Transforming Healthcare - Sunnybrook Hospital · vision of transforming healthcare. Through our research programs and ongoing partnership with the Centre for Research in Women’s

Strategic Plan

Transforming Healthcare:

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Table of ContentsWhen it Matters Most

A Message from Leadership

Our Vision

Our Strategic Goals

Health System Leadership Priorities

Our Strategic Programs

Our Education Priorities

From Research to Transformation

Breast Cancer

Prostate Cancer

Colorectal Cancer

Stroke

Dementia

Interventional Cardiology

Perinatal and Reproductive Research Unit Our Committment to Making Healthcare Better

Printed May 2006

Sunnybrook is there for you when it matters most. Our

programs in cancer, cardiovascular, musculoskeletal, perinatal

and gynaecology, neurosciences, aging and population health,

and trauma and critical care have more than one million patient

visits each year.

Sunnybrook is fully affiliated with the University of Toronto and each

year offers rewarding educational experiences for more than 2,600

students and is home to 600 scientists who annually conduct over

$80 million in research.

Sunnybrook Health Sciences Centre has a strategic emphasis on

programs in women’s health and aging and is proud to be home to

Canada’s largest veterans’ residence, which cares for more than 500

of our country’s war heroes.

Sunnybrook Health Sciences Centre: When it Matters Most

When you’re steps away from losing your independence

When you’ve beentold you have cancer

When knowing makes all the difference

When you know in your heart something is wrong

When your car spins out of control

When the next discovery means a cure

When it’s gone in a stroke

When your baby is 16 weeks premature

When your grandpa says he loves you

When does itmatter most?

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When a community looks to you for care

A Message from LeadershipThrough the implementation of our strategic plan, we are continuing our successful multidisciplinary approach to teaching and research. We will be rolling out a new Centre for Health Services Sciences that will house four key research platforms including clinical epidemiology, clinical trials, knowledge translation and health service/systems research. Together, these areas will lead Sunnybrook’s applied research agenda and be dedicated to generating new knowledge for the healthcare system as a whole.

In addition to defining our strategic academic and clinical programs, we have set out in this document Sunnybrook’s commitment to becoming a national leader in safety practices, waitlist management, the application and development of eHealth technologies, and performance management. These initiatives will act as enablers to our strategic programs to ensure we become one of the safest hospitals in Canada, while maintaining our accountability and improving our ability to respond to the changing needs of the many communities we serve.

Our strategic plan will see the organization encounter new horizons as we pursue our vision of transforming healthcare. There is an exciting future ahead for Sunnybrook and this document represents a snapshot of where we are today and a road map for our future. We look forward to sharing our success with you.

Sincerely,

Virginia McLaughlin Chair, Board of Directors

Leo StevenPresident and CEO

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Thank you for your interest in the strategic directions and priorities of Sunnybrook Health Sciences Centre. Through an extensive process, we have defined the

hospital’s areas of excellence and focus for the future. In this document, you will discover how we are transforming healthcare and why Sunnybrook is one of Canada’s most dynamic academic health sciences centres.

This past year has been full of opportunity. In August of 2005, the Honourable George Smitherman, Minister of Health and Long Term Care, set out a three-point plan for our organization that would improve healthcare for women, reduce wait times for hip and knee replacements, create a state-of-the-art facility for high-risk pregnancies and critically-ill newborns, and improve access for emergency care. From the Minister’s August announcement Sunnybrook Health Sciences Centre is emerging as a strong and vital component of the Ontario healthcare system. We will be doubling the size of our emergency department and regional trauma centre, and adding four floors on top of M-wing at the Sunnybrook Campus to provide a state-of-the-art home for the perinatal and gynecology program currently located at Women’s College, which will include a new neo-natal intensive care unit and labour and delivery suites. M-wing will also be home to new facilities for leading-edge research in cardiac imaging and intervention, Canada’s most comprehensive breast cancer centre, the Toronto Angiogenesis Research Centre, and world-leading research programs in regenerative medicine and neurosciences. In addition we are creating a centre of excellence in hip and knee replacement surgery at the Holland Orthopaedic & Arthritic Centre that will nearly triple its surgical procedures over the next three years to become the largest program of its kind in North America.

Sunnybrook plays a unique role in the Ontario healthcare system. In addition to serving our surrounding community, many of the hospital’s programs provide highly specialized care for people throughout Ontario. Our seven strategic programs – Cancer, Cardiac, Musculoskeletal, Neurosci-ences, Perinatal and Gynaecology, Trauma and Critical Care, and Aging and Population Health – are recognized for their leadership in the research they conduct, the educa-tional opportunities they offer and the care they provide.

Sunnybrook has taken a further step within our strategic programs to identify seven transformation priorities that have international research preeminence. These priorities in breast, prostate and colorectal cancer, interventional cardiology, stroke, dementia, and perinatal and reproductive health, are conducting breakthrough work that is helping to redefine the delivery of healthcare both across Canada and around the world.

Through our strategic programs and transformation priori-ties, Sunnybrook is taking a leadership role in improving the health of women and our aging population including our ongoing role in providing care for Canada’s war veterans. Women’s health and aging are strategic themes for Sunnybrook that are found in the patient-care, research and teaching components of all of our programs and services.

As an academic health sciences centre, Sunnybrook is fully affiliated with the University of Toronto and our academic mission remains a core expression of our organization’s purpose in the healthcare system. Our research enterprise is growing exponentially and each year more than 2,600 students from a wide variety of health professions choose Sunnybrook for their educational experience.

Transforming healthcare is a lofty ambition but it is one that is confidently rooted in our unyielding desire to make healthcare better.

Better not only for our patients – which we will do – but better for patients everywhere. Sunnybrook Health Sciences Centre is fully affiliated with the University of Toronto, which provides the hospital with an academic mandate to conduct breakthrough research and teach new health professionals the latest advances in patient care. As a leading academic health sciences centre, Sunnybrook is committed to trans-forming healthcare by fostering a culture of inquiry among our staff, physicians, educators, and scientists that challenges the status quo and sets new standards of patient care.

Excellence in an academic health sciences centre should be an expectation, not a goal. Accordingly, we are committed to achieving excellence in all that we do. Our mandate can only be attained by continually asking ourselves: How can we improve care for our patients, and how do we transform the delivery of healthcare today and everyday?

To transform healthcare, we must transform ourselves. Sunnybrook cannot be all things to all people. Accordingly, we will focus on the things we do best, and we will provide leadership in the healthcare system in those areas where we believe we can make a difference. As we implement the strategic directions in this document, we will transform our organization into a more focused academic health sciences centre, with programs that are aligned with the changing needs of our healthcare system. Throughout this process, Sunnybrook will discover better ways to deliver health-care to the communities we serve, and we will share best practices with our fellow healthcare providers to improve the entire system.

Sunnybrook will lead in areas critical for health system transformation. We will promote and demonstrate the safest clinical practices. We will commit ourselves to wait-time reporting and waitlist management for our priority areas. We will use information and eHealth technologies to enhance the delivery of care and build relationships among care providers, researchers, edu-cators and patients. We will evaluate and report on our performance to ensure transparency and accountability and we will uphold the principles of patient-focused care to involve our patients and their families in making decisions about the care they receive.

