Capstone research projects database
The Capstone research project is where students work on real-world issues.
See the Capstone projects TRP students have worked on over the years.
Invasive Placentation
Few opportunities exist for healthcare professionals who provide maternity care to gain expertise in invasive placentation.
Background
Management of invasive placentation is medically and surgically complex. As such, it is primarily performed in high-risk tertiary care centres, which limits the opportunities for healthcare professionals to gain experience and expertise in the diagnosis and management of this condition.
Project team
- Kate Kazlovich
- Julia Kfouri
- Conner Janeteas
TRP supervisors
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Investigating the Human Factors of Invasive Line Risk Management in Paediatric Critical Care
This exploratory study used a sociotechnical and human factors approach to understand and improve invasive line risk management in the Cardiac Critical Care Unit at SickKids.
Background
This report provides the background, methods, results and analyses of the InSITE project: an exploratory study conducted at Sick Kids Hospital as part of the graduate studies course LMP2330Y Capstone Project in Translational Research, Translational Research Program at the University of Toronto. Invasive lines refer to any small catheter and accompanying tubing system inserted into a large blood vessel of a patient used to treat critically ill patients. The risk assessment and management of invasive lines is a challenging process due to the large number of variables clinicians must manage and the complex critical care environment in which this work resides. The objective of our study was to describe the current state of invasive line risk management in the Cardiac Critical Care Unit (CCCU) at SickKids from the perspective of health care providers. A sociotechnical framework was adopted to better understand how key sociotechnical factors of clinical work affect the health care providers' interactions with the health care system. This framework promotes efficient resource utilization, prevention of research waste, and a collaborative innovative model where stakeholder experience is incorporated a priori into the project planning of a clinical intervention. The methods of data collection consisted of surveys and semi-structured interviews. Recruitment targeted licensed clinicians currently employed in the SickKids CCCU who worked closely with invasive lines with at least one year of experience in the paediatric critical care setting. The methodology of Human Factors Engineering was utilized to extract relevant tasks, processes and decisions from the interviews to produce a workflow diagram. The clinicians validated the workflows produced and described factors that presented the most significant challenges.
Results included a combined clinical workflow achieved through thematic analysis of transcripts and saturation achieved from individual participant workflow diagrams. The task of discussing with a treatment coordinator was identified by all participants as the most challenging and one that can most benefit from improvement from a future intervention. The sociotechnical factors of time, labour, synchronicity and reliability/performance were identified as the most common themes among participants. In particular, reliability/performance were found to be the most prevalent factors and may guide the future development of enhanced decision-making. His report finds that there is potential for impact with stakeholders at SickKids such as the Translational Engineering department, Artificial Intelligence in Medicine group, Registered Nurses’ Association of Ontario and other pediatric ICUs as well as adult ICUs. Future work is needed to expand clinician perspectives beyond nursing staff to provide a deeper understanding of the current clinical processes. This first-of-its-kind exploratory study presents the roadmap for future studies and demonstrates the feasibility of a Human Factors research approach in the paediatric critical care space.
Project team
- Alexa Lanese
- Meg Sharma
TRP supervisors
Project advisory committee
- Dr. Melissa McCradden
- Dr. Ryan Kealey
- Dr. Ronald Cohn
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MedMarket Mavericks
We want to help patients. There are numerous patients with horror stories about the care available within our country, and there are many individuals that partake in medical tourism to receive the best possible care for their illness.
We want to reduce that medical disparity between our country and the wider world. Patients within Canada should be able to access the best possible care that exists. Often, patients are fighting for their lives. We want to help and give them a fighting chance.
Background
The healthcare system is rampant with challenges, from the emergency room to the doctor’s office. Everyone involved is doing their best to improve the lives of thousands to millions of patients in Canada. With ongoing conversations that our healthcare system is heavily strained, there needs to be pathways that allow for the adoption of proven, and better health innovations into our healthcare system.
Different healthcare systems have specific rules, regulations, and nuances that are not readily apparent to new market entrants. We decided to focus on Ontario, as it is the most populous Canadian province and a major health innovation hub. Furthermore, we hope to leverage the expertise within the province to connect and collaborate with stakeholders to help address the issue of startup procurement within Ontario.
