A Co-Created Community Initiative: National SCI Care, Health & Wellness Strategy
In 2019, Praxis started an engagement process to create a national care strategy by building on the strengths and collective wisdom of the spinal cord injury (SCI) community across Canada. Our engagement with the community led to “Being Bold: Toward a National Spinal Cord Injury Care, Health & Wellness Strategy Discussion Document & Consultation Report” and then a community report “SCI Care for Canada: A Framework for Strategy and Action”, which lays out a framework for an actionable National SCI Care Strategy. (Publication Rivera 2022)
During these meaningful engagements with the SCI community, many examples of SCI care excellence already present within Canada surfaced and Praxis organized Learning Circles to share these stories of excellence with the community to facilitate building an optimum system of care, health and wellness.
The Canadian SCI Network Alliance
Continuing to support the National SCI Care Strategy in Canada, Praxis coordinates the Canadian SCI Network Alliance, which is a national network of networks with an interest in SCI. The goal is to facilitate communication and the spread of SCI best practices and policies, obtain agreement on optimal SCI care, as well as facilitate planning for under-served populations and growing populations (e.g. non-traumatic SCI).
The Alliance consists of leads from SCI networks across Canada, including SCINAPS (SCI Network of the Atlantic Provinces), Circulus (Primary Care Network), North American SCI Consortium (NASCIC), SCI Canada, Alberta Health Services Neurosciences, Rehabilitation & Vision Strategic Clinical Network (NRV-SCN) and Ontario Networks. The networks were selected to include representatives from care, research, and community-based organizations, and are hoping to expand to better cover the geography of Canada. The leads meet on a quarterly basis to share regional and provincial initiatives, and provide input on proposed national plans.
SCI Model of Care
One of the initiatives from the Alliance is the development of a person-centred model of care, led by Drs. Chester Ho and Hope Jervis-Rademeyer. Optimal attributes of models of care were identified through a scoping review led by Dr. Ho, and these include the importance of having multidisciplinary SCI specialty care providers along the continuum, provision of rural SCI services and outreach, integration of primary care, peer mentoring, and using a hub and spokes model of care. The goal is to incorporate these attributes into a SCI model of care to ensure the delivery of optimal care from rehabilitation through to the community. A National SCI Model of Care Executive Committee has been created and includes leadership from the majority of Canadian provinces, and the Alliance acts as the Steering Committee.
Respiratory Care Pathway
The Alliance is also supporting the development of a Canadian Respiratory Care Pathway for SCI, led by Drs. Colleen O’Connell and Chester Ho that was initiated by persons with lived experience and NASCIC. The goal is to develop a pathway spanning acute to community care to optimize respiratory care and patient outcomes. This initiative will commence with an e-scan of care protocols, equipment and SCI Program services across Canada. The data will then be synthesized by an Expert Advisory Committee and shared with SCI Programs in Canada, with an ultimate goal of achieving a national consensus.
