Our Services

The Office of Spread and Scale

The Office of Spread and Scale (OSS) aims to amplify successful models of care and innovative programs beyond our hospital walls, while learning from the success of others. To achieve this goal, we conduct research, consulting, and capacity building activities related to:

  • How to include principles of implementation science in your work, projects, and research grants to help you consider sustainability, spread and scale from the beginning.
  • Assessing readiness for implementation and options for spread and scale, including potential barriers and enablers.
  • How to consider sustainability, spread and scale within digital health evaluations.
  • Strategies for encouraging and supporting patient engagement and involvement of all relevant decision makers.
  • Potential ways to spread and scale your work to similar and new contexts, populations, and settings.
  • How to scale successful initiatives requiring policy changes to allow for successful adoption.

Our Approach

The OSS values collaboration, health equity, and evidence-informed decision-making while prioritizing patient-oriented research and application of practices likely to achieve great impact.

  • Implementation Science: The study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into routine health care and public health settings to improve the impact on population health (National Cancer Institute, Division of Cancer Control & Population Science)
  • Sustainability: The extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations. (Proctor et al, 2011)
  • Spread: Replicating an initiative somewhere else (i.e. one site to another) (Greenhalgh & Papoutsi, 2019)
  • Scale: Deliberate efforts to increase the impact of innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting basis. (ExpandNet; Simmons et al, 2007)

We provide coaching and consultation services for work at any stage, including providing relevant input to funding applications, factors to consider before ethics submission, implementation and dissemination strategies, and planning for next steps. We will work with you to identify a model of service that best suits your project and team needs.

These services are available to those within and outside of Women’s College Hospital. Please contact oss@wchospital.ca for details

  • Leading Canadian Institutes of Health Research (CIHR) funded planning grants to develop research questions and design scalable interventions on a variety of health-related topic areas.
  • Integrating planning for sustainability, spread and scale into digital health evaluations.
  • Supporting implementation science team grants to incorporate planning for sustainability, spread and scale into research projects.
  • Leading a systematic review on sustainability, spread, and scale of Audit & Feedback interventions.

Once per month we host an online discussion group that provides an opportunity for people to discuss a key topic or paper with peers and experts in the field. No experience or expertise in implementation science is necessary as we will always have a place for people who are new to the field.

To register to receive information about upcoming events, please click here.

The OSS is supported by the Ontario SPOR (Strategy for Patient-Oriented Research) Support Unit (OSSU). The OSSU is a network that engages researchers, patients, and other partners in patient-oriented research to improve the health of Ontarians and the health care system.

Additional funding is provided through research grants and consulting contracts.

Our Team

The OSS team includes a core group of individuals from the Women’s College Research Institute, Women’s College Institute for Health Systems Solutions and Virtual Care (WIHV), and several other organizations and universities.

Expertise includes implementation science, digital health evaluation, health services research, health equity, dissemination, communications, and public policy. Additional expertise will be drawn from within and beyond WIHV as needed.

Core Team members include:

Celia Laur, seen from the shoulders up, wearing a grey sweater, shoulder length blonde hair, and smilingCelia Laur is a Postdoctoral Fellow working with Dr Noah Ivers. She is involved in a series of qualitative projects exploring physicians’ antibiotic and opioid prescribing practices in Ontario in an effort to inform upcoming interventions and behaviour change in practice. Celia has a keen interest in implementation science/practice, quality improvement, and how to sustain and spread successful changes within various healthcare settings and across topic areas.

Celia completed her PhD at the University of Waterloo in the School of Public Health and Health Systems under the supervision of Professor Heather Keller. Her work focused on understanding healthcare professionals’ perspectives on implementing, spreading and sustaining nutrition care activities in hospitals across Canada. To apply the lessons learned to another context, she has also explored how Family Health Teams started to set up nutrition screening. Celia is a Registered Public Health Nutritionist in the UK, a Fellow of the Higher Education Academy, and a Life Member of Wolfson College, University of Cambridge. She completed her BSc Honours in Health Sciences at Carleton University in Ottawa, a Postgraduate Certificate in Medical Education at the University of Dundee, Scotland, and a Masters in Public Health Nutrition at the University of Southampton, UK.

