Research Spotlight: Dr. Katie Dainty - Patient-Centred Outcomes

Dr. Katie Dainty

Katie Dainty, PhD, is the Research Chair in Patient-Centred Outcomes at North York General Hospital (NYGH). Dr. Dainty’s research interests include studying issues related to patient and family experiences, organizational behaviour, patient-centred outcome measures and quality improvement in community health care environments.

Dr. Dainty’s expert team allows patient voices to become an equal part of the evidence base used to practice more patient-centred health care. “By collecting patient voices in a rigorous way, it puts this information on par with traditional research, such as randomized trials,” says Dr. Dainty.

“I feel fortunate to be able to use my research expertise in partnership with patients, survivors and their families, to understand the health care system from their perspective and elevate their voice, which hasn’t always been given prominence.

It's an honour for me to be able to bring their experiences to the table, not only from an academic perspective but also from an advocacy perspective – always keeping in mind, I'm not their voice, I just give them one.”

Women with early pregnancy complications

Dr. Dainty recently partnered with Dr. Catherine Varner, an Emergency Physician from Schwartz/Reisman Emergency Medicine Institute (SREMI) at Mount Sinai Hospital, to investigate the lived experiences of women with early pregnancy complications visiting the Charlotte & Lewis Steinberg Emergency and Early Pregnancy Assessment Clinic at NYGH. The goal of this research is to seek women’s perspective on their experience and input on what is needed to reduce the impact and trauma of pregnancy complications in different hospital settings. In March 2019, this study was funded through the North York General Hospital Women’s Health Innovation Fund – a dedicated grant program made possible through a partnership with Shoppers Drug Mart and their Growing Women's Health campaign.

Approximately 5,000 women visit the NYGH emergency department (ED) each year for early pregnancy complications. “This number is much higher than many of us thought,” says Dr. Dainty.

“These women receive good care clinically, but their experience of the health system is very traumatic and extremely emotional. 

We want to understand the process and what we can do to improve the way pregnancy complications are handled in an environment like the ED.”

The Early Pregnancy Assessment Clinic at NYGH provides care for patients three days a week. This clinic is where women received the kind of support and care they need from obstetricians and gynaecologists. Dr. Dainty and team are looking at whether this type of specialized clinic is the answer to reducing the impact of these traumatic events or if health care providers need to reframe the way pregnancy complications are viewed and treated.

Teaming-up with the NYGH Patient and Family Advisors

Dr. Dainty’s team has also worked with Patient and Family Advisors (PFAs) to identify priorities for this unique group of volunteers.

“We worked with them to understand what they do well, what they could do better, and how they want to evolve their contributions to the hospital,” says Dr. Dainty.

“Together we discussed how they feel about their role in the hospital, how they are involved and how the process works.  Our PFA program is way ahead of the game, so we must think about where we go next. 

Once this work is published, I think it may benefit other organizations to see what we are doing.”

NYGH started its partnership with patient and family advisors in 2012 and is one of the longest running hospital-based programs. The PFA program encourages the engagement of patient partners in hospital operations as well as in research studies to ensure their needs and priorities are considered and incorporated.

“I think a key component of the conversation about patient engagement is that it can't be forced, it has to be a very natural process, says Dr. Dainty.

“I highly encourage patient engagement in research, but we must be careful about that imperative and how we foster it.

Our PFA has been very helpful in guiding us on this.”

Involving survivors of cardiac arrest and their families in Research Priority Setting

Dr. Dainty and her team have partnered with the James Lind Alliance (JLA) in the UK, on a project funded by the Canadian Institutes of Health Research, Catalyst Grant, that was ranked first in the competition. The JLA is a non-profit making initiative that brings patients, carers and clinicians together in Priority Setting Partnerships (PSP) to identify and prioritize, on a selected subject, the top 10 unanswered questions or evidence uncertainties that they agree are the most important. The Cardiac Arrest PSP (Canada) lead by Dr. Dainty’s team aimed to identify unanswered questions regarding the pre-hospital, in-hospital, and post-discharge care (both clinical and psycho-social) of adult survivors of sudden cardiac arrest.

The PSP methodology consisted of two online surveys conducted in Canada and a face-to-face workshop held at NYGH.

“This workshop was unique in that it was a combination of a project all about partnering patients and families, and health care providers together to build a research agenda,” says Dr. Dainty.

“What was fascinating was that in the second survey, at the prioritizing steps, the top priority from physicians was about drugs and the bottom priority was about long-term outcomes; on the other hand, the top priority from patients and families was about long-term outcomes and the bottom priority was about drugs.

They were at completely opposite ends, which shows that we needed to work to find consensus. 

The prioritization exercise is to think about where exactly to hit home but at the end of the day all of it is important. It was fascinating to me, it really highlighted that we're not all talking the same language, and that we need to think about that. As researchers we often turn to the clinical, we turn to the drugs, we turn to the interventions, and we need research on that, but we also need more patient oriented research. That was a valuable outcome of the workshop.”

This exciting project is now moving forward to disseminate the findings in early 2020.

NYGH Research Chairs team-up with North York Toronto Health Partners

Recently, North York General and 21 community partners were approved to become an Ontario Health Team. North York Toronto Health Partners (NYTHP) was created to provide seamless care for the North York Community, with a focus on patient groups with more complex and higher needs, including frail seniors, those with mental health and addiction issues, and those at end of life. Thus, providing integrated health care for our community. The NYGH Research Chairs are part of the NYTHP team to provide guidance and evaluation of the Year 1 milestones.  

“I think this is a really unique opportunity, as most OHTs will not have the expertise of Research Chairs to draw from. The OHT is incorporating projects that are part of the Research Chairs areas of expertise, including patient-centered outcomes,” says Dr. Dainty.

Read more about NYTHP.

Katie Dainty’s research studies are great examples of how NYGH is transforming patient care through applied research and innovation.

References

http://www.jla.nihr.ac.uk/priority-setting-partnerships/cardiac-arrest/

http://www.jla.nihr.ac.uk/priority-setting-partnerships/

 

This article first appeared in the March 2020 issue of The Pulse.

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