Louise Rose: One of the last MOHLTC Career Scientists

16 June 2011

Faculty Member - Louise RoseDr. Louise Rose is an established researcher with more than 16 years experience in the field of intensive care nursing. In addition to including the inaugural appointment of the Lawrence Bloomberg Limited-tenure Professorship in Critical Care on her résumé, she may now add she’s one of the final recipients of the Ministry of Health and Long-term Care’s Career Scientist Award.

The Career Scientist Program supported the early career development of health services researchers for 20 years by providing salary support to the best and brightest health services researchers in the province. The award had been instrumental in assisting new researchers to build their careers in Ontario.

Through her research, Louise identified chronic respiratory failure as a growing national health problem resulting in an increasing number of Canadians at risk for, or requiring, prolonged and long-term invasive and non-invasive mechanical ventilation (PMV/LTMV). Insufficient capacity to deliver care to ventilator-assisted individuals in both the acute and chronic care sectors has led to crowding in emergency departments; transfer of critically ill and ventilated patients across provinces and out of Canada with increased risk of adverse events and costs to the health care system; and inappropriate utilization of critical care resources by ventilator-assisted individuals who no longer require acute care. Additionally, long-term physical and psychological consequences can affect quality of life and may impose substantial symptom burden.

In Canada, there is no national strategy, administrative structure or organized regional clinical care system for the management of patients who are at risk or require PMV/LTMV. National and provincial data are unavailable, and information is urgently needed to inform public policy, healthcare funding, better prevention, effective management, and alternative models of delivering service to ventilator users. Accordingly, Louise’s research is this area has been funded by the Canadian Institutes of Health Research (CIHR). Her study, “Understanding Long-Term Mechanical Ventilation in Canada: A Programmatic Approach,” received a three-year grant.

This project will establish a comprehensive national network, enabling collaboration and partnerships across health sectors, professions, and jurisdictions. The information collected will be shared through the establishment of an open access website for clinicians, patients and families. It’s anticipated the sharing of best practices will improve health outcomes, patient safety, and quality of life for the target population across the continuum of care.

Louise received an additional grant from CIHR, which also funded her study “Outcomes of Critically Ill Patients Presenting in Canadian Emergency Departments.” This study is the first to link emergency department care in Canada to hospital outcomes for critically ill patients. Several studies have identified an association between emergency department crowding, suboptimal care, and adverse patient outcomes in various patient populations and organizational contexts. This project will help decision-makers identify a specific sub-population for whom reduced service time in the emergency department may be a critical factor for improving outcomes. The data collected will help drive current emergency department wait time strategies and inform future provincial strategies. To date, there are no population-based studies that examine the relationship between emergency department length of stay and hospital mortality for critically ill patients, no studies of the Canadian health care system, and no published studies that utilize data more recent than 2003.

In addition to the above, Louise holds cross-appointments as a research scientist and director of research at the Provincial Centre of Weaning Excellence at Toronto East General Hospital, as well as adjunct scientist appointments at Mt. Sinai Hospital and the Li Ka Shing Institute at St. Michael’s Hospital. As evidenced, her research interests are directed towards the critical care and emergency specialties with a program of research focused on improving the experience of the mechanically ventilated patient.