Our vision is bold. Our focus is clear. We will focus on those things that matter most to making healthcare better.

Sunnybrook will transform healthcare.

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Our Vision: “Sunnybrook Will Transform Healthcare.”


Health System Leadership Priorities

The capacity to discover new knowledge, translate that knowledge into new opportunities, and then apply that knowledge into developing new models of care is critical to transforming healthcare. Sunnybrook has a leading role to play in improving healthcare, whether it is in caring for patients, developing priority science, training healthcare professionals, or applying new tools and approaches to improve healthcare to the populations we serve.

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Our Strategic GoalsOur vision and our strategic directions are based on our commitment to make healthcare better for patients. To realize our vision, Sunnybrook must remain focused on strategic goals that will guide our activities and be universal to everything we will do in the future. These goals will manifest themselves in every aspect of our organization and will act as the key drivers for us to realize our mission and ultimately achieve our vision of transforming healthcare.

The following goals reflect our dedication to the application of knowledge, to innovations in the delivery of care and its expression in the activities of primary research through to the use of best practice at the bedside. This is our commitment to our patients, our community, and to the healthcare system in improving healthcare for patients everywhere.

Sunnybrook’s strategic goals are:

Quality of Patient Care:1. Lead in innovative care experiences that improve outcomes for our patient populations. 2. Lead in safety best practices.3. Lead provincially and nationally in managing the care of critically ill patients. Research and Education:4. Lead in the creation, translation and application of knowledge into clinical best practice.5. Focus our strategic programs to ensure the development of transformation priorities that are recognized globally. 6. Lead nationally in the education of healthcare professionals. Sustainability and Accountability:7. Lead in performance measurement and management, including financial management and wait-times.8. Become the healthcare workplace of choice.

Sunnybrook’s commitment to women’s health is reflected in our mission and values and is critical to enabling our vision of transforming healthcare. Through our research programs and ongoing partnership with the Centre for Research in Women’s Health (CRWH), Sunnybrook is committed to conducting research that is relevant and useful in today’s healthcare context. This commitment will be further enhanced through the planned capital expansion to house our perinatal and gynaecology program at the Bayview Campus, permitting new col-laboration opportunities with other programs/services. As a leader in the clinical care and research of women’s health issues, Sunnybrook continues to help women live longer, healthier lives.

Programs and services that provide care for an aging population and for veterans of Canada’s wars remain a priority for Sunnybrook Health Sciences Centre. Over the last half of the 20th century, Sunnybrook evolved from its early beginnings as a hospital for Canadian veterans to a fully affiliated teaching hospital of the University of Toronto. We are the largest veterans’ care facility in Canada, as well as the only institution in the country to provide a dedicated centre for people with severe behavioural complications due to dementia. Sunnybrook scientists focus on advancing the understanding, prevention and treatment of conditions associated with aging, such as Alzheimer’s disease and other forms of dementia. At Sunnybrook we continue to embrace our responsibility in the care of the elderly and reinforce the gratitude we have for those who helped forge the way of life we enjoy in Canada.

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Our Strategic Populations: Women’s Health and AgingOur patients and our commitment to making healthcare better are at the root of all that we will do.

The last year has marked an important point in the history of Sunnybrook Health Sciences Centre. In August 2005, the Minister of Health and Long Term Care made an unprecedented announcement that helped chart a new course for our organization. That announcement provided the hospital with a four-floor construction project on M-wing at the Bayview Campus that will house our Perinatal & Gynaecology program, including the devel-opment of a new state-of-the-art Neo-Natal Intensive Care Unit. The Minister’s announcement also included doubling the size of our Emergency Department, and establishing a Centre of Excellence in hip and knee replacement at the hospital’s newly named Holland Orthopaedic and Arthritic Centre.

Sunnybrook will maintain its commitment to women’s health and continue our unwavering dedication to care for Canada’s war veterans through treatment and research that benefit our strategic populations.

Governments and providers are under greater pressure than ever to meet the expectations of Canadians for improving the healthcare system. Canadians want and need a more accountable healthcare system. Proving that healthcare services are improving is at the core of Sunnybrook’s approach to performance management. Sunnybrook will achieve this goal when we are reporting regularly to stakeholders on our performance in opera-tional and strategic areas, and when we have the internal information management infrastructure necessary to provide near real-time data to our Board, leadership and management teams to support decision-making that improves the delivery of care.

Our goal is to be viewed as a recognized leader in corporate accountability and management by government, the Ministry of Health and Long-Term Care (MOHLTC), our affiliated local health integration network (LHIN) partners, and most importantly, our patients. To accomplish this goal, we will:

• Measure, monitor, and manage progress onstrategic goals;

• Measure, monitor and manage clinical and operational efficiency and effectiveness;

• Proactively report objectives and progress to our internal and external stakeholders; and

• Invest in our information infrastructure to deliver a transparent and up-to-date evaluation of our progress.

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Accountability: Performance ManagementSunnybrook will lead in hospital performance measurement and management.

Quality: Safety Sunnybrook will lead in safety best practices.

With the publication of the first comprehensive study on patient safety in Canada by Baker & Norton in 2004, the reality of patient safety issues in Canadian hospitals is becoming evident. At Sunnybrook, we believe that patients entering the healthcare system should have the safest care possible. We take the responsibility for patient safety seriously, and we are committed to doing our part to help others in the system address these issues. We will also commit ourselves to the safety of our staff and those who aid in the delivery of care to our patients.

Sunnybrook will lead safety best practices by building on our strengths in this area. Our Patient Safety Service is the first of its kind in Ontario. It is focused on incor-porating patient safety measures into organizational operations and in support of our clinical services. The Institute for Safe Medication Practices (ISMP) Canada, an independent non-profit agency established for the collection and analysis of medication error reports and the development of recommendations for the enhance-ment of patient safety, is located at the Sunnybrook Campus. We will take advantage of this important partnership to address the issues that – together with

ISMP – will have Sunnybrook acting as the testing ground for patient safety practices toward creating Canada’s first comprehensive patient safety program.

Our goal is to be the viewed as the national leader in patient and staff safety practices and lead safety improvement initiatives for the country. To accomplish this goal, we will:

• Promote the safe provision of care and service;• Establish an incident investigation culture that • will focus on the identification of opportunities,

rather than on blame or punishment;• Leverage our clinical information systems

infrastructure to provide real-time error management capabilities to our physicians at the point of care;

• Create and share knowledge and models of care that will contribute to safe patient care across the country; and• Educate the next generation of healthcare

providers on safe clinical practices and protocols.


Our StrategicPrograms

Sunnybrook Health Sciences Centre will focus on delivering care, educating the next generation of health professionals, and creating and applying knowledge through targeted research initiatives established by our strategic programs in cancer, cardiac, aging and population health, musculoskeletal, neurosciences, perinatal and gynaecology, and trauma and critical care.

