I Boost Immunity (IBI, https://iboostimmunity.com) and Kids Boost Immunity (KBI, https://kidsboostimmunity.com) are online learning platforms designed to raise vaccine literacy for children and adults. As the first platforms of their kind anywhere in the world, users learn about immunization through a series of online quizzes and ‘earn’ lifesaving vaccines for children around the world through UNICEF Canada.

Visitors, known as Boosters, to the websites complete a series of fun and informative online quizzes or share articles and stories through their social networks.

KBI is a free digital learning platform for primary to high school students. KBI encourages students from grades 4-12 to think about immunization in a global context, connecting local classroom learning directly to global giving.

KBI was officially launched in April 2018. Approximately 240 schools from across Canada have registered in the program, with at least 8,000 students answering more than a million quiz questions related to vaccine health; improving student immunization literacy, reducing vaccine hesitancy and protection children against the misinformation spread through social media and the internet.

IBI was launched in April 2016 and has approximately 17,000 Boosters in 25 countries. Boosters have answered more than 1.4 million quiz questions, earning more than 750,000 vaccine doses.

Patients with cancer that experience side effects from their treatment don’t just need help between 9am and 5pm. A pilot project initiated at the Stronach Regional Cancer Centre, Newmarket, Ontario in 2016 has expanded to provide after-hours telephone support and clinical guidance to cancer patients across the province.

Patients call a central contact number to receive symptom management advice from experienced specialized oncology nurses. The pilot project has provided a needed service in a cost-effective and efficient manner, leading to reduced emergency rooms visits. It has delivered patient care when, where and how cancer patients wanted to receive it.

By March 2018, the service had logged 500 calls a month. Of those patients using the service, 94 percent rated the services as "very helpful" and 80 percent reported that without the service they would have gone to the emergency room. Ninety-five percent of the patients who were referred to the hospital received the necessary medical intervention or were admitted. Today, the after-hours telephone support has transformed into a province-wide program available to all hospitals across Ontario that deliver systemic treatment. The initiative provides cancer patients after-hours access to a trusted healthcare professional, from the comfort of their own home.

The ICU Bridge Program (www.icubridgeprogram.org) in the ICUs of the McGill University Hospital Centre (MUHC) and Centre intégré universitaire de santé et de services sociaux (CIUSSS) is reducing the information gap and limiting the stress, anxiety and mental health impacts of the ICU environment through increased communication, heartfelt gesture, and an innovative electronic diary program provided by university-student volunteers.

At the heart of the ICU Bridge Program is a team of university-student volunteers who work from 8am to midnight, seven days a week at the welcome desk to guide visitors, act as a conduit to communicate concerns to the ICU medical team, provide snacks and water, keep young children company as their parents enter the ICU, or simply lend a sympathetic ear.

A second key aspect of the ICU Bridge Program helps patients and their families restore or provide accurate memories of what went on in the ICU through the use of an electronic diary. Post Intensive Care Syndrome (PICS) affects some 50 percent of patients and their families and can make it difficult to recall the ICU stay and distinguish between what was real and what was not.

The ICU Bridge Program adds a friendly face and has been making a world of difference in humanizing the ICU experience, putting patient care and caring volunteers at the centre of what is an intense experience in the intensive care unit.

The DREAM Project team – researchers David Paquin, Ph.D., Sylvie Le May, Ph.D., and Dr. Jean-Simon Fortin – designs technological solutions to reduce pain and anxiety in children who have to undergo a painful medical procedure. By transforming procedures that are already stressful and painful into positive care episodes, the three experts have been tangibly improving the experience of young patients and their families during their hospital stay.

The team created DREAMLAND, one of the first virtual reality video games aimed at reducing procedural pain and anxiety.

Every year, over 20,000 children undergo painful procedures at CHU Sainte-Justine’s mother and child centre in Montreal. Previously, pain management for children consisted primarily of drug administration or no intervention at all, and few non-pharmacological options were available.

DREAMLAND harnesses the power of distraction to manage pain and anxiety. By redirecting the patient’s attention to an imaginary world, the video game helps reduce the player’s pain and anxiety. Each aspect of the game has been carefully crafted to provide continuous distraction. This non-violent game is suitable for children seven years of age and older. It can also evolve to adapt in real time to older or more experienced players.

Preliminary results indicate a decrease in anxiety in 80% of young patients who played DREAMLAND. Pain decreased in 50% of cases and disappeared completely in 30% of young player-patients. The DREAM team’s approach to pain has a direct impact on pediatric patients as it helps reduce the pain felt during different interventions. This could result in improved diagnosis, treatment, outcomes and patient/family care experience.

