D.E. Systems - Poster | MyConference Suite

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Abstracts of Distinction

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53651		Poster	8:00 AM	8:15 AM			1				Exploring the Benefits of 3D Printing for Lower-Limb Prosthetic Sockets	Winfried Heim West Park Healthcare Centre Arezoo Eshraghi West Park Healthcare Centre Clara Phillips West Park Healthcare Centre	The scope of this initiative includes 15-20 lower-limb amputees, who are candidates for a preparatory prosthetic device.	Findings have identified reduced operational costs (down 20% from traditional methods), satisfactory comfort, and turnaround time reduced from weeks to 2 days. Identified challenges that remain include eliminating the reinforcement stage, as well as addressing the learning curve involved in rectifying the residuum CAD file and the inability to capture important residual limb information (i.e., tissue density).	Our initiative has shown promise to reduce costs and turnaround time that allows patients to begin their rehabilitation sooner. However, the abstract CAD rectification leaves clinicians with uncertainty, thus outcome predictability is unmeasurable. To improve the CAD process, further R&D is needed to digitally capture and translate tissue density information into CAD.	3D printing holds great potential to benefit lower-limb socket fabrication. It enables archiving digital residuum impressions for future fabrication and rehabilitation purposes. Initial outcomes are satisfactory, however will require integration of the human touch (i.e., tissue density) into the process for predictability.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53675		Poster	8:00 AM	8:15 AM			2				Brain Injury Speaks: Growing a Stakeholder Engagement Network for Survivors of Brain Injury and their Family Members/Caregivers	Ruth Wilcock Ontario Brain Injury Association Judith Gargaro Ontario Neurotrauma Foundation Gazal Kukreja Ontario Neurotrauma Foundation	The stakeholder engagement network consists of survivors of brain injury as well as their family members and caregivers from all across the province of Ontario. Currently, the network has 439 members and is continuing to grow. It is important that the network represent the perspectives of all severities of BI, all regions, communities, and lengths of time since injury etc. Acquired brain injury is present in all areas of rehab, from mental health and addictions, to orthopaedic injury to diabetes to name a few.	The information gathered through this network will inform future policies surrounding brain injury care. Furthermore, engaging stakeholders in meaningful dialogue about various barriers and challenges they face will cultivate a sense of community. Informational newsletters will be sent to the network to inform members about updates in government policies and network members respond to short surveys. The first survey sent out to the network to gain an understanding of the current barriers to accessing community supports and services received 176 responses (~40% of network members). Motivation is high and it is clear that the brain injury community is ready and willing to speak out.	The Brain Injury Speaks is a new centralized, coordinated, and province-wide initiative aimed at identifying the most pressing and common issues faced by the brain injury community. This stakeholder network is being cultivated by two provincial organizations that focus on quality of life, best practice, and system organization. This is a crucial aspect of raising awareness for the need for a brain injury strategy that can support persons with brain injury who use services in many types of rehabilitation settings. Gathering information and specific data from stakeholders will inform future policies, programs and system changes to improve the quality of life for those living with acquired brain injury.	Bringing the brain injury community together and representing their voices to effect change at the policy level is important. A stakeholder engagement network is an effective way to gather important information and speak to government, policy makers and service providers.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
53676		Poster	8:00 AM	8:15 AM			16				Improving the Implementation of Brain Injury Guidelines Across the Province	Gazal Kukreja Ontario Neurotrauma Foundation Judith Gargaro Ontario Neurotrauma Foundation	Healthcare providers, professionals, and inpatient and community-based facilities across the province engaged in the treatment and rehabilitation of persons with brain injury.	With implementation support, facilities were able to implement the guideline recommendations that were a priority in their rehabilitation or primary care setting. Outcome and process measures inform the future sustainability planning of these initiatives. The tools, resources and methods used in the projects are publicly available online to promote spread and scale up of projects. The most successful projects are those who took the time to engage all the stakeholders from the beginning, temporarily seconded or hired staff to shepherd the project and adherence to the implementation methodology.	There have been several iterations of the catalyst funding initiatives and it is clear that such funding and support is necessary and sufficient to make sustainable change. Change is difficult and requires focused planning and resources. Connections and partnerships have been made across programs that have allowed for sharing of implementation tools and resources. Programs wishing to implement similar strategies to improve the care of individuals with brain injury can access these materials for support and guidance.	Using implementation science to guide the adoption of evidence-informed best practice guidelines promotes sustainability of the adopted guideline. While this work is in the field of Brain injury rehabilitation and support, it is transferable to other inpatient and community settings.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54209		Poster	8:00 AM	8:15 AM			18				Enriching Clients' Lives with the 1000WORDS Photography Program	Rebecca Swift Brain Injury Services Muskoka Simcoe Percival Morier March of Dimes Canada Jeff Young March of Dimes Canada Alda Tee Central East Stroke Network Elizabeth Faraone March of Dimes Canada	The 1000WORDS photography program is offered by a lead agency and its partners in a group setting for individuals who are living with aphasia and/or acquired brain injury.	The program underwent an evaluation in 2017 as part of a MSC. OT student project. The sample size at that time was small. Improvements were noted in scores for the EQ -5D-5L, Communication Integration Questionnaire and the Communication Effectiveness Scale. Participants reported that the program created increased opportunities to participate in conversation. The implementation plan for expansion in 2020 includes evaluation through qualitative reports and satisfaction surveys.	The 1000WORDS Photography Program provides not just training in photographic technique, but also training in visual literacy, communication, leadership and life skills. For people who are experiencing communication difficulties, being equipped with a camera and having the time and opportunity to express themselves within a safe, secure and caring environment, is an incredibly empowering experience.	The resumption of social and leisure pursuits is an essential component of community reintegration and an important aspect to quality of life. Utilizing a LPAA, the 1000WORDS photography program breaks down barriers to leisure, and provides a supportive environment to learn and practice new skills; enhancing and enriching lives for individuals with chronic aphasia and/or ABI.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54375		Poster	8:00 AM	8:15 AM			19				Intimacy and Sex After Stroke	Nina Hovanec University Health Network - Toronto Rehab Vanessa Ong University Health Network - Toronto Rehab Bayla Cheskes University Health Network - Toronto Rehab Kristyn Emmerzael University Health Network - Toronto Rehab Andrea Calvet University Health Network - Toronto Rehab	This initiative may impact patients and carers receiving care from our teams. Clinicians are now able to provide more opportunities to discuss intimacy and sex after stroke as part of their routine practice. The developed resources can be easily utilized by other stroke programs to support and address the prevalent gap of limited opportunities to discuss intimacy and sex after stroke.	Through an iterative, collaborative and reflective approach, the interprofessional working group and their stroke rehabilitation teams have developed resources to address intimacy and sex after stroke. Utilizing passive influencers, such as posters and readily available handouts for patients help to normalize the topic. Embedding proactive influencers, such as a standard script to facilitate goal setting during existing processes, ensures the topic is not overlooked. The resources and processes that emerged from this initiative enables achievement of stroke best practices despite barriers, including shortened length of stay and competing priorities.	The working group developed a practice process and stroke-specific, aphasia-friendly resources to support patients, carers as well as staff when addressing intimacy and sex after stroke. Through passive and proactive influencers the program has moved towards: 1) normalizing the topic of intimacy and sex after stroke; 2) embedding opportunities in existing processes to address the topic, and 3) increasing staff comfort and competency with the topic.	This project evolved over several years, highlighting the implementation process, as well as the patient-centered, diverse and inclusive resources that were developed by a stroke rehabilitation program. Sharing these developed resources is beneficial to facilitate other stroke programs to provide opportunities to address intimacy and sex after stroke.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54376		Poster	8:00 AM	8:15 AM			29				Community-based Pre-operative Education Classes	Kristina Saric Hamilton Health Sciences Teri Czajka Hamilton Health Sciences	This education class is offered to all patients that are scheduled to have an elective TSA with any of the three surgeons who perform this type of surgery. This includes both primary and reverse TSA and is open to patients who are scheduled as a Same Day Home, Same Day Overnight and Same Day Admit.	Initial results indicate that lengths of stay in comparison to estimated lengths of stay are reduced for patients who have attended the education sessions. The implementation of this pre-operative education class has decreased the length of hospital stay in this surgical population. This has also allowed other elective surgeries to remain on schedule and less likelihood of cancelation. Post-session questionnaires demonstrate that patients felt the education, community setting, accessibility and content met their needs. Subjectively, the patients who have attended the pre-operative education class have expressed heartfelt appreciation for the courses content and detailed explanation of what to expect, resulting in decreased anxiety regarding their surgery. Further data collection would have to be completed to analyze whether this education session facilitates enrollment in a well health exercise program post-operatively.	The findings of this initiative prove the benefits of the existence of a pre-operative education class for elective surgeries. Patients often have many questions and concerns regarding their upcoming surgery and will admit that they do not have anyone to connect with regarding this. Pre-operative clinics are often full of medical information, with limited face-to-face time with the surgeon to allow for patients to ask all their questions. This pre-operative education class provides a welcoming and accessible environment for patients to express concerns and present their questions to make them to feel more prepared. This builds a link between the acute care system and community programming to provide optimal patient care across a continuum. This initiative may lead the way to involve other surgical procedures and the development of programming in partnership with the YMCA to have pre-operative prehab programs to prepare patients.	In conclusion, the development of a pre-operative education class for patients with scheduled shoulder surgeries has positively impacted the patient's care, the patient's experience and patient flow on the orthopedic unit. Surgeons continue to feel that this is a benefit to their patients and recommend their attendance at these sessions. This initiative promotes the continued collaborations and partnerships between acute hospital care and community based programming. It paves the way for the hospital's role in promoting over all well health outside of the walls of an institution.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53639		Poster	8:00 AM	8:15 AM			30				Experiences of Patients and Caregivers with Transitions in Care Following Hip Fracture: A Scoping Review	Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto Amanda Everall Leslie Dan Faculty of Pharmacy, University of Toronto Kerry Kuluski Institute of Health Policy, Management and Evaluation, University of Toronto Lauren Cadel Leslie Dan Faculty of Pharmacy, University of Toronto Maliha Asif Leslie Dan Faculty of Pharmacy, University of Toronto	Articles or grey literature that included information about patient or caregiver experiences with care transitions following hip fracture.	Of the 1107 articles identified, 11 were included in the review. Challenges with care transition included poor information sharing by healthcare providers, confusion about the roles of providers and family members and disorganized discharge planning. Suggestions for improving care transitions included creating a patient representative role, increasing geriatrician involvement, using written communication and technology for knowledge sharing.	As the first scoping review exploring experiences with transitions in care for hip fracture, we found that there was an overall dearth of published literature. Most existing literature lacked gender-based analyses. There remains much room for improvement, especially with communication, to improve patient and caregiver experiences.	Experiences of patients and caregivers with care transitions following hip fracture lack sharing of pertinent information and were characterized by role confusion and disorganized, untimely discharge planning. This signals a need for improved policies around care transitions.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53175		Poster	8:00 AM	8:15 AM			33				Inter-Organizational Transfer of Accountability Guideline: From Acute Care to Rehab/CCC to Community Care	Sanja Milicic Iafrate GTA Rehab Network Sharon Ocampo-Chan GTA Rehab Network Charissa Levy GTA Rehab Network	Acute care and rehab/CCC hospitals in the GTA, Home and Community Care rehab service providers in the GTA.	Data analysis indicated the majority of rehab/CCC (78%) and home and community care providers (60%) are experiencing gaps in information received that impacts their ability to provide best patient care. Examples of gaps in information included: missing discharge summaries, medication administration records, safety precautions, etc. Strategies to address gaps in information were integrated in the guideline and discussed with the working groups.	At the clinical level, TOA issues are often unreported, as interprofessional teams have developed temporary fixes and workarounds. Furthermore, online referral systems have not mitigated risks of TOA issues. These findings and consultations were applied to develop an Inter-Organizational TOA guideline. The guideline supports patient transitions across the patient lifespan and care continuum, and consists of 6 principles: 1. Ensure health service providers understand and have knowledge of legislation and policies that guide effective transitions 2. Communicate patient and caregiver preferences and goals to the next level of care 3. Establish one key contact at each transition point 4. Standardize processes for transition by the organization 5. Communicate effectively among health care providers to facilitate transition 6. Acknowledge dual responsibility of senders and receivers in transitions. Each principle will be discussed in detail in the presentation.	Inter-organizational TOA guideline identifies best practices in transitioning patients from one point of care to next and outlines practical applications for clinicians and organizations.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53587		Poster	8:00 AM	8:15 AM			35				Patient and Family Engagement in Rehabilitation Research: Creating a Print Educational Tool	Marina Wasilewski St. John's Rehab Sander Hitzig St. John's Rehab Lisa Di Prospero Sunnybrook Health Sciences Centre Laurie Legere Sunnybrook Health Sciences Centre Siobhan Donaghy University of Toronto	The brochure was developed and initially distributed at SJR to help advance the program's Patient and Family Oriented research agenda.	Two-hundred brochures were printed and distributed at SJR. We also made the brochure web-accessible. Patients and families at SJR were encouraged to share the brochure with peers in their respective communities (e.g. stroke), and thereby acted as ambassadors for PFE in research. The brochure is being used as a template by the Sunnybrook Patient Engagement and Research team as part of a broader toolkit to facilitate greater and more meaningful PFE in their work.	This brochure was the first of its kind to be used as a print educational resource to enhance PFE in rehabilitation research. The development of this brochure aligned with Sunnybrook Health Sciences Centre's Strategic Priority of 'Improving Quality and Creating a Better Care Experience' in as far as it provided patients and families with information that is critical to enabling them to truly be part of the research team.	The development of the "Patient and Family Engagement in Rehabilitation Research" brochure has been a successful initiative that connects patients and families with the SJR research team. Through this initiative, the perspectives and priorities of patients and families are better-reflected in the research that is undertaken at SJR.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53665		Poster	8:00 AM	8:15 AM			42				Registered Practical Nurses in Inpatient Rehabilitation Settings: A Competency Framework	Nancy Snobelen Independent Svetlana Ivanitskaya Central Michigan University Lynn McCleary Brock University Robert Teasell Department of Physical Medicine and Rehabilitation Faculty of Medicine and Dentistry University of Western Ontario Scientist, Lawson Health Research Institute Parkwood Hospital, St. Joseph's Health Care	21 RPNs were interviewed. Informants ranged from 25 to 64 years of age and had, on average, 11 years of rehabilitation experience.	RPNs' rehabilitation-specific knowledge revolved around settings, participants, and activities. Specialized skills were interpreting, consoling, conserving, and integrating. Intervention abilities included easing into rehabilitation, creating milieu, and maximizing patients' efforts. Organizational environment variables of importance to RPNs' work were model of care, role ambiguity, and changes to system and patient paradigms.	Passionate about their jobs, the RPNs were challenged to reflect on the purpose, interventions, and practice of rehabilitation nursing. Individual responses varied by experience, training, and tacit knowledge. Entry-to-practice competencies (CNO, 2014) are not sufficiently detailed. There is increasing encroachment on the biopsychosocial model by organizational factors.	RPNs represent an important, yet underutilized part of the rehabilitation workforce. The outlined competency framework can be used to communicate about RPNs' contributions to interprofessional teams and clinical outcomes and is key to refining a specialized role to optimize resource use and employee satisfaction.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
54235		Poster	8:00 AM	8:15 AM			48				Rehabilitation Unplugged: Rolling out #EndPJParalysis across Alberta in a context of too many projects, too little time, no budget.	Liz Webster Alberta Health Services (AHS) Jennifer Symon Alberta Health Services (AHS) Paul Wright Alberta Health Services (AHS) Isabel Henderson Alberta Health Services (AHS)	The current focus of #EndPJParalysis has been the acute care hospital system, single units or site-wide, with 100% zone participation.	Metrics for individual units enrolled in the "campaign" have been captured via a specialized app and preliminary results align with those of other international jurisdictions. Consistently, evaluations of #EndPJParalysis have demonstrated that it reduces avoidable harm (including falls, incontinence and pressure injuries), improves patient and staff experience and wellbeing and cuts length of hospital stay.	How can Rehabilitation Leaders promote the #EndPJParalysis agenda within the Canadian healthcare system? We must share the Mobilization/Activation mantra with our other healthcare discipline partners and galvanize the strengths of our patients and families to change outdated beliefs about bedrest.	#EndPJParalysis is a shift whose time has come. Evidence of harm from deconditioning has been known for decades yet we still allow patients (especially our elderly) to be immobile for up to 90% each day. This immobility has a negative impact, not only to the patient, but potentially to the wider healthcare system.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
53662		Poster	8:00 AM	8:15 AM			49				Enhancing Preventative Oral Care in Long-Term Care	David Chvartszaid Baycrest Rosanne Aleong Baycrest Rosalind Sham Baycrest Sandra Gardner Baycrest Karen Joseph Baycrest Jagger Smith Baycrest Nelly Villacorta-Siegal Baycrest	238 PSWs and nurses responded to at least one eLearning survey; 25 post-SIDH consultation surveys were completed. The SIDH completed 65 oral health assessments. 30 PSWs and nurses participated in focus groups/interviews.	(1) Personal Support Workers (PSWs) and nurses had high confidence in providing oral care and in identifying oral concerns especially after completing the eLearning module. (2) The eLearning module improved staff knowledge related to frequency of oral care and use of personal protective equipment. (3) SIDH identified greater dental concerns than were identified in the InterRAI MDS by nurses. (4) Ten percent of LTC population was referred to SIDH.	On-the-job training can improve LTCH residents' oral health by enhancing the confidence of point-of-care staff in effectively delivering the daily oral routine. Screening and a direct referral to a dental hygienist on the interprofessional care team through the EMR identify oral care needs and provide a system that ensures continuity of care for older adults.	Online interactive oral care education session, in combination with in-person support of a mobile SIDH, have made a positive impact at Baycrest and can be expanded to other LTC homes across Ontario.	Knowledge Transfer and Exchange Initiative
53636		Poster	8:00 AM	8:15 AM			54				Polypharmacy following non-traumatic spinal cord dysfunction: A retrospective population-based study	Aisha Lofters Women's College Hospital Qi Guan Institute of Health Policy, Management and Evaluation, University of Toronto Tanya Packer Dalhousie University Tejal Patel School of Pharmacy, University of Waterloo Sander Hitzig Sunnybrook Research Institute, Sunnybrook Health Sciences Centre Andrew Calzavara ICES Daniel McCormack ICES Mary-Ellen Hogan Leslie Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto	The cohort included 3,468 individuals with NTSCD who met the inclusion criteria.	The median cohort age was 70 (IQR=62-77) with a nearly even sex distribution. Following in-patient rehabilitation, the mean number of drug classes taken was 11.7 (SD=6). Over half of the cohort (62.7%) were taking medications from 10 or more different drug classes. Risk factors of polypharmacy included being female, low continuity of care, low income, and lower Functional Independence Measures upon discharge from inpatient rehabilitation (i.e., less independent).	While much of the cohort experienced polypharmacy, pre-existing multimorbidity and prescription drug claims prior to inpatient rehabilitation were significant. Rates of polypharmacy among those with NTSCD are higher than in the general population or among those with traumatic injuries, reinforcing the medical complexity of those with NTSCD.	The prevalence of polypharmacy among Ontarians with NTSCD was high, with over half of the cohort taking 10 or more drug classes. Awareness of polypharmacy rates and the potential for inappropriate prescribing among clinicians may reduce potential harms.	Research in Rehabilitation (quantitative, qualitative or mixed methods)

