Toward Canadian Benchmarks for Health Services Wait Times – Evidence, Application and Research Priorities II: Research Syntheses (Archived)
CIHR Institute of Health Services and Policy Research
In partnership with
Conference of Provincial / Territorial Deputy Ministers of Health
Health Canada
CIHR Institute of Cancer Research
CIHR Institute of Circulatory and Respiratory Health
Request for Applications
| Important Dates | |
| Opportunity Launched | December 2005 |
| Content Last Updated | April 10, 2006 (Contact Information) |
| February 15, 2006 | Registration Deadline - Registration packages must be courier stamped by this date. |
| March 15, 2006 | Full applications must be courier stamped by this date. |
| June 2006 | Anticipated notification of decision. |
| July 2006 | Anticipated start date. |
| February 2007 | Report 1 (8 months after funding start date) |
| June 2007 | Report 2 (12 months after funding start date) |
| Summary | |
|
Part of CIHR's mandate is to excel in the creation of new knowledge and its translation into improved health for Canadians, more effective health products and services and a strengthened health care system. The purpose of this Request for Applications (RFA) is to fund research syntheses in order to support evidence-informed decision-making. It is expected that this targeted investment will inform the work of decision-makers tasked with establishing evidence-based benchmarks for medically acceptable wait times in the following areas: cardiac services and procedures, cancer care1 and diagnostic imaging. Funds Available: | |
Table of Contents
Background
Partners
Objectives and Relevant Research Areas
Eligibility
Allowable Costs
Merit Review Process and Evaluation Criteria
General CIHR Guidelines
Conditions of Funding
Communications Requirements
Monitoring, Performance Measurement and Evaluation
How to Apply
Contact Information
Description of Partners
Background
Canadians are passionate about their health care system. Most Canadians visit at least one health care provider during the course of a year, and individual experiences with the health care system are mostly positive. Yet, people are becoming less confident that health care will be there when they need it. Tension between public expectations regarding timely access to appropriate health services and current wait times for some services has not gone unnoticed by health care managers and policy-makers in Canada.
In 2004, a national consultation exercise (Listening for Direction II) was undertaken to identify research priorities among health services administrators and policy-makers.1 Ten priority research themes emerged and "timely access to quality care for all" was a significant and recurring priority among those who participated in these consultations. CIHR's Institute of Health Services and Policy Research (IHSPR) subsequently became the lead national organization responsible for funding research and knowledge translation activities in this area. More information is available at Listening for Direction II
In September 2004, First Ministers agreed to build on past efforts to reduce wait times and improve access by making the following commitments in the Ten-Year Plan to Strengthen Health Care:
- Each jurisdiction agrees to establish comparable indicators of access to health care professionals, diagnostic and treatment procedures with a report to their citizens to be developed by all jurisdictions by December 31, 2005.
- Evidence-based benchmarks for medically acceptable wait times starting with cancer, heart, diagnostic imaging procedures, joint replacements, and sight restoration will be established by December 31, 2005 through a process to be developed by Federal, Provincial and Territorial Ministers of Health.
- Multi-year targets to achieve priority benchmarks will be established by each jurisdiction by December 31, 2007.
- Provinces and territories will report annually to their citizens on their progress in meeting their multi-year wait time targets.
The full text of the Ten-Year Plan is available.
A crucial step in developing evidence-based benchmarks is to understand the existing body of research and learn from the experiences of jurisdictions in Canada and abroad. A second important step is having a clear picture of where further work is needed by identifying gaps where there is currently insufficient evidence to support such benchmarks. In February 2005, the Provincial/Territorial Ministries of Health partnered with CIHR to fund initiatives designed to inform their work in meeting the benchmark-related commitments in the Ten-Year Plan. In May 2005, a number of initiatives were funded in the areas of cancer care (colorectal, lung, gastrointestinal and solid organ malignancies, as well as radiation therapy), joint replacement (hip and knee) and sight restoration (cataract removal and corneal transplantation) The complete list of funded projects from this competition is available and summaries of the materials provided by those teams on October 15, 2005 are available.. In this RFA, federal, provincial and territorial governments are partnering with CIHR to supplement that work by funding initiatives in areas not covered in that first round of synthesis work (i.e. cardiac services and procedures, diagnostic imaging, and types of cancer (or cancer care) not examined by the four cancer teams funded in May 2005).