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Creating Access: Wait-Time Management Sunnybrook will become the national leader in hospital wait-time monitoring and management for our targeted priority areas.

Sunnybrook is committed to comprehensive wait-time reporting and waitlist management for key areas of sur-gical and diagnostic activity as required by the MOHLTC. Wait-time management is perhaps the best example of our effort to focus on improving the effectiveness of the delivery of clinical services. We believe that our approach to waitlist management will ensure improved efficiency and effectiveness for Sunnybrook and the healthcare system. In an era of constrained resources and capacity, Sunnybrook regards the management of waitlists as not only essential, but as representing an area of excellence in which we are prepared to lead and implement best practices for the wider healthcare community.

Our goal is to create a comprehensive wait-time strategy that will coordinate services related to Sunnybrook’s program areas, provide retrospective analyses of service wait times for internal and external audiences, and provide real-time decision support for clinicians at the point of care. To accomplish this goal, we will:

• Commit to the development of comprehensive• wait-time reporting and waitlist management• for key areas of surgical and diagnostic activity;• Integrate wait-time reporting and waitlist • management tools to ensure managers and • clinicians have up–to-date information to make • clinical decisions that are in the best interests • of our patients; and• Focus on efficiency and effectiveness in • the delivery of clinical services to address • individual patient needs while ensuring overall • efficiency and effectiveness for the local • and provincial healthcare systems.

Information: eHealthSunnybrook will use information technology to improve the delivery of care and build relationships among providers, researchers, educators and patients.

As an academic health sciences centre, information is at the core of all that we do: to support clinical decision-making, to support our strategic research priorities, to educate and train the next generation of clinicians and to manage care well beyond our walls. Sunnybrook’s eHealth program will provide a powerful opportunity to improve the quality of care and services we provide and to explore new dimensions of the patient-provider relationship.

Our goal is to explore models of care and extend our expertise to our patients and partners in the broader health system. To accomplish this goal, we will:

• Develop a continuity of care record to strengthen • the relationship with our patients and regional • opportunities with our partners; • Create a virtual health sciences centre by • leveraging our information, knowledge and • telehealth systems;• Enhance patient self-management through • web-based technologies to create linkages • between our internal systems and our • continuity of care record; and• Enhance our decision support and data • infrastructure to support our patient safety, • performance and wait-time management • initiatives.

NeurosciencesSunnybrook is committed to integrating health disciplines to research, diagnose and treat disorders of the brain, mind and central nervous system.

The multidisciplinary Neurosciences strategic program includes a range of health disciplines in the fields of neurosurgery, neurology, psychiatry, psychology and geriatric medicine. In particular, the program has clinical and research expertise in the areas of neurodegenerative disorders, mood disorders, brain tumours and traumatic brain injury with particular priority placed on stroke. Sunnybrook’s Neurosciences Program aims to create a new breed of clinical neuroscientist, through education and research that fosters improved skills and expertise in understanding and managing neuroscience-based disorders that influence affect, behaviour and cognition. The program is pioneering new interventions and imaging analysis techniques to optimize stroke recovery and characterize in detail the anatomical damage and effects on connectivity between parts of the brain and brain status changes that influence rehabilitation, recovery and restoration.

Trauma & Critical CareProviding the best possible care to patients most at risk is the driving force behind the work of Sunnybrook’s Trauma and Critical Care Program.

Trauma and Critical Care is the amalgamation of our trauma, critical care and emergency services which are dedicated to providing high-quality, patient-focused care to patients most at risk. With more than one-third of all trauma service patients served though our critical care units, the program investigates novel therapies and ventilatory and resuscitation strategies to enhance the recovery of patients at the most critical of times. Coordination of a multidisciplinary team is the hallmark of the clinical expertise within this program, which covers the spectrum of care from prevention to rehabilitation. The program also has regional roles in dealing with acute spi-nal cord injury and, through the Ross Tilley Burn Centre, provides care to the majority of major burn injury patients in the province, including wound healing, critical care following burns, burn surgery, burn prevention, psycho-social issues, and rehabilitation.

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Cancer (Toronto SunnybrookRegional Cancer Centre)Toronto Sunnybrook Regional Cancer Centre (tsrcc) makes a difference by delivering precise diagnoses, accurate tumour assessments, new surgical tech-niques and effective individualized treatments.

For more than 25 years, TSRCC has been home to one of Canada’s most comprehensive cancer prevention, research, teaching and treatment programs. As one of North America’s largest cancer centres, multidisciplinary teams at TSRCC provide integrated services in radiation, and medical and surgical oncology, among others. Each disease site within cancer has an interdisciplinary site group, which offers multidisciplinary patient care and engages in a spectrum of research activities. These world-leading research initiatives comprise basic, trans-lational and clinical science, and focus on everything from prevention through to palliation. The TSRCC has developed particular expertise in the areas of breast cancer, genitourinary (urinary tract and bladder- related) cancers, hematological (blood) cancers and gastrointestinal-related malignancies. The TSRCC serves Toronto and the surrounding areas and provides highly specialized tertiary and quaternary services for more than 229,000 patient visits per year.

Cardiac (Schulich Heart Centre)Minimizing the effects of heart disease, and developing and applying heart disease interventions, are at the core of all that we do at the Schulich Heart Centre.

Named to honour Dr. Seymour Schulich, the Schulich Heart Centre is a national leader and one of the largest cardiac care centres in Ontario. It handles more than 6,500 surgical, catheterization, angioplasty and pacemaker cases annually. This renowned centre provides multidisciplinary services in cardiology, cardiac surgery and vascular surgery. It has particular clinical and research expertise in interventional cardiology, including minimally invasive heart procedures and image-guided surgery; drug and device evaluation; imaging systems development and evaluation; regenerative medicine; and outcomes research in the areas of revascularization and electrophysi-ology. The Schulich Heart Centre delivers a full spectrum of in-hospital and ambulatory cardiovascular care, significantly improving the quality of life for patients with heart conditions in Canada.

Aging and Population HealthThe gateway for our local patient population, Sunnybrook’s Aging and Population Health Program looks at ways to transform healthcare for the benefit of our local community.

Our new Aging and Population Health strategic program represents our continued commitment to our local com-munity. Clinical areas within this new program will be devoted to enhancing the continuum of care and leading the transformation of new models of care and knowledge in conjunction with our other six strategic programs and our partners in the healthcare system.

Within the developing Local Health Integration Network (LHIN) environment, we will create alliances to increase community capacity to develop, and foster, support resources and relationships for chronic disease pre-vention and management at an individual, organizational, and inter-organizational level that minimizes the need for hospitalization and maximizes our ability to provide advanced care to those when it matters most.

Through our family practice clinics and our emergency department, the program will act as one of the main access points for patients who are seeking services from our community, as well as those on-site from our veteran’s long-term care facility. The program will focus on hospital alternative strategies that complement existing specialty services to maximize our ability to deliver care to our patients when needed.

