1. 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

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

3. Canadian Neonatal Network™
(CNN)

4. 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

5. 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.

6. Structure of CNN

7. 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

8. Canadian Institute of Health Research
(CIHR)

9. 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."

10. 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

11. 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

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

13. 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

14. EPIC-I Results: Group A (NIT)

15. EPIC-I Results: Group B (CLD)

16. EPIC-I Results: Group C (Controls)

17. 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

18. 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