Our Projects

Maritime Research Network for Family Practice (MaRNet FP) - Dalhousie University

The Maritime Family Practice Regional Network’s largest activity is as a node for CPCSSN, the Canadian Primary Care Sentinel Surveillance Network. It continues to thrive with now over 80,000 Nova Scotia primary care patients included.  Each year the network grows, both in terms of the number who have ‘plugged in’ to the network and the quality of the data being collected. 

In Nova Scotia, we have recruited 55 sentinel physicians and nurse practitioners from 20 sites, both urban and rural environments, and are poised to expand further over the next several months.  The sites incorporate the Nightingale electronic medical record (EMR) system. In addition to general health information, data are being collected on eight chronic diseases:  hypertension, diabetes, osteoarthritis, COPD, depression, epilepsy, Parkinson’s disease, and dementia.  The data are robust and the algorithms used by CPCSSN to identify cases of diabetes, hypertension, etc. have a sensitivity and specificity of 90 per cent and higher, in most cases.  Researchers are already beginning to use the collected data for research projects and it is expected that the data resulting from CPCSSN efforts will become a key information source for national chronic disease management.

Read more about the Canadian Primary Care SEntinel Surveillance Network.

Read more about Hypertension in patients with Type 2 Diabetes. 

Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: implementation and realist evaluations is a multi-provincial study aiming to provide case management for those living with one or multiple chronic diseases who frequently use the health system.

Case management is led a by a family practice nurse or social worker in a primary care setting, with collaboration from other providers and community resources.

The Models of Access and Practices in Nova Scotia study aims to build a descriptive atlas of how all primary practices in Nova Scotia are organized and specifically what access is like from the patient’s perspective.  Preliminary findings are already being presented and are of interest to our local decision-makers and providers.

The Transdisciplinary Understanding and Training on Research – Primary Health Care programme has been a tremendous success with well over 100 trainees having participated since its inception.  The objective, to build a critical mass of skilled, independent researchers and to increase the interdisciplinary and trans-disciplinary focus in primary health care, has clearly been met. The trainees, many now independent researchers,  are influencing the way in which primary care research is being conducted.  The applicants for the tenth and final year of training have been selected and discussion is underway in how to sustain this program.

Screening for Poverty And Related social determinants and intervening to improve Knowledge of and links to resources (SPARK) is a multi-provincial study aiming to address poverty and social needs through sociodemographic data collection and screening for benefits and community resources.

This study will take place in primary health care clinics with a designated Patient Navigator offering assistance and follow-up to patients. 

BRIC NS—Building Research for Integrated Primary Healthcare in Nova Scotia—is a research network that seeks to improve primary healthcare and integrated services for people with, or at risk of developing, complex healthcare needs.  BRIC NS research is patient-oriented, which means it engages patients as partners and focuses on patient-identified priorities and improves patient outcomes.

BRIC NS is:

• building capacity in Nova Scotia for the conduct and application of patient-oriented research

• mobilizing research efforts and encouraging investigators to apply for funding available to network members

• creating partnerships within and across various sectors of the health care system—including public health and primary health care, as well as secondary, tertiary, home and long-term care

• looking outside the health sector to forge new connections with such important services as education, housing and social services

• developing connections with counterpart networks in other provinces

• leading the way to more comprehensive approaches to improving individual and population health, health equity and health system outcomes

• engaging patients as partners in our governance and research projects

BRIC NS is the Nova Scotia Primary and Integrated Health Care Innovations Network, an initiative of the Strategy for Patient-Oriented Research (SPOR).  BRIC NS has $1 million in funding over 5 years from the Canadian Institutes of Health Research (CIHR) and the Nova Scotia Health Research Foundation (NSHRF).  Additionally, BRIC NS has facilitated the funding of multiple primary healthcare research projects.

BRIC NS has a tri-partite leadership model to ensure that science, policy and practice are working together to identify and support priority-driven research.

