In early 2020, with COVID-19 spreading and the demand for critical care rising, emergency departments across Ontario prepared for worst possible scenarios.

While North York General Emergency Department honed protocols and repurposed space for sick patients, Dr. Rohit Mohindra, an emergency physician at North York and clinician scientist at the Schwartz/Reisman Emergency Medicine Institute based at Sinai Health, realized the importance of emergency department research during a global pandemic.

North York General Hospital is one of Canada’s busiest emergency departments and has been a partner of the Schwartz/Reisman Emergency Medicine Institute since its founding in 2013. With over 120,000 emergency department visits per year at North York, Dr. Mohindra recognized adding research to the hospital’s pandemic response was an obvious and important next step.

“To quickly acquire information about a new virus, we needed large hospitals that were likely to see many COVID patients be part of the national COVID registry,” said Dr. Mohindra.

Launched within weeks of Canada’s first case of COVID-19, the COVID-19 Emergency Department Rapid Response Network began gathering data to develop prediction tools for which patients were likely to require hospitalization, intensive care or even die from the virus.

Mohindra and his team had already spent two years building North York General’s emergency research program with the support of the Schwartz/Reisman Emergency Medicine Institute. It meant they already the necessary tools, such as personnel, technology, and staff support, to make significant contributions to the network. Within two months of joining, North York contributed 1,500 cases to the national registry of COVID-19 cases.

Dr. Rohit Mohindra, clinician scientist at the Schwartz/Reisman Emergency Medicine Institute based at Sinai Health

“In emergency medicine we are very good at adapting and reacting to situations as they arise, and COVID-19 has been a perfect example of that,” said Dr. Paul Hannam, Program Medical Director and Chief of emergency services at North York General Hospital. “Applying an analytic approach to the data we capture in our emergency department every day ensures we can evaluate our care and find new ways to improve.”

Since joining NYGH, Dr. Mohindra has also led emergency research collaborations with other departments like obstetrics, surgery, and critical care, building a team that’s transforming emergency research at the hospital.

“Emergency departments serve several different purposes in any community acute resuscitation, urgent treatments which require hospital services, and access to care for vulnerable populations,” Dr. Hannam said. “When our health care system is under pressure, we see it first. Embedding a research program in one of Canada’s busiest emergency departments gives us a chance to be an early warning system.”

With more than 65 per cent of all hospitalizations taking place in non-academic centres in Canada, Dr. Kevin Katz, clinician researcher and Medical Director of Infection Prevention and Control at North York General Hospital, says conducting research in large volume community hospitals is a no-brainer.

“North York General is a leading community academic hospital,” Dr. Katz said. “We strive to provide leading edge diagnostics and therapeutics to our patients through applied research.”

The pandemic has brought clinical research to the forefront and has also shown the reliance of the Canadian health care system on emergency departments, adds Dr. Mohindra.

“COVID has shown us how quickly we can get research launched while ensuring it is safe, and it has also shown us ways to make care better,” he said. “We always put patient care first, so looking for ways we can do it better is a natural extension of what we are already trying to do.”