Amputee

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53651		Poster	8:00 AM	8:15 AM			1				Exploring the Benefits of 3D Printing for Lower-Limb Prosthetic Sockets	Winfried Heim West Park Healthcare Centre Arezoo Eshraghi West Park Healthcare Centre Clara Phillips West Park Healthcare Centre	The scope of this initiative includes 15-20 lower-limb amputees, who are candidates for a preparatory prosthetic device.	Findings have identified reduced operational costs (down 20% from traditional methods), satisfactory comfort, and turnaround time reduced from weeks to 2 days. Identified challenges that remain include eliminating the reinforcement stage, as well as addressing the learning curve involved in rectifying the residuum CAD file and the inability to capture important residual limb information (i.e., tissue density).	Our initiative has shown promise to reduce costs and turnaround time that allows patients to begin their rehabilitation sooner. However, the abstract CAD rectification leaves clinicians with uncertainty, thus outcome predictability is unmeasurable. To improve the CAD process, further R&D is needed to digitally capture and translate tissue density information into CAD.	3D printing holds great potential to benefit lower-limb socket fabrication. It enables archiving digital residuum impressions for future fabrication and rehabilitation purposes. Initial outcomes are satisfactory, however will require integration of the human touch (i.e., tissue density) into the process for predictability.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation

