23 November, 2017
 1. CIHR Team in Maternal-Infant Care: Translating Knowledge Into Improved Care

Principal Investigator: Shoo Lee, Mount Sinai Hospital
Co-investigators: Hayward R, Joseph KS, Armson BA, Dendukuri N, Barrington KJ, Baker GR, Magee LA, Ohlsson A, Saigal S, Sauve R, Shaw N, Skarsgard E, Stevens B, Liston RM, Aziz K, O'Campo P, El-Hajj M 
Network Contact: Shoo Lee
Funding Agency: Canadian Institutes of Health Research (CIHR) Funding Granted: $1,727,068 (Yr1) (2008-2013)

A major weakness in health research is the inability to effectively, efficiently and rapidly translate knowledge into improved quality of care, better patient outcomes and reduced health care costs. Preterm birth is a prime area for developing knowledge translation models to improve quality of care. The costs of preterm birth are estimated to exceed $1 billion annually in Canada and include NICU care, which is expensive and often prolonged. Unfortunately, little is known about how to reduce preterm births and the outcomes for preterm infants have not improved in recent years. This research program is designed to improve outcomes and reduce costs through a better understanding of how different practices and risks affect the long-term health of preterm infants, how improved methods of knowledge translation can enhance quality of care, and how the use evidence can be extended to patients for counseling and decision making. Our objective is to conduct an integrated program of research, training and knowledge translation aimed at creating innovative methods and models for improving quality of care for pregnant women, infants and their families. We will involve researchers, clinicians, administrators, professional bodies and community groups from across Canada. We will establish a unique national database that spans the entire period from pregnancy to childbirth, infancy and developmental follow-up, and use it to develop and test innovative methods and models for quality improvement. We will conduct 5 projects that will assess the therapy and non-therapy related risk factors for preterm infants, use evidence to identify best practices and indicators, develop and evaluate decision support tools to facilitate practice change, implement and evaluate an evidence-based practiceidentification and change (EPIC) system for improving care for newborn infants and their families, and develop updated prognostic tools for family counseling and decision making. 

    

 2. The World Health Organization Global Survey for Maternal and Perinatal Outcomes in Canada

Principal Investigator: Brian Anthony Armson, IWK Health Centre; Shoo Lee, Mount Sinai Hospital
Co-investigators: Armson BA, Heaman M, Murphy P, Walker M, Janssen P, Klein M, Allen V, Attenborough R, Andruschak J, Suave R, Pasquier J-C, Dumont A, Bujold E, Moutquin J-M, Frick C, Ohlsson A, Crane JMG, Platt RW, Liu S, da Silva O, O'Brien B, von Dadelszen P, Bottomley J, Der K
Network Contact: Shoo Lee
Funding Agency: Canadian Institutes of Health Research (CIHR) Funding Granted: $500,000 (2008-2010)

The aim of this partnership between WHO and Canada is to create a network of focused information on the health and health services provided to mothers and their babies. This information will be used to assess mother, fetal and newborn outcomes, monitor differences in services, evaluate programs, identify trends in technology and identify areas of concern. One topic already identified, and to be addressed by this proposal, is the increase in health risks for both mother and baby. The purpose of this study is to examine the relationship between the type of delivery, the care received immediately after delivery and heatlh outcomes for both mother and baby. This information will enable us to better provide care for mothers and their babies. These relationships will be compared among provinces across Canada and between other countries.

    

 3. Neonatal-Perinatal Interdisciplinary Capacity Enhancement (NICE) Team in Quality of Care Improvement

Principal Investigator: Shoo Lee, University of British Columbia
Co-investigators: Baker R, Langley JM, MacNab YC, Moehr JR
Network Contact: Shoo Lee
Funding Agency: Canadian Institutes of Health Research (CIHR) Funding Granted: $1,000,000 (2003-2008)

Although knowledge translation is key to improving quality of care, our ability to do so is limited. We will establish an interdisciplinary team of researchers, providers and decision makers to enhance capacity for knowledge translation to improve quality of care for babies and their mothers. The Neonatal-Perinatal Interdisciplinary Capacity Enhancement Team (NICE) will build upon the successful collaboration of the CNN to establish 2 new research networks, the Canadian Perinatal Network (CPN) and the Canadian Pediatric Surgery Network (CAPSNET). The establishment of these two networks will develop new methods and models of knowledge translation to improve quality of neonatal care through the inter-disciplinary teams. Status: Presently being established.

    

 4. Tertiary-Neonatal Bed Costing Project

Principal Investigator: Shoo Lee, University of British Columbia
Funding Agency: BC Provincial Health Services Authority (PHSA)
Network Contact: Shoo Lee
Funding Granted: $40,000 (2003-2004)
 

    

 6. Evidence-based Practice Identification & Change (EPIC)

Principal Investigator: Shoo Lee, University of British Columbia
Co-investigators: Aziz K, Cronin CM, Lee DSC, Matthew JD, Ohlsson A, Parvez B, Peliowski A, Sankaran K, Seshia M, Singhal N, Synnes A, Thiessen P, Walker R, Baker R, Hoube J, Langley J, Liston R, McNab Y, Moehr
Network Contact: Shoo Lee
Funding Agency: Canadian Institute for Health Research (CIHR)
Funding Granted: $717,252 (2002-2006)

Although NICUs have been instrumental in improving neonatal survival outcomes, still variation exists in outcomes and care provided at different NICUs. This study will develop, evaluate and establish a national system to help NICUs work together across Canada to improve quality of care for sick newborn infants on an on-going basis. Scientific methods utilizing the best available data and evidence will be used to design systems that enable all Canadian hospitals to deliver the highest standard of care available today. Successful conclusion of this study will result in significantly improved neonatal outcomes. Status: Study in progress.