In addition, our applied research will focus on better understanding the factors that impact the health of our communities and help inform the health system of cost effective interventions that support our target populations. Through our new Centre for Health Services Sciences, this program will be devoted to investigating evidence-based healthcare, patient safety and quality, utilization analysis and management, knowledge translation, population health, health informatics, healthcare financing, and clinical trials to determine better ways to deliver the highest quality of care possible to our patients.

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Musculoskeletal (Holland Musculoskeletal Program) Easing pain and restoring mobility is the driving force behind our work in the Holland Musculoskeletal Program.

As one of the largest joint replacement centres in Canada, Sunnybrook is a key referral centre for surgery of the hip and knee joints, including arthroscopic procedures, and is the first government-designated Hip and Knee Centre of Excellence in Canada. The Holland Musculoskeletal Program provides integrated services in orthopaedic surgery, orthopaedic trauma and rheumatology and has particular expertise in the areas of hip, knee, spine, shoulder, upper extremity and rheumatology. A key focus of musculoskeletal research is on gender differences in the incidence of musculoskeletal disease and injury, discrep-ancies in the availability of service related to gender and the impact of gender differences on treatment, rehabilitation and outcome. As a result, many of our musculoskeletal care processes are also designed to address aspects of women’s health and aging, including early discharge planning and managing activities of daily living at home.

Perinatal & GynaecologySunnybrook’s Perinatal and Gynaecology (P&G) Program is focused on helping women live longer, healthier and more fulfilled lives in collaboration with our patients, their families and our healthcare partners.

Mandated by the government to be a leader in women’s health, Sunnybrook’s P&G Program provides Level III maternal and newborn care to the Greater Toronto Area, a mandate shared with Mount Sinai Hospital and the Hospital for Sick Children. Our program provides a com-prehensive scope of services in obstetrics, including services for high-risk mothers and babies, and gynaecology, employing advanced techniques such as laparoscopic surgery for the treatment of many conditions such as endometriosis, urinary incontinence, urogynaecology issues and fibroids. Supported by world-class research in this field, our P&G program is committed to developing skilled professionals focused on conducting research that is relevant and useful in today’s healthcare context.


From Research To Transformation

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As an academic health sciences centre, we take pride in our education and teaching mandate and each year we provide learning opportuni-ties for more than 2,600 students. We respect our traditional, yet evolving, role as a provider of integrated clinical and research training for Nursing, Medicine (medical undergraduates, residents, and postdoctoral clinical and research fellows), as well as students from more than 20 healthcare professions. As a fully affiliated partner of the University of Toronto, Sunnybrook continues to evolve the clinical educational setting in ways that provide an excellent training experience that benefits the hospital, the developing professional and the patients we serve. Sunnybrook is continually evaluating students’ experiences, and the contribution of our clinician leaders, to ensure that our strategic programs maintain a high profile in the education community. We are committed to maintaining leadership standards for education that not only attract the best teachers and students, but also ensures we retain the best candidates after they complete their training.

Professional development and education at Sunnybrook will be a primary driver in our pursuit of transforming healthcare, particularly as patient care becomes increasingly integrated and multidisciplinary across healthcare profes-sions. While clinician roles continue to expand, professional requirements are also becoming more stringent. In response, Sunnybrook will foster a professional learning environment that brings out the best in our dedicated personnel, which extends to our practice-based research approach to advocate for and promote the integration of research, education and clinical practices across our organization. This effort is truly multidisciplinary and represents a systematic approach to creating new and innovative approaches to care.

Sunnybrook also recognizes that knowledge translation throughout the care cycle is a crucial component for ensuring that we are continually learning and improving the delivery of care. To address the increasing demand for services, new approaches will be required to improve clinical effectiveness and efficiency. Only by applying

“best practices,” and discovering and evaluating “better, best practices,” will we will realize our vision of transforming healthcare. This is our commitment to leadership in clinical education – a program of knowledge translation that will directly contribute to the academic mandate of Sunnybrook – using the skills of some of the world’s best teachers and scientists to focus on making Sunnybrook a leading academic health sciences centre among our academic peers and beyond.


Our Education Priorities

From discovery to best practice, research at Sunnybrook Research Institute (SRI) spans the spectrum from basic science to translational research and knowledge transfer into clinical care. Scientists at Sunnybrook strive to understand and prevent disease and develop diagnostics and treatments that enhance and extend life. Research and clinical teams collaborate closely in their shared aim of discovery and its accelerated translation into the clinic to improve patient care.

In our pursuit to transform healthcare, maintain an environment of research and clinical excellence, and support our strategic programs and transformation priorities, Sunnybrook is committed to enabling our academic enterprise through the following initiatives:

Establishing a new Centre for Health Services Sciences (CHSS) that will be dedicated to integrating new knowledge into the health-care system. CHSS will help Sunnybrook to lead the translational research agenda and achieve our mandate as an academic health sciences centre by positioning SRI as a leader in the areas of system analysis, management utilization and evidence-based changes in the delivery of care. CHSS will engage in research activities that strive to reveal the mechanisms of human health and disease, with the aim of translating these findings to the bedside. Research activity will span four platforms: clinical epidemiology, clinical trials, knowledge translation, and health service/systems research.

Integrating ambulatory care across all Sunnybrook campuses and strategic pro-grams, to focus on building best practices and developing new models of care. With ambulatory care activities representing the vast majority of services performed within the healthcare system, and constitut-ing an increasing proportion of Sunnybrook’s activity, the impact of our transformational agenda will ultimately be outside the traditional hospital setting. Sunnybrook believes that an integrated approach to ambulatory care will be at the heart of everything we do, and that a coordinated and consistent approach to ambulatory care across our sites and programs will enhance services to our patients and provide a wider range of service options to them.

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Our role as an academic health sciences centre is to discover, apply, evaluate and translate knowledge, thereby ensuring that the findings we generate will benefit our patients now and in the future. Our strategic program areas of cancer, cardiac, neurosciences, trauma and critical care, musculosk-eletal, perinatal and gynaecology, and aging and population health, provide Sunnybrook with the framework to do the following:

• Ask priority science questions;

• Develop and refine technologies and therapies;

• Test technologies and therapies in preclinical applications;

• Conduct and evaluate clinical trials and outcome analyses;

• Transfer results of clinical trials and outcomeanalyses to effect new models of care and

best practices; and

• Integrate new models of care and best practices into standards of care.

This dynamic process of clinical transformation through scientific discovery is continual and takes as its main aim the optimal health of our patients and communities, now and in the future.

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Focusing on three key priority science areas:

Genes, Proteins and Cells Sunnybrook scientists that study genes, proteins and cells are internationally recognized for the excellence and innovation of their research. Research in this area – cutting across cancer, inflammation and immunity, and regenerative medicine – aims to discover and explain how molecules and cells work, seeking to improve clinical methods of diagnosis, treatment and prognosis. Sunnybrook scientists will continue to do research that supports the strategic programs, in particular cancer and cardiac care. For example, they will seek to understand the fundamentals of blood vessel growth, a field of research called angiogenesis. Within this field, they will study how to shrink or stop tumour growth by regulating blood vessel growth and will test new therapies designed to do just this. They will also investigate ways to regulate blood vessel growth to heal heart disease. The Toronto Angiogenesis Research Centre (TARC), which is unique in Toronto and strategically differentiates SRI from its peers, will be located in the new MOHLTC-approved space in the M wing.