Brain Injury / Neuro / Stroke

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53675		Poster	8:00 AM	8:15 AM			2				Brain Injury Speaks: Growing a Stakeholder Engagement Network for Survivors of Brain Injury and their Family Members/Caregivers	Ruth Wilcock Ontario Brain Injury Association Judith Gargaro Ontario Neurotrauma Foundation Gazal Kukreja Ontario Neurotrauma Foundation	The stakeholder engagement network consists of survivors of brain injury as well as their family members and caregivers from all across the province of Ontario. Currently, the network has 439 members and is continuing to grow. It is important that the network represent the perspectives of all severities of BI, all regions, communities, and lengths of time since injury etc. Acquired brain injury is present in all areas of rehab, from mental health and addictions, to orthopaedic injury to diabetes to name a few.	The information gathered through this network will inform future policies surrounding brain injury care. Furthermore, engaging stakeholders in meaningful dialogue about various barriers and challenges they face will cultivate a sense of community. Informational newsletters will be sent to the network to inform members about updates in government policies and network members respond to short surveys. The first survey sent out to the network to gain an understanding of the current barriers to accessing community supports and services received 176 responses (~40% of network members). Motivation is high and it is clear that the brain injury community is ready and willing to speak out.	The Brain Injury Speaks is a new centralized, coordinated, and province-wide initiative aimed at identifying the most pressing and common issues faced by the brain injury community. This stakeholder network is being cultivated by two provincial organizations that focus on quality of life, best practice, and system organization. This is a crucial aspect of raising awareness for the need for a brain injury strategy that can support persons with brain injury who use services in many types of rehabilitation settings. Gathering information and specific data from stakeholders will inform future policies, programs and system changes to improve the quality of life for those living with acquired brain injury.	Bringing the brain injury community together and representing their voices to effect change at the policy level is important. A stakeholder engagement network is an effective way to gather important information and speak to government, policy makers and service providers.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
53981		Poster	8:00 AM	8:15 AM			5				A cognitive assistive technology to increase the safety and independence during meal preparation for people living with Brain Injury: Therapists' perspective	Carolina Bottari University of Montreal Deirdre Dawson University of Toronto Sylvain Giroux University of Sherbrooke Mélanie Couture Centre for Research and Expertise in Social Gerontology Sareh Zarshenas University of Montreal	Therapists from various disciplines who have at least 2 years of experience working with patients with TBI in outpatient rehabilitation settings, community settings or private sectors.	Individuals from various disciplines shared their perspectives on COOK. Having a goal of being independence, decreasing the level of burden on families/therapists, COOK as a comprehensive tool and usability of technology at home and long-term care were considered as advantages of this technology. While having a severe TBI, financial barriers, lack of supportive caregivers, remote areas were mentioned as the main barriers of implementation of this technology within the living location of patients with TBI.	This study was a first step to acquire in-adept information about various aspects of using this technology in a real living context from the team of care perspective in Ontario. These findings also shed light on the next phase of this study with the focus on clients' and caregivers' standpoint and an embedded case-study in a real context of living of clients with TBI.	These findings will be very helpful to improve this technology and customize it considering the needs of clients, caregivers and the team of care and the context of living situation.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
54750		Poster	8:00 AM	8:15 AM			7				A case study to describe a novel way of assessing balance before and after botulinum toxin injection in a patient with lower limb spasticity	Chris Boulias West Park Healthcare Centre Farooq Ismail West Park Healthcare Centre George Tourlidas West Park Healthcare Centre Shannon Reid West Park Healthcare Centre Frank Bunn PHD Associates, York University Chetan Phadke West Park Healthcare Centre	The subject was a 56 year old male with stroke that occurred 7 years ago resulting in spasticity on the left side of the body.	The subject received 400 units of BoNTA intramuscularly for treatment of spasticity in the left arm muscles; he was not receiving any other medications. The subject walked independently without assistive and had no history of trips or falls. Patient and clinician perception of spasticity decreased as expected at 1 month post-BoNTA and returned to baseline level at 3 months post-BoNTA. A similar trend was also seen in the MATT recorded balance measure. Clinical tests of gait and balance did not show any change.	We visually checked the videos to confirm if the MATT system accurately deducted points indicating balance impairment. The MATT system was able to pick subtle head movements perceptible only during multiple video replays reviewed offline. This indicates the strength of the computerized assessment compared to clinician scored balance assessments which can miss the subtle movements which may be imperceptible to a naked eye without benefit of multiple replays. Since the clinical tests of balance and self-efficacy did not change, it was not immediately clear if the head movements picked by the MATT system indicate voluntary weight shift or underlying balance impairment. Decrease in spasticity as a result of BoNTA injection may have induced subtle changes in the centre of mass resulting in gentle head sway. In the POMA assessment, the MATT software was unable to recognize that the subject used his right (unaffected) arm to push off the chair in the sit to stand test. However, the software also accurately deducted a point for use of arms as the arm was abducted in order to assist with sit to stand.	Even though the MATT system utilizes a Kinect camera, the algorithms used in the software, under certain conditions, can allow use of assistive devices such as a cane or a walker as well as allow another individual to walk alongside the patient in case of a sudden loss of balance. The MATT system shows great promise; however, it requires some fine tuning with input from clinicians, patients, and researchers in the GTA.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
53399		Poster	8:00 AM	8:15 AM			9				Successes and challenges to implementing and sustaining Quality Based Procedure length of stay targets in inpatient Stroke rehabilitation.	Megan Wormald Toronto Rehab, UHN Alexander Lo Toronto Rehab, UHN Karl Wong Toronto Rehab, UHN Edith Ng Toronto Rehab, UHN	QBP LOS targets are now used with all patients with Rehab Patient Group (RPG) 1100 to 1160 in the high intensity, Inpatient Stroke Rehab Service.	Teams are satisfied with the approach used to facilitate change: "great discussions between inpatient and outpatient teams;" "Great format. Please continue." Team members generated change ideas and implemented plans into practice. New processes have been sustained after one year. Over 80% of patients with RPG 1140-1160 met QBP LOS targets, an increase from 10% at baseline. Barriers to reach 100% adherence were identified and mitigated.	Change is constant in rehab to support the evolving best practice recommendations, the changing healthcare system, and patients' needs. Learnings from the approach taken and the processes developed can inform facilitation of change in rehab settings. Barriers identified were both systemic and local, which can generate opportunities to learn across services.	An environment to foster active team engagement, use of data with clear objectives and outcomes, and the use of a systematic QI approach were important steps taken to support the transition to QBP LOS targets. QBP targets are now implemented; the teams continue to meet, learn, and celebrate together for ongoing improvement.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53479		Poster	8:00 AM	8:15 AM			10				Improving discharge transitions in inpatient stroke rehab with patient partner	Jennifer Shaw Toronto Rehab, UHN Lucy Kilby Toronto Rehab, UHN Lara Kaufman Toronto Rehab, UHN Karl Wong Toronto Rehab, UHN Edith Ng Toronto Rehab, UHN	Stroke inpatients who are discharged to live in the community will receive both components of PODS customized for the Inpatient Stroke Service.	Key opportunities identified were: education on day of discharge and use of teach-back. This led to the addition of teach-back meeting 3 days before discharge. From 280 meetings held, 380 questions were raised and followed-up by the team. 100% of patients and caregivers said they would recommend teach-back meetings to others and found timing "just right". Questions raised are tracked and majority are related to medical concerns and medications.	The PODS initiative provided an opportunity for the teams to examine current practices and to better address patients' discharge transitions. Teach-back meetings have allowed learning gaps be identified and addressed before discharge, including questions related to medications. Unplanned readmission rates was zero post implementation.	Customization of PODS is important to foster sustainment of process and to meet the specific needs of patients in inpatient stroke rehab. Teach-back meetings support the teams in addressing learning gaps before discharge and continue to help identify opportunities for ongoing improvement to support discharge transitions.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53549		Poster	8:00 AM	8:15 AM			11				Community transitions in outpatient stroke rehab: Co-designed with persons with stroke, caregiver, & community partners	Alona Berkovitz Toronto Rehab, UHN Karl Wong Toronto Rehab, UHN Edith Ng Toronto Rehab, UHN	All outpatients in the Stroke Rehab Services receive the transition bundle developed to better support community transitions.	To support community transitions as a continuum, the transition bundle were developed to address 4 key components: (1) goal setting with patients, (2) education and resources to foster self-management, (3) pre-discharge teach-back meeting, and (4) community partnerships to offer more direct links to community resources and access to post-discharge telephone follow-up.	The partnerships with patient, caregiver, and community partners were instrumental in developing the necessary processes and tools to support community transitions as a continuum from outpatient stroke rehab to community living post-discharge. Processes to enhance connections with community resources and to foster self-management may in turn lower readmission rates.	Patient, caregiver, and community partners provided insights and ideas that were invaluable to shape this initiative and its outcomes. The transition bundle developed continue to be refined. Lessons learned can benefit organizations with an interest in improving community transition experiences in outpatient rehab settings.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53583		Poster	8:00 AM	8:15 AM			12				Creation of an Interprofessional Outpatient Discharge Letter	Abigail Leung Providence Healthcare Valerie McWhinnie Providence Healthcare Tiffany Wu Providence Healthcare Jennifer Joachimides Providence Healthcare	The Discharge Letter will be provided to all patients attending the Outpatient Stroke and Neuro Clinic and forwarded to their primary care physicians.	Survey results revealed inconsistencies across the GTA in how information was being shared at time of discharge from outpatient Stroke and Neuro clinics. Staff at Providence as well as primary care physicians felt that completion of an Interprofessional Outpatient Discharge Letter would be beneficial to their practice. They provided recommendations regarding format and content of the letter. Patients and caregivers identified the need for the letter but were unable to identify what the content of the letter should be.	Implementation of the discharge letter will ensure that patients are provided with timely information about the care they have received and any recommendations the team has made. Improving the effectiveness of our communication with primary care physicians will contribute to best practice, to better continuity of care for our patients and will limit breakdowns in accountability by providing consistent handover.	Development of an Interprofessional Outpatient Discharge Letter will assist in improving communication between the outpatient team and the primary care physician. We hope that it will ensure a smooth transition for our patients across the continuum of care.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53674		Poster	8:00 AM	8:15 AM			13				Acquired Brain Injury (ABI), Mental Health & Addictions Collaboratives: Using shared-care model & discussion about sequential/concurrent care to address complex, unmet needs of adults with moderate-to-severe ABI complicated by mental health and/or addictions.	Michelle Pangilinan SEO ABI System Navigator, Community Brain Injury Services (Providence Care Hospital)	A 16 member regional initiative (ABI, Physiatry, Mental Health, Addictions, Housing, Home & Community Services to address risks of adults with ABI and mental health/addiction.	As a result of the working group, three Collaboratives have been implemented across the SE LHIN. To date, 9 cases have been presented resulting in 80 recommendations being brought forward.	The shared-care model incorporating discussion about sequential/concurrent care leads to improved continuity and efficiency of care, along with enhanced provider understanding of services, mandates, roles, admission criteria, and how best to work with people with ABI and comorbidities. In addition, improved communication and enhanced collaboration is fostered amongst service providers.	