• Science Lead: Fred Burge, Department of Family Medicine, Dalhousie University

• Clinical Lead: Rick Gibson, Primary Health Care and Department of Family Practice, Nova Scotia Health Authority

• Policy Co-Lead: Lynn Edwards, Primary Health Care & Chronic Disease, Nova Scotia Health Authority

• Policy Co-Lead:  Charmaine McPherson, Risk Mitigation Acute and Primary Care, Nova Scotia Department of Health and Wellness

BRIC NS members include individuals from across the province who have a research interest in primary and integrated healthcare.  This includes primary care practitioners, researchers, decision-makers, citizens and learners.  To learn more about BRIC NS, including how to join, visit the website.

The overarching goal of the Structured Process Informed by Data, Evidence and Research (SPIDER) project is to establish and evaluate a model to help primary care practices optimize care for patients with persisting complex care needs and who take multiple medications. SPIDER will attempt to reduce the risk of harm related by targeting attention to potentially inappropriate prescriptions (PIPs) in adults aged 65 years of age and older. SPIDER, a uniquely positioned pragmatic cluster randomized trial, will be rolled out in the seven regions that have Practice Based Research Networks (PBRNs) across the country. Locally, it is one of the Building Research for Integrated Primary Healthcare in Nova Scotia multi-year CIHR funded projects. See https://bricns.com/

PUPPY Study – Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year: A Longitudinal Mixed Methods Study with Rapid Reporting and Planning for the Road Ahead.  The PUPPY-study leverages current research with an experienced team to address clinical management and health system interventions in primary care (PC). Most healthcare visits in Canada are to family physicians and nurse practitioners. Our study also examines growing pharmacist PC services. If PC access and care is done well, it decreases the number of both COVID and non-COVID patients requiring acute care and directly facilitates capacity across our healthcare system as the anticipated waves of COVID fallout emerge. As the locus of most healthcare interactions, including those to detect, triage, and treat COVID, exploration of rapid policy change in PC and its impacts on patient access and outcomes is critically relevant to clinical management and health system interventions. Our cross-jurisdictional study will analyze the impact of COVID-related transformation on multiple key elements of PC.  Through our established network, we will rapidly identify and share best practices and strategies for managing patients and provider wellbeing throughout the pandemic trajectory.

“The CUP Study: Comparative Analysis of Centralized Waitlist Effectiveness, Policies, and Innovations for Connecting Unattached Patients to Primary Care Providers”.  This study will compare centralized wait lists in Nova Scotia, Quebec, and Ontario to see how effective they are at connecting unattached patients to primary care providers. The findings from this study will be shared with stakeholders from all three provinces.

Care-By-Design (CBD), a new model of primary medical care in Long Term Care in the Capital District Health Authority, aims to provide comprehensive, skilled, timely resident-centered care making appropriate use of specialized health care resources in serving residents.  The coordinated nature of the CBD model has created relationships, lines of communication and structures for sharing ongoing concerns and collaborations for finding solutions.  Preliminary are demonstrating the effectiveness of this approach to care.

Family doctors and other primary care providers offer access to care and coordinate services that patients need throughout the system. There are more family doctors per person than ever before in Nova Scotia (and the rest of Canada), but more people than ever struggle to access the care they need, and primary care providers report stress and unmanageable workloads. While multiple factors contribute to these problems, increasing administrative workload related to providing care and operating clinics may play a substantial role.The Research Nova Scotia funded A thousand papercuts: Understanding and addressing changing administrative workload in primary care study addresses the overarching goal of reducing administrative workload while ensuring efficient coordination of care in Nova Scotia.

Sixty Nova Scotia practices participated in this study of the “Quality and Costs of Primary Care”.  Key questions were to determine how primary care is organized in Canada and how patient experience compares province-to-province and to other countries.  Results will be forthcoming.

The TRANSFORMATION Study is a multi-provincial research project aiming to improve both the science of performance measurement and the ways those results are reported to practitioners, decision makers, and the public to encourage improvement within the health care system. To view information on our four linked studies, please visit www.transformationphc.ca or contact our Project Manager, Stephanie Blackman, at transform@dal.ca and follow us on Twitter. (@transformphc).