    

 7. Status and Needs of Tertiary Perinatal Services in British Columbia

Principal Investigator: Shoo Lee, University of British Columbia
Funding Agency: British Columbia Ministry of Health Services
Network Contact: Shoo Lee
Funding Granted: $30,000 (2002-2003)

    

 8. Evaluation of universal leukoreduction in the neonatal intensive care unit (NICU) population

Principal Investigator: Paul Hebert, University of Ottawa
Co-investigators: Ferguson D, Lee SK, Shapiro S, Walker R, Barrington K, Joseph L, Blajchman MA Network
Network Contact: Shoo Lee
Funding agency: Canadian Institutes of Health Research (CIHR)
Funding Granted: $76,628 (2001-2003)

Red blood cell transfusions affect the immune system and there are concerns that they may cause immunosuppression. However, there is conflicting evidence about the benefits and costs of universal pre-storage leukoreduction. In particular, its clinical effect and impact in neonates have not been established. This study will examine nosocomial infection rates as well as hospitalization and 30-day mortality before and after implementation of a universal pre-storage leukoreduction program in Canadian hospitals to determine whether pre-storage universal leukoreduction significantly reduces nosocomial infection rates in the neonatal population. Status: Data collection and analysis complete. Publications in progress.

    

 9. Extending the usefulness of artificial neural networks to estimating outcomes in intensive neonatal care

Principal Investigator: Monique Frize, University of Ottawa
Co-investigators: Walker R
Network Contact: Robin Walker
Funding agency: National Science and Engineering Research Council (NSERC), Medical Research Council of Canada (MRC)
Funding Granted: $100,000 (2001-2005)

The Medical IDEAS (Intelligent DEcision Aid System) Research Group is developing artificial intelligence approaches to facilitate research and decision-making in various medical environments. This project will apply artificial neural networks to solve problems in the NICU using the Case-Based Reasoning system, and to develop decision support systems for use in the NICU. Status: Study in progress.

    

 10. Neonatal Health Services in Canada

Principal Investigator: Ying MacNab, University of British Columbia
Co-investigators: Dean C, Gustafson P, Klinkenberg B, Lee SK, Ohlsson A
Network Contact: Shoo K. Lee
Funding agency: Medical Research Council of Canada
Funding Granted: $149,220 (2000-2002)

Improvements in NICU care combined with a highly regionalized system of neonatal-perinatal care delivery have significantly reduced infant mortality and especially benefited low birth weight infants who are at high risk of prolonged and costly hospitalizations. This study will identify important geographical and inter-hospital variations in the regionalized system of perinatal care in Canada. A significant impact of this study will be the dissemination of comprehensive information on neonatal-perinatal health care delivery in Canada, geographic and inter-hospital differences relating to such care, and potential factors related to such differences which may be used for quality improvement at the hospital and regional levels. A state-of-art geographic information system will be developed so that integrated information can be clearly, precisely and visually displayed and conveyed. This assessment of service needs and effectiveness of health care delivery will be important for future health policy and resource planning at the health administrative levels. Status: Data analysis and publications in progress.

    

 11. Infants born into NICUs and their caregivers
Full Title: Infants born into NICUs and their caregivers :a study of the relationship between their health related quality of life, NICU practices and outcomes, and post-NICU health care utilization

Principal Investigator: Shoo K. Lee, University of British Columbia
Co-investigators: Klassen A, Barer M, Raina P Network
Contact: Shoo K. Lee Funding Agency: Hospital for Sick Children Foundation Funding Granted: $127,916 (1999-2001)

This study will validate two pediatric health related quality of life instruments on a Canadian population-based sample of NICU survivors, and use them to measure the health related quality of life of children admitted to NICUs at 4 years of age. It will also link health related quality of life with demographic and socio-economic information, and with NICU outcomes and practice data, to assess the independent and interactive effects of different risk factors on long term health outcomes and resource use. Finally, it will assess the health related quality of life of the informal family caregivers of NICU survivors in relation to that of NICU survivors. Status: Data collection complete. Data analysis and publications in progress.

    

 12. Data Collection in the NICU
Principal Investigator: Shoo Lee, University of British Columbia
Co-Investigator: Margaret Pendray
Network Contact: Shoo Lee
Funding Agency: BC Children’s Hospital Foundation
Funding Granted: $40,000 (1998-1999)
    

 13. Illness severity, practice variations and resource consumption in NICUs

Principal investigator: Shoo K. Lee, University of British Columbia
Co-investigators: Andrews W, Boulton J, Brabyn D, Lee DSC, Matthew JD, McMillan DD, Newman C, Ohlsson A, Peliowski A, Pendray M, Sankaran K, Schmidt B, Seshia M, Synnes A, Walker R, Whyte R
Network Contact: Shoo K. Lee
Funding agency: Medical Research Council of Canada
Funding Granted: $737,280 (1995-1998)

Neonatal intensive care units (NICU) provide vital care for sick newborn infants, and have been instrumental in helping Canada achieve one of the lowest infant mortality rates in the world. NICUs treat a range of illnesses, from prematurity and respiratory distress syndrome, to birth trauma and infection. However, NICU care is very expensive, and quality of care may differ among hospitals. This study examines how differences in clinical practices among Canadian NICUs affect outcomes of sick newborn infants, and how the resources needed to provide this care may affect quality of care. This will help us determine which practices are most effective, and how to organize and manage NICUs to provide the best and most cost-effective care. In addition, since this study will be conducted in parallel with a similar study in the US, we will be able to compare the performance of Canadian NICUs with those in the US. Status: Data collection complete. Publications in progress.