New Collaborative Will Improve Respiratory Care - CFHI and Boehringer Ingelheim Partner to Spread INSPIRED Approach to COPD

Dr. Graeme Rocker, Clinical Improvement Advisor at the Canadian Foundation for Healthcare Improvement and lead for Halifax-based Capital Health's INSPIRED Approaches to COPD Care program, with a patient (CNW Group/Canadian Foundation for Healthcare Improvement)

OTTAWA, April 15, 2014 /CNW/ - The Canadian Foundation for Healthcare Improvement today launched a pan-Canadian collaborative focused on improving care for patients with chronic obstructive pulmonary disease (COPD), supported by Boehringer Ingelheim (Canada) Ltd. (BICL). The collaborative will assist healthcare organizations to adapt and implement an innovative approach to COPD developed at Capital Health, Nova Scotia, that helped improve patient care, support families and caregivers, significantly reduce the use of acute care services and lower costs.

"Our Government is committed to supporting innovative partnerships that improve care for patients," said the Honourable Rona Ambrose, Federal Minister of Health. "Through funding for the Canadian Foundation for Healthcare Improvement, we are helping healthcare organizations across the country implement best practices in COPD care via this unique partnership."

INSPIRED (Implementing a Novel and Supportive Program of Individualized Care for patients and families living with Respiratory Disease) is a hospital-to-home, coordinated and proactive approach to care and advanced COPD. The program provides patients and their families with self-management education, psychosocial and spiritual care support and advance care planning. Six months after enrolment in the program at Capital Health's Queen Elizabeth II Health Sciences Centre, INSPIRED patients' ER visits, hospitalizations and lengths of stay fell by more than 60 percent. In 2014, INSPIRED received an Accreditation Canada Leading Practice designation as a noteworthy example of high-quality leadership and service delivery in COPD care.

"INSPIRED is an innovative way of providing better patient care that is also more cost effective," said CFHI President Maureen O'Neil. "CFHI is pleased to be working with our Clinical Improvement Advisor, Dr. Graeme Rocker and Boehringer Ingelheim to help spread this approach to COPD care."

Respirologist and CFHI Clinical Improvement Advisor Dr. Graeme Rocker, Respiratory Therapist Ms. Joanne Michaud-Young and Spiritual Care Practitioner Dr. Cathy Simpson developed and implemented INSPIRED after noting that current models of care were largely reactive, under stress and failing, with significant costs to patients, families and the healthcare system.

"This program restores the dignity of the patient and family during late stages of COPD and through end-of-life care," said Dr. Rocker. "We are delighted to have the opportunity to share our successful experience with others through CFHI's novel collaborative."

COPD is the fourth-leading cause of death in Canada and a primary cause of hospital visits. Based on recent estimates, COPD exacerbations cost Canadian healthcare systems more than $750-million a year, not including routine care.

"Boehringer Ingelheim is pleased to be a part of this unique program that will address the underlying unmet needs of patients and their families living with moderate to severe COPD," said Richard Mole, President and CEO, Boehringer Ingelheim (Canada) Ltd. "This program will offer a fully integrated approach to COPD care and support while also improving the patient experience."

Under the partnership agreement, BICL will provide direct funding to CFHI to support the collaborative. The partnership will enable teams to take advantage of educational resources and other capacity building supports. In addition, CFHI and BICL will partner with the Alberta-based Institute of Health Economics (IHE) to undertake complementary policy and economic analyses.

CFHI is providing funding and other support to help teams from across Canada implement INSPIRED-like approaches to COPD care. This is the second of two collaboratives in CFHI's recently launched Spreading Healthcare Innovations Initiative. The first collaborative focuses on reducing inappropriate antipsychotic medication use in long term care.