Research evidence on the relationship between waits, health and quality of life will rarely be sufficient, alone, to point to an obvious benchmark. Nevertheless, evidence on these relationships is critically important information for decision-makers to take into account in developing wait time benchmarks in priority areas. The availability of evidence of this nature varies widely, across broad clinical areas, and across different procedures and services within any given clinical area. For example, there are broadly accepted, evidence-based norms regarding when some diagnostic or clinical services are most appropriate (e.g. prenatal screening). But these represent the exception. For other procedures, the amount of relevant evidence on any one particular relationship (e.g. between wait time and independence in activities of daily living for patients with various cardiac conditions) varies considerably. The body of evidence may reflect work from many different venues, using different methods, based on different populations, over different time periods, and so on. In such situations, syntheses become important tools for translating a body of evidence into a form and format useful to decision-makers.
Partners
CIHR - IHSPR is dedicated to identifying and developing collaborations with other CIHR institute(s), branch(es) or office(s), funding organizations and stakeholders to enhance the availability of funding for this strategic initiative, and to create, where appropriate, opportunities for relevant knowledge exchange and translation. Applicants are invited to visit the Descriptions of Partners to find a list of partners and their respective mandates and/or strategic interests. This list will continue to evolve as new partners join in this initiative.
Objectives and Relevant Research Areas
The purpose of this RFA is to fund research syntheses in order to support the work of decision-makers tasked with establishing evidence-based benchmarks for medically acceptable wait times in the following areas: cardiac services and procedures, cancer care and diagnostic imaging.
More specifically, the objectives of this RFA are to support initiatives, in each of the three priority clinical areas, designed to address ALL of the following:
- Synthesize research evidence regarding the relationships between patient characteristics (e.g. age, clinical severity or stage of illness, co-morbidities, etc.), health service wait times, and mortality/survival, health status or quality of life;
- Summarize wait time benchmarks that are currently used nationally or internationally, and research evidence (if any) that was used to support their selection;
- Identify areas/procedures where there is currently sufficient evidence, and/or general consensus exists, regarding wait time benchmarks; indicate the benchmarks being used, and the range of settings where such benchmarks are currently applied;
- Identify priority areas and questions for future research (particularly with respect to the types of relationships between wait times and health status/quality of life described in objective #1 above) that are likely to yield research evidence of use to decision-makers in considering additional wait time benchmarks;
- Support knowledge translation/exchange between the funded applicant (s) and decision-makers through, at a minimum, the creation of two reports;
- Support knowledge translation and dissemination activities regarding new knowledge generated through this initiative.
The ONLY eligible projects under the present RFA include those focused on subsets or combinations of the following priority clinical areas:
- Cancer care, except in the following areas: colorectal, lung, gastrointestinal and solid organ malignancies, as well as radiation therapy
- Cardiac services and procedures, including but not limited to: cardiac surgery, cardiac catheterization, percutaneous coronary intervention, and pacemaker and defibrillator procedures and,
- Diagnostic imaging
In order to meet the information needs of decision-makers, funded applicants will be expected to prepare two reports: the first report is due in February 2007 or 8 months after the funding start date and the second report is due in June 2007 or 12 months after the funding start date. The content of these reports is outlined in the "Conditions of Funding" section.
Eligibility
Eligibility criteria for all CIHR research funding programs apply. The business office of the institution of an eligible Nominated Principal Applicant generally administers CIHR funds. Please refer to the Eligibility Requirements for CIHR Grants and Awards regarding the eligibility requirements for individuals and institutions.
Allowable Costs
Applicants should review -A9">Use of Grant Funds and -A10">Eligibility of Expenses, Employment under Grants within the General Guidelines for All Research Grants for a complete listing and description of allowable costs and activities.
The full application must provide a detailed justification of all costs.
In addition, the following expenditures will be considered eligible for funding received through this RFA:
- Release time for clinical experts or health system decision-makers, more specifically up to 25% for applicant (s) salary(ies). The dollar amount awarded may be used only for the actual replacement costs of the designated recipient and may not be reallocated to other research or related expenses. Funds granted for other purposes may not be reallocated to a release time stipend. Recipients of release time stipends are not considered employees of CIHR.
- Consulting fees, provided that such costs are well justified.
- The salary(ies) of research assistants.
- Knowledge translation related costs, such as:
- Costs of networking activities, including collaboration, planning, and research exchange activities directly related to the proposed project, and extra travel funds required for members and trainees separated by a significant distance. Eligible activities must involve substantive and meaningful interaction between research and system policy/ management personnel
- Costs associated with the creation and distribution of communication tools (e.g. plain language summaries or other user driven methods)
- Purchase and maintenance of research equipment and other research tools.
Grants awarded under this RFA are NOT to be used as bridging or emergency funding; or, to support ongoing studies.