Aisha Lofters, seen from the waist up, wearing a pink blouse with arms crossed and smilingAisha is a scientist at the Women’s College Research Institute (WCRI), adjunct scientist at IC/ES, and an Associate Professor in the Department of Family and Community Medicine at the University of Toronto. She currently holds a New Investigator Award from the Canadian Institutes of Health Research, and holds the Chair in Implementation Science at the Peter Gilgan Centre for Women’s Cancers at Women’s College Hospital in partnership with the Canadian Cancer Society.

Aisha is also the Provincial Primary Care Lead, Cancer Screening at Cancer Care Ontario (Ontario Health). Her research program focusses on improving quality of care in cancer screening and prevention, particularly for populations that experience marginalization.

Rumaisa Khan, seen from the chest up, wearing a brown jacket and headscarfRumaisa Khan is the Innovation Spread and Scale Lead at the Peter Gilgan Centre for Women’s Cancers at WCH, where she works to develop, evaluate, and spread and scale innovative models of care that push the envelope on women’s cancers. Rumaisa has a strong interest in health equity, implementation science and patient engagement, and is particularly interested in pushing programs and methods to engage under-screened racialized women in prevention and health communication efforts. Rumaisa holds a Master of Public Health in Health Promotion from the Dalla Lana School of Public Health, and an Honours Bachelor of Arts from the University of Toronto. Rumaisa holds professional experiences at the national and international level, through leading policy reports for youth support with the Wellesley Institute, as a Queen Elizabeth Scholar with the University of Nariobi, and supporting virtual care evaluations with the Centre for Digital Health Evaluation at WCH.

Noah Ivers, seen from the neck up, wearing glasses, short brown hair, and smilingNoah is a scientist at Women’s College Research Institute (WCRI) and adjunct scientist at IC/ES. He is also a family physician at Women’s College Hospital (WCH) and an assistant professor in the Department of Family and Community Medicine at the University of Toronto. Recently receiving the New Investigator Award from the Canadian Institutes of Health Research, Noah is leading change that will make a difference for patients and families across Ontario.

Dr. Onil Bhattacharyya, seen form the shoulders up, wearing a white lab coat, short black hair, and smilingOnil is a senior scientist at Women’s College Research Institute (WCRI) and the Frigon Blau Chair in Family Medicine Research at Women’s College Hospital and recipient of the Commonwealth Fund Harkness Fellowship in Health Care Policy and Practice. He practices family medicine and is an associate professor at the University of Toronto in Family and Community Medicine and the Institute of Health Policy, Management and Evaluation (IHPME). His research focuses on the integration of care for people with complex needs, examining how health systems can build capacity for innovation in service delivery.
He co-led Building Bridges to Integrate Care, a citywide incubator for new models of care, and is now co-lead of Better Access to Care for Complex Needs (BeACCON), a provincial network within the national Canadian Institute for Health Research Strategy for Patient Oriented Research. Onil is also interested in helping health care organizations become more adept at improving existing services and exploring new ways of providing care. He does this by adapting innovation methods from the design and software industries, like user-centered design and Lean Startup to generate new models of care, studying their relationship with methods to improve quality and rigorously measure the impact of services.

Implementation Support Team members include:

  • Dr. Celia Laur – Scientific Lead
  • Katherine Ford, RD, PhD, CIHR Health System Impact Fellow with the University of Waterloo & the Canadian Nutrition Society
  • Alyssa Kelly, PhD(c), University of Toronto (on leave)
  • Zeenat Ladak – CIHR Health System Impact Fellow with the Office of Spread & Scale and University of Toronto
  • Priscilla Medeiros, PhD, Knowledge Mobilization Specialist at the Edwin S.H. Leong Centre for Healthy Children
  • Sam Petrie, PhD, CIHR Health System Impact Fellow with the Ted Rogers Centre for Heart Research & the University of Toronto
  • Josh Porat-Dahlerbruch, PhD, Ben Gurion University; the Israel Implementation Science and Policy Engagement Centre (IS-PEC)
  • Nida Shah, Manager, Virtual Care, WIHV
  • Jennifer Shuldiner, PhD, Research Lead, WIHV
  • Camille Williams, PhD, WIHV

Contact us at oss@wchospital.ca to learn more about how we can help you achieve impact.