Imaging The imaging faculty at SRI is world-renowned. Imaging scientists will continue to explore how to visualize molecules, cells, tissues, organs and whole organisms. Using physics, mathematics and engineering, they will develop and improve imaging technologies, including ultrasound, magnetic resonance imaging, digital mammography, X-ray, optical and PET/CT technologies. These technologies will help clinicians to diagnose and assess disease and to guide and monitor therapies like the minimally invasive surgeries being pioneered in the transformational priority areas of breast cancer and interventional cardiology. The Imaging Research Centre for Cardiac Intervention, which when built will see the achievement of a critical mass of clinical and research expertise and state-of-the-art equipment and facilities, is just one example of Sunnybrook’s leadership in this priority science area.

Clinical Epidemiology Scientists in clinical epidemiology explore the causes, consequences and treatment of disease to improve patient care and ensure the wise use of limited healthcare resources. Scientists at Sunnybrook will continue to apply scientific methods to issues in clinical medicine across all of the priority areas and in partnership with the strategic programs. This includes analyzing disease incidence and distribution, treat-ment efficacy, long-term prognosis, diagnostic test performance, health status measurement, health policy and the economic impact of diagnostics and treatments. For example, studies will investigate how we can make our healthcare system and treatments more effective and less expensive and if a new technology or treatment is a major improvement over an existing one. The methods are wide-ranging: randomized controlled trials, meta-analyses, surveys and database studies, for example. Scientists in clinical epidemiology at Sunnybrook will work with provincial and federal policy makers to help them make informed decisions about treatment and prevention.

Strengthening our research partnerships in the transformation of healthcare. This includes our partnership with the University of Toronto and the Institute for Clinical Evaluative Sciences (ICES), which was established by the MOHLTC to do research on issues affecting the effectiveness, efficiency and quality of medical care in Ontario and which is collaborating with Sunnybrook on our Centre for Health Services Sciences. Developing transformation priorities that are recognized globally. Within our strategic programs are areas of academic pre-eminence, or established research strengths. That is, those that have a national and international presence and that strategically differentiate us from our sister academic health sciences centres. Our transformation priorities drive our quest to generate innovative and relevant knowledge and are at the core of our strategic directions – the areas in which Sunnybrook will lead in the transformation of clini-cal practice to improve healthcare for patients everywhere.

Our transformation priorities are …

Sunnybrook Health Sciences Centre has an internationally recognized research and clinical program in breast cancer. The expertise across

disciplines is wide-ranging. With the recent approval from the Ontario Ministry of Health and Long-Term Care, Sunnybrook will be constructing a 30,000 square foot multidisciplinary breast cancer research centre with funding from the Canada Foundation for Innovation and the Ontario Research Fund – Research Infrastructure, that will be without equal in Canada. Within the field of breast cancer, Sunnybrook has proven clinical and research leadership, especially in the areas of prevention, early detection and treatment. Research and clinical teams collaborate on issues that span the spectrum of care. Clinical challenges inform research endeavours; in turn, research findings are translated efficiently from the laboratory to the clinic.

Sunnybrook is transforminghealthcare… for breast cancer patients and their families.

Prevention and Early Detection:

• The imaging faculty at Sunnybrook Research Institute is world-renowned. Scientists are developing and refining techniques – ultrasound, magnetic resonance, X-ray detection, digital mammography and others – to improve and evaluate methods to detect and treat breast cancer.

• Sunnybrook was the sole Canadian participant in the international DMIST trial, which found that digital mammography (DM) detects more cancers than film mammography in women who are 50 or younger, are pre-menopausal, or have dense breasts. Imaging scientists at Sunnybrook pioneered the development of DM, and were the first to show that when used with a contrast agent (dye), it can detect tumours that standard film mammography sometimes misses.

• Sunnybrook scientists published landmark results showing that magnetic resonance imaging (MRI) detects breast cancer tumours earlier and with better sensitivity than clinical breast exams, mammography or ultrasound, in women at high genetic risk for the disease.

• Sunnybrook’s familial clinic for breast cancer provides services and education to people who have a family history of breast cancer and raises awareness of the importance of prevention and early detection.

Development and Assessment of New Treatments and Models of Care:

• Scientists and pathologists at SRI are analyzing the molecular “fingerprints” of tumour cells toward being able to predict disease outcome and develop individu-alized therapies.

• Radiation oncologists at Sunnybrook were the first in the world to use palladium seeds to treat breast cancer. After the outpatient procedure, the implanted radioactive material releases slowly from the seeds over a few weeks without any toxic effects.

• Sunnybrook scientists are world leaders in the study of angiogenesis, the birth of blood vessels, which in cancer contributes to tumour growth. Scientists at Sunnybrook were among the first to test a therapy called metronomic antiangiogenic chemotherapy, in which lower doses of chemotherapy are given continuously over a long period, which results in fewer side effects than the standard of care.

• Sunnybrook leads many clinical trials of breast cancer treatments. Researchers have played roles in produc-ing practice-changing results, including those from a clinical trial that found letrozole reduced the risk of breast cancer recurrence by 40 per cent in women who had been on tamoxifen for five years.

• Sunnybrook was the first to offer customized intensity modulated radiation therapy to treat breast cancer.

• Canada’s first patient-centred, multidisciplinary clinic for the management of locally advanced breast cancer and inflammatory breast cancer opened at Sunnybrook in 2004. The clinic is redefining cancer research and treatment for the typically young women affected by this disease.

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Transformation Priority:

Breast Cancer Sunnybrook is helping patients to minimize the impact and maximize the outcome of a diagnosis of breast cancer through research into prevention, early detection and the development of new diagnostic tools and targeted treatments.

In prostate cancer, as with most cancers, it’s important to detect tumours early to achieve the best possible outcome. Accordingly, Sunnybrook

emphasizes the importance of screening and early detec-tion. Through our service offerings and research initiatives, Sunnybrook is addressing the entire continuum of this disease, from researching enhanced technologies and methods for prevention and early detection, to designing more effective treatments, to giving comprehensive psychosocial support. Sunnybrook has shown exceptional leadership in all of these areas. In treatment, for example, the prostate cancer team is focusing on ways to deliver precise radiation and surgery to reduce the chance of damage to healthy tissue. The multidisciplinary model of care involves many highly skilled clinicians, scientists and other healthcare staff.

Sunnybrook is transforminghealthcare… for prostate cancer patients and their families.

Prevention and Early Detection: • The innovative, new Prevention and High Risk Early

Detection Surveillance Clinic offers surveillance to patients and teaches them how to prevent and delay getting prostate cancer.

• A major laboratory initiative that incorporates a transgenic (animal) model of prostate cancer prevention is underway to identify protective micronutrients, natural and synthetic, and analyze dietary interventions. Scientists are studying if a low-fat, low-carbohydrate Atkins-style diet cancels out the carcinogenic effect of a high-fat diet.

