Annual Impact Report 2021

Last fall, Aimee Cooper’s 11-year-old daughter, Mady, was found unconscious on the school playground and was rushed to the Alberta Children’s Hospital. It became clear that Mady was suffering from seizures — and they were getting worse, occurring as many as four times a day and sometimes lasting for as long as an hour. Doctors eventually determined that Mady’s seizures were psychogenic, caused by extreme stress. With treatment from mental health specialists in hospital, she improved and was ready to go home.

While her parents were grateful, they worried about being able to care for Mady on their own. The Acute at Home program relieved their fears. This innovative community-funded outreach service enables children in mental health crisis to receive intensive mental health care in the comfort of their own homes from specially trained therapists, social workers and nurses — in person, by video or by phone. “Acute at Home was our lifeline,” says Aimee. “We are so grateful to the generous people who’ve made the program possible. I don’t know how we would have survived without it.”

Anyone who’s given a COVID-19 test to a child knows that it can be difficult for everyone involved. This year, BC Children’s Hospital clinicians were part of a multidisciplinary initiative that developed a novel COVID-19 test involving a simple mouth rinse kids could gargle and spit, making testing easier and less stressful. This project was one of many BC Children’s undertook this year in order to understand — and where possible alleviate — the pandemic’s wide range of effects on children and youth. In 2021, support from partners also helped researchers at BCCH explore the mental health effects of the pandemic on young people; study the spread of the virus in schools; and investigate vaccine safety for children and youth.

Children and youth undergoing cancer treatments often face extended hospital stays. Those with Acute Lymphoblastic Leukemia (ALL), for example, are treated with four to five cycles of chemotherapy; each cycle lasts four to eight weeks, with only short breaks between rounds. “Being in hospital over long stretches of time, often in quarantine, can take a terrible toll on patients and their families, who literally move to CHEO and put everything else on pause,” says oncologist Dr. Donna Johnston.

To prevent this dislocation, the CHEO team has developed the ability to offer treatment to ALL patients at home. CHEO was recently approved to give some ALL patients specialized pumps that slowly deliver a controlled amount of chemotherapy drugs. Slightly bigger than the insulin pumps used by many diabetes patients, chemo pumps are small enough to be carried in a backpack, allowing patients to continue their treatment at home. Caregivers know that the comfort of home is a powerful healer. Surrounded by family, friends, pets and their favourite things, a young person’s mental health, sleep and physical comfort improve. “The freedom to leave the hospital while receiving life-saving treatment keeps a family together in an environment where they feel most comfortable and in control,” explains Dr. Johnson. “A chemo pump is a simple solution, but the benefits are significant.”

While Indigenous peoples represent 15% of Manitoba’s population, as many as 50% of the families treated at the Health Sciences Centre (HSC) Children’s Hospital in Winnipeg are Indigenous. The Children’s Hospital Foundation of Manitoba is proud to partner with Indigenous organizations to help meet the health care needs of Indigenous children and youth.

In early 2021, the Assembly of Manitoba Chiefs (AMC) and Children’s Hospital Foundation of Manitoba partnered to help fight COVID-19; aided by an AMC donation, the Foundation and AMC worked together to supply 30,000 face masks to all First Nations communities in Manitoba, and to make masks available to any children and families requiring care at the Children’s Hospital’s Emergency Department and specialist clinics. The design of the mask includes the Children’s Hospital mascot as well as a spirit bear design that references Jordan’s Principle, “a child-first principle that aims to eliminate service inequities and delays for First Nations children,” in the words of the Assembly of First Nations.

When a patient is in a critical state, time is of the essence. Health care teams need to feel confident in their skills and abilities, and must be ready to communicate and collaborate seamlessly to ensure the best possible outcome. Children’s Hospital at London Health Sciences Centre is home to the Michael Gunning Simulation Centre, a state-of-the-art facility that uses team simulations to hone clinicians’ skills — and, importantly, to optimize team communication and dynamics.