We will create design requirements which reflect the needs that the final intervention must address to be successful. These design requirements will be created through a co-design process with stakeholders from startups, startup supporting organizations, healthcare organizations, and procurement organizations. With key players and decision makers able to ideate on the challenges of startup procurement, we hope to filter out the “wants” and hone down on underlying needs.
Contact us if you are interested in having a discussion!
Inclusion criteria
1. Leadership from small and medium-sized start-ups in Ontario that have a market-ready product and have passed verification and preliminary trials and testing. This includes:
- Start-ups with current or previous attempts at adoption by Ontario healthcare organizations regardless of their success
- Start-ups with a medical device and/or digital health solutions
2. Individuals from start-up supporting organizations operating in Ontario including:
- Start-up incubators, or accelerators ex: H2I, MaRS DD, CanHealth, OBIO
3. Individuals from Ontario healthcare organizations involved in the procurement process:
- Procurement teams, or decision-makers at healthcare organizations such as hospitals
- Individuals from group purchasing organizations or procurement experts
Exclusion criteria
- Start-ups without a market-ready product and larger well-established companies that no longer face the challenges of small or medium-sized start-ups
- Healthcare organizations outside of Ontario or start-ups outside of Ontario
- Start-ups with biotechnology and drug solutions, and consumer health products and solutions are excluded from this study.
Project team
- Zoya Aziz Bhatti
- Derek Sheunghei Choi
TRP supervisors
nYOUtrition
This mixed methods study explores user demographics, experiences, and needs at U of T food banks to identify service gaps and inform improvements, including development of a new food bank and initiatives like vertical gardens.
Background
The purpose of our study was to address some of the gaps that exist in understanding food insecurity at UofT, and to understand UofT Food Bank usage and the characteristics and needs of its users. This information is vital to improving services to users and can be used to inform the developers of the new food bank at UofT. Therefore, this was an exploratory and descriptive study aimed to understand the services provided by the food bank,effectiveness of these services, and how we might enhance user experience. Our mixed methods study was divided into two main objectives: 1. A quantitative component to understand the current state of food services, the user demographics (age, gender, dependents, dietary restrictions, educational status) and preferences to determine whether it is necessary to improve the overall quality of food.
2. A qualitative component to understand the user experience at the food bank, by discovering personal insights about the food bank, its services, and the food it provides. The study consisted of two versions of a survey, one for UTSG Food Bank users (iii) and another for UTM Food Centre users (iv), the latter which included questions about vertical gardens; as well as two versions of a follow-up semi-structured interviews. Through surveys, we collected information such as basic demographics, food bank usage (type of food, frequency, etc.), food bank user experience, their needs and future improvements desired for the food bank, and insights about the vertical gardens at the UTM Food Centre. Once users completed the survey, they had the option to indicate if they were interested in participating in a semi-structured interview following an interview guide. Through interviews, we were able to better understand the user journey and experience.
Project team
- Kathleen Camaya
- Helen Liu
- Nabilah Juma
- Chelsea Foo-Fat
TRP supervisors
See our community directory for more on committee members.
Optimizing Patient Experiences in Ketamine-Assisted Psychotherapy: A Journey Mapping Approach
Accessing ketamine-assisted psychotherapy for treatment-resistant depression is hindered by stigma, high costs, and fragmented care pathways. Additionally, there is a critical lack of data on patient experiences during ketamine-assisted psychotherapy, making it challenging to optimize care. Our project addresses this need by using patient journey mapping to systematically capture the experiences of individuals undergoing ketamine-assisted psychotherapy, identify barriers, and co-create strategies to enhance accessibility, care quality, and patient outcomes.
Background
Ketamine-assisted psychotherapy offers a transformative treatment for individuals with treatment-resistant depression. Despite its promise, many patients face significant barriers, such as stigma, limited provider knowledge, and high costs. Our project bridges this gap by focusing on patient journey mapping, a visual and qualitative method that captures patient experiences across the care pathway—from initial awareness of ketamine-assisted psychotherapy to post-treatment integration.
The study involves two phases:
- Phase One: Conducting semi-structured interviews with individuals undergoing or having undergone ketamine-assisted psychotherapy to create patient journey maps.
