Research Agenda

Ongoing Projects

• PSI Foundation Funded Project: TiC Evaluations Rural Network Study: multisite evaluation of transition in care activities across an alliance of three rural hospitals in Ontario

• Transforming Emergency Department Management of Common Conditions by Automation of Throughput using Artificial Intelligence

• Rural community responses to COVID-19 survey 

The specific aim of this survey/ study is to gain a better understanding of: A) The impacts of the pandemic/ lockdown on rural Ontarians, B) The responses of rural Ontarians to the COVID-19 pandemic and C) How they are coping/ strategies they are using.

• INITIATE Protocol

• Family Physician Rural Resident Retention Survey

• Endoscopic Polypectomy Performed in Clinic for chronic rhinosinusitis with polyps: The EPIC Randomized Control Study 

Past Projects & Publications

• Mulligan, E., Tuff, L. R., Leclair, J., Mcmillan, J., Devin, B., Elbeddini, A., & Gazarin, M. (2020, March). Implementation of a closed-loop medication reconciliation process for ambulatory oncology patients at Winchester District Memorial Hospital. In Healthcare Management Forum (Vol. 33, No. 2, pp. 85-89). Sage CA: Los Angeles, CA: SAGE Publications.
  
  
• Gazarin, M., Mulligan, E., Davey, M., Lydiatt, K., O'Neill, C., & Weekes, K. (2019). Improving patient preparedness for the operating room: A quality improvement study in Winchester District Memorial Hospital–A rural hospital in Ontario. Canadian Journal of Rural Medicine, 24(2), 44.

• Gazarin, M., Devin, B., Tse, D., Mulligan, E., Naciuk, M., Duncan, S., ... & Elbeddini, A. (2020). Evaluating an inpatient deprescribing initiative at a rural community hospital in Ontario. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 1715163520929734.

• Gazarin, M., Ingram-Crooks, J., Hafizi, F., Hall, L., Weekes, K., Casselman, C., ... & Tse, D. (2020). Improving urinary catheterisation practices in a rural hospital in Ontario. BMJ open quality, 9(1).

• Hafizi, S., Nadeau, C., Gazarin, M., & Mulligan, E. (2020). Refractory Unforeseen Anaphylaxis Case in a Rural OR Unit. Case Reports in Surgery, 2020.

• Elbeddini, A., Gallinger, J., Davey, M., Brassard, S., Gazarin, M., Plourde, F., & Aly, A. (2020). A Case of Fournier’s Gangrene in a Patient Taking Canagliflozin for the Treatment of Type II Diabetes Mellitus. The American Journal of Case Reports, 21, e920115-1.

• Helmer-Smith, M., Fung, C., Afkham, A., Crowe, L., Gazarin, M., Keely, E., ... & Liddy, C. (2020). The Feasibility of Using Electronic Consultation in Long-Term Care Homes. Journal of the American Medical Directors Association.

• Hogan, K. A., Gazarin, M., & Lapenskie, J. (2016). Development and implementation of an antimicrobial stewardship program in a rural hospital. The Canadian journal of hospital pharmacy, 69(5), 403.

• Improving Compliance to Canadian Diabetes Association 2016 Updated Guidelines in Patients with Clinical Cardiovascular Disease

• Thyroidectomy audit in rural hospital evaluation

• Colonoscopy audit in rural hospital evaluation

•  The Catering of Critical Incident Reporting Systems to Different Hospitals MAC- QI/Critical Incidents

• Evaluating the impact of an electronic care coordination platform (Aetonix) on efficiency of Health Link care coordinators (Health Technology Fund Project)

• Identification & Flagging of Suspected Sepsis through Screening at ER Triage: A quality improvement study in Winchester District Memorial Hospital, a rural hospital in Ontario

• Increasing use of the Barthel Index tool upon admission & discharge for older Medical/Surgical patients: A quality improvement study in Winchester District Memorial Hospital, a rural hospital in Ontario 

• CLRI-LTC eConsult Expansion into Long-term care homes - This study looked at implementing the Champlain BASE eConsult service in two to four of Ontario’s long-term care homes in order to improve integration of care through better timely access to multiple care providers for complex aging residents.  

• “My Plan” – Integrative Health Coaching for Those Affected by Dementia - The purpose of this project was to evaluate the effect of integrative health coaching on individuals affected by dementia.  

• Age-adjusted D-dimer cut-off levels to rule out deep vein thrombosis: A prospective outcome study - The aim of this study was to assess the efficacy and safety of an age-adjusted progressive cut-off of D-Dimer to rule out Deep Vein Thrombosis (DVT). 

• Boehringer Ingelheim Funded Project: WDMH and Community Heart Failure & Diabetes Care Quality Improvement Project with North Dundas Medical Clinic - The overall aims were to evaluate the adherence to the guidelines when providing care for heart failure patients with and without diabetes, to create a heart failure pathway, and implement it in North Dundas Medical Clinic and WDMH. The result is more specialized and defined care for these patients in our community.   

• Comparison of two inpatient care models on a Medical-Surgical Ward at a Rural Ontario Hospital on hospital budget and from the physician, nurse, and patient perspectives - The study involved looking at our recent change in care model on the Medical-Surgical Unit. Before March 2020 “family medicine” patients were admitted under the care of their family physician, who would round on their inpatients in the morning before going to their clinic. Since March 2020, “family medicine” and “orphan” patients are now admitted under the care of one or two full-time hospitalist physicians. This study looked at nurse, physician, and patient satisfaction as a result of this change in the model of care, as well as the effect on hospital budget.
  
  
•  Using natural language processing to determine prevalence of pre- or asymptomatic COVID-19 in patients undergoing chest CT for non COVID indications within Eastern Ontario - a collaborative multicenter observational study - This study drew upon a collaboration of Eastern Ontario hospitals to critically evaluate CT chest studies being performed for clinical indications other than suspected COVID-19 and determine the frequency of CT findings that could be attributable to COVID-19.
  
  
• Emergency Department Patterns of UTI Investigation in the Delirious Elderly: A Retrospective Chart Review - This study investigated practice patterns surrounding UTI in delirious elderly patients.
  
  
• Caring for Babies: A Study of Ontario Maternal-Newborn Hospitals on the Effectiveness of Parent-targeted Education (ONesiE) - Hospitals providing Maternal Newborn care began this project to evaluate the effectiveness of several methods of reducing newborn pain and distress, during painful procedures, as well as the effectiveness of related parent targeted education. 
  
  
• Improving Transitions in Care for Children and Youth with Mental Health Concerns: Implementation and Evaluation of an Emergency Department Mental Health Clinical Pathway- This collaborative project was undertaken by the Children’s Hospital of Eastern Ontario, Cornwall Community Hospital, WDMH, and other community partners, with the overarching goal of improving timely access to mental health resources for youth who enter the ER and ensuring a seamless transition to the services required (tailored to their individual needs).

•  Reducing Rates of Hospital-Acquired Delirium in Older Inpatients: A quality improvement study in Winchester District Memorial Hospital, a rural hospital in Ontario - Evidence shows that preventing and reducing hospital-acquired delirium in elderly patients decreases morbidity and mortality in this patient population. The team has focused on improving patient orientation to time and place, improving sleep, and introducing friendly visiting focused on stimulating the mind. 

Grants 

WDMH and the Rural Research Network have been awarded funding from different organizations such as:

• The Ontario Ministry of Health and Long-Term Care (MOHLTC)
• The Canadian Institute for Health Research (CIHR)
• Various pharmaceutical companies
• Physicians Services Incorporated (PSI) Foundation