SPARK: Conversations by Children's Healthcare Canada

Tune in to our first-ever live SPARK: Conversations podcast; recorded live at Children’s Healthcare Canada’s 2023 Annual Conference.  In this compelling episode, healthcare leaders, Drs. JC Cowden and Nel Weiman, join host Dr. Katharine Smart to unravel the intricate health equity landscape. Drawing from their extensive experiences, the trio explores tangible strategies, real-life stories, and crucial mindset shifts necessary to foster equitable healthcare practices. Listeners will be inspired to adopt a curiosity-driven approach, engage in collaborative efforts, and embrace humility in their pursuit of creating a more equitable and inclusive healthcare system. From practical tools to poignant narratives, this episode provides invaluable insights for healthcare professionals, policymakers and anyone passionate about dismantling healthcare disparities. 

In this podcast, Dr. Javeed Sukhera discusses child and youth mental health, emphasizing the challenges faced in accessing timely and appropriate mental health services in both Canada and the United States. He highlights the underfunding of mental health services, the need for a collaborative approach, and the importance of trauma-informed care. Dr. Sukhera also touches on the differences between the healthcare systems in the two countries and the potential for improving access to care through innovative models.

This podcast features an insightful conversation with Dr. Justine Cohen-Silver, a pediatrician who is making a significant impact in children’s health and healthcare through an innovative school-based program that addresses the social determinants of health. The Model Schools Pediatric Health Initiative (MSPHI) at Unity Health Toronto aims to improve health outcomes for children in under-served communities. 

In this podcast, Dr. Katie Birnie discusses pediatric pain management, focusing on the newly developed National Pediatric Pain Management Standard, the first of its kind in the world. A collaboration between Solutions for Kids in Pain (SKIP) and the Health Standards Organization, the new standard establishes a set of guidelines for the delivery of pain management for children from birth to 19 years. It provides guidance to healthcare organizations on how to deliver equitable and quality pain management across hospital settings serving children and youth. This standard sets the stage for improving pain management in children and youth across the continuum of care.Overall, this podcast highlights the ground-breaking work being done in Canada to improve the management of pain in children and youth, with a strong emphasis on equity, patient partnership, collaboration, and implementation.

Description:  Health systems serving children and youth face numerous challenges and complexities. At the intersection of these challenges, health leaders recognize that the answers are not simple and they must be effective in seeing beyond these complexities and leveraging connections that will help them to intentionally drive their system. As health care becomes more integrated, the capacity to create connectivity and working with shared interests among stakeholders is key to building influence and creating active change. This is particularly important in health care due to the inter-twined responsibilities, interconnected decisions, and critical outcomes that are involved. On this episode of SPARK: Conversations, we sit down with Dr. Michael Gardam to discuss how health system leaders can effectively mobilize stakeholders and resources to transform complex health systems and how to motivate and sustain large scale change. From the SARS outbreak to the current COVID-19 pandemic, infectious diseases physician Dr. Michael Gardam has been on the front lines of Canada's health emergencies.As the Chief Executive Officer at Health PEI, Dr. Gardam brings with him a distinguished track record of health system leadership and insight, both in Canada and internationally. Speaker Names: Dr. Michael Gardam Speaker Bio: Michael is the Chief Executive Officer at Health PEI, the health authority that delivers publicly funded healthcare in Prince Edward Island.  He is also the Chair of the Board of Directors of HealthCareCAN, the national voice for healthcare organizations and hospitals across Canada.  Michael is a pioneer of using complexity science-based approaches to improve patient safety, system transformation, staff engagement and other complex challenges.  He has advised organizations in Canada and internationally, including the World Health Organization, the Centers for Disease Control and Prevention, Excellus Blue Cross Blue Shield, Hand Hygiene New Zealand, the Irish Health Services Executive and the Maryland Patient Safety Center, the Canadian Foundation for Healthcare Improvement, the Canadian Patient Safety Institute, as well as numerous hospitals across Canada. His interest in physician leadership and organizational culture led him to become Chair of the Medical Advisory Committee at UHN (2015-2017) and Chief of Staff and Humber River Hospital in Toronto (2018-2020).  He is also currently the Program Director of the York University Schulich School of Business Healthcare Leadership Development Program, and an instructor for the Physician Leadership Institute of Joule (Canadian Medical Association). 

