Doctor’s efforts make community hospitals hubs of healthcare research

Dr. Jennifer Tsang's efforts to grow a national community hospital research network continue to gain momentum while raising the profile of research at Niagara Health.

Niagara Health is at the forefront of healthcare research among community hospitals thanks to the tenacity of Dr. Jennifer Tsang, who is heading up a national effort to inspire medical research beyond academic settings.

Dr. Tsang, Physician Research Lead, Intensivist and Physician Co-Lead, Critical Care Research Program, has recruited community hospitals in eight provinces and counting to be part of a national network that gives more people access to clinical trials while growing the body of healthcare research that doctors around the world can refer to when treating patients.  

“We started small but it’s grown massively,” Dr. Tsang says. “It’s such a simple idea but no one ever thought about a national research network because community hospitals aren’t academically oriented. Some are totally focused on delivery of service and don’t feel research is their domain but the work my team and I are doing has gotten lots of traction over the past few years.”

Meanwhile, Dr. Tsang’s work has made Niagara Health a leader in healthcare research happening outside of academic hospitals while creating greater equity in healthcare. 

“If you only provide research in academic hospitals in major urban areas, people in smaller or rural centres never get the chance to be part of clinical trials,” Dr. Tsang says. “If you don’t have research in community hospitals, you’re creating healthcare inequity. Healthcare research shouldn’t be considered an ivory tower activity.”

Dr. Tsang’s efforts to build a national network date back to 2019, when she initiated the creation of the Canadian Community Intensive Care Unit (ICU) Research Network (CCIRNet) with the support of Niagara Health leadership. The initiative raised the profile of research being done at community hospitals and the need for more.

Historically, most medical research has been conducted in academic hospitals in larger centres. But more than 90 per cent of hospitals in Canada are community hospitals, she notes.

“Most patients receive care in community hospitals. If research is only done in academic hospitals, we’re missing out on so much research potential and slowing down research,” Dr. Tsang says.

Patients in academic hospitals aren’t always representative of the general population, impacting research findings, she adds.  

Additionally, community hospital research can target health issues unique to a particular region; for example, developing a Care for Older Persons Research Program in Niagara, where nearly 24 per cent of the population is 65 or older. In comparison, older adults represent, on average, 19 per cent of the population elsewhere in Canada.

“We want to improve outcomes for patients,” Dr. Tsang says. “That’s really the goal.”

Dr. Tsang has published multiple papers on the importance of community hospital research, in addition to participating in multi-centre COVID-19 studies that informed healthcare practices throughout the pandemic.

She has also obtained significant grants in the past five years to support research at network hospitals. Dr. Tsang was part of multiple national research teams that secured 24 grants totalling more than $50 million from the Canadian Institutes of Health Research (CIHR) to conduct clinical trials across Canadian sites, including Niagara Health. That money was also used to expand research capacity at Niagara Health and within other community hospitals.

In addition, Dr. Tsang has brought in more than $1 million in external funding to Niagara Health through clinical trial revenue and Physicians’ Services Incorporated Foundation grants to support the addition of six research staff, including senior research and qualitative research co-ordinators, a part-time post-doctorate fellow and three research assistants.

Dr. Tsang has spoken at several national and international conferences and been part of panel discussions promoting the importance of community hospital research and building a national network, all while raising the profile of Niagara Health among clinicians keen to satisfy their own research interests and be part of important quality improvement work.

Establishing community hospitals as research hubs shows future clinicians they can enjoy a career of research outside of academic hospitals, she says.

“There’s a lot of work being done externally that’s putting Niagara Health at the national forefront. People know Niagara Health. They know Niagara Health is a research centre,” Dr. Tsang says. “We’re trying to get the word out there so that more academically oriented clinicians will go to community hospitals.”