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Toronto stands out for excellence in cystic fibrosis care in North America

Toronto, July 27, 2018

By Selma Al-Samarrai

St. Michael’s Cystic Fibrosis team and Toronto General Hospital’s lung transplant team after a session on day three of the U.S. organizations’ site visit.
St. Michael’s Cystic Fibrosis team and Toronto General Hospital’s lung transplant team after a session on day three of the U.S. organizations’ site visit.

St. Michael’s Hospital’s Cystic Fibrosis Clinic and Toronto General Hospital’s Lung Transplant Program were the destinations last month for 70 American health-care professionals visiting to see first-hand the high quality care that people living with cystic fibrosis receive in Toronto, once they need a lung transplant.

“Toronto has some of the best outcomes in the world after transplantation, so we knew something special was going on there,” said Dr. Bruce Marshall, senior vice president for Clinical Affairs at the Cystic Fibrosis Foundation who visited the two hospitals.

“The focus of this visit was for the clinicians from across the United States to understand the process for patients in Toronto moving from cystic fibrosis care, to lung transplant, to post-transplant care, so they could improve their own processes.”

The reason their visit centred on Toronto was twofold: the Cystic Fibrosis Foundation is running an ongoing quality improvement initiative specific to cystic fibrosis lung transplant processes and outcomes which St. Michael’s and Toronto General are a part of, and Canadian cystic fibrosis care is documented for being one of the best.

In fact, a 2017 research study found that Canadians with cystic fibrosis live an average of 10 years longer than their American counterparts, with one of the reasons pointing to the fact that patients are more likely to receive a lung transplant, and to do better after it.

The largest lung transplant centre in Toronto is at Toronto General Hospital, and their team works closely with St. Michael’s Cystic Fibrosis Clinic to ensure that the continuum of care for these patients who need lung transplants is coordinated, organized, and prompt.

“When the Cystic Fibrosis Foundation first started doing this quality improvement work, they realized that in Toronto, the Cystic Fibrosis Clinic works closely with the transplant centre, and much more so than centres in the U.S. So, they decided we would be a good benchmark clinic for cystic fibrosis care,” explained Dr. Elizabeth Tullis, Director, Toronto Adult Cystic Fibrosis Centre, St. Michael’s Hospital.

The visitors included staff from nine American cystic fibrosis centres and nine American transplant centres.

“Cystic fibrosis patients are unique because unlike most patients who receive lung transplants, cystic fibrosis patients will continue to have cystic fibrosis in other organs and to require specialized care from the cystic fibrosis team,” explains Dr. Cecilia Chaparro, a respirologist appointed with both SMH’s Cystic Fibrosis Clinic and Toronto General’s Lung Transplant Program.

“I enjoy working with cystic fibrosis and lung transplant patients, and most importantly, as a bridge between the two programs. I try my best to bring cystic fibrosis knowledge to the transplant team and patients, and transplant knowledge to cystic fibrosis team and patients.”

Dr. Marjorie Godfrey, director of The Dartmouth Institute Microsystem Academy and director of the cystic fibrosis quality improvement initiative, was both the planner and one of the attendees for this U.S. site visit.

“The care of people with cystic fibrosis seeking lung transplants at St. Michael’s and Toronto General is exceptional. We listened to a lung transplant patient and her mom describe their experiences which demonstrated the team work between the two facilities. The smooth and seamless care processes, the mutual respect, and the strong leadership both within each institution and together, provides a model of leadership that all centres are envious of,” said Dr. Godfrey.

“We are honoured to have partnered with these teams. Traveling to high-performing care centers like St. Michael's Hospital and Toronto General Hospital stimulates energy and a sense of ‘can do’ to achieve the outcomes and best practices witnessed at the site visit in their own centres.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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