Merit Review Process and Evaluation Criteria
Criteria for Merit Review
The following general criteria will be used to evaluate the full application:
Relevance and Potential Impact:
- How important (potential health impact, incidence/prevalence), and widely encompassing of the clinical area(s) in question, are the procedures and/or services for which the synthesis work will be undertaken? What is the potential for important new observations or knowledge?
- Have the applicants identified key (clinical and/or policy) collaborators and stakeholders, where relevant, as well as methods for engaging/consulting with them?
- Above/beyond the two required reports outlined in the "Conditions of Funding" section of this RFA, how realistic, appropriate and potentially effective, is the overall plan for knowledge translation/exchange during, and after, the granting in light of the critical time path for the work, and the resources available?
Scientific Merit:
- How appropriate and rigorous is the proposed approach to the synthesis work? How well have the applicants anticipated difficulties in their approach and considered alternatives? How clearly have the applicants outlined their proposed methods for the review of evidence, including methods for identifying, selecting and appraising peer reviewed literature and grey literature?
- How appropriate to the research proposed is the training or track record of the applicant (s) in terms of research, research synthesis and knowledge translation and exchange? How relevant is the recent research of the applicant (s)?
- What is the likelihood that this team can complete the research and required reports in a timely fashion?
- How appropriate is the proposed critical time path?
- What experience does the research team have in research synthesis and the development of research summary documents for senior policy-makers?
- How realistic is the proposed methodology relative to the reporting requirements of the work?
Evaluation Process
Full applications will be initially screened by CIHR staff to ensure that: (a) all proposed expenditures are eligible; (b) all materials comply with format requirements and include appropriate documentation; (c) reporting requirements are acknowledged; and (d) research falls within the scope of at least one of the three eligible priority clinical areas.
Prior to merit review, appropriate representatives of the funding partners will have access to anonymous project titles and summaries to review proposals for relevance to their strategic interests. This information will be used for decisions regarding financial commitments to this RFA and will be conducted independently of and will have no impact on the merit review process.
A CIHR merit review committee comprised of relevant research peers and decision makers will evaluate the full applications deemed eligible by CIHR staff. The merit review panel will be created specifically for this RFA. Committee members are selected based on suggestions from many sources including the institute(s) / portfolio(s) and partner(s), following CIHR's Policy on Confidentiality, Conflict of Interest and Privacy Issues in Peer and Relevance Review (CCIP). Names of panel members will be published on the CIHR website after competition results are announced.
Full applications will be assessed and rated by the merit review committee using the evaluation criteria listed below. Relevance and potential impact, relative to the objectives of the RFA, and scientific merit, will be given equal weight in the assessment of the applications reviewed by the committee. The committee will then rate each application, using the CIHR Merit Review scale.CIHR's Merit Review Scale:
| Relevance & Potential Impact | Scientific Merit | ||
| Fundable: | enormous | outstanding | |
| extremely significant | excellent | ||
| very significant | very good | ||
| Seldom funded: | significant | acceptable, but low priority | |
| Not fundable: | moderate | needs revision | |
| limited | needs major revision | ||
| negligible | seriously flawed |
On completion of merit review, appropriate representatives of the funding partners will receive the ranking list, merit scores (ratings) and recommendations of the merit review committee with regards to funding level, for the submitted applications that fall in the fundable range. The list will be used for funding decision-making purposes; the identities of applicants will not be known to the partners at that time.
General CIHR Guidelines
This Request for Applications will follow the -A">General Guidelines for All Research Funding Grants.
Conditions of Funding
All conditions specified in CIHR General Grants and Awards Policies shall apply to applications funded through this Request for Applications. Conditions cover areas such as Applicant and Institutional Responsibilities, Ethics, Official language policy, Access to Information and Privacy Acts, and Acknowledgement of CIHR Support. Successful applicants will be informed of any special financial conditions prior to the release of funds or when they receive CIHR's Authorization for Funding (AFF) document.
In addition to CIHR standard guidelines and requirements, the following special conditions shall apply:
- In order to meet the information needs of health care decision-makers, funded applicants will be expected to prepare two reports: in February 2007 or 8 months after the funding start date (Report 1) and in June 2007 or 12 months after the funding start date (Report 2). The researcher will make these reports available to CIHR. CIHR will forward these reports to officials reporting to federal, provincial and territorial Ministers of Health. All reports should be in a form and format suitable to these audiences, and the Executive Summaries of Reports 1 and 2 will be written in a form and format as prescribed by CIHR. CIHR reserves the right to publish these reports on the CIHR website, and requests that Reports 1 and 2 will be made available by the research teams on a website of their choice, to which reference can be made on the CIHR web site.