• To tackle the challenging clinical problem of determining who should have a biopsy to detect prostate cancer, scientists are developing a risk-grouping model that uses all relevant risk factors.


• TSRCC researchers are pioneers of the active surveillance approach to prostate cancer. In this approach, clinicians monitor newly diagnosed prostate cancer patients who have a favourable risk profile to see how the disease progresses before intervening with surgery or chemotherapy. Active surveillance is being adopted worldwide. This approach spares about one-third of patients the toxic effects of therapy and does not seem to increase the risk of disease progression.

• TSRCC is a world leader in the study and clinical adminis-tration of high-dose radiation therapy, prostate brachy-therapy and intensity modulated radiation therapy.

• Radiation oncologists at TSRCC are among the first in the world conducting to use 3-D image-guided radiation therapy to treat men with prostate cancer. The therapy, which combines 3-D ultrasound and computed tomography technologies, delivers precise external beam radiation, a non-surgical alternative to the current standard of seed therapy.

• Sunnybrook has many ongoing clinical trials evaluating treatments for prostate cancer, including those related to active surveillance, androgen deprivation therapy, high-dose-rate brachytherapy, intensity modulated radiation therapy, conformal radiation therapy and antiangiogenic therapies.

• Sunnybrook opened the first clinic in Ontario devoted to non-medical sexual counseling for men with prostate cancer and their partners.

• The prostate team at TSRCC pioneered an innovative surgical procedure that enables doctors to remove the prostate, but leave intact the nerves involved in sexual function. TSRCC is the only centre in Canada, and one of only a few in North America, that offers this procedure.

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Sunnybrook’s multidisciplinary expertise in researching and treating prostate cancer focuses on prevention, early detection and treatment.


Prostate Cancer

Through TSRCC, Sunnybrook takes a preventive approach to colorectal cancer by using colo-noscopy screening to encourage prevention

or early detection of colorectal cancer. TSRCC also provides many services, conducts leading-edge research and develops new treatment protocols to support patients with colorectal cancer. Sunnybrook is transforming care for patients with colorectal cancer through its multidisciplinary clinics and the provision of genetic counseling and complex colorectal surgery. Furthermore, TSRCC is the only centre in Canada, and one of the few in North America that is conducting clinical research in cancer chronobiology and chronotherapy.

Sunnybrook is transforminghealthcare… for colorectal cancer patients and their families.

Prevention and Early Detection: • The preventive oncology program houses a familial

clinic for colorectal cancer and provides services and education to people who have a family history of colorectal cancer. It helps raise awareness of the importance of prevention and early detection.

• Researchers at TSRCC and the Institute for Clinical Evaluative Sciences (ICES) are investigating the extent of screening for colorectal cancer in Ontario. Results of a large study of almost one million Ontarians showed that less than one-fifth are being screened and that a major opportunity exists to improve screening practices and thus the colorectal health of Ontarians.


• Sunnybrook is conducting multiple clinical trials on the use of metronomic antiangiogenic chemotherapy to treat colorectal cancer. This therapy aims to stop cancer-spreading blood vessels from growing. It is given in low doses over a long period and has fewer harmful effects than does standard chemotherapy, which is given in higher doses over shorter periods.

• The TSRCC will be designated the coordinating centre in the Northeast Greater Toronto Area for the Patient-Centred Disease Site Networks, thereby improving collaboration between all types of provider organizations to govern cancer services in hospitals and the community. Gastrointestinal and colorectal cancer will be disease sites addressed as part of Sunnybrook’s role.

• Clinical epidemiologists are leading a project that spans four provinces to analyze the rates of serious complications due to colonoscopy. This project, like others in the area of outcomes research, is generating findings that have policy-shaping implications.

• Researchers in medical oncology are conducting large trials looking at new therapies for early and advanced colon cancer. One study, for example, is studying the impact of melatonin on the sleep patterns of colon cancer patients.

• Scientists at TSRCC are leaders in the fields of cancer chronobiology and chronotherapy, which concern the relationship between circadian rhythms and cancer. Specific to colorectal cancer, they have established that there is a correlation between the body’s natural rhythms and quality of life. Additionally, using animal models, they have found that delivering chemotherapy at certain times of the day, to be synchronous with the body’s rhythms, can reduce toxic side effects.

• Oncologists at TSRCC are leaders in knowledge transfer in colorectal care. Research at Sunnybrook has demonstrated the need to remove an adequate number of lymph nodes at the time of surgery to make decisions about adequate postoperative care with chemotherapy. This knowledge was used to influence and change the practice of GI surgeries in Ontario and elsewhere.

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From screening to treatment, Sunnybrook has the multidisciplinary expertise and cutting-edge techniques needed to lead the way in generating innovations in colorectal cancer.


Colorectal Cancer

Stroke is a leading cause of death and adult neurological disability in Canada and a priority for Sunnybrook. Stroke care at Sunnybrook is based

on an integrative model of best practices, teaching and research that, as with the neurosciences program overall, focuses on the ABCs: affect, behaviour and cognition. The program provides leadership, training and expertise in building community capacity for stroke resources. To our community it offers regional access and a continuum of providers and services for the prevention and treatment of stroke. Through intensive research efforts, Sunnybrook’s neuroscientists are leading in the discovery and quick translation of best practices to optimize outcomes after stroke, a leadership role that extends locally and nationally.

Sunnybrook is transforminghealthcare… for stroke patients and their families.

Prevention and Early Detection: • Researchers in radiology at Sunnybrook are testing a new

magnetic resonance imaging (MRI) technique called magnetic resonance direct thrombus imaging that can detect “complicated” plaque in the arteries of patients without symptoms. This early detection would allow clinicians to treat patients before they advance too far along the path to a stroke or heart attack.


• Sunnybrook is a regional stroke centre for the North and East Greater Toronto Area; it takes a national, provincial and regional leadership role in delivering evidence-based care, best practices teaching and research, and a continuum of stroke care.

• Sunnybrook scientists and clinicians at The Heart and Stroke Foundation Centre for Stroke Recovery are collaborating on projects related to understanding and treating stroke and similar conditions. Collaborating with Sunnybrook are The Baycrest Centre for Geriatric Care and The Ottawa Health Research Institute. Sunny-brook scientists are leading a number of projects, from mapping the changes in structure and function that happen in the brain after stroke, to designing and testing rehabilitation strategies to optimize recovery from stroke.

• Sunnybrook scientists and clinicians are at the cutting edge of developing rehabilitation strategies using biofeedback, bilateral training and sensorimotor condi-tioning with functional electrical stimulation and directed physiotherapy.

• Imaging scientists are using state-of-the-art research-grade magnets to study the use of virtual reality techniques with functional magnetic resonance imaging to help stroke patients regain function and independence.

• Sunnybrook scientists are involved in potentially practice-changing clinical trials to test new brain- protecting drugs designed to be used in the early hours after acute stroke.

