Chair's Report to the Board

Advisory Board (IAB) meeting and to this 2024 SREMI Report. Once again it highlights the important accomplishments and contributions to health science and education made by SREMI faculty over the past year to improve emergency care.

Emergency care is in crisis. The surge in patient numbers, combined with increasing complexity due to an underfunded primary care system, is overwhelming emergency departments. A lack of adequate acute hospital beds for patients requiring admission, as well as insufficient long-term care facilities and home support services, result in delays in patient discharge from both hospitals and emergency departments. These challenges are compounded by a shortage of physicians and nurses across the healthcare system. The cumulative strain creates a high-pressure environment, with emergency care providers bearing the brunt of this stress, often leading to burnout.

This environment of clinical and operational stress is even worse than last year, and adds to the challenge of conducting high quality emergency care research. It is equally important to generate new knowledge, understand current realities, and test innovative strategies to address this crisis. Just as the healthcare landscape evolves, so too must the programs that support it. SREMI’s outstanding clinical support and education initiatives remain strong, adaptable, and forward-thinking and play a crucial role in meeting the evolving needs of both patients and practitioners.

This 2024 SREMI annual report highlights the many projects completed and underway, and the amazing number of publications and awards received by SREMI faculty. Once again, I am amazed at the academic output and by the talent of the SREMI team. Director Dr. Bjug Borgundvaag, Research Director Dr. Shelley McLeod, and Deputy Director Dr. Catherine Varner continue to provide inspiring leadership while also spearheading significant individual research initiatives.

North York General Hospital and Sinai Health Collaboration

The collaboration of Sinai Health and North York General Hospital (NYGH) is a foundational strength of SREMI, combining a referral university-based hospital with a busy active community hospital. Most of the emergency care in Canada is provided in community settings that have different challenges and needs than urban academic sites. NYGH is a shining example of a community hospital dedicated to quality care and promoting relevant academic pursuits. Dr. Rohit Mohindra continues to lead the NYGH emergency academic activities and contribute to the overall SREMI academic output with his important projects. Dr. Anton Helman’s FOAMed program of EM Cases and his very successful EM Cases Summit is the most highly regarded educational program in emergency medicine in the country and perhaps internationally.

SREMI Research Activities

You can read more details of the research activities in Dr. McLeod’s Research Report. The SREMI research output is once again remarkably successful. The programs combine to include important contributions to knowledge in very important aspects of emergency care. A large list of publications (42 in the past year) and the prominence that SREMI faculty play at the Canadian Association of Emergency Physicians is evidence of the important leadership role that SREMI carries in emergency research and knowledge translation in Canada. Some highlights. Dr. Bjug Borgundvaag is an international leader in state of the art care of alcohol use disorder and cannabis hyperemesis syndrome. Dr. Rohit Mohindra investigates the use of AI in diagnostic processes such as asthma. Drs. Keerat Grewal and Catherine Varner co-wrote an editorial that exposed and shared the difficulties and inappropriateness of a diagnosis of cancer in the ED. Dr. Varner co-wrote an editorial that promotes better strategies and support for early pregnancies and pregnancy loss. Dr. Jacques Lee continues his groundbreaking work on social isolation and loneliness in the elderly. Dr. Shelley McLeod led the evaluation of the virtual urgent care pilot program in Ontario and published insightful findings that will help guide the integration of virtual care into health systems. She also completed the data collection for the Predictors of Workload in the Emergency Room (POWER III) study that is critical to workforce planning immediately and into the future.

SREMI Education and Support Programs

Educational programs at SREMI are world renown. EM Cases, as mentioned, is famous across the western world. These programs not only elevate the quality of emergency care but also set a high standard for professional development. Additionally, SREMI’s public and professional education initiatives—such as those focused on early pregnancy care and cancer diagnosis and treatment—serve as vital advocacy for improved clinical care. The Geriatric Fellowship program, developed and lead for many years by Dr. Don Melady, is a world authority and has trained fellows who are current leaders in geriatric care at centers around the world. Dr. Melady plays a leadership role in the International Federation of Emergency Medicine and CAEP and was promoted to full Professor at the University of Toronto this year in recognition of his contributions. Mount Sinai also announced the Don Melady Chair in Geriatric Medicine in 2024.

International Advisory Board Chair Transition

It has been a great honor and privilege to serve as Chair for the IAB for the past 3 years. As an advisory board, it is essential to regularly renew membership and leadership. You can see in this report the breadth of experience and expertise across the members of the IAB. I am particularly grateful and enthused that Dr. Matthew Cooke from the UK has agreed to take over the Chair position after this year’s meeting. Matthew is a recognized world authority in emergency care and its systems. We are lucky to have him on the board and look forward to his leadership. Our board aims to provide support and advice to the SREMI leadership team and enable local, national and international connections to expand collaborations.

Reflections from the Chair

I am very grateful to the SREMI leadership team (Dr. Bjug Borgundvaag, Dr. Shelley McLeod and Dr. Catherine Varner) for their unwavering support and guidance of all faculty and their activities and the continuous support they provide to the IAB. Additionally, I would like to extend my heartfelt thanks to all the SREMI staff, whose dedication and hard work are absolutely essential to the success of the team and its endeavors.

Emergency care plays an ever more central role in our healthcare systems as well as carrying a disproportionate burden when our health systems are failing. I am hopeful that with commitment and resolve from individual care givers and continued leadership of organizations like SREMI, we can overcome the deficiencies in our current healthcare systems.

SREMI should be very proud of its local, national and international reputation in emergency medicine research and education and the influence it has and will continue to have.