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Ontario Medical Review
May 6, 2024
Jessica Smith

From the operating room to newborn care: OMA campaign showcases health-care transformation

New Centred on Care videos feature doctors’ innovative health-care ideas

More than two million Canadians are living with an eating disorder at any given time, but despite the prevalence of the problem, the disorders are often hidden.

They should not be ignored, says Dr. Karen Trollope-Kumar, a family physician and chief medical officer at Body Brave, an online eating disorder clinic based in Hamilton.

“They’re serious, complex, brain-based illnesses and they’ve got really high mortality rates,” she said.

Dr. Trollope-Kumar is one physician in the Ontario Medical Association’s Value of Doctors campaign, featuring the Centred on Care video series, which highlights her clinic and the work of other doctors driving change. The series showcases the innovative solutions of Ontario doctors who are helping change the course of health care. It began last fall with the release of three episodes and continues this spring, with three more, aligning with the OMA’s urgent health-care priorities and solutions.

Dr. Trollope-Kumar is featured in the series’ fourth video, spotlighting her work at the Body Brave clinic. She co-founded and runs Body Brave alongside her daughter, Sonia Kumar, who survived an eating disorder after suffering for eight years.

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This story is part two in a recap series of the campaign videos.

“It was a terrifying experience,” Dr. Trollope-Kumar said. “Getting help for her was so difficult, long waiting lists. Fortunately, over time, she slowly began to get better.”

Team-based care vital to recovery

One of the biggest challenges with eating disorder treatment, she says, is that it’s primarily hospital-based. She believes most people living with an eating disorder need community based care that is available when they need it.

Following her recovery, Sonia phoned her mother one day and suggested they quit their jobs — Dr. Trollope-Kumar was a family physician, and Sonia was an economist — to start an eating disorder clinic. And the Body Brave clinic was born, with a vision to provide community-based support — a health-care solution outlined in the OMA’s Prescription for Ontario: Doctors’ Solutions for Immediate Action report — for people living with eating disorders. 

The clinic, a registered charity, launched in August 2017. Patients don’t pay out of pocket — services are either covered by OHIP or donor-funded.

“Without the whole team, we couldn’t possibly address a condition as complex as eating disorders” — Dr. Karen Trollope-Kumar, family physician and chief medical officer at Body Brave

The COVID-19 pandemic presented a new challenge for Body Brave as demand increased exponentially. The clinic now serves nearly 2,000 people a year. 

The clinic switched to virtual services shortly after the pandemic began, says Dr. Trollope-Kumar. Body Brave harnessed the power of technology in other ways as well, including creating the Recovery Support Program, a suite of online self-help services that includes a self-assessment questionnaire sent within 48 hours to those who reach out for more information. 

Team-based care, another health-care solution highlighted by the OMA, is also vital to Body Brave’s operations. The clinic’s team also includes a social worker, occupational therapists, psychotherapists and dietitians. 

“Without the whole team, we couldn’t possibly address a condition as complex as eating disorders,” Dr. Trollope-Kumar said.

Collaboration needed to balance and optimize care

Also embracing the team-based care model is the Mississauga and western Toronto-based Trillium Health Partners, where family physicians and pediatricians at Credit Valley Hospital are using a collaborative approach to balance pediatric acute care needs with demand for newborn assessments.

The focus of the Centred on Care campaign’s fifth video is Dr. Ali Damji, head of the primary care division at THP, and his colleagues, family physician Dr. Sapna Khosla and pediatrician Dr. Jane Healey, who together launched the Newborn Assessment Team. This novel approach was developed in fall 2022 at THP’s Credit Valley Hospital to address increasing pressures on acute pediatric services.

What is Centred on Care?

The stories shared in our Centred on Care video series are diverse in the specialty featured, patients served, care provided and geographic location shown. In each of the six videos, the physicians and health-care teams featured recognized an unmet need in a population and took it upon themselves to improve the situation. 

Viewers hear from physicians who are leaders in their communities and have introduced innovative solutions to health-system challenges. The doctor-patient relationship is paramount, with physicians providing critical care to their patients, whether they are awaiting surgery, requiring mental health support or living in under-resourced communities.

Watch more of the series
“There were numerous positive outcomes, both for patients and physicians, as well as benefits we didn’t expect” — Dr. Ali Damji, head of the primary care division at Trillium Health Partners

The Newborn Assessment Team was launched less than four weeks after planning began. Early implementation steps included pediatricians running educational sessions for family physicians, and training them to perform newborn assessments.

Working together, the pediatricians and family physicians designed an integrated workflow that enabled the latter to provide shift-based newborn assessment coverage. It also allowed family physicians greater flexibility so they can return to their practices or other clinical activities on the same day, without ongoing patient care responsibilities in the Mother Baby Unit.

“There were numerous positive outcomes, both for patients and physicians, as well as benefits we didn’t expect,” said Dr. Ali Damji.

Pediatricians were freed up to focus on more pressing patient cases, while newborns were assessed and subsequently discharged more quickly. Finally, the program helped connect parents with potential family doctors, “an unexpected but important benefit,” Dr. Damji said.

The approach has become so successful that it’s been implemented permanently at Credit Valley Hospital in Mississauga.

Moving forward, Dr. Damji’s team is looking to expand this approach to other THP hospitals and further leverage the expertise of family physicians to better support and streamline patient care while improving these doctors’ connections with hospitals.

Reimagining the OR to reduce wait times, limit resources

In southwest Ontario, a surgeon and his team have reimagined how their operating room works for select orthopedic and sports medicine surgeries, doubling the number of patients who can be treated in one day.

Wait times for non-urgent orthopedic surgeries have been growing each year. But Dr. Abdel-Rahman Lawendy, an orthopedic surgeon and medical lead at the Nazem Kadri Surgical Centre at London Health Sciences Centre, found a way to reduce the backlog while improving quality of care.

Centred on Care’s final video focuses on how his centre doubled the number of procedures per day. They improved efficiency by focusing on selective low-risk procedures, such as ACL reconstruction or foot surgery, while reducing the number of complex procedures.

“Our optimized approach reduced and used only the equipment, tools and staff required for these types of operations,” Dr. Lawendy said.

This includes ensuring patients interact with only one nurse before and after surgery. Surgical teams are formed based on experience in the surgical procedures offered and are kept together in “tightly knit groups,” he said. “We’re focused on high efficiency while maintaining the highest quality of care.”

Dedicated surgical centres within public hospitals, like the Nazem Kadri Surgical Centre, free up hospital operating rooms for more critical procedures, such as cancer and cardiac surgeries, while addressing the surgical backlog, he added.

“We’re focused on high efficiency while maintaining the highest quality of care” — Dr. Abdel-Rahman Lawendy, orthopedic surgeon and medical lead at the Nazem Kadri Surgical Centre

Dr. Lawendy said patient satisfaction is “very high” with the new model. Research has shown that treating patients in surgical centres using this approach results in decreased wait times, increased patient satisfaction and fewer patient complications post-surgery.

The OMA has been calling for integrated ambulatory centres — surgical centres like Dr. Lawendy’s — in its Prescription series as part of a new model of care and to help eliminate the pandemic backlog of health-care services.

He hopes this innovative approach to non-urgent surgical procedures continues to spread in Ontario to improve the system for everyone.

Jessica Smith is an OMA staff writer.