• The Regional Stroke Centre at Sunnybrook was the first to pilot a tele-rehab initiative, the first acute-to- rehabilitation clinical care model of its kind aimed at providing stroke patients with better rehabilitation assessment, planning options and outcomes. It uses videoconferencing to coordinate inter-organizational and multidisciplinary case management for health professionals at stroke facilities in Ontario.

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Sunnybrook’s Neurosciences Program is at the frontier of building and integrating knowledge across disciplines and programs. Within that, there is a concentrated effort on stroke – understanding how the brain responds to a stroke and, subsequently, attempts to reorganize.


Stroke

Based on the Canadian Study of Health and Aging, eight per cent of Canadians aged over 65 have dementia, with the rate of incidence

doubling for every five years of age thereafter. Canadians are living longer and, therefore, the prevalence con-tinues to rise. Sunnybrook’s neurosciences program has expertise in neurodegenerative disorders including Alzheimer’s disease (AD) and other dementias. Scientists are also studying how stroke and dementias interact, as research shows that the risk of one increases the risk of the other. Other efforts focus on helping people to live with the effects of dementia and maintain personhood throughout the course of the disease, particularly in light of the challenging behavioural symptoms they face. Sunnybrook is identifying new, more efficient ways to assess and diagnose these diseases, and is optimizing therapies to improve the quality of life for patients and their families.

Sunnybrook is transforminghealthcare… for dementia patients and their families.

Earlier and More Accurate Diagnosis:

• Researchers in geriatric psychology are trying to predict earlier and better which people are most at risk of developing AD. Using neuropsychological tests, they have predicted which of a study’s participants were most likely to develop AD within five and 10 years. Findings have helped to identify clearer criteria to diagnose mild cognitive impairment in memory- impaired patients that may predict the development of AD.

• Using imaging technologies, Sunnybrook scientists have found that the pattern of changes in the limbic system of the brain differs for men and women with probable AD. Women are seemingly more vulnerable to the effects of AD. Understanding sex differences will help clinicians diagnose and monitor the course of the disease better.

• Scientists are elucidating the interactions between cerebrovascular diseases, like stroke, and hardening of the arteries, and are finding that the location of the damage may play a role in causing cognitive challenges like dementia that interfere with patients’ ability to function independently.


• The multidisciplinary ABC (affect, behaviour and cognition) memory clinic offers outpatient assess-ment by specialists in cognitive neurology, geriatric medicine and psychiatry, and social work. It produces high-quality research and adds to the development of best practices. It uses a unique training model to mentor health professionals across these disciplines.

• Sunnybrook scientists are working to develop and refine clinical and neuro-imaging tools that will help clinicians monitor disease progression and response to therapies for dementia.

• Sunnybrook scientists have identified a possible link between a certain area of the brain and AD by analyzing regional blood flow in the brains of people with and without AD using single photon emission computed tomography.

• Sunnybrook scientists are pioneers in using virtual reality techniques and functional magnetic resonance imaging to look at patterns of activity in the brains of people with and without cognitive challenges due to aging, dementia and stroke. Findings will contribute valuable information toward the develop-ment of targeted treatments.

• Sunnybrook scientists were instrumental in a multinational clinical trial that found the drug donezepil was effective for people who had vascular dementia arising from cerebrovascular disease (stroke). This suggests that the cholinergic system is involved in vascular dementia, as it is in AD, and has clear implications for treatment.

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Sunnybrook’s Neurosciences Program has a unique way of understanding and treating neurodegenerative disorders of brain structure and function, like dementias, and provides care in a way that makes it easier for patients and their families to live fuller and more engaging lives.


Dementia

The vision of Schulich Heart Centre is to develop and practice interventional cardiovascular medicine of the highest quality. This is achieved

through initiatives in imaging research, drug and device evaluation, and outcomes research as applied to revascularization, electrophysiology, cardiovascular surgery and regenerative medicine. Research and clinical activities in interventional cardiology are directed toward diagnosis and treatment that involves physical interaction with the heart or vasculature in the absence of open surgical exposure or direct contact. This emphasis, which aligns with the vision of the centre and with our commitment to patient-focused care, is not meant to exclude or marginalize traditional cardiac or vascular surgery but, rather, is consistent with broad trends in cardiovascular care toward less invasive approaches.

Sunnybrook is transforminghealthcare… for cardiac patients and their families.

Integrative Diagnostic and Therapeutic Technologies:

• The Imaging Research Centre for Cardiac Intervention (IRCCI) is a state-of-the-art facility funded by the Canada Foundation for Innovation and Ontario Innovation Trust. Scientists from Sunnybrook and other institutes involved in the IRCCI are developing and evaluating technologies for cardiovascular imaging to improve early detection and treatment for cardiovascular conditions. Foci are revascularization, myocardial regeneration and resynchronization (electrophysiology) through the integration of magnetic resonance imaging with traditional X-ray angiography.

• In the first multi-centre clinical trial of its kind, Sunnybrook researchers in cardiovascular surgery provided evidence that radial artery grafts from the forearm should be used in place of vein grafts from the leg in heart bypass surgery. This finding challenges 30 years of surgical practice.

• Cardiovascular surgeons at Sunnybrook were the first to perform a stand-alone, minimally invasive thorascopic maze procedure to treat atrial fibrillation, a serious heart rhythm disorder.

• Our cardiovascular surgery team has pioneered the use of intra-operative laser fluorescent imaging to confirm that newly constructed bypass grafts are functioning before thepatient leaves the operating room. This has the poten-tial to improve the long-term outcome of bypass surgery.

• Schulich Heart Centre is one of only a few centres in Ontario that has a cardiac catheterization lab built to full operating room (OR) standards. This means that implant procedures (e.g., for pacemakers) can take place in the same suite as interventional procedures. Removing these procedures from the OR has resulted in better patient access and shorter waiting times.

• Sunnybrook scientists are leading the Ontario Consortium for Cardiac Imaging (OCCI), a multi-institutional initiative that with industry partners has teamed to establish a world-leading centre in cardiac imaging for patient management. OCCI scientists and their clinical partners at Sunnybrook are investigating the anatomy and function of cardiac development/congenital heart disease, myocardial characterization for ischemic heart disease and coronary imaging/intervention.

• Sunnybrook imaging scientists are pioneers of micro- bubble ultrasound technology that allows clinicians to see tiny blood vessels, such as those found in the muscle of the heart. Clinical research centres worldwide are using this technology to diagnose heart disease.

• Sunnybrook scientists have found that changes in microcirculation oxygen levels can differentiate normal from abnormal muscle tissue in the heart. This non- invasive test could be used to help predict the clinical benefit of procedures for patients with heart disease.

• Sunnybrook scientists are working with scientists from the Institute for Clinical Evaluative Sciences (ICES) to study patient outcomes after interventional cardiology. Their aim is to define which patients benefit most from interven-tional procedures, valuable information that helps to direct resources to those that will derive the greatest benefit.

• Scientists from Sunnybrook and ICES scientists have contributed prominently to the efforts of the Cardiac Care Network of Ontario to forecast future needs for invasive cardiac procedures. This work in systems plan-ning has been adopted by several other provinces.