Report 1 is intended to provide information on objectives #1, #2 and #3 above, that is:
- Synthesize research evidence regarding the relationships between patient characteristics (e.g. age, clinical severity or stage of illness, co-morbidities, etc.), health service wait times, and mortality, health status or quality of life;
- Summarize wait time benchmarks that are currently used nationally or internationally, and research evidence (if any) that was used to support their selection;
- Identify areas/procedures where there is currently sufficient evidence, and/or general consensus exists, regarding wait time benchmarks; indicate the benchmarks being used, and the range of settings where such benchmarks are currently applied;
Report 2 will contain the results of work addressing objective #4 above, specifically:
- Identify priority areas and questions for future research (particularly with respect to the types of relationships between wait times and health status/quality of life described in objective #1) that are likely to yield research evidence of use to decision-makers in considering additional wait time benchmarks.
Access to Information Act and Privacy Act, and the Personal Information Protection and Electronic Documents Act (PIPEDA)
All personal information collected by CIHR about applicants is used to review applications, to administer and monitor grants and awards, to compile statistics, and to promote and support health research in Canada. Consistent with these purposes, applicants should also expect that information collected by CIHR may be shared as described in Use and Disclosure of Personal Information Provided to CIHR for Peer Review.
CIHR as a federal entity is subject to the Access to Information Act and the Privacy Act, therefore the requirements of these two statutes will apply to all information located in CIHR's premises including, without limitation, cost-sharing agreements related to this Request for Applications and all matters pertaining thereto.
While respecting the application of the Privacy Act to federal entities, all signing parties involved in a collaborative agreement will also be bound by the Personal Information Protection and Electronic Documents Act (PIPEDA). All personal information (as identified by the PIPEDA) collected, used or disclosed in the course of any commercial activity under collaborative agreements related to the Request for Applications will be collected, used and disclosed in compliance with the PIPEDA.
Communications Requirements
Grant recipients are required to acknowledge CIHR, its institutes and partners in any communication or publication related to the project. See CIHR General Grants and Awards Policies, Acknowledgement of CIHR's Support for details on CIHR's communication requirements. The contributing institutes / partners will be identified on the Authorization for Funding and decision letter.
All acknowledgements should make clear that the conclusions and opinions found in the reports or other publications are solely those of their authors and that no official endorsement by CIHR or its partners is intended or should be inferred.
The intellectual property rights in all works produced as a result of these grants will belong to the grant recipients. More specifically, copyright to Reports 1 and 2 above will belong to the authors of those reports, but the authors will grant the federal, provincial and territorial governments free, irrevocable and unlimited sole licences to use, copy, publish, and translate those reports throughout the world. Grant recipients will not publish any of the Reports 1 or 2 mentioned above, nor the information contained in those reports, for a period of 30 days from their actual dates of receipt by CIHR.
Monitoring, Performance Measurement and Evaluation
CIHR is committed to demonstrating results to Canadians for the money invested in health research. Therefore, processes for monitoring progress and appropriate use of funds, as well as for performance measurement and program evaluation are in place. As a result, funding recipients must:
- adhere to CIHR's reporting requirements, including those articulated above and provide required information in a timely fashion.
- contribute to the monitoring, review and evaluation of CIHR's programs, policies and processes by participating in evaluation studies, surveys, workshops, audits and providing data or reports as required for the purpose of collecting information to assess progress and results;
- encourage their associates, trainees and administration to participate in the monitoring, review and evaluation of CIHR's programs, policies and processes as required.
How to Apply
The application process is comprised of two steps: Registration and Full Application.
Review the registration and application instructions provided in How to Apply for Funding.
Select "Operating Grants" (Registration and Application) from the Application Packages.
Additional instructions must be followed for this RFA:
a) Research Module:
In the Research Funding Program section of the Research Module (page 8 of the web form printed report), select "Strategic Initiative/RFA" and enter the title of this RFA.
The research proposal section of the Research Module for this initiative is limited to a maximum of 6 pages, including the Summary of Research Proposal (p. 9). Figures, tables and references may be listed in additional pages.