Description:  The news media shapes our collective mindsets about key issues and what needs to be done to address them. The unprecedented viral surge in the demand of young patients seeking emergency medical care faced by hospitals and healthcare systems serving children and youth across Canada highlighted the immense amount of pressure placed on the pediatric health system. Additionally, long wait times are another issue which can have lifelong impacts on children and are promoting a larger national conversation about how we need to rethink and reprioritize investments in children’s health. Other concerns include erosion in trust of health officials which may be spilling over into lack of routine vaccine uptake.Recognizing the media’s impact on addressing children’s issues is essential in shifting mindsets and building support for the actions necessary to ensure the wellbeing of children. This podcast will address the role of the news media in influencing public thinking about children’s issues and its effects on the pediatric health system.Carly WeeksCarly Weeks is an award-winning national reporter who has been covering health for The Globe and Mail for more than a decade. Carly helped lead the paper's coverage of COVID-19 and its effects on the health system. She also writes about the intersection of misinformation and health.

In a recent op-ed published in the Ottawa Business Journal, Dr. Jason Berman spoke about the importance of research innovation and cross-industry collaborations in tackling today’s healthcare crisis. “To improve healthcare meaningfully, we need the business community, the hospital community and the academic community to break down traditional silos and press fast-forward on promising innovations. The CHEO RI established a new Innovation Core, the purpose of which is to create a rich support ecosystem designed for healthcare innovators who aim to improve the lives of children and youth by actively working to expand the innovation core and its services at the CHEO RI.This podcast will address how research and partnering with stakeholders across the spectrum- from high tech to business partners to patients could be an important aspect of reshaping tomorrow’s health care. Additionally, the importance of involving patients and families in research initiatives at the RI and how any type of reform needs to be informed by the patients and families involved will be discussed. Objectives:Discuss and illustrate how research can be leveraged to bring much needed, innovative change to the health care system and Canada requires further investment in research to be a leader.Talk about how we need to start thinking “outside the box” of what a traditional research institute does and how we can collaborate with stakeholders across the spectrum – breaking down traditional silos between the research, hospital and business communities.  We need to work across sectors and form partnerships to find creative solutions and close healthcare gaps.Promote the work of the innovation core at the CHEO Research Institute.  Speaker Name/Bio: Dr. Jason Berman is the CEO and Scientific Director of the CHEO Research Institute and the Vice-President Research at CHEO. He is also a Full Professor in the Department of Pediatrics at the University of Ottawa. Previously he served as Associate Chair, Research, Department of Pediatrics, and Professor of Pediatrics, Microbiology & Immunology and Pathology at Dalhousie University and interim Vice President Research, Innovation and Knowledge Translation for the IWK Health Centre in Halifax, Nova Scotia. He has overseen the pediatric leukemia program for the Maritimes since 2005 and chairs an international clinical trial for children with Down syndrome and myeloid leukemia. He is internationally recognized for pioneering research using zebrafish to study childhood cancers and rare inherited diseases.  His laboratory has served as the Atlantic node of the Centre for Drug Research and Development and a national hub for zebrafish modeling of orphan diseases. He has been co-chair of the C17 Childhood Cancer Network Developmental Therapeutics Committee and Director of the Clinician Investigator Program and Medical Research Graduate Program at Dalhousie. He is president of the Canadian Society for Clinical Investigation, vice president of the Canadian Hematology Society and a founding member of the Canadian Rare Disease Models and Mechanisms Network.

Description: January’s SPARK: Conversations monthly podcast is on Indigenous child health with our podcast host, Dr. Katharine Smart in conversation with special guest, Dr. Cindy Blackstock. As an internationally recognized First Nations scholar and child welfare expert, Cindy has been the driving force behind promoting reconciliation to ensure culturally based equity for First Nations children and families. Cindy is the Executive Director and co-founder of the First Nations Child & Family Caring Society of Canada, Associate Professor & Director of First Nations Children’s Action Research and Education Service at University of Alberta and Professor in McGill’s School of Social Work. In this podcast, Cindy will be exploring the utilization of Jordan’s principle and the Spirt Bear Plan to achieve culturally based equity for First Nations Children. She will be providing guidance to non-Indigenous system leaders and health care professionals working in pediatrics to support them in promoting reconciliation within their practice to better serve Indigenous children, youth, and their families.Speaker Name/Bio: Cindy is the Executive Director and co-founder of the First Nations Child & Family Caring Society of Canada, Associate Professor & Director of First Nations Children’s Action Research and Education Service at University of Alberta and Professor in McGill’s School of Social Work. As a nationally and internationally respected advocate for the rights of Indigenous children and a member of the Gitksan First Nation, Cindy has 25 years of social work experience in child protection and Indigenous children’s rights. Further, her research spans the identification & remediation of structural inequalities affecting First Nations children, youth & families. An author of over 50 publications & a widely sought after public speaker, Cindy has collaborated with other Indigenous leaders to assist the United Nations Committee on the Rights of the Child in the development and adoption of a General Comment on the Rights of Indigenous children. Recently, she also worked with Indigenous young people, UNICEF & the United Nations Permanent Forum on Indigenous issues to produce a youth friendly version of the United Nations Declaration on the Rights of the Child. Her promotion of culturally based and evidence informed solutions has been recognized by the Nobel Women’s Initiative, the Aboriginal Achievement Foundation. Frontline Defenders and many others. 