The rigorous preparation that care providers undergo at the Centre prepares them to act quickly and effectively to treat children and youth at pivotal moments of their lives. According to one pediatrician who received training at the Centre, “One of the [simulated] scenarios was based off a particularly difficult case that we had at our hospital. It allowed us to work through the case more effectively and having a debrief after really helped to ensure I felt confident and reassured about how to handle a similar case in the future.” During the COVID-19 pandemic, the Centre played a new role as a test bed for emerging health and safety protocols, helping to establish best practices for other hospitals. Support from partners helps to sustain the Michael Gunning Simulation Centre as a leading-edge site of medical education in the region, where care providers build skills that can make the difference at critical moments in fragile young lives.

Among expectant mothers in Quebec, 30% experience heightened levels of depression and anxiety — a figure that has increased during the COVID-19 pandemic. Studies conducted at CHU Sainte-Justine and elsewhere show that the first 1,000 days of a child’s life have a decisive impact on future health, meaning that the repercussions of parents’ mental health challenges during early development can be significant and long-lasting. In response to these realities, psychologist and researcher Dr. Sylvana Côté developed the “Toi, moi, bébé” program to help improve the mental health and wellness of expectant mothers, their partners and their babies; an initial group of 500 mothers and partners are being enrolled. Through combined online and telephone support, offered from pregnancy to three months postpartum, Dr. Côté’s team aims to support a healthy transition to parenthood. Donor support is making this program possible, and also supporting a study to help the team analyze its effects; if “Toi, moi, bébé” yields the expected benefits, it may be expanded and offered more widely across Quebec.

In 2021, the IWK team administered more than 51,000 COVID-19 vaccinations. With the vaccine rollout initially prioritizing older adults who were most at risk, in February 2021 the IWK took the unusual step of expanding our focus beyond children and families: the hospital led Nova Scotia’s first prototype community clinic for the 80+ population. Later in the year, with vaccinations happening mainly in pharmacies, the IWK stepped up to run the province’s only pediatric community clinic. Donor support helps give children’s hospitals the capacity to respond quickly to emerging needs. “The IWK Vaccine Clinic’s ability to adapt nimbly as provincial vaccine strategies evolved is a testament to our commitment to lead provincially,” observes Stacy Burgess, IWK Director of Children’s Medical, Critical Care and Rehabilitation Services.

On September 24th, 2021 Kaleb Slaney turned 10. But instead of cake and a gathering of friends, Kaleb had to head to the Janeway Children’s Hospital to have his tonsil removed. At first, Kaleb was disappointed, assuming he would spend his special day sedated and in pain. His first clue that the day wouldn’t be all gloom came as soon as the doors of the Janeway swung open: he was greeted by the day surgery staff belting out ”Happy Birthday” as he registered. Next, he was wheeled to the surgery floor where gifts and more songs awaited. Nurses, doctors and other Janeway staff regularly popped by with birthday wishes while he awaited his procedure. Although they couldn’t see it behind his mask, Kaleb was beaming. After his surgery, the Child Life Department arrived in his room with birthday streamers, a banner and a gift.

Every day, children’s hospitals make extra efforts to make health challenges easier for young patients — from simple gestures like birthday balloons to major facility redesigns that accommodate families over long stays. Donor support helps hospitals to create and sustain healing environments that help kids feel better, in every sense.

Every month, 20 to 30 young people arrive at the Jim Pattison Children’s Hospital’s Emergency Department in mental health crisis. Family members, parents or primary care givers accompanying these patients are often frightened both for the children, who are at risk of self-harm, as well as for themselves. Since people in a state of mental health crisis can often be unaware of their actions, those seeking to help them or provide care — whether loved ones or hospital staff — may be at risk of harm.

With donor support, our Hospital has been able to add safety enhancements to the Emergency Department, creating a more secure environment for patients, family members and clinical care providers. Even patients in extreme states of crisis are able to await assessment in a dedicated space that minimizes the risk of self-harm and helps to reduce fear and stress for everyone seeking to support the young patients. This separate environment also minimizes stress and disruption for patients and families seeking other forms of care in the Emergency Department.

