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Dr. Cheryl Forchuk is the recipient of the 2020 Innovation Award for her work to prevent discharges from hospital to homelessness. Throughout her career, Dr. Forchuk has been investigating potential best practice approaches to prevent homelessness in our community for a wide range of people, including those with severe mental illness, veterans, families, and youth. 

Her recent project, ‘Preventing Hospital Discharge into Homelessness: No Fixed Address Version 2 (NFAv2)’ streamlines housing and income services by bringing them into the hospital, and integrating them into a coordinated system of care.  

Research shows that when someone is housed, their use of medical and social services decreases. Safe and adequate housing is required for individuals to recover from illness. 

 Version one of this program was a great success, providing direct access to a housing advocate and Ontario Works from inpatient hospital psychiatric units in London. The No Fixed Address v2 program provides individual inpatients, at risk of becoming homeless, with housing and financial assistance while in hospital. A collaborative approach which includes the local Canadian Mental Health Association, the Salvation Army Rent Stability Bank, Ontario Works, and the City of London brings community supports to the hospital. This enables patients to recover from their illness and reduces the number who may return to the hospital. Dr. Forchuk’s use of in-depth, individual, quantitative interviews, and qualitative focus groups, allows stakeholders to voice their experiences with the program as well as capture traditional outcomes. 

“This innovative program has been so successful in London’s hospitals that the City of London has integrated the NFAv2 service within its municipal housing support programs,” explains Dr. Arlene MacDougall, Lawson Scientist and Dr. Forchuk’s nominator. “It also has the potential to be integrated across the province as the best practice in reducing homelessness in communities. Her efforts have been recognized by multiple funding agencies, and it will soon be the model for the rest of the nation to follow. Dr. Forchuk’s commitment to improve the lives and of those in our community makes her truly deserving of this award.” 

“The No Fixed Address research project is the first evaluation anywhere of a strategy that aims to reduce the number of hospital patients being discharged into homelessness,” says Dr. Forchuk. “I’m really proud of our collective efforts. We have been able to help a lot of people, and have also learned a lot throughout the course of this study.” 

Chronic wounds represent a significant burden in Canada. Between four and 30 per cent of patients develop a chronic wound, depending on the health care setting. Over 85 per cent of all Spinal Cord Injury (SCI) survivors will experience health complications related to pressure ulcers, injuries to the skin and underlying tissue resulting from prolonged pressure. These types of wounds can significantly reduce participation in meaningful activities and overall quality of life. 

Research from around the world shows that electrical stimulation can help speed the healing of pressure ulcers. This therapy is currently done by a trained health care provider and is not readily available for people across Canada.Electrical stimulation therapy (E-Stim) is a wound treatment that involves applying low levels of electrical current to the wound bed and surrounding tissues. It stimulates several healing processes, promotes local circulation and prevents infections. 

The E-Stim Collaboration: A Best Practice Implementation Project for Better Pressure Ulcer Care aims to improve the coordination of pressure ulcer care and promote the use of evidence-informed wound treatments for people living with SCI. In particular, the research project is studying how to best provide E-Stim to people with pressure ulcers, in their own communities.

“Over the years I’ve seen the serious impact pressure ulcers have on the lives of people with spinal cord injury and other health challenges. This is what drives my commitment to not only develop best practice guidelines, but also to ensure they are put into action,” says Dr. Pamela Houghton, Associate Scientist, Lawson and Professor, School of Physical Therapy at Western University. “Advances in technology make it possible for more people with care needs to live at home.”

The pilot project in the South West LHIN has a unique model that builds capacity in the community and taps into the lived experience of people with pressure ulcers and SCI. It brings together the expertise of researchers, clinicians and managers from academia, hospital centres and community care.

Partners include the Parkwood Institute Research program at Lawson Health Research Institute, Western University, Saint Elizabeth’s Health Care Research Centre, Sunnybrook Health Sciences Centre and the South West Community Care Access Centre. An interdisciplinary specialized team, called SCIPUT, has been established within the Spinal Cord Injury Rehabilitation program provided at Parkwood Institute, St. Joseph’s Health Care London.

“Our collaborative team is using the PLAN-DO-STUDY-ACT quality improvement model. This allows us to learn from each cycle and make adjustments as we go,” says Dr. Houghton. “We have just completed the first cycle and are reporting on lessons learned.” Funded by the Rick Hansen Foundation, the team hopes this will set the stage for a larger cross-country initiative.

Those interested in participating can contact phoughto@uwo.ca. The study is open to:

• Individuals with an open pressure ulcer and with a condition that causes limited mobility and/or requires a wheelchair;
• Those who are able and willing to participate in treatment plan, and communicate feedback; and,
• People who are eligible to receive services from South West CCAC.

Image Electrical stimulation (E-Stim) directly stimulates several wound healing processes, promotes local circulation and prevents wound infections. It produces faster healing and wound closure. A trained health care provider applies low levels of electrical current to the pressure ulcer using specialized equipment.