The Canadian Foundation for Healthcare Improvement is a not-for-profit organization dedicated to accelerating healthcare improvement for Canadians. With a $10 million annual federal investment, CFHI supports the development of innovations that could save provincial-territorial healthcare budgets over $1 billion per year. CFHI is funded through an agreement with the Government of Canada.

http://www.cfhi-fcass.ca/Elearning/spreading-healthcare-innovations-initiative/inspired-approaches-to-copd

FACT SHEET

INSPIRED Approaches to COPD: Improving Care and Creating Value

ABOUT THE COLLABORATIVE

INSPIRED Approaches to COPD: Improving Care and Creating Value is the second collaborative in CFHI's Spreading Healthcare Innovations Initiative. These collaboratives bring together organizations to make sustainable changes that improve patient experience and outcomes, better coordinate approaches to complex health needs and maximize healthcare efficiencies. CFHI, in partnership with Boehringer Ingelheim (Canada) Ltd. (BICL), will provide approximately ten healthcare organizations with funding, coaching, educational materials and tools, and other support in a quality improvement collaborative aimed at improving care for patients with chronic obstructive pulmonary disease (COPD). COPD is the fourth-leading cause of death in Canada and a primary cause of hospital visits. Based on recent estimates, COPD exacerbations cost Canadian healthcare systems more than $750-million a year, not including routine care.

THE INNOVATION

A team at Nova Scotia's Capital Health, led by respirologist and CFHI Clinical Improvement Advisor Dr. Graeme Rocker, Respiratory Therapist Ms. Joanne Michaud-Young and Spiritual Care Practitioner Dr. Cathy Simpson, developed and implemented the INSPIRED (Implementing a Novel and Supportive Program of Individualized Care for patients and families living with REspiratory Disease) model of care. INSPIRED takes a new, proactive approach to care and advanced COPD. By responding to the underlying unmet needs of patients and families living with moderate to severe COPD, INSPIRED delivers more holistic patient care, supports family caregivers and reduces reliance on hospital-based care. Through INSPIRED, patients and families receive self-management education, psychosocial and spiritual care support and advance care (end-of-life) planning. Six months after enrolment in the program at Capital Health's Queen Elizabeth II Health Sciences Centre, INSPIRED patient and family experiences of care improved and patients' ER visits fell by 62 percent, hospitalizations fell by 64 percent and days in hospital fell by 63 percent. The reduction in hospitalizations saved an estimated $900,000 in COPD care - more than three times the annual operating costs of the INSPIRED program. In 2014, INSPIRED received an Accreditation Canada Leading Practice designation as a noteworthy example of high-quality leadership and service delivery in COPD care.

ABOUT THE PARTNERSHIP WITH BOEHRINGER INGELHEIM (CANADA) INC.

Under the partnership agreement, CFHI is responsible for facilitating the INSPIRED collaborative and will work in partnership with BICL to leverage expertise, assets and outreach to support the planning, implementation and post-collaborative phases. BICL will support the collaborative through $500,000 in direct funding to CFHI. BICL will also make a variety of educational and capacity-building supports available to teams should they wish to avail themselves of these resources, including BICL's Health Care Affairs Managers. In addition, CFHI and BICL will partner with the Alberta-based Institute of Health Economics (IHE) to undertake complementary policy and economic analyses.

The partners have agreed that this collaborative and the financial support will not be used to promote directly or indirectly any specific medications or therapies. They will also uphold Canada's Research-Based Pharmaceutical Companies (Rx&D) Code of Ethical Practices 2012. In doing so, the partners seek to set a new standard for a unique public, not-for-profit and private sector partnership that will improve healthcare for Canadians.

ELIGIBILITY  

Canadian healthcare organizations that provide care to COPD patients are eligible to apply. Participating organizations may need to reach beyond their usual boundaries to develop multi-stakeholder partnerships. Further details are available in the Prospectus for this 12-month collaborative.

FUNDING

CFHI is providing seed funding of up to $500,000 (total funding envelope) among approximately 10 sites (about $50,000 per team) for direct costs related to adapting and implementing the INSPIRED-like model of care. CFHI, in partnership with BICL, will also provide support to teams in the development and implementation of their spread plans through faculty and staff.

