Novel Innovations

Due to the collaborative nature of CL work, a number of unique units and activities have been founded by CLD members. For example:

• The Psychosocial Oncology and Palliative Care (POPC) Division of the Princess Margaret Hospital is responsible for the psychosocial wellbeing of cancer patients at PMH. It is administratively equivalent to medical or radiation oncology, and functions as an integration of psychiatry, palliative care, social work and chaplaincy. Created and run by Dr. Gary Rodin, it is also a center of academic work with multiple research fellows investigating many facets of the cancer experience. Furthermore, Dr Rodin has established the Global Institute of Psychosocial, Palliative and End-Of-Life Care (GIPPEC) which is an interdepartmental and interdivisional Institute of the University of Toronto devoted to promoting and developing interdisciplinary research that addresses the medical, psychological, social, legal, ethical, cultural and religious problems related to psychosocial and palliative care of individuals with advanced and terminal disease.

• In a further example of inter-disciplinary activity, Mary Jane Esplen (RN PhD) heads the DeSouza Institute- a centre for knowledge translation which provides continuing education and professional development support for oncology health professionals. It has instituted provincial and national programs to increase the expertise of psychosocial care principles across disciplines, including nurses, social workers, psychologists and medicine. A multidisciplinary DeSouza working group developed interprofessional competencies for oncology, across the illness trajectory from prevention to palliative care, that embed psychosocial competencies within a ‘novice to expert’ framework.

In a similarly collaborative framework, members of the CLD have energetically partnered with primary care organizations to address insufficient mental illness resources in primary care. Sanjeev Sockalingam is the co-lead for Extension of Community Health Outcomes (ECHO) Ontario Mental Health, which is a provincial primary care capacity building initiative using tele-video conferencing to increase access to scarce specialist resources to support providers and improve patient outcomes in underserved areas. ECHO Ontario Mental Health will expand to 6 new ECHO mental health programs in 2018-19. Jon Hunter is the Co-chair of the Ontario College of Family Physician’s Collaborative Networks for Mental Health Care and  Addictions and Pain, which link over 5oo family practitioners in Ontario to mental health specialists for ‘just in time’ responsiveness to clinical dilemmas.

• Kim Miller, Madeline Li and Gary Rodin have novel educational programs running in Kuwait-where they have been teaching communication skills workshops to oncologists, nurses and allied health personnel at the Kuwait Cancer Control Center – and in Kenya, where the teaching has focused on Communication Skills training for Gyne Oncology fellows via Skype, using role play and other novel didactic methods.
   
• Bob Maunder and Jon Hunter have focused on the impact of relationships on health and the delivery of healthcare through peer-reviewed publications, books for both the professional and the lay public, and numerous public speaking events. Within the CLD appreciating the relationship or attachment style of a patient undergoing treatment has become a basic approach to understanding  how to optimally help patients.
   
• A number of Rehabilitation Centers are now staffed by psychiatrists within the CLD; these include the Toronto Rehabilitation Institute, St John’s Rehab, and Bridgepoint Active Healthcare. The task of helping patients and their families, with the physical and mental consequences of significant trauma or severe illness is a new and evolving focus for CL activities.
   
• A drive to improve quality in CL clinical work across the Division has resulted in a citywide program for collecting descriptive statistics on Cl team functioning in each teaching site. We have also created the ‘Self-Assessment kiosk’ a free online source of validated questionnaires which assess many aspects physical and mental health, open to anyone, anywhere, at any time.