Centre for Digital Health Evaluation

The Centre for Digital Health Evaluation (CDHE) offers timely, high-quality evaluations of digital health technologies at various stages of maturity by partnering with leading experts in the health and technology sectors. Together, CDHE harnesses insights from Ontario’s world-leading experts in digital health economic evaluation, implementation, policy, and practice to support the Ministry of Health.

The Centre’s objectives include:

  1. Build a streamlined, responsive needs assessment process for both innovative and mature digital technologies.
  2. Provide timely, but scientifically rigorous and clinically applicable real time evaluations of digital technologies that are tailored to the specific needs of the clinical problem or technology solution.
  3. Provide clear, practical advice to health system stakeholders, agencies, and the Ministry regarding procurement, adoption, policy making and investment decisions.
  4. Build provincial capacity for rapid standardized evaluations of digital technologies, conducted in various clinical settings across the province.

To learn more about the CDHE and its services, visit: cdhe.wchwihv.ca

Equity-Mobilizing Partnerships in Community (EMPaCT)

Learning from Diversity: An Innovation in Inclusive Engagement

If we want an inclusive health system that is socially just and fair for all, we need to hear from people who have diverse lived experiences and apply a health equity lens to everything.
EMPaCT is an innovation that addresses both.
Monthly, EMPaCT collaborates with project implementers in the healthcare system (EMPaCT Impact Partners) to help them identify tangible ways to advance health equity within their work.

Equity-Mobilizing Partnerships in Community (EMPaCT) is a patient engagement model co-designed to:

  • Centre the voices of diverse community members
  • Build capacity for inclusive and impactful partnerships

Diverse members of community co-created EMPaCT to:

  • Highlight community needs and priorities – based on their lived experiences
  • Meet monthly to consult with Impact Partners to identify key areas for action on health equity within their work

We are an expert advisory group independent of any specific project. Impact Partners who engage EMPaCT contribute to its financial sustainability.

Who consults with EMPaCT?

EMPaCT works with project implementers (EMPaCT Impact Partners) seeking to learn from people with diverse lived experiences, enhance the inclusivity of their work and reduce health inequities.

Impact Partners include:

  • health system decision-makers
  • policy-influencers including health/social service administrators
  • research teams

What do consultations result in?

Consultations help Impact Partners understand:

  • how different communities might be impacted by a project
  • what unintended outcomes may occur as a result of the project
  • how equity in health can be better addressed for the communities involved

EMPaCT also conducts Health Equity Assessments (HEAs). Unlike most HEAs which are conducted by scientists, academics and policy administrators, EMPaCT HEA evaluations and recommendations are based on the diversity of lived experiences that members of EMPaCT bring to the process as a collective analytical lens.

To our understanding, we are the first community-based group of people with diverse lived experiences to offer and conduct HEAs.

For more, view this video: EMPaCT: Partnering for Change

Impact Partners complete an Intake Form and consultation slide template and return them to EMPaCT prior to the Scoping meeting.

As a key part of the process, Impact Partners receive coaching to prepare them for an effective engagement with EMPaCT.

Step 1: Scoping Meeting: The Scoping meeting refines the scope of the consultation to focus on what value EMPaCT can bring to the Impact Partner’s project.

The Impact Partner revises both the Intake Form and consultation slides as needed and returns them to EMPaCT prior to the Preparatory Meeting.

Step 2: Preparatory Meeting: The Preparatory meeting focuses on the key questions for discussion and the communication skills needed so that the consultation results in authentic dialogue for co-learning.

The refined consultation slides form the foundation of the consultation.

Step 3: EMPaCT Community Consultation: During the consultation, Impact Partners engage members of EMPaCT to learn:

  • how different communities might be impacted by the project
  • what unintended outcomes may occur from the Impact Partner’s project
  • how equity in health can be better addressed for the communities involved

Step 4: Written Report: Impact Partners receive a written report containing recommendations from the consultation process validated by all members of EMPaCT.

