Complex Care

To promote innovative, interdisciplinary research related to the broad area of complex care in children's health. The Norman Saunders Complex Care Initiative fund has designated approximately $100,000 to be used annually to provide clinicians in the field of paediatric complex care in Canada with grant funding to pursue research ideas that are currently not the targeted areas of conventional funding agencies. This money would be used to fund a stand-alone project or may be used as seed money to pursue a pilot project that would then be funded by a larger granting agency. Projects eligible for funding from a disease specific granting agency or industry will not be considered.

• Subject to a competitive review process
• Approximately $100,000 is available per year. Maximum annual budget is $50,000.00.
• Projects requiring more than one year of funding may be considered; however evidence of an application for other external funding will be a requirement if a second year of funding is required.
• The budget must be thoroughly justified as preference will be given to excellent projects with an economical but feasible budget that would allow for more than 2 projects/year to be funded

Grant applications should be focused on children with medical complexity, defined as children who share the following four characteristics:

• presence of one or more complex chronic conditions that are often multisystem and severe
• have a functional limitation that is often significant and impacts their daily lives, often causing the child to be reliant on technology such as feeding tubes and tracheostomies
• high health care utilization, requiring specialized care and services from different providers in multiple sectors
• caregivers identify high health care service needs e.g. care provision in the home and care coordination which can have significant social and financial impacts of the family

Please note: applications that relate to specific patient populations that have a primary underlying diagnosis with firmly established advocacy and support groups and access to other funding sources (e.g. childhood cancer, cystic fibrosis, transplant patients) will not be considered for this competition.

Funding aims to provide more knowledge/awareness/tools to improve care to CC population through projects which relate to a range of relevant domains/activities including:

• Developing/testing/piloting novel models of care e.g. medical home
• Enhancing care coordination
• Defining/measuring/improving outcomes
• Addressing health systems issues
• Quality of life
• Designing/evaluating therapeutic interventions

• Physicians, nurses, allied health professionals, researchers and trainees who are affiliated with an academic health science centre or university in Canada.
• New and early career investigators are encouraged to apply.
• Research partnership with patients and families, community groups, policymakers and/or family advisors is strongly recommended and applications should clearly describe how patients and family will be engaged through the research and knowledge translation process (including in the budget).

Applicants should submit their applications as follows:

• Submission is electronic only and must be sent as a single PDF file
• The submission should be presented in one PDF file containing (in this order):
  • Completed Norman Saunders Complex Care Initiative Grant Application form (PDF)
  • Proposal and Appendices (see details below)
  • CVs of all applicants/co-applicants (abbreviated version, maximum 5 pages)
  • Internal scientific review which may include hospital RI or university review.  Here is an example Scientific, Feasibility, and Operational Review form if your institution doesn’t have its own form
  • Please upload reviewers’ comments. (if unable to obtain this then will need to contact us directly to discuss at grantcomp.paedmed@sickkids.ca).  Here is an example of a form that may be used if your institution doesn’t have its own form

Proposal

• Three single-spaced pages to be submitted electronically. Please do not exceed the page limit - only 3 pages will be evaluated. Use only 8.5" by 11" paper, one side only, single space type no smaller than 12 points, a margin of one inch around the page.
• Must include:
  • • Background, Rationale and Objective(s), highlighting what is currently known and what the gaps in knowledge are,
    • Research Question and Research Methods (design, measures, analysis),
    • Budget, Timeline and Feasibility,
    • Roles and Expertise of Research Team Members
    • Potential Impact of project and relevance to the Norman Saunders Complex Care Initiative (see Background, Purpose, Criteria above)
    • Knowledge Translation and Dissemination plan

    Please ensure that patient and/or family engagement is addressed in at least one section of your proposal.

Appendices

• Maximum two pages of references 
• Maximum two figures
• Maximum two reprints, manuscripts (only if pertinent)
• One page budget justification ((NB ineligible expenses include conference travel, standard office equipment, computer hardware, furniture, and salary support for investigators.) Patient-partner compensation is allowable (see Guidelines for Patient-Partner Compensation by CHILD-BRIGHT Network and Strategy for Patient-Oriented Research (SPOR) (PDF)
• Letters of support (if appropriate)

Submit your application

Applications are to be emailed to: grantcomp.paedmed@sickkids.ca

Submission deadline

Applications for the 2024 grant are due September 30, 2024.

Download a summary

Access a PDF summary of the grant competition information (PDF).

Contact

Erin Crawford
Administrative Assistant
Paediatric Medicine
erin.crawford@sickkids.ca
416-813-7654 x428525

Composition of review committee

Committee of at least seven members which may include:

• Committee Chair (to be decided from amongst the committee members)
• A representative member from the Division of Paediatric Medicine, SickKids
• A senior scientist from the Research Institute, SickKids
• A representative from Holland Bloorview Kids Rehab
• An Allied Health Professional
• A member of Dr. Norman Saunders’ family
• A family/parent representative
• A complex care clinician from outside of Toronto
• Ad hoc reviewers may be invited depending on topics submitted for review

Peer-review process and evaluative criteria

In general, the CIHR peer review process and ranking scales will be followed.