- Phase Two: Hosting a collaborative workshop with healthcare providers within the ketamine or psychedelic therapy field to translate findings into actionable, patient-centered strategies.
This study combines qualitative insights with expert collaboration to propose strategies for improving overall patient satisfaction, enhancing accessibility, and fostering tailored and equitable mental health care. The outcomes will guide advancements in ketamine-assisted psychotherapy and inform best practices for psychedelic-assisted therapies in Ontario and beyond.
Project team
TRP supervisors
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Optimizing the usability of hospital antibiograms: A step towards efficient diagnostic stewardship (STRIDE)
This cross-sectional survey identifies key factors influencing clinician use of antibiograms in Ontario hospitals and offers actionable recommendations to improve access, training, and integration into clinical practice.
Background
Background: Our study examines the key barriers and facilitators as perceived by clinicians regarding the use of antibiograms in hospital settings.
Methods: This cross-sectional study involved physicians in Toronto hospitals and pharmacists Ontario-wide that met the inclusion criteria. Data was collected through an online self-administered survey. The primary outcome was factors associated with increased antibiogram usage determined by multivariable logistic regression. Secondary outcomes included a compilation of clinicians’ recommendations for changes to hospital antibiogram format and measures that institutions can take to increase antibiogram use; these recommendations are reported by percentages, frequencies, and weighted mean score.
Results: A total of 149 responses from 123 physicians and 31 pharmacists, were analyzed. Significant independent predictors of antibiogram use included: antibiogram access in institutions (OR 111.11, 95% CI:17.5–1001, p<0.0001), satisfactory training in antibiograms (OR 11.34, 95% CI:2.03–63.29, p=0.008), higher prescription frequency (>5/month) (OR 9.7, 95% CI: 1.39–71.42, p=0.0026), and working in infectious diseases (OR 37.07, 95% 1.65–1001, p=0.023). Recommendations for changes in antibiograms to increase their usability included: developing simple, interactive, digital, colour-coded versions, providing syndrome-specific data, posting antibiograms on a website or mobile apps, providing guidance on usage, integrating antibiograms into electronic health records, coupling antibiograms with treatment guidelines, offering frequent updates and email notification of updates, and requesting feedback via email.
Interpretation: In order to increase antibiograms usage, it is recommended to address key barriers and facilitators noted by clinicians by developing interventions addressing access, education, promotion, updates and notification, and gathering feedback.
Project team
- Ayesha Athar
- Kaitlyn Gosalves
TRP supervisors
Project advisory committee
- Dr. Linda Dresser
- Dr. Derek McFadden
- Dr. Allison McGeer
- Dr. Andrew Morris
See our community directory for more on committee members.
PAT-a-CAKE: Pediatric Assessment Tools and Clinical Advances in Kids Evaluation
Evaluating the methods used by physicians, nurses, and physician assistants for assessing pain in pediatric patients.
Background
Pain is a universal and distressing experience for hospitalized children, with lifelong implications if inadequately recognized or managed. Timely and accurate pain assessment is essential in pediatric emergency departments (EDs) to guide appropriate interventions, alleviate suffering, and lower the risk of both immediate and long-term psychosocial repercussions.
At present time, there is limited evidence describing the actual pain assessment practices within pediatric EDs in Ontario, and no data on the degree to which recommended protocols are being followed at Humber River Hospital. Without a clear understanding of the current state of practice and the factors driving variations in care, the development and implementation of effective quality improvement initiatives are hindered.
The proposed study would identify existing pain assessment procedures for children ages two to twelve who arrive at the emergency room of Humber River Hospital in order to fill this important knowledge gap. This project will investigate the explicit and implicit factors impacting adherence to recommended guidelines using qualitative methodologies with a varied range of healthcare practitioners, including physician assistants, nurse practitioners, and physicians. Through examining these concerns from the perspectives of healthcare professionals, this study seeks to pinpoint the obstacles and enablers that impact clinical judgment, the choice and application of standardized instruments, and the recording of pain assessment procedures. Ultimately, the insights received will inform the development of tailored interventions and support evidence-based improvements in pediatric pain assessment practices, ensuring more consistent and effective pain management for children in the emergency care setting.
Project team
TRP supervisors
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Perineal Model with 4th-Degree Tear for Obstetrics Resident Training
Severe perineal tears are rare events, making it difficult for residents to receive adequate training.