Addressing gaps in the system, Collaboratives provide a mechanism to generate effective ways to address the unmet needs of people identified as high risk with moderate to severe ABI and a comorbidity of mental illness and/or addictions. Clients consent presentation by the Lead Agency, consents are valid for 6 months and monthly updates are provided by the Lead Agency.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53648		Poster	8:00 AM	8:15 AM			14				Implementing Telemedicine processes within an Outpatient Stroke Clinic: Success, Challenges, and Learnings	Goldie Litvack Providence Healthcare - Unity Health Toronto Godfrey Wong Providence Healthcare - Unity Health Toronto Laura Conway Providence Healthcare - Unity Health Toronto Bronwen De La Huerta Providence Healthcare - Unity Health Toronto Sarah Gillespie Providence Healthcare - Unity Health Toronto	Clients who received SLP services via telemedicine, clinicians who provided telemedicine services, and administrators/staff involved in the telemedicine process.	Key findings will include feedback from clients and clinicians on their experience with telemedicine. Discussions with the administrators and staff will provide information on the successes, challenges, and learnings that were gleaned from their experience in developing and implementing the processes to support service delivery via telemedicine.	The findings from this project will help inform our continual quality improvement initiative to provide the best care for our clients, as well as inform our ability to support clinicians in delivering services via telemedicine. These findings and learnings will also provide a foundation to implement telemedicine process and delivery models into other areas of care.	Telemedicine provides an important tool for healthcare organizations to deliver care to clients when and where it is needed by improving access and flexibility. There will need to be continual cycles of learning and transformation in processes and perspectives to implement telemedicine effectively into the clinical workflow.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53676		Poster	8:00 AM	8:15 AM			16				Improving the Implementation of Brain Injury Guidelines Across the Province	Gazal Kukreja Ontario Neurotrauma Foundation Judith Gargaro Ontario Neurotrauma Foundation	Healthcare providers, professionals, and inpatient and community-based facilities across the province engaged in the treatment and rehabilitation of persons with brain injury.	With implementation support, facilities were able to implement the guideline recommendations that were a priority in their rehabilitation or primary care setting. Outcome and process measures inform the future sustainability planning of these initiatives. The tools, resources and methods used in the projects are publicly available online to promote spread and scale up of projects. The most successful projects are those who took the time to engage all the stakeholders from the beginning, temporarily seconded or hired staff to shepherd the project and adherence to the implementation methodology.	There have been several iterations of the catalyst funding initiatives and it is clear that such funding and support is necessary and sufficient to make sustainable change. Change is difficult and requires focused planning and resources. Connections and partnerships have been made across programs that have allowed for sharing of implementation tools and resources. Programs wishing to implement similar strategies to improve the care of individuals with brain injury can access these materials for support and guidance.	Using implementation science to guide the adoption of evidence-informed best practice guidelines promotes sustainability of the adopted guideline. While this work is in the field of Brain injury rehabilitation and support, it is transferable to other inpatient and community settings.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54209		Poster	8:00 AM	8:15 AM			18				Enriching Clients' Lives with the 1000WORDS Photography Program	Rebecca Swift Brain Injury Services Muskoka Simcoe Percival Morier March of Dimes Canada Jeff Young March of Dimes Canada Alda Tee Central East Stroke Network Elizabeth Faraone March of Dimes Canada	The 1000WORDS photography program is offered by a lead agency and its partners in a group setting for individuals who are living with aphasia and/or acquired brain injury.	The program underwent an evaluation in 2017 as part of a MSC. OT student project. The sample size at that time was small. Improvements were noted in scores for the EQ -5D-5L, Communication Integration Questionnaire and the Communication Effectiveness Scale. Participants reported that the program created increased opportunities to participate in conversation. The implementation plan for expansion in 2020 includes evaluation through qualitative reports and satisfaction surveys.	The 1000WORDS Photography Program provides not just training in photographic technique, but also training in visual literacy, communication, leadership and life skills. For people who are experiencing communication difficulties, being equipped with a camera and having the time and opportunity to express themselves within a safe, secure and caring environment, is an incredibly empowering experience.	The resumption of social and leisure pursuits is an essential component of community reintegration and an important aspect to quality of life. Utilizing a LPAA, the 1000WORDS photography program breaks down barriers to leisure, and provides a supportive environment to learn and practice new skills; enhancing and enriching lives for individuals with chronic aphasia and/or ABI.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54375		Poster	8:00 AM	8:15 AM			19				Intimacy and Sex After Stroke	Nina Hovanec University Health Network - Toronto Rehab Vanessa Ong University Health Network - Toronto Rehab Bayla Cheskes University Health Network - Toronto Rehab Kristyn Emmerzael University Health Network - Toronto Rehab Andrea Calvet University Health Network - Toronto Rehab	This initiative may impact patients and carers receiving care from our teams. Clinicians are now able to provide more opportunities to discuss intimacy and sex after stroke as part of their routine practice. The developed resources can be easily utilized by other stroke programs to support and address the prevalent gap of limited opportunities to discuss intimacy and sex after stroke.	Through an iterative, collaborative and reflective approach, the interprofessional working group and their stroke rehabilitation teams have developed resources to address intimacy and sex after stroke. Utilizing passive influencers, such as posters and readily available handouts for patients help to normalize the topic. Embedding proactive influencers, such as a standard script to facilitate goal setting during existing processes, ensures the topic is not overlooked. The resources and processes that emerged from this initiative enables achievement of stroke best practices despite barriers, including shortened length of stay and competing priorities.	The working group developed a practice process and stroke-specific, aphasia-friendly resources to support patients, carers as well as staff when addressing intimacy and sex after stroke. Through passive and proactive influencers the program has moved towards: 1) normalizing the topic of intimacy and sex after stroke; 2) embedding opportunities in existing processes to address the topic, and 3) increasing staff comfort and competency with the topic.	This project evolved over several years, highlighting the implementation process, as well as the patient-centered, diverse and inclusive resources that were developed by a stroke rehabilitation program. Sharing these developed resources is beneficial to facilitate other stroke programs to provide opportunities to address intimacy and sex after stroke.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54912		Poster	8:00 AM	8:15 AM			20				Understanding the Clinical Integration of Virtual Reality in a Rehabilitation Setting	Srot Kadakia West Park Healthcare Centre Lisa Da Cunha West Park Healthcare Centre Gemma Mancuso West Park Healthcare Centre Lee Verweel West Park Healthcare Centre Henry Mah West Park Healthcare Centre	Staff members participated in this initiative including physiotherapists, occupational therapists, and recreation therapists. Feedback from information technology, equipment specialists and patients were also included in the analysis.	Clinicians provided a vast amount of feedback with related to ideal features of a VR headset with respect to hardware and software, integration of immersive VR into a rehabilitation setting. Results are categorized as follows: 1) procurement criteria; 2) clinical integration and patient safety; 3) technical equipment integration and infection control.	This initiative may inform the implementation of immersive VR in rehabilitation and in other clinical settings. Future initiatives can build upon these findings to create guidelines for immersive VR use with specific populations/diagnoses, as well as optimize clinical integration, making the system wide adoption of VR more feasible.	Incorporating immersive VR into rehabilitation has the potential to enhance clinical outcomes and create positive experiences for patients. Further exploration of benefits, integration, and best practices associated with using immersive VR in a rehabilitation setting is necessary to ensure the adoption of this promising intervention.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53548		Poster	8:00 AM	8:15 AM			22				Piloting of a Patient-Oriented Discharge Summary (PODS) Meeting at a Rehabilitation Inpatient Stroke Program	Sara J.T. Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto Bishev Mila St. John's Rehab, Sunnybrook Health Sciences Centre Stephanie R. Cimino University of Toronto Stephanie Durocher St. John's Rehab, Sunnybrook Health Sciences Centre Inna Panteleev St. John's Rehab, Sunnybrook Health Sciences Centre Gina Lam St. John's Rehab, Sunnybrook Health Sciences Centre	Study participants included 10 stroke inpatients and focus groups with stroke clinical staff members.	The pilot project indicated there were several logistical challenges with implementing a PODS with stroke inpatients (patient and staff timing issues, clearer role definition, etc.) but that there is general support for using the PODS as a way to improve the discharge process.	Preliminary findings suggest that a PODS approach is feasible and acceptable in a stroke rehabilitation inpatient program. However, further refinement of the PODS, as well as its implementation, are required in order to integrate it into stroke clinical practice.	This study provides insights on the feasibility and acceptability of a PODS approach for stroke care. The materials and strategies developed can be modified for other stroke clinical care settings.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53699		Poster	8:00 AM	8:15 AM			24				Content validity and sensibility assessment of a survey to characterize secondary lower body musculoskeletal issues post-stroke	Filip Potempski University of Toronto Kara Patterson Department of Physical Therapy, University of Toronto; Toronto Rehabilitation Institute, University Health Network	Nine people with stroke >1 yr (41-81 yrs); all left side affected. Five experts (41-55yrs) from neuro (2), ortho (2) and research methods (1) fields.	Median score was ≥7/10 for 94% of statements rated by experts and 88% of statements rated by people with stroke. No statement was rated ≤4/10. Interview comments centered around clarification of wording of questions. For the MSK survey, the sites of pain most often reported by the 9 people with stroke were lower back (5/9 people) and left hip (4/9 people). Frequency ranged from 1-2 times/week to daily and pain severity ratings ranged from 1-6/10.	The MSK survey met the sensibility criteria among people with stroke and experts and thus possesses content validity and is feasible to administer to people post-stroke. Preliminary findings indicate that the affected hip and the lower back are common sites of pain post stroke. The MSK survey was revised for clarity based and data collection is ongoing.	A survey to characterize secondary lower body MSK issues is valid, feasible and provides preliminary evidence that MSK issues post stroke. Future work will examine revised survey responses from a larger sample size. Anticipated results may highlight the importance of long term follow up for MSK health post-stroke.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
54823		Poster	8:00 AM	8:15 AM			25				Movement medicine: A systematic review on the effect of early aerobic exercise initiation on symptom recovery following concussion	Ainsley Kempenaar 1) Postgraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2) Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada Mark Bayley 1) Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada; 2) University Health Network - Toronto Rehabilitation Institute, Toronto, ON, Canada	Pediatric and adult patients with diagnosed concussion or mTBI, participating in a structured aerobic exercise intervention initiated within 14 days post-injury.	The search generated 112 unique abstracts, of which 5 met inclusion criteria. Sample sizes ranged from 16 to 103 participants. Of the four studies that were able to analyze between-group differences, one showed significantly faster recovery in the early aerobic exercise group compared to control, while three showed no significant difference. Two studies demonstrated a trend toward faster initial symptom resolution in the early exercise group.	Preliminary RCT evidence suggests that aerobic exercise initiated in the early post-concussion period does not exacerbate symptoms or prolong recovery time, and may potentially hasten recovery. To inform future practice guidelines, larger and more rigorous RCTs are required to better define the optimal exercise parameters to facilitate symptom recovery.	This review suggests that early aerobic exercise initiated within the first two weeks may not only treat but also potentially prevent post-concussion syndrome. Further research is required to guide healthcare providers on optimal exercise dosage.	Systematic Literature Review