“The pandemic created a need for health care teams to pivot quickly to offer virtual care,” says Lucas Milinovich, Director of Urgent and Ambulatory Care at Hamilton Health Sciences Centre. But while COVID-19 forced the rapid adoption of virtual tools, it quickly became clear that slowing the spread of the virus was not their only benefit.

“From an educational perspective, virtual care creates opportunities for patients to easily access information and resources from home,” explains Virtual Care Specialist Julie Matthews, noting the availability of diverse online resources, such as informational videos, online classes and virtual group sessions. Virtual care also saves time, money and disruption for patients who have far to travel for an in-person appointment, or who may face transportation challenges due to financial or medical circumstances. There are also advantages for health care workers. Online appointments enable them to monitor patients remotely and share test results online without needing physical space for consultations. As the immediate imperatives of the pandemic subside, HHSC and McMaster Children’s Hospital expect to continue offering virtual and in-person services concurrently, according to the specific needs of patients.

The Montreal Children’s Hospital’s H.B. Williams Craniofacial and Cleft Surgery Unit is dedicated to the treatment of children with craniofacial disorders. As one of the only centers in Canada with expertise in facial distraction, the team has provided comprehensive care to patients across the province and from other parts of Canada for the past 15 years. “More and more, the expertise of the craniofacial team is being sought out by families across the country, and beyond,” says Dr. Mirko Gilardino, the Unit’s director. “Donor support is invaluable in helping the team meet the needs of children whose families seek our specialized expertise.” The cleft and craniofacial team, which performed 81 surgeries in 2021, offers cutting-edge neonatal mandibular distractions, as well as orthodontic care including naso-alveolar molding to optimize the aesthetic outcome of surgical repairs. A highly collaborative and multidisciplinary approach — drawing together expertise from 19 specialties — allows us to manage complex cases successfully and provide the highest quality of care and the safest surgical treatments to our patients.

In the fall of 2020, SickKids teamed up with several Ontario universities and community groups to study why Black communities were being hit especially hard by COVID-19. It wasn’t just Canada: the same trend was observed in the U.S. and U.K. In fact, around the world, certain population subgroups — usually minority groups — were contracting the virus more readily, getting sicker and disproportionately dying. The study, led by Dr. Upton Allen, SickKids scientist and Head of Infectious Diseases, is assessing three main angles within Black Canadian communities: the prevalence of COVID-19 infection, the level of immunity and risk factors—both physical and sociodemographic. Are there unique characteristics in Black populations that make them more susceptible to the worst outcomes of COVID?

In an unprecedented collaboration with Black community groups, including the Jamaica Canadian Association and the Black Health Alliance, the research team began recruiting 2,000 Black Canadians and 1,000 non-Black participants (for comparison) in early 2021. Their blood is being analyzed for COVID-19 virus antibodies, and their socio-economic and pre-existing medical conditions are being assessed. The team is also evaluating the relationship between vitamin D levels and the risk of getting COVID-19 (since vitamin D deficiency is more prevalent among Black populations). Donor support is helping Dr. Allen and other SickKids scientists contribute to global efforts to tackle the virus and develop more effective responses to future pandemics.

When she was just a couple of months old, Aubrey was diagnosed with Beals syndrome, a rare genetic disorder that affects the connective tissue. A surgeon at the Stollery Children’s Hospital accelerated her treatment to prevent a curvature in the baby’s spine from fatally affecting her lungs. Over the next few years, Aubrey endured a number of procedures, including surgeries and halo traction, to straighten her spine, clear space for her organs and allow her to grow. These efforts helped Aubrey eat properly and increased her mobility and lung function.

In the fall of 2021, Aubrey needed to be placed in traction again. This time, the COVID-19 pandemic meant that her family faced the wrenching prospect of being separated from Aubrey for the months of her treatment, to minimize the risk that any of them would contract the virus or spread it to other vulnerable patients. Thanks to donor support and the extraordinary efforts of a dedicated nurse practitioner, Aubrey was able to receive this care at her home, in the small town of Barrhead, Alberta — more than an hour away from the Stollery. Support from donors helps give Canada’s children’s hospitals the flexibility to deliver the right care in the right place at the right time. For Aubrey and family, the right place was wherever they could be together.