ABOUT THE FACULTY

Core Faculty & Staff

Graeme Rocker Lead Faculty MA, MHSc, DM, FRCP, FRCPC, is a Professor of Medicine at Dalhousie University, Halifax, Nova Scotia, Former Head of the Division of Respirology at Capital Health (2006-2014) and is CFHI's first-ever Clinical Improvement Advisor. He has authored more than 150 original manuscripts and book chapters, bringing extensive clinical and management expertise in the areas of end-of-life care, palliation, dyspnea (breathlessness) in patients with advanced COPD and support for their informal caregivers. Dr. Rocker received the 2009 Roger Bone Award from the American College of Chest Physicians for advances and leadership in end of life care. He is the medical director of the INSPIRED community-based outreach program in Halifax for patients and families living with advanced COPD. Dr. Rocker works with CFHI as an improvement coach in the Atlantic Healthcare Collaboration and Triple Aim Improvement Community.

Catherine Simpson PhD, MDiv, MA, BA, is a founding member of the INSPIRED COPD community outreach team. She is currently responsible for facilitating home-based, psychosocial-spiritual support, and advance care planning for those living with advanced COPD. She also works part-time as a health ethics consultant for the Nova Scotia Health Ethics Network (NSHEN) housed within the Department of Bioethics at Dalhousie University, Halifax, NS. NSHEN's mandate involves working with provincial healthcare organizations to strengthen ethics capacity. Her past experience includes work in the areas of pediatric health promotion, continuing medical education, healthcare chaplaincy, and a stint as coordinator of the Clinical Ethics Consultation component of Capital Health Ethics Support service. Ongoing ethics and practice interests include the role of hope in healthcare, the ethics of patient- and family-centred and exploring new models of non-siloed, multi-disciplinary, co-operative care.

Terrence Sullivan PhD Professor, Department of Health Policy
University of Toronto, is the independent board chair of the Canadian Agency for Drugs and Technologies in Health (CADTH). He also chairs the board of Public Health Ontario (the Ontario Agency for Health Protection and Promotion). From 2001 to March 2011 he occupied successively responsible positions at Cancer Care Ontario (CCO), the final seven years as President and CEO during which period the entire organization transformed its business model to performance measurement and improvement of cancer services.

Kaye Phillips PhD, Senior Director of Evaluation and Performance Improvement, Canadian Foundation for Healthcare Improvement, Ottawa, Ontario.

Jennifer Verma CFHI Lead MSc, BJH, Senior Director Collaboration for Innovation and Improvement, Canadian Foundation for Healthcare Improvement, Ottawa, Ontario.

Guest Faculty

Jean Bourbeau MD, MSc, is respirologist and full professor in the Department of Medicine and Epidemiology & Biostatistics, McGill University. He is the director of the Respiratory Epidemiology and Clinical Research Unit (RECRU) and the Pulmonary Rehabilitation Unit at the Montreal Chest Institute of the McGill University Health Centre (MUHC), and the director of the COPD axis of the Respiratory Network of the FRQS, Quebec, Canada. He is the president of the Canadian Thoracic Society (CTS) and the president of the board of the Reseau quebecois en asthme et MPOC (RQAM). He is also on the executive committee and chair the Dissemination & Implementation committee of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). His areas of research and expertises are in COPD, Rehabilitation and Disease and Self-management, Health and Behavior, Clinical Evaluative Research and Applied Research. He holds funds from the FRQS, the Canadian Institute of Health Research (CIHR) and the industry as Investigator-initiated projects. His research includes large epidemiological study in COPD (Canadian Cohort of Obstructive Lung Disease "CanCOLD") and evaluative research projects with respect to new approaches in disease management applied to different COPD populations and environments of practice including primary care. He has over 200 publications in peer review journals, book chapters and a book in COPD. His work and research, particularly in COPD, Pulmonary Rehabilitation, Disease and Self-Management in COPD (Living Well with COPD website: www.livingwellwithcopd.com) has not had impact only in research but also in the clinical practice and the public domain worldwide.

James Downar MD, is a critical care and palliative care physician at the University Health Network in Toronto. He completed medical school at McGill University, and residency programs in Internal Medicine, Critical Care, and Palliative Medicine at the University of Toronto. He also completed a Master's degree in Bioethics at the Joint Centre for Bioethics at the University of Toronto. His current academic interests focus on communication and decision-making for seriously ill patients, palliative care for non-cancer illnesses, and palliative care in the critical care environment.