MSK

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53582		Poster	8:00 AM	8:15 AM			27				Activity trackers are unreliable for monitoring sleep in hospitalized patients with cognitive disorders	Christopher Patterson Department of Medicine, Division of Geriatrics, McMaster University Justin Lee Department of Medicine, Division of Geriatrics, McMaster University Christina Reppas Department of Medicine, University of Toronto Shailee Siddhpuria UBC Faculty of Medicine, University of British Columbia Manan Ahuja McMaster University, Michael G Degroote School of Medicine Jessica Gormley McMaster University, Michael G Degroote School of Medicine	Sixty-seven participants (mean age 83, 66% female) were enrolled. 3% ambulated independently, 91% with an assistive device and 5% were non-ambulatory.	Twenty two patients (33%) had a diagnosed neurocognitive condition at baseline or developed postoperative delirium during their hospitalization. Of these, 7 participants had dementia at baseline and delirium developed in 18 patients during their hospital stay. In the group with cognitive disorders, the activity monitors failed to record 48% of potential sleep data compared to 22% in the group without cognitive disorders.	This research highlights the potential challenges of using devices that have been validated for healthy adults and applying them to older adults with cognitive disorders. Alternative methods may be required to reliably and accurately evaluate sleep in future research investigations involving this patient population in order to implicate these technologies into practice.	Sleep data tracking using wrist monitors in our study of hospitalized older adults was inconsistent in participants with cognitive disorders. These activity monitors should not be used to track patients sleep data in a rehabilitation or recovery setting, as it cannot provide reliable information to their provider.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53678		Poster	8:00 AM	8:15 AM			28				The Challenges and Opportunities involved in establishing a Rapid Access Clinic for Hip and Knee Arthritis in an Urban Community Hospital Setting	Melaine Wistuba Michael Garron Hospital Nancy Elford Michael Garron Hospital Sherri Stevenson Michael Garron Hospital	1FTE APP performs assessments, 6 week post-operative reviews, develops patient resources, and other organizational initiatives.	Our RAC is on track to have increased referrals and assessments performed. Feedback from stakeholders has been positive. Concerns were initially expressed with respect to achieving projected surgical volumes if assessments were done by the APP as opposed to surgeons. Ongoing collaboration and review is essential to address concerns. Analysis of RAC metrics and feedback will be ongoing to allow for real time adjustments.	Expediting surgeon consult, patient resources, reducing wait times and optimizing resources are key RAC benefits. Research opportunities exist from analyzing assessment data including physical rehabilitation outcome measures for program planning. Assessment data can be mined to flag factors such as fall risk, tenuous social supports, and same day surgery candidates.	Communication amongst stakeholders facilitates adaptations to RAC practices to reflect organizational needs and preferences of our patients, surgeons and referral sources. APP involvement in hospital initiatives increases awareness of the hip and knee arthritis program while leveraging the clinical experience of the APP.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54376		Poster	8:00 AM	8:15 AM			29				Community-based Pre-operative Education Classes	Kristina Saric Hamilton Health Sciences Teri Czajka Hamilton Health Sciences	This education class is offered to all patients that are scheduled to have an elective TSA with any of the three surgeons who perform this type of surgery. This includes both primary and reverse TSA and is open to patients who are scheduled as a Same Day Home, Same Day Overnight and Same Day Admit.	Initial results indicate that lengths of stay in comparison to estimated lengths of stay are reduced for patients who have attended the education sessions. The implementation of this pre-operative education class has decreased the length of hospital stay in this surgical population. This has also allowed other elective surgeries to remain on schedule and less likelihood of cancelation. Post-session questionnaires demonstrate that patients felt the education, community setting, accessibility and content met their needs. Subjectively, the patients who have attended the pre-operative education class have expressed heartfelt appreciation for the courses content and detailed explanation of what to expect, resulting in decreased anxiety regarding their surgery. Further data collection would have to be completed to analyze whether this education session facilitates enrollment in a well health exercise program post-operatively.	The findings of this initiative prove the benefits of the existence of a pre-operative education class for elective surgeries. Patients often have many questions and concerns regarding their upcoming surgery and will admit that they do not have anyone to connect with regarding this. Pre-operative clinics are often full of medical information, with limited face-to-face time with the surgeon to allow for patients to ask all their questions. This pre-operative education class provides a welcoming and accessible environment for patients to express concerns and present their questions to make them to feel more prepared. This builds a link between the acute care system and community programming to provide optimal patient care across a continuum. This initiative may lead the way to involve other surgical procedures and the development of programming in partnership with the YMCA to have pre-operative prehab programs to prepare patients.	In conclusion, the development of a pre-operative education class for patients with scheduled shoulder surgeries has positively impacted the patient's care, the patient's experience and patient flow on the orthopedic unit. Surgeons continue to feel that this is a benefit to their patients and recommend their attendance at these sessions. This initiative promotes the continued collaborations and partnerships between acute hospital care and community based programming. It paves the way for the hospital's role in promoting over all well health outside of the walls of an institution.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53639		Poster	8:00 AM	8:15 AM			30				Experiences of Patients and Caregivers with Transitions in Care Following Hip Fracture: A Scoping Review	Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto Amanda Everall Leslie Dan Faculty of Pharmacy, University of Toronto Kerry Kuluski Institute of Health Policy, Management and Evaluation, University of Toronto Lauren Cadel Leslie Dan Faculty of Pharmacy, University of Toronto Maliha Asif Leslie Dan Faculty of Pharmacy, University of Toronto	Articles or grey literature that included information about patient or caregiver experiences with care transitions following hip fracture.	Of the 1107 articles identified, 11 were included in the review. Challenges with care transition included poor information sharing by healthcare providers, confusion about the roles of providers and family members and disorganized discharge planning. Suggestions for improving care transitions included creating a patient representative role, increasing geriatrician involvement, using written communication and technology for knowledge sharing.	As the first scoping review exploring experiences with transitions in care for hip fracture, we found that there was an overall dearth of published literature. Most existing literature lacked gender-based analyses. There remains much room for improvement, especially with communication, to improve patient and caregiver experiences.	Experiences of patients and caregivers with care transitions following hip fracture lack sharing of pertinent information and were characterized by role confusion and disorganized, untimely discharge planning. This signals a need for improved policies around care transitions.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53688		Poster	8:00 AM	8:15 AM			31				Bridge to recovery: Using an experience based design approach to improve patient goal setting	Janice Hon Bridgepoint Active Healthcare, Sinai Health System Saba Memon Bridgepoint Active Healthcare, Sinai Health System	Interviews: 17 patients (12 female, 5 male, median age: 72 yrs); Focus groups: 16 ortho team members; Co-design workshop: 18 key stakeholders.	The four themes identified were 1.Expectation of recovery; 2. Perception/focus evolves over time; 3. Timing/readiness to set goals; 4. Communication. Along with gap analysis data, the theories of change were identified. The key features for change ideas were used to develop a patient-facing tracking tool and an ortho rehab orientation program. These tools will be piloted and at least one PDSA cycle will be completed by March 31, 2020.	Patient experience in goal setting can be affected by a number of factors, including unit processes, patient and staff factors. Our findings revealed that patient's understanding of the rehab program, timing of goal setting and being able to track their progress are some of the key considerations to improve patient experience in goal setting.	Using the Experienced Based Design approach, we were able to identify the key themes and considerations to guide the development of change ideas to improve patient experience in goal setting for the inpatient orthopedic rehab setting.	Research in Rehabilitation (quantitative, qualitative or mixed methods)

Paediatrics

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53653		Poster	8:00 AM	8:15 AM			45				A partnership of practice and knowledge translation to create evidence-based interprofessional standards of care	Ashleigh Townleigh Holland Bloorview John Kooy Holland Bloorview Nancy Searl Holland Bloorview Heidi Schwellnus Holland Bloorview Joanne Wincentak Holland Bloorview Kim Krog Holland Bloorview Shauna Kingsnorth Holland Bloorview Joanne Maxwell Holland Bloorview Anthony Danial Holland Bloorview	This partnership of clinicians, practice experts and KT experts supports timely and effective adoption of best practices. The evidence for interventions for our population is often sparse, which is critical that we have up to date knowledge, but also that we have the right subject matter expertise involved in the process to ensure the highest standards of care. Front-line providers rarely have the time or the expertise to review and synthesize all the potentially relevant research evidence into something that is meaningful for clinical activity. This novel partnership enables a robust, yet rapid process that enhances use of research evidence to inform our standard of care development through identification and synthesis of relevant evidence. In the first 2 years of this initiative, we used this method to inform new standards of care for serial casting, enteral feeding and stoma care, and infant care in our pediatric rehabilitation setting.	This partnership initiative speaks to leveraging expertise from multiple sources (KT, practice, clients and families) to support collaboration that extends beyond traditional interprofessional examples, and acknowledges the value of expertise from all these different sources. This initiative demonstrates an effective and sustainable model for ensuring the highest standards of care, can likely be replicated in other organizations and settings, and fosters stronger relationships between knowledge synthesis and translation experts and those involved in supporting and delivering interprofessional care.	As noted above, in the first 2 years of this initiative, we have employed this method to inform new standards of care for serial casting, enteral feeding and stoma care, and infant care in our pediatric rehabilitation setting. Once the evidence synthesis has been conducted, and the new standard of care is developed and approved, the clinical members of the working group then become the clinical experts and support the spread of knowledge across the clinical programs to ensure the new expectations for practice are fully understood. For some standards, we have also created new companion educational documents for clients and families to support the continuance of best practices in the home setting. The Rapid Review partnership has been a successful initiative that has not only facilitated greater rigour in how evidence informs our standards of care, but has also allowed for the development of capacity with respect to evidence gathering and synthesis in the interprofessional teams.	The rapid response process described above has been successfully employed to enhance the use of research evidence, and inform standard of care development through identification and synthesis of relevant evidence. This partnership of front line clinicians, practice experts and KT experts allows for timely and effective adoption of best practices to ensure the highest standards of care. This novel partnership enables a robust, and timely process that meaningfully engages stakeholders, and leverages and celebrates diverse expertise. In the first 2 years of this initiative, we have employed this method to inform new standards of care for serial casting, enteral feeding and stoma care, and infant care in our pediatric rehabilitation setting.	Knowledge Transfer and Exchange Initiative
53696		Poster	8:00 AM	8:15 AM			46				Supporting Canada's national efforts for safe opioid use - a pediatric rehabilitation hospital's initiative to provide opioid education	Rachna Chaudhary Holland Bloorview Kids Rehabilitation Hospital Louise Rudden Holland Bloorview Kids Rehabilitation Hospital Jenna Doig Holland Bloorview Kids Rehabilitation Hospital Sarah Rumbolt Holland Bloorview Kids Rehabilitation Hospital Anthony Danial Holland Bloorview Kids Rehabilitation Hospital Tamara Milicevic Holland Bloorview Kids Rehabilitation Hospital	The handout is used at an Ontario pediatric rehabilitation hospital whenever opioids are dispensed for weekend pass.	The handout was incorporated into a standardized process where nursing provides education on medications for weekend pass (early 2019). Internal 72 hour post-discharge phone call results are limited due to small sample sizes and time-frames to show significant trends. Nursing feed-back suggests it is a useful communication tool for patients and families. It helps families understand how use these medications safely and effectively.	Management of the opioid crisis has been multi-pronged from federal, provincial and community initiatives. The creation of a 'opioid medication safety guide' at a pediatric rehabilitation hospital illustrates a hospital-level initiative to align with the national strategy in providing balanced information and practical tips in managing this class of medications.	Health Canada's regulations around safer use of opioids can be further encouraged by tailoring the messaging to support the hospital's patient population and implementing regular education at strategic time-points with key team members.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation

Senior-Focused Care

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53626		Poster	8:00 AM	8:15 AM			47				The Role of the Transition Planner at a Reactivation Care Centre (RCC)	Sarah Rydahl St. Joseph's Healthcare	The RCC is a 30 bed unit using an innovative service delivery model to provide specialized programming not typically available to ALC patients in acute care. The mandate of the RCC is, through activation to restore social, cognitive, and physical function to facilitate transition back to the community with increased supports. This inititiative is aimed to evaluate the efficacy of discharges and inproved Barthel score which is a reflection of improved patient independence. The Barthel index was measured on patient admission and discharge, and compared over time. In addition, we collected descriptive data on the location of discharge for all included patients and average length of stay.	The TP thus uses the Barthel score as a measure to discharge a patient from the facility and successfully return to the community with supports. In September, there were 21 discharges from the RCC total. From those 21 discharges, 18 showed an improvement in their Barthel score. In October, 19 patients were discharged and 19 patients discplayed an improvement in their Barthel score. The finale outcome measure examined the total number of dischares per location and month. The percentage of discharges home in June was 38%, in July was 41%, in August was 44% and in September and October were 52% and 58% respectively. Home is defined as a community dwelling including, but not limited to: personal home or apartment, subsidized housing and a retirement home.	The RCC model allows patients to reactivate sufficiently enabling their return to home with supports. The role of the TP is imperitive to this model to ensure that patients receive the appropirate supports, encouraging successful discharge from the hospital and allowing those who would otherwise remain in acute care to reactivate to return home therefore improving patient flow.	Patients at th RCC were able to maintain or restore optimal funcational capacity. This allows for an improved qualtity of life for the patients to achieve their goals. The role of TP is essential to providing supports in the community for the patients and families to facilitate a safe and successful discharge.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
54235		Poster	8:00 AM	8:15 AM			48				Rehabilitation Unplugged: Rolling out #EndPJParalysis across Alberta in a context of too many projects, too little time, no budget.	Liz Webster Alberta Health Services (AHS) Jennifer Symon Alberta Health Services (AHS) Paul Wright Alberta Health Services (AHS) Isabel Henderson Alberta Health Services (AHS)	The current focus of #EndPJParalysis has been the acute care hospital system, single units or site-wide, with 100% zone participation.	Metrics for individual units enrolled in the "campaign" have been captured via a specialized app and preliminary results align with those of other international jurisdictions. Consistently, evaluations of #EndPJParalysis have demonstrated that it reduces avoidable harm (including falls, incontinence and pressure injuries), improves patient and staff experience and wellbeing and cuts length of hospital stay.	How can Rehabilitation Leaders promote the #EndPJParalysis agenda within the Canadian healthcare system? We must share the Mobilization/Activation mantra with our other healthcare discipline partners and galvanize the strengths of our patients and families to change outdated beliefs about bedrest.	#EndPJParalysis is a shift whose time has come. Evidence of harm from deconditioning has been known for decades yet we still allow patients (especially our elderly) to be immobile for up to 90% each day. This immobility has a negative impact, not only to the patient, but potentially to the wider healthcare system.	Ideas, Inventions and Innovations that will Transform the Rehabilitation Mosaic
53662		Poster	8:00 AM	8:15 AM			49				Enhancing Preventative Oral Care in Long-Term Care	David Chvartszaid Baycrest Rosanne Aleong Baycrest Rosalind Sham Baycrest Sandra Gardner Baycrest Karen Joseph Baycrest Jagger Smith Baycrest Nelly Villacorta-Siegal Baycrest	238 PSWs and nurses responded to at least one eLearning survey; 25 post-SIDH consultation surveys were completed. The SIDH completed 65 oral health assessments. 30 PSWs and nurses participated in focus groups/interviews.	(1) Personal Support Workers (PSWs) and nurses had high confidence in providing oral care and in identifying oral concerns especially after completing the eLearning module. (2) The eLearning module improved staff knowledge related to frequency of oral care and use of personal protective equipment. (3) SIDH identified greater dental concerns than were identified in the InterRAI MDS by nurses. (4) Ten percent of LTC population was referred to SIDH.	On-the-job training can improve LTCH residents' oral health by enhancing the confidence of point-of-care staff in effectively delivering the daily oral routine. Screening and a direct referral to a dental hygienist on the interprofessional care team through the EMR identify oral care needs and provide a system that ensures continuity of care for older adults.	Online interactive oral care education session, in combination with in-person support of a mobile SIDH, have made a positive impact at Baycrest and can be expanded to other LTC homes across Ontario.	Knowledge Transfer and Exchange Initiative
53392		Poster	8:00 AM	8:15 AM			50				Reactivation Model- Empowering Clients to Unlock their Potential through an Integrated, Holistic Approach to Care	Sarah Tam Lee SE Health Bethany Kwok SE Health	Clients who participated in the program demonstrated the following characteristics: older adults living with frailty, have multiple co-morbidities, at risk of further decline, require assistance with activities of daily living (ADLs) and instrumental ADLs (IADLs), and have difficulty managing their condition. This initiative has been implemented in different programs with a range of participants for example, one program is a 75 bed facility and another is a 10 bed program.	The key findings of the initiative will be presented from the perspective of two programs that have been implemented: Program 1; a 75 bed facility: With data collected between Dec 2018-June 2019, participants have seen improvement in the following areas: falls risk by 29%, improvement of ADLs (such as bathing) and IADLs (such as shopping) have improved by 43% and 61% respectively. Program 2; a 10 bed program: With data collected between Jan 2019-Aug 2019, participants on average in this program demonstrate improvements in health status by 26%, falls risk by 27% and improvement in ADLs by 14%.	This initiative has been designed with the capability to be implemented at various sites and reactivation settings. In addition, it has the ability to be tailored to suit the needs of our partner's diverse patient population. The processes within the model leverages knowledge and expertise from the participant (patient), our care team and our hospital/community partners to create care plans that are holistic, based on best practices and evidence that are relevant to the population being serviced. This initiative also emphasizes interdisciplinary collaboration in care planning. In understanding that many care settings have different healthcare professionals but often working in silos, the element of a collaborative approach utilized in our initiative provides an opportunity to break down barriers between disciplines and foster collaboration to create meaningful care plans for persons living with frailty.	This model allows persons living with frailty an opportunity to recover in a like-home setting; shortening hospital length of stay and risk of further deconditioning associated with a hospitalization. They are able get stronger, feel better and transition home safely with supports. They leave our care with the knowledge and skills to take control and manage their health.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation

Special Needs (e.g., wound care, bariatric)

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53568		Poster	8:00 AM	8:15 AM			52				Improving the Patient Experience for Patients with Bariatric Care Needs	Sarah Bingler Michael Garron Hospital	4 inpatients interviewed Pilot project was conducted on two inpatient medicine units. 5 sessions completed, 43 staff attended (RN/RPN/OT/PT/OTA/PTA	Qualitative Patient Interview Results identified 3 themes : o Equipment concerns (size, availability and reliability) o Frustration by inactivity and dependence on caregivers o Personal Hygiene - mainly positive reviews of hygiene care but one report of insufficient night staff for incontinent care and no shower access ATOP results (possible scores range from 0-120, higher score indicates more positive attitude). o Baseline: mean 71 (N=29) o Post Intervention: mean 68 (N=19) Distribution of scores pre and post intervention was similar with approximately 1/3 of scores below 60 (more negative attitudes) and 2/3 above 61-120 (more positive attitudes). No significant change in staff bias post education. Average participant rating of education session 3.9/4 or very effective (n=21).	Patients with bariatric care needs and direct patient care staff identify many common areas for improvement. Staff rated the educated sessions very effective but Attitude Towards Obese People scores did not change post education. Results confirm the existence of obesity bias in some healthcare staff . Occupational therapists have a unique set of skills that are well suited to empower patients to participate in their own care and to enable staff with the knowledge to provide a high level of care to patients affected with obesity.	Results of this quality improvement initiative confirm that patients affected by severe obesity have unique care needs in hospital. Patients express that they often are not provided with bariatric equipment, are not transferred out of bed and occasionally staff have difficulty providing personal care. While staff rated bariatric education sessions as being very effective, it is clear that there is a need for further transfer and equipment training for staff. The presence of obesity bias in many staff was confirmed and this was not significantly changed post education. Results of this QI project indicate that there is an ongoing need to both educate and support staff in order to improve the hospital experience for patients affected by severe obesity.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation

