Community hospitals provide care to the majority of Canadians.
The participation of community hospitals in research is essential if we wish to accelerate knowledge generation and knowledge mobilization and ensure that Canada’s diverse population is appropriately represented in clinical research studies. As the Principal Investigator of this program, Dr. Tsang’s advocacy has included both academic and grassroots organizing efforts. She has authored four op-eds calling for the inclusion of community hospitals in research.
Ross, K., Tsang, J. (2017). It’s time to increase community hospital-based health research. Academic Medicine, 92, 727. https://pubmed.ncbi.nlm.nih.gov/28557913/
Gehrke, P., Binnie, A., Chan, S., Herridge, M., Cook, D.J., Burns, K.E.A., Tsang, J. (2019). Fostering community hospital-based research. Canadian Medical Association Journal, 191, E962- E966. https://pubmed.ncbi.nlm.nih.gov/31481424/
Tsang, J.L.Y., Binnie, A., Farjou, G., Fleming, D., Khalid, M., Duan, E. (2020). Participation of more community hospitals in randomized trials of treatments for COVID-19 is needed. Canadian Medical Association Journal, 192, E555. https://pubmed.ncbi.nlm.nih.gov/32575032/
Tsang, JLY., Fowler, R., Cook, D.J., Ma, H., Binnie, A. (2021). How Can We Increase Participation in Pandemic Research in Canada? Canadian Journal of Anesthesia. https://pubmed.ncbi.nlm.nih.gov/34642867/
In 2019, Dr. Tsang, along with Dr. Alexandra Binnie from William Osler Health System, co-founded the Canadian Community ICU Research Network (CCIRNet) – an association of Canadian community ICU professionals with an interest in clinical research. The goal of CCIRNet is to foster a culture of research in the community ICU setting across Canada with a view to increasing patient enrollment and improving the generalizability of study results. CCIRNet aims to break down the barriers that have traditionally existed between academic and community hospitals, at the level of research, in the hopes that this will lead to better care for our patients.
By sharing communal knowledge and experience, CCIRNet hopes to support community ICUs in achieving their research goals. Thus far, CCIRNet has 60 members representing 26 community hospitals across 6 provinces. We are currently developing a toolkit: A Guide to Building a Community Hospital Clinical Research Network: Strategies from a Multidisciplinary Front-line Perspective. Kian Rego, a Brock University Graduate Student and Niagara Health Research Student, is working on a knowledge mobilization strategy to disseminate this toolkit across Canada.
During the COVID-19 pandemic, Dr. Tsang, along with a team of researchers in Canada, led by Dr. Fowler from Sunnybrook Health Sciences Centre, obtained a total of $10 million CIHR grant to support the COVID-19 Network of Clinical Trials Networks (NoN).
As part of this work, Dr. Tsang is a member of the COVID-19 NoN Steering Committee and she co-chairs the COVID-19 NoN Community Acute and Critical Care Working Group, with a mandate to increase research capacity and activity in community hospitals across Canada through financial and infrastructural support. Currently, 16 community ICU research programs are being supported by COVID-19 NoN.
Dr. Jennifer Tsang
Dr. Alexandra Binnie
ICU Research Physician Lead and Intensivist, William Osler Health System
During the COVID-19 pandemic, Dr. Tsang led a national survey, funded by the Canadian Critical Care Trials Group (CCCTG) Early Career Research Award, examining the motivating factors, barriers, and facilitators of community ICU participation in COVID-19 clinical trials.
Tsang, JLY., Fowler, R., Cook, D.J., Burns, K.E.A., Hunter, K., Forcina, V., Hwang, A., Duan, E., Patterson, L., Binnie, A (2022). Motivating Factors, Barriers and Facilitators of Participation in COVID-19 Clinical Research: A Cross-Sectional Survey of Canadian Community Intensive Care Units. PLOS One. https://pubmed.ncbi.nlm.nih.gov/35476678/
Dr. Tsang has recently completed a cohort study comparing patient characteristics, outcomes and trial metrics of community ICUs vs academic ICUs participating in the CIHR-funded PROSPECT multicentre RCT. Her work demonstrated that patients enrolled from community ICUs are different from those enrolled from academic ICUs and that community ICUs can conduct clinical trials as well as academic ICUs.
Tsang JLY, Binnie A, Duan EH, Johnstone J, Heels-Ansdell D, Reeve B, Trop S, Hosek P, Dionne JC, Archambault P, Lysecki P, Cirone R, Zytaruk NL, Dechert W, Camargo MP, Jesso R, McMillan E, Panchbhaya Z, Campbell T, Saunders L, Copland M, Kavikondala K, Cook DJ. (2022). Academic and Community ICUs Participating in a Critical Care Randomized Trial: A Comparison of Patient Characteristics and Trial Metrics. Critical Care Explorations. 4(11): e0794. https://pubmed.ncbi.nlm.nih.gov/36419633/
Dr. Tsang is currently leading a national qualitative study, funded by the Physicians’ Services Incorporated (PSI) Foundation, to explore the factors influencing Canadian community ICU involvement in health research. Paige Gehrke, an ICU nurse at Niagara Health, who recently obtained her Master of Science in Nursing Degree from McMaster University, is the lead Research Coordinator on this study. She has interviewed a total of 36 participants thus far. Kian Rego, a Master Student of Madelyn Law and Dr. Tsang, is the Research Student on this study.
In collaboration with Dr. Alexandra Binnie, Dr. Tsang is co-leading a cohort study comparing the characteristics and outcomes of COVID-19 patients cared for in community vs academic ICUs in Ontario. This study is funded by PSI Foundation. Daniel Pestana, research assistant at Algarve Biomedical Centre in Faro, Portugal, is conducting this study under the co-supervision of Dr. Tsang and Dr. Binnie.
In collaboration with Madelyn Law, an Associate Professor at Brock University and the Director of I-EQUIP, Dr. Tsang and Dr. Binnie are co-supervising a Post-Doctoral Fellow, Elaina Orlando, who is also the Research Manager of Niagara Health, on a case study to understand the COVID-19 NoN Community Acute and Critical Care Working Group’s efforts to increase research capacity in Canadian Community Hospitals using the Consolidated Framework for Implementation Research. This study is supported by CIHR through COVID-19 NoN Post-Doctoral Fellowship Fund.
Paige Gehrke, Research Coordinator
Kian Rego, Graduate Student, Brock University; Research Student, Niagara Health
Daniel Pestana, Research Volunteer, William Osler Health System. Research Assistant, Algarve Biomedical Centre, Faro, Portugal
Elaina Orlando, Post-Doctoral Fellow
Dr. Tsang is also a co-investigator for the Life-Threatening Illness National Group (LifTING) Research Training Platform (funded by CIHR). Her role is to provide mentorship and develop training programs for researchers in community hospitals. She is also a member of the Ontario Hospital Association’s Hospital-Based Coordination Working Group with a mandate to build research capacity in Ontario hospitals, including community hospitals.
Most recently, Dr. Tsang obtained external funding from COVID-19 NoN (CIHR) to support a McMaster University undergraduate student to examine the feasibility of using a simplified biological sampling protocol in translational biology study. The goal is to make translational biology study more feasible in community hospitals where there are limits in biological sample processing.
Lastly, Dr. Tsang led an international team of scientists in submitting a CIHR grant application in March 2023 entitled Precision Medicine in Community Acquired Pneumonia (CAP) to examine whether 1) molecular endotypes could predict corticosteroid response in patients with severe CAP, 2) biological sample collection is feasible in community hospitals, and 3) a “simplified” biosampling protocol would generate samples that are adequate for proteomic, transcriptomic and DNA methylation analysis?