Darcy D. Marciniuk MD, FRCPC, FCCP, is a Professor of Medicine in the Division of Respirology, Critical Care, and Sleep Medicine at the University of Saskatchewan, Saskatoon, SK, Canada. Dr. Marciniuk received his Doctor of Medicine from the University of Saskatchewan where he assumed his current faculty position with the University of Saskatchewan. His interests include COPD, clinical physiology, pulmonary rehabilitation and chronic disease management. Dr. Marciniuk is recognized internationally as an expert and leader in his field, with more than 250 invited national and international presentations. He has published more than 120 peer-reviewed publications, chapters, and reviews. Dr. Marciniuk is the immediate Past-President of the American College of Chest Physicians (ACCP), and the first from outside the United States in the 78-year history of the organization, the largest respiratory society in the world. He is also a Trustee of the Chest Foundation, and a board member of the Lung Health Institute of Canada. Dr. Marciniuk has served as a founding Steering Committee member of Canada's National Lung Health Framework (2007-2011), Chair of the Royal College of Physicians and Surgeons of Canada Respirology Examination Board (2004-2007), Chair of the Forum of International Respiratory Societies (2012-2013) and President of the Canadian Thoracic Society (CTS) (2006-2007). Dr. Marciniuk has been the lead author of the three most recent COPD clinical practice guidelines published by the CTS, a panel member of international clinical practice guidelines in COPD and cardiopulmonary exercise testing, and is a current panel member of a joint CTS/ACCP clinical practice guideline on preventing acute exacerbations of COPD. Dr. Marciniuk was the Medical Lead of the Inspire COPD Program (2002-2005) and the LiveWell Chronic Disease Management Program (2005-2012), and continues to serve as Medical Director of the LiveWell Optimizing COPD Program. Dr. Marciniuk has been bestowed with the Distinguished Scientist Honor Lecture by the ACCP (2011), the Founder's Award by the Canadian Lung Association (2013), and the 2013 Distinguished Researcher Award by the College of Medicine, University of Saskatchewan.

R. Sean Morisson MD, FAAHPM, is Director of the National Palliative Care Research Center, a national organization devoted to increasing the evidence base of palliative care in the United States. He is also the

Director of the Hertzberg Palliative Care Institute; Professor of Geriatrics and Medicine; and Hermann Merkin Professor of Palliative Medicine in the Brookdale Department of Geriatrics and Palliative Medicine at the Mount Sinai School of Medicine in New York City. During 2009-2010, he served as President of the American Academy of Hospice and Palliative Medicine.

ABOUT THE SPREADING HEALTHCARE IINNOVATIONS INITIATIVE

The Spreading Healthcare Innovations Initiative is focused on taking promising practices in healthcare delivery and spreading them more widely. The Initiative to date is comprised of two collaboratives, each focused on helping healthcare organizations implement a practice that has demonstrated success at improving patient care in another organization.

ABOUT CFHI

The Canadian Foundation for Healthcare Improvement is a not-for-profit organization dedicated to accelerating healthcare improvement for Canadians. With a $10 million annual federal investment, CFHI supports the development of innovations that could save provincial-territorial healthcare budgets over $1 billion per year. CFHI is funded through an agreement with the Government of Canada.

Visit www.cfhi-fcass.ca/innovation for more information.

SOURCE Canadian Foundation for Healthcare Improvement

Image with caption: "Dr. Graeme Rocker, Clinical Improvement Advisor at the Canadian Foundation for Healthcare Improvement and lead for Halifax-based Capital Health's INSPIRED Approaches to COPD Care program, with a patient (CNW Group/Canadian Foundation for Healthcare Improvement)". Image available at: http://photos.newswire.ca/images/download/20140415_C9817_PHOTO_EN_39226.jpg

For further information:

Paulette Roberge
Senior Communications Specialist
Canadian Foundation for Healthcare Improvement
W: 613-728-2238 ext. 288
C:  613-790-1070
E: paulette.roberge@cfhi-fcass.ca