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Sunnybrook’s success in translating scientific advances in cardiology to direct patient care is making it possible to provide less invasive treatment alternatives to people with cardiovascular disease.


InterventionalCardiology

Through Sunnybrook’s Perinatal & Gynaecology (P&G) program, and in partnership with the University of Toronto, the Perinatal and Reproductive

Research Unit (PRRU) is a multidisciplinary program that conducts clinical research to answer important questions relating to perinatal and reproductive health. Researchers in the unit have conducted some of the most significant clinical trials influencing perinatal practice worldwide. In an effort that stretches not just nationally, but also interna-tionally, our researchers design and conduct multi-centre randomized controlled trials in obstetrics, neonatology and gynecology. Our researchers, working with the University of Toronto, leading the Maternal Infant Reproductive Unit, and working collaboratively with the Centre for Research in Women’s Health, have shown how dedication, team work and the rigorous pursuit of best evidence makes a dif-ference to the lives of women and their infants.

PRRU researchers have disseminated their findings widely, with the aim of improving best practices and delivering new models of care for women and their children around the globe. The expertise found at PRRU cuts across obstetrics, gynaecology, neonatology, nursing, internal medicine and other disciplines, and staff apply methods from basic science, clinical epidemiology, biostatistics, data management, health economics and health services in their research. PRRU researchers work with multidisciplinary steering committees and an expanding collaborative group of international clinicians and scientists drawn from over 200 centres in more than 30 countries. A new range of exciting synergies await the PRRU with the relocation of the P&G strategic program to our Bayview site.

Sunnybrook is transforming healthcare… for women, their families and new babies.

Monitoring Pregnancy and Reducing Risk:

• Sunnybrook’s high-risk perinatal program, known for excellence and innovation in care, is one of two such government-mandated centres in the Greater Toronto Area. The program leads in the planning and coordina-tion of high-risk perinatal care through alliances with Health Canada, the Ministry of Health and Long-Term Care, the Child Health Network and the Department of Public Health.

• Canada-wide, only Sunnybrook has a multidisciplinary antenatal clinic that cares specifically for women who are carrying multiple pregnancies. This clinic was set up to deal with the impact of the increase in multiple births over the past decade. It has resulted in a consensus statement from the Society of Obstetricians and Gynecologists of Canada (SOGC) on how to manage multiple pregnancies.

• The pioneering work of the staff of the multiples clinic has established them as leaders in advising national bodies such as the SOGC, Multiple Birth Canada and Health Canada on policy matters.

• Sunnybrook was the first in Ontario to use fetal fibro-nectin screening in clinical practice to test if a woman is truly at risk for preterm labour. Following the inclusion of this test into practice, Sunnybrook reduced the number of unnecessary hospital admissions.

• Sunnybrook scientists have investigated the role of intrauterine infection with ureaplasma urealyticum, a mucosal pathogen that commonly affects the urogenital tract and can cause premature birth, spontaneous labour or other serious delivery-related problems.

Improving Labour and Delivery Practices:

• In an international clinical trial, Sunnybrook scientists showed that planned cesarean sections were safer than vaginal deliveries for breech births. These landmark find-ings resulted in new clinical guidelines around the world.

• Neonatologists at Sunnybrook are involved as either steering committee members or investigators on several large, multicentre clinical trials, including those focused on determining the best indicators for, and developing the best methods to assess, the long-term impact of obstetrical interventions.

• One study is examining the benefits and risks of treatments that aim to reduce the risk of death and neurodevelop-mental problems that are associated with preterm births.

• Sunnybrook scientists are striving to find better approaches to induce labour to prevent maternal morbidity and assess the merits of routine screening for gestational diabetes during pregnancy.

• Sunnybrook scientists are striving to find better approaches to induce labour to prevent maternal morbidity and assess the merits of routine screening for gestational diabetes during pregnancy.

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Sunnybrook’s commitment to women’s health is rooted in our belief that having a healthy population begins with ensuring not only that women receive the absolute best care, but that their children – at the very beginning of their lives – do so, too.


Perinatal and Reproductive Research Unit

Sunnybrook is committed to making healthcare better for patients everywhere. Our strategic planning process has identified the main areas to which we will commit the organization, so that we can fulfill our vision of transforming healthcare. Sunnybrook’s strategic directions, and the actions we will take, will enable us to realize that commitment.

Our strategic plan has identified the following:

Sunnybrook will focus our clinical activities to support:

• Our strategic programs;

• Our strategic populations of women’s health and aging; and

• Our community – through our continued commitment to primary/secondary services for our local service area.

Sunnybrook will focus our academic and research activities to:

• Represent the role of our seven strategic programs in transforming healthcare;

• Build on the demonstrated excellence of our transformation priorities and define a focused academic leadership agenda for Sunnybrook within the broader healthcare system;

• Establish the Aging and Population Health strategic program to meet our community’s needs;

• Lead the translational research agenda through our new Centre for Health Services Sciences; and

• Enable our academic enterprise by carrying out our integrated ambulatory care strategy and further solidifying our research excellence within the priority science areas.

Sunnybrook will lead the Health System Leadership Agenda in the areas of:

• Patient Safety “Sunnybrook will lead in safety best practices.”

• Performance Management “Sunnybrook will lead in hospital performance measurement and management.”

• Wait-time Management “Sunnybrook will become the national leader in hospital wait-time monitoring and wait-list management for our targeted priorities areas.”

• eHealth “Sunnybrook will use information technology to enhance the delivery of care and relationships among providers, scientists and patients.”

Leadership will be required to transform healthcare – not only for Sunnybrook, but also for the healthcare system as a whole. We will need leadership from all levels and all healthcare disciplines if we are to realize our goals. We believe that helping people achieve their fullest potential will help us to transform healthcare. Therefore, Sunnybrook has also established a Leadership Institute in partnership with the University of Toronto’s Joseph L. Rotman School of Management to help promising healthcare leaders at Sunnybrook achieve their fullest potential. The Leadership Institute will be an important component in realizing our vision.

We also recognize that, no matter what obstacles we face as a system, innovation comes from people with the will, desire and focus to lead change and, ultimately, make a difference. We are committed to that belief. That is Sunnybrook’s commitment to our staff, the healthcare system and, most importantly, to patients everywhere – not only for today, but for every day.

Together, we will transform healthcare.

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Our Commitment to Making Healthcare Better

Sunnybrook campus2075 Bayview AvenueToronto, Ontario M4N 3M5Telephone: 416.480.6100

Holland Orthopaedic and Arthritic Centre43 Wellesley Street EastToronto, Ontario M4Y 1H1Telephone: 416.967.8500

Sunnybrook Perinatal and Gynaecology ProgramLocated at Women’s College76 Grenville StreetToronto, ON M5S 1B2Telephone: 416.323.6400

www.sunnybrook.ca

Documents

Transforming Healthcare - Sunnybrook Hospital · vision of transforming healthcare. Through our research programs and ongoing partnership with the Centre for Research in Women’s