The Mount Sinai Hospital’s Tele-Pulmonary Rehabilitation Program is increasing access to this much needed, and guideline-recommended, service across Quebec for patients with chronic obstructive pulmonary disease (COPD). Taking advantage of RUIS (Réseaux Universitaires Intégrés de Santé), McGill’s secure video-conferencing system and REACTS (Remote Education, Augmented Communication, Training and Supervision) platform, patients with chronic obstructive pulmonary disease at regional hospital sites are granted access to Mount Sinai Hospital’s specialized interdisciplinary team which includes a respirologist, COPD nurse, respiratory therapist, physiotherapist, dietitian and occupational therapist. This allows patients with COPD across Quebec to benefit from the specialized interdisciplinary team while at the same time reducing patient travel and minimizing costs for its partner sites.

Since being launched in January 2017, over 400 patients from nine sites have participated in the tele-pulmonary rehabilitation program. Of these patients, 87 percent have completed the program. Assessments of patient progress have shown that participants experience improvements in a variety of measures. Two additional hospital sites are expected to join the program in 2020.

Mount Sinai is optimizing use of the provincial tele-health system. With 9 sites, Mount Sinai Hospital is fast becoming the best way to create new pulmonary rehabilitation programs in the province, improving accessibility to pulmonary rehabilitation with minimal cost. They are putting patients first in this front-line, technology enabled initiative.

In the Acadian Peninsula, in northern New Brunswick, an innovative partnership has unfolded between a clinical social worker, a child welfare psychologist from the Social Development Department (SDD), and a psychologist for the Vitalité Health Network’s Children/Youth Mental Health Services. They have drawn on best practices to develop an operational clinical model that provides optimal responses to the needs of children with complex difficulties such as trauma, mental health problems, attachment issues and more. The model is relevant for clients in foster care as well as in therapeutic facilities that serve children and youth with complex difficulties. The Clinical Supervision Model provides different approaches and initiatives to address the dynamics associated with children’s complex needs. The model’s crowning achievement, however, is the development of the Clinical Consultation Team (CCT) concept. CCT intervention begins when youth are placed in foster care or in a therapeutic facility. Their needs, characteristics and challenges are clearly identified and recognized. The CCT meets regularly throughout the youth’s placement, and plans out the youth’s return to his or her family or transfer to another resource. If the youth is hospitalized outside of his or her region or admitted to an external resource for evaluation, the CCT will also oversee the youth’s return to a resource in his or her own community. Youth are given a seat at the table and, when capable, they can share their own impressions and perceptions of the results of the strategies and interventions aimed at achieving their optimal recovery.

In 2019, the results of a study on the Clinical Supervision Model’s performance showed a significant decrease in police interventions, involvement with the justice system, hospitalizations for psychiatric issues and ambulance use. Parents and youth support networks have indicated that the CCTs make them feel valued, involved, understood and included. Thanks to the Clinical Supervision Model developed in the Acadian Peninsula, more youth are able to stay in their community, with the support they need.

A team at the Adult Neurodevelopment Stabilization Unit at the Nova Scotia Health Authority (NSHA) has developed a program that has proven to reduce restrictive practices and is helping clients learn and modify future behaviour that ultimately enhances their overall quality of life. The program is putting patients first in meaningful ways.

There is an increased likelihood of receiving restrictive practices for clients experiencing a mental health crisis or those with complex behaviour and intellectual disability. When alternative behaviour management practices exist to reduce the frequency and duration of restraint and restrictive practices, these interventions should be implemented.

The NSHA Adult Neurodevelopment Stabilization Unit has successfully innovated a new standard of care that is being shared with other community agencies. They are creating a shift of cultural awareness from reactive responding to a more proactive preventative approach and getting results based on team education, applications of the NSHA Least Restraint Policy and the development of functional behaviour assessments and treatment plans.

Staff are better prepared when challenging behaviour occurs and have the capacity to teach clients adaptive skills. The Stabilization Team have become better observers of lower levels of escalation and are able to intervene earlier so the need for more intrusive treatment is reduced.

Reports show a significant reduction in the use of restraints, including chemical restraints, and improvements in quality of life as demonstrated by access to community, improved structure and routine. Patients have increased community access and encouragement from their families to participate in activities. Increased advocacy and increased staff engagement have also occurred ensuring the best practices identified become the usual practices in the facilities.

The Adult Neurodevelopment Stabilization Unit at NSHA is a model for putting patients first through proactive prevention and intervening in the least intrusive manner possible.

The Ajax Harwood Clinic (https://ajaxharwoodclinicblog.wordpress.com) just east of Toronto is delivering accessible, inclusive and sustainable patient-centred care through collaboration, innovation, and empowerment of patients, caregivers and learners.