• Each application will be assigned to two-three reviewers for independent assessment
• Each application will be evaluated on:
  • clinical relevance to complex care in children’s health,
  • scientific merit,
  • feasibility,
  • relevance to the intent of the Norman Saunders Complex Care Initiative
• The scores given by the reviewers will be discussed at the reviewer committee meeting
• A consensus of scores and ranks will be reached; committee members with a conflict of interest with the applicants will be recused from the decision making regarding that grant
• The budget must be thoroughly justified as preference will be given to excellent projects with an economical but feasible budget that would allow for more than two projects/year to be funded
• Results including reviewers’ suggestions/feedback will be provided to applicants

Responsibility and accountability

The following is required of all funded applications:

• Obtain REB approval from institutions involved
• Begin funding within twelve months of receipt of funds
• Submit annual progress report
• Submit final report with a financial statement within six months of project completion
• Return unused or remaining funds
• Be prepared to present findings at a symposium to showcase projects funded by the NSCCI

2023

• The value of MUAC Z-scores in the assessment of malnutrition in enterally-fed children with medical complexity – Julie Johnstone (PI) [The Hospital for Sick Children]
• Understanding the Impact of Behaviours of Concern on Outcomes for Children and Families Participating in the Neurodevelopmental Disorders Complex Care Coordination Program – Sarah MacEachern (PI) [Alberta Children’s Hospital]

2022

• Building Partnerships with Families of Children with Medical Complexity: A Qualitative Study of Excellent Critical Care Clinicians – Kate Nelson (PI). [The Hospital for Sick Children]
• iKnow to Grow: Incorporating shared decision-making into in-hospital decisions for children with medical complexity – Peter Gill (co-PI), Francine Buchanan (co-PI). [The Hospital for Sick Children]

2021

• Understanding Changes in Hospitalization and Mortality Patterns Among Children and Youth with Medical Complexity (CMC) during the COVID-19 pandemic - Eyal Cohen (PI), Kate Nelson (PI), Paula Robson (KU). [The Hospital for Sick Children]
• SWIFT: Studying the Wider Impact of Faster Genetic Testing in Critical Care - Linh Ly (PI), Lauren Chad (PI). [The Hospital for Sick Children]
• Development of Physician-Caregiver Trust During Inpatient Care of Children with Medical Complexity - Tammie Dewan (PI), Chantelle Barnard (PI). [University of Calgary]

2020

• Understanding Approaches to Decision-Making among Caregivers of Chidlren with Meidcal Complexity: A Qualitative Study - Kate Nelson (PI). [The Hospital for Sick Children]
• The Role of Family Adaptation in the Transition to Adulthood for Youth With Medical Complexity: A Qualitative Case Study - Lin Li (PI), Patricia Strachan (PI). [McMaster University]
• Application of polygenic risk score for predicting bone fragility in children with medical complexity - - Fiscaletti M (PI), Manousaki D (PI) [Sainte Justine University Hospital Center]
• An Essential Subset Of Good Outcome For Complex Care - Nora Fayed (PI) [HSPRI/Queens]

2019

• A Mixed-Methods Evaluation of the Unique Experiences of Stakeholders from a Satellite Clinic in Northern Ontario for Children with Medical Complexity – Nathalie Major(PI), Eyal Cohen (PI), Julia Orkin (PI) and Nora Fayed (PI). [Children’s Hospital of Eastern Ontario / The Hospital for Sick Children / Queen’s University]
• Digital Health for Complex Care Kids (DigiComp Kids) – A Co-Design and Usability Testing Study – Nancy Carter (PI), Marissa Bird (PI) [McMaster University School of Nursing]
• Patient-reported experiences and outcomes for the care of children with medical complexity and palliative care needs in the ED – § Nathalie Orr Gaucher(PI), Anne-Josée Côté (PI). [CHU Sainte-Justine, Université de Montréal and Alberta Children’s Hospital, University of Calgary]

2018

• High Flow Nasal Cannula Therapy for the Management of Obstructive Sleep Apnea in Children with Complex Medical Conditions – Indra Narang (PI). [The Hospital for Sick Children]
• Understanding the Relationship between Pain Trajectories and Well-being in Children and Youth with Cerebral Palsy – Darcy Fehlings (PI) [Holland Bloorview Kids Rehabilitation Hospital]
• Patterns of care in children with CNS static encephalopathy according to location of death: A mixed methods study of parents’ experiences – Nathalie Orr Gaucher (PI), Nina Kleiber (PI). [Université de Montréal]

For details on funded projects from 2017 and earlier, please email Erin Crawford at erin.crawford@sickkids.ca