Training the Next Generation of Applied Health Researchers
New fellowship program places researchers in Ontario Health Teams to improve learning and health outcomes.
By Heidi Singer
Mulugeta Chala is settling into his new workplace. The newly minted PhD has just moved his family across the province to start a fellowship program in London, Ontario. For the next year, he will support the Western Ontario Health Team as it works to provide more integrated, patient-centered care.
“The most important thing for me is to understand what quality care means for these patients and how we measure it,” he says. “What is the patient experience and how do we design care based on feedback from patients?”
Chala is one of 12 postdoctoral fellows who are applying their research skills to real-world problems through DLSPH’s Impact Fellows program. The new fellowship program places recent graduates in Ontario Health Teams (OHTs) for a year, where they support local projects while learning first-hand about health systems change. The Impact Fellows program is an innovative partnership between DLSPH and the Ontario Ministry of Health, one that provides on-the-job training while building research and evaluation capacity in OHTs.
“The vision is for the fellows to help move us toward a learning health system,” says Patrick Feng, who with IHPME Profs. Ross Baker and Meghan McMahon pioneered the program for DLSPH’s Institute of Health Policy, Management and Evaluation. “We want to make research and learning part of the health system culture, so that whenever a health organization tries something new, they collect data and use this to evaluate and reflect on what they’ve done.
“The fellows are a fantastic resource for building that learning culture.”
Modelled after CIHR’s highly successful Health System Impact Fellowship, the Impact Fellows program matches Fellows with host and academic mentors and provides ongoing training throughout the fellowship. Fellows work closely with their host OHTs to address complex issues like transitions in care.
“It’s about finding the gaps in care,” says Chala. “When patients are discharged from hospital, they often bounce around between providers but nobody has the full picture.”
Chala has unique perspectives to offer his health team as they work to keep patients out of hospitals. As a former physiotherapist, he’s used to working collaboratively. And in his native Ethiopia, the vast majority of health care takes place in the community, with a diverse group of providers that includes relatives, friends and neighbors.
“In rehab, we use a psychosocial model of care, and we understand you can only fix a small part of the problem in the hospital,” he says. “There are impacts on patients that go well beyond pain, that you can’t fix in a hospital. How are we going to get them to work or church? You have to bring together communities for that.”
Five hundred kilometers away, another Fellow is helping integrate hospital information systems with primary care records. When the system is complete, health records will be more consistent and patient-centered.
“Whether it’s acute care or mental health and addictions, it’s about making sure primary care has the information it needs to reach the best decisions for patients’ follow-up and continued care” says Natalie Montgomery, who is embedded in the Lanark, Leeds and Grenville OHT.
Montgomery is not only helping to design the digital system – she is also working with primary care to co-create forums to engage other providers on the benefits of shared electronic medical records. She will evaluate the impact of these engagement activities with a view to ensuring providers and patients are effectively immersed in the process and developing best practices for others OHTs.
Montgomery had just finished her doctorate at the University of Ottawa in population health when she saw a tweet advertising the fellowship. With her background in patient care research, community engagement and health communications, she saw it as a perfect fit.
“I’ve been really happy and impressed with the level of learning, developmental, social, and networking supports we are constantly provided by IHPME,” she says. “It’s outstanding.”
A key element of that support comes from other Fellows. Each Fellow has a unique local project, but they learn as a group – attending orientation, training sessions, and conferences together.
“The fellows have really come together,” says program manager Angela Del Monte. “They meet regularly to share ideas and resources, to provide moral support, and to champion each other’s successes.”
Back in London, Chala hopes he can help his team understand what truly community-based care could look like.
“We see Canada as the country with the best healthcare system, but there’s always room for improvement,” he argues. “That’s what I’m seeing in the Ontario Health Teams. This is one of the greatest opportunities in my life, but I can also bring my perspectives to support them.”