You must clearly indicate in the Summary of Research Proposal (p. 9), which of the following 3 clinical priority areas your project is addressing:
- Cancer Care
- Cardiac Services and Procedures
- Diagnostic Imaging
Any applicant wishing to apply to undertake syntheses for more than one priority clinical area should submit a separate registration and application for each clinical area.
b) Common CV Module
You must submit full Common CV modules for the Nominated Principal Applicant, Principal Applicants, Principal Decision-maker Applicants and one Co-Applicant on the team. Only abbreviated CVs (maximum 3 pages) are required for any additional Co-Applicants. Full CVs will not be considered for these applicants. The first page of the abbreviated CV should only include the contact information of the Co-Applicant (mailing address, telephone number, fax number, e-mail address, and CIHR PIN number). This information must be kept separate from the rest of the CV because it will not be forwarded to reviewers. The second and third page of the CV should include information on current grants held, relevant publications from the last five years, and expertise keywords.
All applicants including Decision Makers must have a CV and a CIHR PIN number.
Send Application by Courier to:
RE: "Toward Canadian Benchmarks for Health Services Wait Times - Evidence, Application and Research Priorities II"
Canadian Institutes of Health Research
Room 97, 160 Elgin Street
Address locator: 4809A
Ottawa, Ontario K1A 0W9
Contact Information
For questions on CIHR funding guidelines, how to apply, and the peer review process contact:
Tamara Marshall (Updated: 2006-04-10)
Program Delivery Officer
Canadian Institutes of Health Research
Telephone: (613) 941-0861
Fax: (613) 954-1800
Email: tmarshall@cihr-irsc.gc.ca
For questions about this initiative and research objectives contact:
Kim Gaudreau
Associate, Strategic Initiatives
CIHR Institute of Health Services and Policy Research and
CIHR Institute of Population and Public Health
Telephone: (613) 957-6128
Fax: (613) 954-1800
Email: kgaudreau@cihr-irsc.gc.ca
Description of Partners: CIHR Institutes and Partner Organizations
Note: Additional partners are expected to join this funding initiative over the coming year.
Canadian Institutes of Health Research (CIHR)
CIHR is Canada's major federal funding agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.
CIHR - Institute of Health Services and Policy Research (IHSPR)
CIHR - IHSPR is dedicated to supporting innovative research, capacity-building and knowledge translation initiatives designed to improve the way health care services are organized, regulated, managed, financed, paid for, used and delivered, in the interest of improving the health and quality of life of all Canadians.
CIHR - Institute of Cancer Research (ICR)
One of the clinical priority areas that this RFA covers is cancer care. The CIHR Institute of Cancer Research (ICR) supports research to reduce the burden of cancer on individuals and families through prevention strategies, screening, diagnosis, effective treatment, psycho-social support systems, and palliation. ICR is also committed to supporting outstanding research to address important priorities related to access and the use of cancer care services throughout the entire cancer control continuum from prevention to palliation.
In December 2005, ICR launched an RFA entitled Access to Quality Cancer Care that seeks to increase health services research in cancer and address issues related to access to care above and beyond wait times for services. In alignment with that RFA and for the purposes of this RFA, ICR is specifically interested in funding evidence to support decisions regarding medically acceptable wait times in the eligible research areas for cancer described under Objectives and Relevant Research Areas.
CIHR - Institute of Circulatory and Respiratory Health (ICRH)
CIHR - ICRH supports research into causes, mechanisms, prevention, screening, diagnosis, treatment, support systems, and palliation for a wide range of conditions associated with the heart, lung, brain (stroke), blood, blood vessels, critical care and sleep.
Conference of Provincial / Territorial Deputy Ministers of Health
The Conference of Provincial/Territorial Deputy Ministers of Health provides leadership on a wide range of health care issues important to all Canadians. As the members of the Conference, Canada's thirteen Provincial/Territorial Deputy Ministers of Health address common challenges facing all jurisdictions, share information and innovative practices to improve the operation of health care services, and work collaboratively to reform health care in Canada. Currently chaired by New Brunswick, the Conference reports to Provincial/Territorial Ministers of Health.
Health Canada
Health Canada is the federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances. By working with others, Health Canada strives to:
- Prevent and reduce risks to individual health and the overall environment;
- Promote healthier lifestyles;
- Ensure high quality health services that are efficient and accessible;
- Integrate renewal of the health care system with longer term plans in the areas of prevention, health promotion and protection;
- Reduce health inequalities in Canadian society; and
- Provide health information to help Canadians make informed decisions.
1 Organizations that partnered to conduct this consultation include: Canadian Health Services Research Foundation, CIHR’s IHSPR, the Canadian Institute for Health Information, the Canadian Coordinating Office for Health Technology Assessment, the Advisory Committee on Governance and Accountability of the Federal/ Provincial/ Territorial Conference of Deputy Ministers of Health, and the Health Statistics Division of Statistics Canada.
2 Only select types of cancers are eligible for funding. See section entitled “Objectives and Relevant Research Areas” for more information.