Spinal Cord Injury

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53635		Poster	8:00 AM	8:15 AM			53				Experiences of Patients and Healthcare Providers with Medication Self-Management for Spinal Cord Injury	Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto Tejal Patel School of Pharmacy, University of Waterloo Aisha Lofters Women's College Hospital Sander Hitzig Sunnybrook Research Institute, Sunnybrook Health Sciences Centre Tanya Packer Dalhousie University Amanda Everall Leslie Dan Faculty of Pharmacy, University of Toronto Lauren Cadel Leslie Dan Faculty of Pharmacy, University of Toronto	Nineteen persons with SCI/D and 32 healthcare providers participated in the telephone interviews.	Persons with SCI/D and healthcare providers most frequently discussed disease controlling strategies such as managing medications and treatments, monitoring/managing side effects and controlling symptoms/complications, which relate to medical management. Emotional and role management, such as social interactions and internal strategies (acceptance, positivity, grieving), were discussed in much less detail.	While most participants discussed disease controlling strategies in detail, a notable omission was discussion around goal setting and creating action plans. It was also evident that most providers did not reflect on the impact that medication taking had on everyday life, while persons with SCI/D discussed this in much more detail.	Medication self-management is a continually evolving process as the situations, goals, and preferences of persons with SCI/D relating to their medications changes. Thus, more frequent and comprehensive discussions, including the co-creation of action plans are needed to support persons with SCI/D.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53636		Poster	8:00 AM	8:15 AM			54				Polypharmacy following non-traumatic spinal cord dysfunction: A retrospective population-based study	Aisha Lofters Women's College Hospital Qi Guan Institute of Health Policy, Management and Evaluation, University of Toronto Tanya Packer Dalhousie University Tejal Patel School of Pharmacy, University of Waterloo Sander Hitzig Sunnybrook Research Institute, Sunnybrook Health Sciences Centre Andrew Calzavara ICES Daniel McCormack ICES Mary-Ellen Hogan Leslie Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto	The cohort included 3,468 individuals with NTSCD who met the inclusion criteria.	The median cohort age was 70 (IQR=62-77) with a nearly even sex distribution. Following in-patient rehabilitation, the mean number of drug classes taken was 11.7 (SD=6). Over half of the cohort (62.7%) were taking medications from 10 or more different drug classes. Risk factors of polypharmacy included being female, low continuity of care, low income, and lower Functional Independence Measures upon discharge from inpatient rehabilitation (i.e., less independent).	While much of the cohort experienced polypharmacy, pre-existing multimorbidity and prescription drug claims prior to inpatient rehabilitation were significant. Rates of polypharmacy among those with NTSCD are higher than in the general population or among those with traumatic injuries, reinforcing the medical complexity of those with NTSCD.	The prevalence of polypharmacy among Ontarians with NTSCD was high, with over half of the cohort taking 10 or more drug classes. Awareness of polypharmacy rates and the potential for inappropriate prescribing among clinicians may reduce potential harms.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53638		Poster	8:00 AM	8:15 AM			55				Opioid claims for persons with traumatic spinal cord injury: A population-based study using the Narcotic Monitoring System	Aisha Lofters Women's College Hospital Tanya Packer Dalhousie University Sander Hitzig Sunnybrook Research Institute, Sunnybrook Health Sciences Centre Tejal Patel School of Pharmacy, University of Waterloo Qi Guan Institute of Health Policy, Management and Evaluation, University of Toronto Andrew Calzavara ICES Daniel McCormack ICES Mary-Ellen Hogan Leslie Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto	The cohort included a total of 2,286 persons with TSCI.	Seventy-four percent of the cohort were male with a median age of 44 (IQR=27-58). Thirty-five percent of the cohort received at least one opioid prescription during the observation period. Twenty percent received chronic opioids. Of those on chronic opioids, 39% were receiving high dose (over 90 MME daily). The median daily MME for those receiving chronic opioids and chronic high dose were 59 (IQR=24-168) and 212 (136-345), respectively.	Despite the Canadian opioid guidelines recommendation of a maximum daily 90 MME, a substantial proportion (39%) of persons with TSCI receiving chronic opioids exceeded that limit.	During the observation period, many persons with TSCI received opioids. Future research should focus on risk factors for chronic, high-dose opioids and on predictors of opioid dose.	Research in Rehabilitation (quantitative, qualitative or mixed methods)

