Locating EPIC/PHSI in a Sea of Acronyms (CNN; CIHR-PHSI; EPIC; EPIC/PHSI) Shoo K. Lee, MBBS, FRCPC, PhD Director, Canadian Neonatal Network™ Scientific Director, iCARE Professor of Pediatrics, University of Alberta EPIC/PHSI Training Workshop November 9 & 10, 2006 Toronto Ontario

Objectives Overview CNNTM Overview CIHR Overview EPIC/PHSI Locate EPIC/PHSI in CNN and CIHR

Canadian Neonatal Network™ (CNN)

Background of CNN Founded in 1995 Multidisciplinary researchers 30 hospitals & 16 universities across Canada All 30 tertiary NICUs in Canada Standardized NICU database CNN researchers have published extensively in peer-reviewed journals and made many presentations at scientific conferences

Objective of CNN To conduct leading, innovative, collaborative research leading to improvements in neonatal-perinatal health and the quality of healthcare in Canada and internationally.

Structure of CNN

CNN Sites CNN Sites--30 EPIC/PHSI Sites--25 St. John’s Saskatchewan Halifax Calgary Québec City Moncton Victoria Vancouver St. John Regina Sherbrooke Fredericton Winnipeg Montréal New Westminster Ottawa Kingston Kingston Toronto Hamilton London

Canadian Institute of Health Research (CIHR)

CIHR CIHR Mandate "To excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system."

CIHR - Partnerships for Health System Improvement (PHSI) The purpose of this initiative is to support teams of researchers and decision-makers interested in conducting applied health research useful to health system managers and/or policy makers over the next two-to-five years. EPIC/PHSI funded for $100,000 x 3 years

CIHR and Knowledge Translation Knowledge translation is the exchange, synthesis and ethically-sound application of knowledge - within a complex system of interactions among researchers and users - to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system EPIC/PHSI is built upon knowledge translation

Evidence-based Practice Identification and Change (EPIC) EPIC/PHSI

Evidence-based Practice Identification and Change (EPIC) Scientific method for quality improvement Innovation - 3 pillars: Evidence-based Uses published research literature Variations in outcomes for targeted intervention Use data to identify practices associated with variations in outcomes Combined expertise Uses a national network of clinicians and experts to share expertise and experience A template that is generalizable to all NICUs Create culture of continuous quality improvement and evidence-based practice and change

EPIC-I Results: Group A (NIT)

EPIC-I Results: Group B (CLD)

EPIC-I Results: Group C (Controls)

EPIC-I Conclusions EPIC is effective at reducing NI and BPD in the NICU Interventions targeting one outcome may affect other outcomes EPIC may be more effective and less costly at improving quality of care than traditional CQI methods

EPIC/PHSI Objectives Test the generalizeability of EPIC Determine the sustainability of EPIC Establish and evaluate a national system to support NICU quality improvement efforts based on EPIC