Gathering data to improve care through the Road to Recovery Initiative

Dr. Brittany Dennis (MD PhD) is a clinician scientist with the Interdisciplinary Division of Addiction Medicine at Providence Health Care and is completing an addiction medicine fellowship with the BC Centre on Substance Use (BCCSU). She was one of the winners of the 2022 Carraresi Foundation Early Career Clinician Investigator Award. Her project, titled “The Road to Recovery Initiative (R2RI): A prospective evaluation of a novel program for the delivery and coordination of addiction care,” aims to evaluate the implementation of a new approach to addiction care and generate data to promote evidence-informed and coordinated substance-use care in British Columbia and beyond.

Dr. Dennis looks forward to helping strengthen connections between all communities directly affected by the substance use crisis, including researchers, clinicians, and especially patients and families. The data generated from this work will directly inform ways to adapt and improve the R2RI to address the needs of affected populations.

An innovative new initiative

The Road to Recovery Initiative is designed to address major gaps in care affecting individuals who use substances and support them through all phases of recovery. Providence Health Care (PHC), the provincial Ministry of Health and Ministry of Mental Health and Addiction, Vancouver Coastal Health (VCH) and VCH/PHC’s Regional Addiction Program (RAP), are working closely together to re-organize existing clinical services to promote an integrated system of care and enable seamless access.

Simultaneously, addiction treatment capacity will be majorly increased. Approximately 100 new addiction treatment beds will be added to St. Paul’s Hospital, or a location close by, over the next five years.

An evaluation of a novel health service.

Dr. Dennis’ project, funded through the Carraresi Foundation Early Clinician Investigator Award, is a prospective evaluation of the first phase of the R2RI.  

“It is an evaluation of a brand new, very novel health service – a new approach to addiction care delivery that has never been tested before, across the world,” says Dr. Dennis. She will be working directly with Dr. Seonaid Nolan, the Principle Investigator of the R2RI and current Division Head for PHC’s Interdepartmental Division of Addiction Medicine.  

Their team is supported by the collaboration of important members of PHC and the BCCSU. This includes Cheyenne Johnson, Executive Director, Dr. Travis De Wolfe, Program Manager, and Dr. Thomas Kerr, Head of Research from the BCCSU; Dr. Andrea Ryan, Head of Clinical Service, Dr. Erika Mundel, Project Manager, and Julie Lajeunesse, Operational Lead of the R2RI; Dr. Nadia Fairbairn and Miranda Compton, RAP Medical and Operational Leads, and Harmony Johnson, Vice President, PHC’s Indigenous Wellness and Reconciliation Team.

Tracking data to improve care

The project has three main objectives. The first is to describe and evaluate the implementation of the service over its first year, taking a detailed look at the development, adaptation, progress, and overall functionality of the service.

The second objective is to evaluate health and social outcomes among people who access any R2RI service, such as substance use trends and quality of life, and health care utilization patterns, such as how often a patient presents to the emergency department or is admitted to the hospital.

The third objective is to capture individual patient experiences and satisfaction with the R2RI clinical services, identify opportunities for improvement, and understand how access to these new services impacts a patient’s addiction treatment trajectory.

“The second that patients are actually accessing care through this new service, we will be tracking important data, including the number of patients coming in, the types of patient populations we’re treating, the types of substance use disorders we’re treating, and the type of treatments we’re giving out through the program,” says Dr. Dennis.

Finding ways to adapt and improve the program

This evaluation will create an observational cohort study that will follow patients over time, track what is and is not working in the program, and discover ways to improve it to meet the needs of this vulnerable population.

Dr. Dennis is excited to hear directly from patients and clinicians about their experience with the R2RI and gather suggestions for improving care. She wants to know the “what, when, why and how” of patient and clinician experiences with the R2RI.

She and her team will explore different trends in substance use behaviors, identify challenges and areas for growth in addiction health services, characterize important features of the populations accessing care, and improve the provincial capacity to tailor approaches to care in response to the substance use crisis. This work will advance understanding of addiction care and service delivery and provide a voice for patient experiences.

“It’s a very big undertaking, and it’s going to include many different types of methodology and design, but we’re just so excited to have the government and philanthropic support to be able to  create a service that directly addresses needs and really looks at the major gaps in care that we’re often losing people to,” says Dr. Dennis.