December’s SPARK: Conversations monthly podcast is on health systems transformation with our podcast host, Dr. Katharine Smart in conversation with special guest, Helen Bevan. Helen is a Strategic Advisor and leader of large scale change within the National Health Service (NHS) in England, the largest public healthcare system in the world. Helen will be discussing her experiences and expertise in large scale change and providing guidance to system leaders in health care on addressing complex issues in child health and how to redesign and strengthen our child health systems in Canada to better serve children and youth.

Description: The Canadian healthcare system is currently unable to meet the demands of the people who need it. Children and adults alike are seeing extended wait times for emergency rooms, ambulances and surgeries as well as closures of essential rural emergency centers due to staffing shortages. Dr. Katharine Smart, the current president of the Canadian Medical Association, has previously warned that Canadian healthcare is on the brink of collapse. She joins us as she nears the end of her presidential term to discuss the current state of Canadian healthcare, speaking to the importance of provider well-being and the nuances of collaborating and advocating both as individuals and organizations to bring about systemic change.This is Part 2 in a two-part series. To hear Dr. Smart speak on the impact mis and dis information has on our population and how we rebuild trust in healthcare, listen to Part 1 of this series “Getting the Facts Straight: Tackling mis/disinformation through patient-provider relationships”.Note: This interview was recorded in July, 2022, prior to Dr. Smart’s transition to CMA Past-President.Speaker Bio: Dr. Katharine Smart is a pediatrician in Whitehorse, Yukon and Past President of the Canadian Medical Association. Her work is centered on developing collaborative partnerships with community and government services to serve marginalized children using a model of social pediatrics. She works primarily with children who have experienced trauma and adverse childhood events, and she witnesses the broad and lasting impact these events have on children and their development daily. She is passionate about improving services for marginalized children in an effort to change their life trajectory.In addition to her community-based work, Dr. Smart enjoys acute care and provides on-call services to the hospital. Before moving to the Yukon, she was a pediatric emergency medicine physician at the Alberta Children’s Hospital in Calgary. Dr. Smart is the past president of the Yukon Medical Association.

Description: COVID served as a catalyst for the spread and uptake of mis- and disinformation, threatening the trust Canadian citizens have in vaccines and, frankly, putting lives at risk. Further, the extra disease burden on the healthcare system exacerbated pre-existing problems, including in the area of health human resources (e.g., staff burnout and shortages). Some may ask, So what? Why are these problems so concerning? How do we go about rebuilding trust in healthcare and science? Dr. Katharine Smart has been tackling these problems as President of the Canadian Medical Association (CMA). As she transitions to the role of Past-President, Dr. Smart joins us to reflect on these issues, speaking to the importance of the longitudinal patient-provider relationship and innovative ways that clinicians can meet people where they’re at.This is Part 1 in a two-part series. To hear Dr. Smart discuss staff burnout and bringing our healthcare system back from the brink of collapse, listen to Part 2 of this series, “Healing the Healthcare System: Staff burnout, honest leadership and collaboration”.Note: This interview was recorded in July, 2022, prior to Dr. Smart’s transition to CMA Past-President.Speaker Bio: Dr. Katharine Smart is a pediatrician in Whitehorse, Yukon and Past President of the Canadian Medical Association. Her work is centered on developing collaborative partnerships with community and government services to serve marginalized children using a model of social pediatrics. She works primarily with children who have experienced trauma and adverse childhood events, and she witnesses the broad and lasting impact these events have on children and their development daily. She is passionate about improving services for marginalized children in an effort to change their life trajectory.In addition to her community-based work, Dr. Smart enjoys acute care and provides on-call services to the hospital. Before moving to the Yukon, she was a pediatric emergency medicine physician at the Alberta Children’s Hospital in Calgary. Dr. Smart is the past president of the Yukon Medical Association.

