There was a time when registered nurse Paul Norman and Dr. Christopher Patey used to meet in the cafeteria of Carbonear General Hospital to discuss their ongoing research interests.
“Now we have an office and multiple projects that people are working on from all different places,” Norman recently told The Compass, seated across from Patey in the office of the Carbonear Institute for Rural Research & Innovation by the Sea (CIRRIS) on the eighth floor of the hospital.
Indeed, it’s exciting times for the pair, who have both worked in the hospital’s emergency room since 2007. It took a few years for the two health-care professionals to start working more closely on research initiatives. Through the 12-month 6for6 research program for rural physicians, Patey and Norman worked together on an application to improve efficiency in an emergency room setting.
The fruit of their combined labour is SurgeCon, which specifically addresses staff and workforce management. The application turned some heads, attracting a $100,000 grant from the Canadian Institutes of Health Research. The project is now one of three up for a massive $4.8 million research grant from the same group (CIRRIS is among a number of partners on that grant application, so some of that funding would come back to Carbonear along with other sites where SurgeCon would be tested).
Like Patey, Norman has an interest in challenging the way things are done within rural health-care facilities such as the hospital in Carbonear. As the two worked together more and more, the idea came about of finding a place to house these projects and ideas about improving health care.
“It all kind of (came together) at roughly the same time where we said, ‘We really need somewhere house these ideas and build off of them and have a site in a rural community where we can do some community-based research,’” explained Patey, who teaches with Memorial University’s Faculty of Medicine and handles a once-a-week family clinic in Spaniard’s Bay.
From there, the idea for CIRRIS developed. Patey, the CEO for CIRRIS, noted most often, academic research on rural medicine is handled in larger city centres and not in places like Carbonear.
“It’s hard to do rural research when you’re sitting in St. John’s — not that it’s a wrong thing to do, it’s just a different view,” Patey said. “So, we’ve taken it with the idea that we want to bring people out and do stuff that comes from the front line in our community out here in Carbonear and surrounding areas.”
They credit Eastern Health and the Trinity Conception Placentia Health Foundation for being supportive of the endeavour, which has taken shape over the last year. CIRRIS was incorporated a few months ago and is on the verge of holding its first annual general meeting.
While SurgeCon remains its flagship project, CIRRIS has plenty of other kettles boiling simultaneously.
“We’ve actually had to slow it down,” Patey said, seated in front of a wall covered with dozens of sticky notes highlighting various ideas for projects.
They have a 3D printer set up at the hospital and developed a tongue depressor dispenser in collaboration with the medical school’s 3D printing lab. CIRRIS has engaged local high school students on the use of the 3D printer as well. They’ve also investigated the health benefits of the food fishery and recently came out with a research paper on fish hook removal.
“That kind of just spurs the idea that just … sometimes when you’re outside of St. John’s, you think outside the box and you think differently because of just the settings you’re in on a day-to-day basis,” he said. “So, the goal is to continue to encourage that different thought process.”
Norman’s main research interest remains investigating how health-care services can be delivered effectively and efficiently, but he’s quick to stress the fact this does not pigeonhole CIRRIS.
“We want to be able to support any kind of research that anyone is interested in,” said Norman, who is currently CIRRIS’ vice-chair.
“I would say too that, we have an interest in improving health care,” Patey said, chiming in quickly. “What happens with rural sites is … you do things that improve your own site. Right now, we have probably one of the highest functioning emergency departments (in Carbonear) — I don’t even know where, maybe in Atlantic Canada.
“We’re turning over patients really effectively, and we’re hoping we provide great care when we do that, but we’re not often researching and publishing that or releasing that to other emergency departments. So, a lot of small initiatives that we do in rural departments could be very well beneficial to all rural departments in Canada.”
The model presently being established in Carbonear could be implemented elsewhere across the province or region, Patey also believes. Having a set up in place with dedicated staff focused solely on CIRRIS is something Norman and Patey would love to see happen down the road. They envision having PhD candidates and work-term students coming on board to conduct research based in Carbonear.
“With the collaboration from the regional health authority Eastern Health and our foundation of Trinity Conception Placentia, you can see this replicating across other sites in Newfoundland as well,” he said. “So, there’s no reason you couldn’t run one of these in Corner Brook or Grand Falls where you have collaboration between health-care resources to develop a site or just a hub of activity where you would improve health care.”
As a team, Norman and Patey see a lot of value in having both a physician and nurse perspective available for whatever project awaits them.
“I love the idea that when we’re in a room with 300 physicians giving a talk and I say, ‘I don’t know the answer to that, but Paul does,’” Patey explained. “Because we live in different worlds (and) because we exist in different worlds, we often don’t have the other person’s view. I think the silos that exist in health care now of nurse, physician, and this is what you do — we need more crossover from that.”
Anyone interested in learning more about CIRRIS or eager to share ideas for research can contact Patey at firstname.lastname@example.org.
“We want to bring in the community in this space,” Patey said. “We look at representation from town councils, industry and collaborations. If you have ideas you want to bring in, swing them by us. That’s what we’re here for.”