The clinic is specifically designed and furnished to encourage collaborative care and empowerment. It features a large community room, a teaching conference room for group activities and has additional space for other healthcare providers such as mental health workers. Health and wellness group medical appointments, as well as patient programs for managing chronic disease and wellness promotion, are routinely offered.

Technology, such as electronic medical records, helps the healthcare team share information while the Internet and social media (https://www.facebook.com/ajaxharwoodclinic/) are used to inform, educate and motivate patients. Even the waiting room is as an opportunity to communicate, where TV screens present information that reflects the medical needs of the clinic’s patients. Ajax Harwood Clinic is a real patient medical home for so many.

An innovative program at the Holland Bloorview Kids Rehabilitation Hospital in Toronto, Ontario (https://www.hollandbloorview.ca) is continuously advancing care and transforming the field of patient and family engagement. The Family Leadership Program enables children, youth and families to partner fully with the hospital and the Bloorview Research Institute to co-design governance and policy frameworks, programs and services, as well research that advances patient and family-centred care.

The program consists of more than 170 volunteer child, youth and family leaders who’ve participated in 183 special projects, initiatives and committees in 2016-17. Their time, energy and expertise guide and influence hospital improvements. Through the Children’s Advisory Council, for example, clients and their children as young as three years old partner with the hospital to shape the organization’s quality improvement plan so that it reflects their needs and preferences.

Convinced that things can always be better through partnership and collaboration, Holland Bloorview has simply made things better for patients and for their families.

Dr. Les Kalman, Assistant Professor at the Schulich School of Medicine & Dentistry in London, Ontario, is leading a volunteer-based program that provides free dentistry to those with challenging economic circumstances. DOCS, Dental Outreach and Community Services (https://www.schulich.uwo.ca/about/community_programs/docs.html), is a massive collaborative effort with community-based resource centres, industry partners and volunteers . The outreach program is now a mandatory component of the 4th year dental curriculum at Western, and since the program was implemented in 2011, the program has served more than 1600 patients who otherwise would not have received dental care.

DOCS was established with the patient’s best interest in mind, providing the best possible treatment without judgement or prejudice. The program operates with a mobile dental clinic that travels to various communities. A unique reciprocal community-based learning outreach model brings students and volunteer staff into the community, then patients to the university. Dr. Kalman maintains the program’s outreach aspect, to provide patients accessibility and familiarity. Many patients in southwestern Ontario can smile again because of Dr. Kalman’s passion and dedication to patient-centred care. Dr. Kalman and the DOCS program are privileged to have the generous support from all the amazing volunteers!

Québec-based pharmacist Alexandre Chagnon is the founder of askyourpharmacist.ca, a secure website where patients can obtain free, reliable advice about their health and medications. Thanks to his leadership and initiative, he’s attracted a team of more than 150 pharmacists from across Québec, who together have already carried out over 1,000 online consultations, allowing more than 22,000 patients to obtain reliable, confidential online health information.

The website developed by Mr. Chagnon, askyourpharmacist.ca, was built based on an analysis of patients’ browsing habits when searching for online health information. The goal was simple: to help as many patients as possible and be as responsive as possible to their needs. So far, the pharmacists registered on the site have received questions from patients aged 14 to 90. The addition of a Facebook page also gives Alexandre another way to reach people: https://www.facebook.com/qpupharmacien/.

These results attracted the attention of the Canadian Pharmacists Association, which invited Alexandre to present the website during the 2017 Innovation Showcase. The Ordre des pharmaciens du Québec also awarded him the Prix Innovation 2017, one of the highest honours a Quebec pharmacist can receive.

Opal (http://www.opalmedapps.com/), an e-health app developed by Dr. Tarek Hijal, Dr. John Kildea and Prof. Laurie Hendren, empowers and informs oncology patients at the McGill University Health Centre in Montreal, QC. Patients using the app can access their clinical notes and lab test results as well as personalized educational material, appointment schedules and a real-time waiting-room management tool. It also allows patients to fill out symptom and satisfaction questionnaires online, which helps their healthcare team provide better and more timely care.

Opal is a comprehensive app that is unique in a number of different ways: it was developed with a patient co-leading the healthcare team; it allows patients and professionals to see the same data and make decisions together; it encourages patients to actively participate in their care by providing symptom questionnaires and visualizations; it is integrated with a waiting room management system; and, it automatically personalizes patient educational material according to their diagnosis and stage of treatment. The development team is currently working on a caregiver version of Opal that will allow patients to share their data with caregivers. As always, the Opal team are practicing what has become their trademark–patient-centered software development.