Background
Up to 65% of vaginal deliveries are complicated by some form of tear or episiotomy. Severe tears can lead to long-term complications; however, they are rare enough that residents have few opportunities to receive training from experienced obstetricians. Residents who receive simulation-based training have improved performance, but we do not currently have a model for 4th degree perineal tears.
Project team
- Shirley Hutchinson
TRP supervisors
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Pilot Marshal Project
The Pilot Marshal Project aims to support researchers as they implement Pilot Projects within unique and complex environments.
Interventions that are found to be effective on an individual scale, or within a specific context, often fail when implemented in a separate context.
Using the SUPPORT-Dialysis Pilot Project as a case study, we will identify key barriers and facilitators to Pilot Project implementation. Based on these findings, we will develop a Process Model to help guide the process of translating research into practice.
Background
In April 2023, the SUPPORT-Dialysis pilot study was launched at Toronto General Hospital. The study aims to determine the feasibility of using an electronic patient-reported outcome measures (ePROMs) assessment and response toolkit to improve symptom and distress screening and management support for patients on dialysis.
One month after the launch of the SUPPORT-Dialysis pilot study, it was found that several patients flagged as needing symptom management support were not referred for additional symptom care support by their nephrology clinicians. When translating research from the lab to the bedside or across different patient populations, many issues arise during the initial implementation of clinical trials or pilot projects.
The capstone project aims to use the SUPPORT-Dialysis pilot as a case study to determine and address the barriers and facilitators to successful implementation of pilot projects.
Project team
- Owen Jones
- Sara Macanovic
TRP supervisors
Project advisory committee
- Dr. Karen Born, Assistant Professor (teaching stream) and program director of the MHSc in Health Administration in The Institute of Health Policy, Management and Evaluation (IHPME)
- Dr. Sonia Rodriguez-Ramirez, Transplant nephrologist, UHN
- Dr. Katherine Rud, SSHRC-funded Postdoctoral Fellow, School of Social Work, University of Windsor
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PrEP Access Navigator (PAN): Creating a Comprehensive ‘Application Cheat Sheet’ for the Trillium Drug Program
The PrEP Access Navigator (PAN) seeks to address the significant barriers uninsured individuals aged 23-64 face when applying to Ontario’s Trillium Drug Program (TDP). By simplifying the complex application process, PAN aims to make Pre-exposure Prophylaxis (PrEP) more accessible, reducing financial, procedural, and digital obstacles. This innovative, patient-centric digital tool provides tailored guidance, empowering vulnerable populations to navigate the system with ease and efficiency, ultimately improving health outcomes and reducing HIV transmission rates.
Background
Accessing life-saving medications like PrEP is a challenge for many uninsured individuals in Ontario due to barriers associated with the Trillium Drug Program (TDP). Financial constraints, complicated paperwork, and a lack of digital support deter individuals from completing the application, leaving vulnerable populations at heightened risk of HIV transmission. The PrEP Access Navigator (PAN) seeks to address these challenges by functioning as a virtual "cheat sheet" that simplifies and personalizes the application process. By guiding users step-by-step, PAN ensures they receive the support they need to overcome application hurdles.
PAN’s development follows the Translational Research Framework from the University of Toronto, progressing through two phases: 'Understand' and 'Act.' During the 'Understand' phase, informal research and consultations with academic literature identified accessibility barriers. The 'Act' phase focuses on iterative development and usability testing, where 20 participants will provide feedback on PAN’s initial version during secure, Zoom-based prototyping interviews. This feedback will inform thematic analysis and guide improvements for subsequent versions.
Integration with existing networks, such as the AIDS Committee of Toronto (ACT) and pharmacies, is expected to enhance service efficiency and patient experience. PAN’s streamlined approach aims to increase PrEP uptake and reduce HIV transmission rates, demonstrating how digital tools can bridge healthcare accessibility gaps. Beyond addressing immediate barriers, PAN provides a replicable model for improving access to other healthcare services, setting a precedent for equitable, patient-focused digital interventions. Partnerships and further pilot testing will ensure PAN’s impact continues to grow.
Project team
TRP supervisors
See our community directory for more on committee members.