Infancy is a developmental period when children are most vulnerable and when they present with the greatest potential. Infant and early mental health (IEMH) involves the social, emotional, cognitive wellbeing of infants and young children. IEMH care aims to ensure every child has the best possible start in life.Research tells us that:Infant and early child development sets the stage for later development and functioning.Babies and young children who experience adversity are at increased risk of poorer health and social outcomes in childhood and later in lifeSuch adverse childhood experiences influence development of the baby’s brain, the number and type of connections between brain cells, how they respond to stress, and even their DNAYoung children are the most vulnerable with the least access to mental health services and supportsThe development of infants and young children is strongly affected by the quality of their relationships with adults (parents or other caregivers)Love and nurturing can protect against some of the negative experiences of young childrenWe know what to do. We have the evidence and practice and policy requirements are clear. Changes are required to training and education of healthcare practitioners. Early intervention services must be accessible in a timely manner and responsive to the needs of the child and family. Policy change is required to support at-risk families and involves partnership between families, healthcare, community services, and child welfare. Listen while Dr. Chaya Kulkarni discusses leadership, evidence-informed practice and policy, resources, and educational opportunities to increase Canadian capacity to ensure all babies get off to a great start.This session will be of interest to:Healthcare professionalsFamilies & CaregiversSocial service providersLegal servicesSpeaker BioDr. Chaya Kulkarni is the Director of Infant and Early Mental Health Promotion (IEMHP). This national organization, at The Hospital for Sick Children, also known as SickKids, aims to improve outcomes across the lifespan through translating and promoting the science of early mental health into practice with families during pregnancy, infancy, and early childhood. Chaya is also an advisor to Dolly Parton’s Imagination Library, a member of the Strategic Advisory Committee at the Ontario Centre of Excellence on Child & Youth Mental Health, and a member of the Board at Family Day Care Services. Prior to joining IEMHP, Chaya was VP, Parent and Professional Education at Invest in Kids, and has also served as Senior Policy Analyst and Researcher for the Office of the Official Opposition, Queen’s Park. 

The ongoing COVID-19 pandemic has taught us many lessons, including best practices for immunizing populations efficiently. To retain what we have learned, and continue to improve vaccine confidence and uptake, the Canadian population will rely on experts like Dr. Manish Sadarangani to lead robust infectious disease and prevention research. On this episode of SPARK: Conversations, we sat down with Dr. Sadarangani to discuss natural and vaccine immunity to COVID-19, approaches to combatting new variants, and how we can improve vaccine and science communication. We explore the possibility of the COVID-19 vaccine becoming a routine vaccination, and how to best promote the importance of keeping up with those routine childhood immunizations.

Guest:Susa Benseler, MD, PhD; Director, Alberta Children’s Hospital Research Institute at the Cumming School of Medicine; Strategy Lead, Child Health and Wellness Research Strategy; Husky Energy Chair in Child and Maternal Health; Alberta Children’s Hospital Foundation Chair in Paediatric Research; University of CalgaryChildren’s Healthcare Canada’s strategic priorities include informing the development of innovative and integrated health systems and advocating to improve children’s health and health systems. The SPARK: Conversations podcast series is a new solutions-focused podcast that connects the child health community with system leaders who tackle wicked problems and discuss ideas to inform the development of innovative and integrated systems serving children and youth.Dr. Benseler has completely re-organized and improved the research environment for basic and clinical research. Dr. Benseler has strengthened the relationship between the Department of Paediatrics and the research institute with transparency, inclusiveness, and teamwork. This has led to remarkable new research partnerships between basic scientists and clinical researchers. Dr. Benseler has been able to develop a new level of community engagement which is extra-ordinary. Dr. Benseler has successfully stewarded the Child Health Research Platform as one of two winning submissions for the Cross-Cutting multi-million dollar initiative at the University of Calgary. ACHRI is the only research institute with a clear focus on research within the University, across campus, and in our community. These developments have all been the brainchild of Dr. Susanne Benseler and her team at ACHRI.Summary:Children are the foundation of Canada’s future, and as such, research in child health is research on the future of our nation. Conducting health research with children is an ethical imperative to understanding treatment and prevention effectiveness, relative costs of child healthcare, and tactics to advance equitable healthcare. We had the opportunity to sit down with groundbreaking child health researcher, Dr. Susa Benseler, to understand the current landscape and trajectory of child health research. Dr. Benseler explains the need for an ongoing, national conversation, outlines why a cross-sectoral approach is impactful, and gives advice to others hoping to ‘scale up’ their child health research plans. She sheds light on her interdisciplinary vision to advance children’s healthcare in a positive direction. 

Children and their family members have unmatched, dyadic impacts on each other’s health. This is especially prominent in children and families that, due to unfortunate circumstances, are frequently connected with hospitals, researchers, and health systems. As such, it is imperative that we engage families in healthcare processes, and recognize their stories, experiences, and input as the valuable forms of knowledge that they are. We recently had the opportunity to sit down and discuss family partnership with Rachel Martens. Rachel provides a unique perspective on this topic as she has seen child healthcare from the lenses of both a parent and a professional. On this episode of SPARK: Conversations, Rachel helps us dig into best practices in family engagement and the importance of the human aspect in child healthcare. She also offers advice to practitioners on the balancing act between involving family partners, while avoiding causation of potential burnout and discomfort.

