration between the RCN’s partner institutions, since teams had to include co-applicants from at least two hospitals in the network.
“Centres that do quality of care research tend to be better at what they do,” says Dr. Meguerditchian. “The grants also allow us to ensure that the McGill-affiliated hospitals become leaders in field of cancer care quality, developing innovative ways of delivering care and evaluating their impact.”
In this issue, we feature three of the six projects currently underway.
Straight talk about breast cancer
When a woman is diagnosed with breast cancer she has no idea what to expect and often does not know where to find reliable information.
A team of RCN breast cancer specialists from St. Mary’s Hospital Center (SMHC) and the McGill University Health Centre (MUHC) are undertaking a research project, which involves interviewing Canadian breast cancer patients and survivors to capture their experiences in their own words.
The recordings will then be posted on HealthExperiences.ca and will allow researchers to determine if the type of information provided by patients is more useful than standard information sources currently available. The interviews will also provide health care professionals with a deeper understanding of the experience of breast cancer.
The initiative is based on the award-winning Health Experiences Research Group at the University of Oxford in the United Kingdom.
Patients from across the country and from a broad range of cultural and socio-economic groups will tell their story. The team is using rigorous qualitative research methods to capture the full range of experiences associated with breast cancer: Patients can be newly diagnosed or survivors spanning a number of years. While the interviewer will prompt patients with questions, the focus will be on the patient’s story and what is most relevant to her, including the emotions surrounding the diagnosis and treatments, as well as the support systems available.
“There is a value in seeing and hearing people's real life experiences: It helps others understand what it’s really like to have breast cancer. It’s like a support group online” says Dr. Donna Stern, project leader and an oncologist at SMHC. “In addition, we hope this project will describe breast cancer in a way not available from health professionals or accurately from the Internet.”
SMHC-MUHC team: Oncologist Dr. Donna Stern will lead a team that includes Dr. Tarek Hijal, Dr. Neil Kopek, Dr. Susan Law and Ms. Ilja Ormel.
Reducing lymphedema
Beating cancer is a tremendous victory, however some patients face debilitating long-term complications. For instance, 10 to 30% of patients who undergo surgery for a gynecological cancer will develop lymphedema.
Lymphedema. a condition in which excess fluid (lymph) collects just beneath the skin causing swelling (edema), usually presents three to six months post-surgery and has a major impact on a patient’s self-image and quality of life. Symptoms of lower limb lymphedema include a feeling of fullness and stiffness in your legs and difficulty walking.
Currently, there are no guidelines on the prevention of lower limb lymphedema in gynecological cancer patients treated with surgical lymph node dissection. A team of RCN health care professionals from the MUHC and the Jewish General Hospital (JGH) will determine if the incidence of lymphedema can be reduced with a comprehensive risk reduction program.
The project will recruit 50 patients and take two years to complete. The team will look for patients at risk of developing lymphedema based on their treatment history and the stage and grade of their cancer. The treatment group will then receive custom-fit compression stockings, an individualized exercise program as well as information on how to reduce the risk of developing the condition. The control group will only receive information.
“We are hypothesizing that patients who get the intervention will be less likely to develop lymphedema, or the condition will develop more slowly and be less severe,” says Shirin Shallwani, the project co-lead and a physiotherapist with the MUHC Lymphedema Program.
MUHC-JGH project team: Physiotherapist Ms. Shirin Shallwani and co-investigator Dr. Anna Towers will lead a team that includes Dr. Lucy Gilbert, Dr. Walter Gotlieb, Ms. Pamela Hodgson, Ms. Lisa Kham, Dr. Shannon Salvador and Ms. Angela Yung, supported by their collaborators, Ms. Rachel Pritzker, Dr. Judith Soicher and Dr. Jadranka Spahija.
Enhancing recovery after surgery
Imagine potentially reducing post-operative complications after kidney cancer surgery by up to 50 percent. This is just one of the goals of an RCN research project being undertaken by urologists at the JGH and MUHC. The study’s overall aim is to optimize the quality of care for patients with kidney cancer and decrease complications, side effects, mortality and length of stay.
To achieve this, an Enhanced Recovery After Surgery (ERAS) team will be put in place in the Urology Departments of the JGH and the MUHC.
ERAS is an internationally recognized program that focuses on improving patient outcomes and speeding up recovery. ERAS programs focus on making sure patients are active participants in their own recovery. It also aims to ensure patients always receive evidence-based care at the right time.
“The RCN-sponsored ERAS team will look at all areas of the patient’s journey through the surgical process with the aim of replacing traditional practices with evidence-based best practices when necessary,” says Dr. Franck Bladou, lead researcher and Chief of Urology at the JGH.
The seven-member JGH ERAS team which includes nurses, a urologist, anesthesiologist, surgeon, and dietician have begun meeting. A pre-study has been launched to establish protocols, create education materials, develop checklists and conduct patient surveys.
The team will track various data pre and post establishment of the ERAS program to determine if, over the two years of study, patient outcomes are improved.
“If our study achieves the expected results of improving the patient experience and reducing post-surgical complications rates, other surgical programs for cancer or other diseases will likely be interested in establishing their own ERAS program,” says Dr. Bladou.
JGH-MUHC project team: Urologist Dr. Franck Bladou will lead a team that includes Dr. Maurice Anidjar, Dr. Wassim Kassouf and Dr. Simon Tanguay.