Other

Submission ID	Parent Title	Day	Start Time	End Time	Room		Poster #	Poster PDF	Poster Video	Comments	Title	Author Information	Study Sample or Initiative Scope	Findings	Discussion	Conclusions	Abstract Category
53175		Poster	8:00 AM	8:15 AM			33				Inter-Organizational Transfer of Accountability Guideline: From Acute Care to Rehab/CCC to Community Care	Sanja Milicic Iafrate GTA Rehab Network Sharon Ocampo-Chan GTA Rehab Network Charissa Levy GTA Rehab Network	Acute care and rehab/CCC hospitals in the GTA, Home and Community Care rehab service providers in the GTA.	Data analysis indicated the majority of rehab/CCC (78%) and home and community care providers (60%) are experiencing gaps in information received that impacts their ability to provide best patient care. Examples of gaps in information included: missing discharge summaries, medication administration records, safety precautions, etc. Strategies to address gaps in information were integrated in the guideline and discussed with the working groups.	At the clinical level, TOA issues are often unreported, as interprofessional teams have developed temporary fixes and workarounds. Furthermore, online referral systems have not mitigated risks of TOA issues. These findings and consultations were applied to develop an Inter-Organizational TOA guideline. The guideline supports patient transitions across the patient lifespan and care continuum, and consists of 6 principles: 1. Ensure health service providers understand and have knowledge of legislation and policies that guide effective transitions 2. Communicate patient and caregiver preferences and goals to the next level of care 3. Establish one key contact at each transition point 4. Standardize processes for transition by the organization 5. Communicate effectively among health care providers to facilitate transition 6. Acknowledge dual responsibility of senders and receivers in transitions. Each principle will be discussed in detail in the presentation.	Inter-organizational TOA guideline identifies best practices in transitioning patients from one point of care to next and outlines practical applications for clinicians and organizations.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53547		Poster	8:00 AM	8:15 AM			34				Together in Movement and Exercise (TIME™): How community-healthcare collaboration creates exercise opportunities for people with balance and mobility challenges	Diane Tse UHN-Toronto Rehab Margot Catizzone UHN-Toronto Rehab	TIME™ has expanded to 48 sites with the support of 27 healthcare partners across Canada. This enables 400 participants per week to stay active.	Research confirms that TIME™ is safe and feasible to implement (Salbach 2014) with benefits to participants' balance, strength and confidence (Salbach 2014, Merali 2018). Fitness instructors described the healthcare collaboration as the key to program implementation and success (Skrastins 2019). Conversely, healthcare partners have an evidence-based CBEP to refer individuals who are exiting the healthcare system.	As healthcare resources continue to be stretched, the importance of building capacity for community exercise for people with balance and mobility challenges is clear. The community-healthcare partnership integral to the TIME™ model, offers people with disability access to a safe and beneficial exercise program in the community, outside of the healthcare setting.	TIME™'s community-healthcare partnership model can be replicated to build similar CBEPs for people with disability. In order to continue building capacity and to broaden the reach of the program to more rural or remote communities, innovative ways to support this collaboration in program delivery will need to be explored.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53587		Poster	8:00 AM	8:15 AM			35				Patient and Family Engagement in Rehabilitation Research: Creating a Print Educational Tool	Marina Wasilewski St. John's Rehab Sander Hitzig St. John's Rehab Lisa Di Prospero Sunnybrook Health Sciences Centre Laurie Legere Sunnybrook Health Sciences Centre Siobhan Donaghy University of Toronto	The brochure was developed and initially distributed at SJR to help advance the program's Patient and Family Oriented research agenda.	Two-hundred brochures were printed and distributed at SJR. We also made the brochure web-accessible. Patients and families at SJR were encouraged to share the brochure with peers in their respective communities (e.g. stroke), and thereby acted as ambassadors for PFE in research. The brochure is being used as a template by the Sunnybrook Patient Engagement and Research team as part of a broader toolkit to facilitate greater and more meaningful PFE in their work.	This brochure was the first of its kind to be used as a print educational resource to enhance PFE in rehabilitation research. The development of this brochure aligned with Sunnybrook Health Sciences Centre's Strategic Priority of 'Improving Quality and Creating a Better Care Experience' in as far as it provided patients and families with information that is critical to enabling them to truly be part of the research team.	The development of the "Patient and Family Engagement in Rehabilitation Research" brochure has been a successful initiative that connects patients and families with the SJR research team. Through this initiative, the perspectives and priorities of patients and families are better-reflected in the research that is undertaken at SJR.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53624		Poster	8:00 AM	8:15 AM			36				Leadership and Rehabilitation professionals: A literature review	Meera Premnazeer Department of Occupational Science & Occupational Therapy: University of Toronto; 160-500 University Ave, Toronto, Ontario M5G 1V7 ; Gobika Sithamparanathan Department of Occupational Science & Occupational Therapy: University of Toronto; 160-500 University Ave, Toronto, Ontario M5G 1V7 ; Andrea Duncan Department of Occupational Science & Occupational Therapy: University of Toronto; 160-500 University Ave, Toronto, Ontario M5G 1V7	Examination of leadership in scope of practice of rehabilitation professionals	Incorporating leadership qualities of rehabilitation professions may be necessary for progress beyond healthcare and to further strengthen the profile of practice.	Leadership within Rehabilitation professions has been reported to be a crucial part of research, practice and education. Adaptation of existing models, practice frameworks and interprofessional education have contributed to the development of leadership in Rehabilitation programs. This study will contribute to exploring enablement of leadership qualities in interprofessional teams and also provide opportunities to advocate for the importance of utilizing Rehabilitation professionals in novel roles beyond the traditional practice setting. These modifications to the existing profile of Rehabilitation professionals will contribute to the leadership scope of this holistic healthcare sector.	This research study will provide insights into leadership in Rehabilitation professions where there is a potential to analyze and incorporate creative tools in the scope of practice.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53657		Poster	8:00 AM	8:15 AM			37				Collaborating for Care: Creation of a Highly Integrated Rehabilitation Outreach Services Transition Team (HIROS) to Improve Access and Flow to Rehabilitation Services	Chris Pollard Hotel Dieu Shaver Health and Rehabilitation Centre David Ceglie Hotel Dieu Shaver Health and Rehabilitation Centre Zuher Ismail Niagara Health Darlene Venditti Niagara Health	This project affects all members of the interprofessional team at both healthcare organizations, and ALC patients awaiting transfer to a bedded level of rehabilitative care.	To be determined. This project is in progress.	Although project results are pending, key learnings from this initiative will inform how this approach of a focused mobile Rehabilitation Team can assist in the care and transitions of patient awaiting rehabilitation care. In addition, learnings will be gained about how this approach can facilitate the access to rehabilitative care for patients who have barriers to transfer to a rehab facility (eg. due to medical needs, dialysis, or isolation requirements). Results may inform and address issues related to resource in-equity for this subset of patients and assist with informing the planning of new care models that may improve access and flow to rehabilitation care.	To be determined.	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
54627		Poster	8:00 AM	8:15 AM			38				Vision Loss: Impact on Health	Lisa Tyrrell Vision Loss Rehabilitation Ontario Sue Marsh- Woods Vision Loss Rehabilitation Ontario	Based on the above research reference, a new healthcare agency was created. This vision loss rehabilitation agency addresses the needs of those with blindness/partial sight. The impact of health when co-morbidities exist, has led to identifying a greater need for working relationships with community partners, to address those with complex needs.	Vision loss rehabilitation services, are often unknown and misunderstood, for people with blindness/partial sight. As a new agency, it integral to help physicians, hospitals, social support services and other community partners understand the complex needs and impact on health. Based on quadruple aim, administering thee right rehabilitation service, at the right time, to right individual in the right way will lead to better outcomes in safety, mobility, performance and independence.	Vision loss rehabilitation therapy helps people with all levels of vision loss to develop or restore key daily living skills, helping enhance their independence, safety and mobility. Ophthalmologists, optometrists and other health care professionals refer their patients with vision loss for this therapy as a part of their overall care plan. We receive referrals from hospitals, care coordinators and many other community partners. Families and the individual experiencing vision loss can self refer as well. Vision loss rehabilitation therapy is provided by certified therapist who will work with individuals and caregivers to create a personalized rehabilitation plan to meet their needs and goals. The use of measured outcomes, Canadian Occupational Measurement Outcome tool (COPM) is used to create a client centered approach to care. This plan may include a range of services, depending on the individual needs and goals. Services may be delivered over a series of appointments in home or community, their workplace, over the phone, online or at one of our Vision Loss Rehabilitation Canada centers. Once you refer a patient/client to us, our team will reach out to them directly within 2-5 business days. We will work with them to assess their needs and goals and develop a personalized rehabilitation plan. During our initial intake we determine if support with navigation and service coordination is required. We can: Guide a client and their family through the vision rehabilitation journey. This includes help going through the goals and aligning their care plan with the right therapist. Follow-up and coordination of external referrals and supports as the client receives external services. The impact of vision loss has significant impact on learning and may be a factor with other supports they are receiving. We will work closely with other health care professions so that they understand the impact of the vision loss on learning. Our certified low vision therapists can help someone understand and use their remaining functional vision. Essential skills for daily living therapists, can assist someone with managing medications, safety in the kitchen, personal self care etc. Learning to travel independently with vision loss is an essential skill. Our certified specialists teach individuals, how to navigate through their home safely and independently; about different types of white canes - ID, support and long ;how to safely cross streets how to use public transportation and how to use accessible GPS apps. Our services help children who are blind or partially sighted gain the skills they need to grow into successful, confident adults. Assistive technologists provide an assessment and recommendations on technologies that meet the clients needs	Vision Loss Rehabilitation Ontario is committed to providing Health Authorities and other government funders with the right services at the right time for their clients. Our success is measured by the following outcomes: ✓ Decreased hospital length of stay, number of admissions and re-admissions ✓ Reduction in number of professionals and touchpoints during the client care journey ✓ Improved functional outcomes and independence ✓ Reduction and prevention in the number and severity of falls ✓ Increased ability to remain in own home requiring less resources ✓ Reduced need for institutionalization ✓ Increased satisfaction, quality of life and confidence of individuals and their family in their ability to manage and cope with their vision loss ✓ Improved patient care experience	Rehabilitation-Related Best Practice Initiative or Organizational Innovation
53536		Poster	8:00 AM	8:15 AM			39				Exploring Patient Partnerships in Interprofessional Rehabilitative Care	siobhan Donaghy Sunnybrook Health Sciences Centre - St. John's Rehab; University of Toronto Sander Hitzig Sunnybrook Health Sciences Centre -St. John's Rehab	Study participants included 8 interprofessional healthcare team members and 2 patients / family members.	Factors influencing patient engagement and suggestions for enhancing it in the rehabilitation program were identified.	The perspectives of clinicians, patients and their families on patient partnership in goal setting and decision-making processes will provide insights on how to enhance the care experience for patients in the rehabilitation program.	This study provides insights on how patient partnerships can be fostered by interprofessional teams in an adult rehabilitation context, supporting active engagement and an enhanced care experience for patients.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53545		Poster	8:00 AM	8:15 AM			40				The Role of Packaging on Independent Eating in Individuals with Hand Impairments	Sander L. Hitzig Sunnybrook Research Insititute; University of Toronto Wendy López St. John's Rehab, Sunnybrook Health Sciences Centre Elizabeth Linkewich North & East GTA Stroke Network Sylvia Szkudlarek OCAD University Stuart Werle OCAD University Siobhan Donaghy University of Toronto Stephanie R. Cimino University of Toronto Candice Tay University of Toronto Susan Wang University of Toronto	Purposeful sampling was used to recruit six participants living with a functional hand impairment.	Five major themes were identified through the analysis of interview transcripts and video-taped recordings: 1) Challenging factors, 2) Facilitating factors of packaging, 3) Ideal components of packaging, 4) Feelings and Emotions, and 5) Strategies and Support.	Our descriptive study illustrated that there is an opportunity for enhanced education and functional therapy for individuals who have acquired a hand injury, which specifically address strategies for opening food packages. Universal design principles may also be applied in the food packaging industry to increase accessibility to certain foods.	Individuals living with hand impairments often face challenges in opening various types of food packaging. Occupational therapists are skilled to assess and assist these individuals in overcoming such challenges. Designers also play a key role in helping to create universally accessible food package options.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53634		Poster	8:00 AM	8:15 AM			41				"Clearly they are in the circle of care, but…": Perceptions of personal health information sharing with community pharmacists in an integrated care model	Sara Guilcher Leslie Dan Faculty of Pharmacy, University of Toronto Zahava Rosenberg-Yunger Health Services Management, Ryerson University Katie Dainty Institute of Health Policy, Management and Evaluation, University of Toronto Amanda Everall Leslie Dan Faculty of Pharmacy, University of Toronto Jennifer Lake Leslie Dan Faculty of Pharmacy, University of Toronto Teagan Rolf von den Baumen Leslie Dan Faculty of Pharmacy, University of Toronto	22 individuals participated, with nine pharmacists, six decision-makers, and seven clinicians.	The main themes were: different definitions of circle of care, as clinicians and decision-makers felt community pharmacist involvement was situational; perceived value of sharing personal health information for patient outcomes within a fragmented health care system; uncertainty about what information can and should be shared, and how to share information, with descriptions of processes.	Concerns surrounding privacy of personal health information and circle of care represent a barrier for the involvement of community pharmacists in integrated care models. Potential enablers to mitigate privacy concerns include relationship-building between community pharmacists, patients, and health care professionals, and mutual access to information sharing platforms.	Perceptions that clinicians and decision-makers have about community pharmacists and privacy impact information-sharing and are incongruent with Ontario's privacy legislation. Education is needed among health care professionals on privacy legislation especially as health systems move towards integrated care models	Research in Rehabilitation (quantitative, qualitative or mixed methods)
53665		Poster	8:00 AM	8:15 AM			42				Registered Practical Nurses in Inpatient Rehabilitation Settings: A Competency Framework	Nancy Snobelen Independent Svetlana Ivanitskaya Central Michigan University Lynn McCleary Brock University Robert Teasell Department of Physical Medicine and Rehabilitation Faculty of Medicine and Dentistry University of Western Ontario Scientist, Lawson Health Research Institute Parkwood Hospital, St. Joseph's Health Care	21 RPNs were interviewed. Informants ranged from 25 to 64 years of age and had, on average, 11 years of rehabilitation experience.	RPNs' rehabilitation-specific knowledge revolved around settings, participants, and activities. Specialized skills were interpreting, consoling, conserving, and integrating. Intervention abilities included easing into rehabilitation, creating milieu, and maximizing patients' efforts. Organizational environment variables of importance to RPNs' work were model of care, role ambiguity, and changes to system and patient paradigms.	Passionate about their jobs, the RPNs were challenged to reflect on the purpose, interventions, and practice of rehabilitation nursing. Individual responses varied by experience, training, and tacit knowledge. Entry-to-practice competencies (CNO, 2014) are not sufficiently detailed. There is increasing encroachment on the biopsychosocial model by organizational factors.	RPNs represent an important, yet underutilized part of the rehabilitation workforce. The outlined competency framework can be used to communicate about RPNs' contributions to interprofessional teams and clinical outcomes and is key to refining a specialized role to optimize resource use and employee satisfaction.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
54034		Poster	8:00 AM	8:15 AM			43				Introducing Solution-Focused Communication as a driver for successful interprofessional collaboration	Sarah Keenan Holland Bloorview Kids Rehabilitation Hospital C.J. Curran Holland Bloorview Kids Rehabilitation Hospital Anna Oh Bloorview Research Institute Gillian King Bloorview Research Institute Yukari Seko Ryerson University, Bloorview Research Institute Joanne Maxwell Holland Bloorview Kids Rehabilitation Hospital	Of 140 eligible participants, 37 SPs completed surveys at baseline and three follow-ups (directly after the training, at 3 months, & at 6 months).	Quantitative & qualitative findings both suggested that the training proved an effective way to achieve substantial and sustainable improvements in SFC knowledge, confidence, & use of techniques among participating SPs. The intervention facilitated the integration of a strengths-based, solution-building approach at an individual & team level, providing SPs with a common language for client-centred care and optimal collaboration with colleagues.	The findings of this study demonstrate that SF language supports a shift in focus from trying to solve problems for clients to clients' strengths and resources. The principles and strategies were seen to provide a shared language and framework among colleagues that facilitated collaborative, solution-focused conversations with clients and families toward a shared goal.	Findings indicated that the 2-day training proved an effective way to achieve substantial and sustainable improvements in knowledge of SFC practices, confidence in using these practices, actual use of SFC techniques, and integration of SFC elements in practice. The educational intervention provided SPs from diverse disciplinary backgrounds with a common language and organizational guidance toward how to implement client-centred, strengths-based philosophy into practice.	Research in Rehabilitation (quantitative, qualitative or mixed methods)
54150		Poster	8:00 AM	8:15 AM			44				Harnessing Our Compassion: Implementing a Strategic Approach (Schwartz Rounds) to Address the Cultural Health of Hospitals and Health Systems)	Nancy Searl Holland Bloorview Kids Rehabilitation Hospital Joanne Maxwell Holland Bloorview Kids Rehabilitation Hospital	222 clinicians completed pre- and post-test surveys two weeks following SR on various self-report measures, while 494 parents of pediatric patients reported on clinician empathy.	A dose effect was found indicating that attendance positively predicted self-reports of empathy (p < .01), as well as co-worker guidance (p = .07) and alliance (p = .06). Moreover, attendees reported greater overall coworker support (p < .01) and greater insight into compassionate care (p < .001). Attendees also specified they had more conversations about SR with their co-workers (p < .001) and supervisors (p < .05) compared to non-attendees. Finally, parents reported significant increases in clinician empathy throughout the duration of Rounds (p < .01).	Overall, the international and national research suggests that Schwartz Rounds® is an effective, replicable program to promote empathy, compassionate care and strengthen relationships among modern day Canadian healthcare professionals. Clearly, Canadian organizational practices need to adopt this innovative route to enhance hospital quality and experience for those who receive care as well as those who provide care.	Given the high rates of clinician burnout being reported across of heath care system, programs that support empathy and compassion amongst health care providers is essential not only to the experience of clinicians, but also in supporting high quality patient care and outcomes. Programs such as Schwartz Rounds provide an important, evidence-based means of supporting health care workers to deal with the many stressors that are a part of the day to day delivery of health care services, and support a culture of caring and compassion.	Research in Rehabilitation (quantitative, qualitative or mixed methods)

Date

November 27, 2020

Location

Virtual Conference
https://live.remo.co/e/gtabpd2020

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