Misinformation and even disinformation are not new concepts in science. This has been evident during the COVID-19 pandemic while the world has monitored, shared, and re-shared information on the spread of the virus, public health restrictions, and immunization. Recently, the COVID-19 discussion has become even more emotionally charged with a vaccine available for some children in Canada. Unfortunately, we can see that the skills required for critical consumption of evidence appear lacking in many areas. We live in a world driven by metrics, and unfortunately, headlines are often misleading, and people share information without reading the full text or confirming the accuracy of the information. Uncertainty, discomfort, and mistrust are lingering as Canadians are having difficult, divided conversations with their loved ones around the dinner table, on the phone, and on Zoom. To combat this, Dr. Krishana Sankar and the team at ScienceUpFirst focus on the clear and accurate distribution of scientific evidence. On this episode of SPARK: Conversations, we sit down with Dr. Sankar to discuss the importance of simple, clear, and up-to-date evidence distribution, and how to do so effectively.

While COVID-19 has resulted in a global health crisis with considerable negative health impacts affecting children and youth, climate change has been an evolving and escalating global threat to child health for even longer. The global mean temperature warming is escalating and will have lasting momentum for centuries to millennia. However, immediate action can mitigate future warming in the next two decades and will immediately improve air quality. Unfortunately, the impact of climate change on child health and the healthcare system is multifaceted and today’s children are expected to bare disproportionate burden in their lifetime. The health impacts span the full pediatric age-range and can affect almost any organ system through acute illness and injury or chronic, complex stressors, including both mental and physical aspects.  In sum, climate change can have negative effects on long-term neurodevelopment, alters the social and environmental determinants of health, and can potentially amplify burdens for children with pre-existing medical conditions. Join us for an evidence-informed discussion with pediatric intensive care doctor, Dr. Anna Gunz, in which we explore the impact of climate change on child health, healthcare systems, and beyond.

This podcast focuses on patient partnership for child health research, practice,  and systems. Listen in as Dr. Katie Birnie shares her perspective on patient partnership and Partnering for Pain, an award-winning research program which she leads and which integrates patient and family partnership and multi-stakeholder engagement to improve the prevention, assessment, and management of pain experienced by children and their families. At the time of the rollout of a COVID vaccine for children, this initiative has many resources available to ensure #ItDoesntHaveToHurt (https://partneringforpain.com/2020/12/12/resources-and-strategies-for-managing-fear-of-needles-and-vaccination-pain/). We discuss terminology  (engagement, partnership, family- and child-centred care), the value of patient  partnership to child health research, clinical care, and system planning. Dr. Birnie also shares practical advice to help embed patient partnership into the routines of children's healthcare.

Health inequities are “unfair, avoidable, and remediable differences in health status between countries and between different groups of people within the same country” (WHO, 2013, p 3). COVID has revealed inequities that many in healthcare, some more than others, already knew existed. We’ve noted differences in who is exposed to and infected by COVID, who ends up in hospital or ICU, and who is able to or choses to follow public health guidance (masks, social distancing, vaccines). For example, Ontario data show a higher risk for COVID exposure and infection among racialized and low-income communities. As well, vaccine uptake is lower, and hesitancy higher among these same groups for whom there has been a disproportionate burden of COVID-19 outcomes, and in whom vaccination will prevent more infections and severe outcomes. Vaccine passports have been implemented to incentivize vaccination and reduce COVID risk in our communities. But does this public health intervention have the potential to further disparities? How do we reap the benefits while reducing the inequities?Listen into this SPARK: Conversations podcast as we discuss COVID, Kids, and health equity with Dr. Kwadwo Kyeremanteng.

Due to its federated nature, Canada does not have a national structure for the governance of child health or health care. Joined up governance (or a ‘whole of government’ approach) has been touted as an important tool in tackling “wicked” problems in children’s health and healthcare, which involves multiple ministries responsible for health, social services, and the social determinants of health. Integrating child health systems and services is such a wicked problem because, many services, for children with medical complexity, for example, are delivered through various healthcare “systems” (hospital, home care, respite, other community-based care) and other systems (e.g., social services, education, justice, finance, Indigenous affairs).Join Children’s Healthcare Canada and special guest, Dr. Eyal Cohen, in a discussion about Joined up governance. He explains how it works, why it is important, and how its structure could positively impact the lives of all children, including those with medical complexities.