Step 5: Feedback from Impact Partner: Impact Partners provide feedback on how they modified their project based on the findings of the report. They also provide feedback on the process of engagement. The process creates transparency in the patient engagement and community consultation process.

The members of EMPaCT cover a wide range of diverse and intersectional lived experiences. Our experiences are best represented by the diversity jigsaw.

Digital library: Members of EMPaCT co-create digital tools and use them to share key concepts. You can access these tools here: EMPaCT Digital Library

Impact Partner consultation reports: These are confidential reports issued to Impact Partners that summarise their engagement with EMPaCT. These reports include key findings from the consultation and actionable recommendations for project-implementers.

Webinars and presentations: Members of EMPaCT are frequently invited to present on issues related to patient engagement and diversity, equity and inclusion. You can view these resources here: EMPaCT Digital Library

Academic co-authored publications:

Building equitable patient partnerships during COVID19: Challenges and key considerations. https://www.longwoods.com/content/26582/healthcare-policy/building-equitable-patient-partnerships-during-the-covid-19-pandemic-challenges-and-key-considerati?platform=hootsuite&utm_campaign=HSCampaign . Sayani, A., Maybee A., Manthorne J., Parsons. J., Bloch. G., Hwang, S. W, Nicholson, E., & Lofters, A. (2021). Healthcare Policy 17 (1).

Equity-Mobilizing Partnerships in Community – EMPaCT: Co-designing patient engagement to promote health equity. https://www.longwoods.com/content/26768/healthcare-quarterly/equity-mobilizing-partnerships-in-community-empact-co-designing-patient-engagement-to-promote-hea . Sayani, A., Maybee A., Manthorne J., Parsons. J., Bloch. G., Hwang, S. W, Nicholson, E., & Lofters, A. and the members of Equity-Mobilizing Partnerships in Community (2022). Healthcare Quarterly 24 (Special issue).

Community engagement toolkit

Policy briefs

To request a specific knowledge translation product please email Dr. Ambreen Sayani at ambreen.sayani@Wchospital.ca.

EMPaCT Members

You can learn more about the members of EMPaCT below:

Fatah Awilseen from the chest up, wearing a maroon button up shirt, black beard and short hair, and smilingMy name is Fatah and I am a young person who identifies as Muslim, Black, and ethnically Somali. I was raised in Scarborough and still reside in the east-end of the GTA. I have experience living amongst immigrant and racialized communities and have grown up seeing economic disparities and disparities in access to health.

I advocate for mental health care, health equity, issues impacting youth, and upward social mobility for the communities I come from and live alongside.

Emily Cordeaux, seen from the chest up, wearing a blue knit sweater, glasses, long brown hair, and smilingI am a white 30-something woman with Scottish and English roots who calls Toronto home. My parents moved to Canada the year before I was born, and my siblings and I grew up in Montreal and Toronto. I am motivated by loved ones’ experiences navigating the healthcare system for complex and chronic health conditions and mental health concerns.

I advocate for a healthcare system that centres the needs of everyone and promotes health and wellbeing.

Victoria Garcia I’m a young woman with a strong desire to support those in need. Throughout my adolescence and into my adulthood, I frequently visited hospitals. I have had type 2 diabetes since I was a young child. Although my family is from El Salvador and Nicaragua, I was born in the beautiful city of Toronto, Ontario. As a society’s crown ward, I was involved in the child welfare system and am now making the transition to independence. I discovered that I required a lot of assistance in figuring out where to seek care for my physical and mental health.

I am employed by the community and justice services sector. I want to raise awareness of issues like how underpaid and understaffed hospital employees are. We must make sure that healthcare professionals are treated fairly and with respect.

Ryan Hinds, seen from the waist up, wearing a white collared button up, bald, and smilingMy life experiences allow me to bring the perspective of a newcomer to Toronto and challenges shared by many inexperienced with navigating Canadian systems. I also bring experience as a caregiver to elder loved ones, supporting them through home care and various other health care services. Guyanese born, I’m also able to share my experience living, learning and working in Toronto as a Black male and will continue to advocate for equity and social justice in all discussions.

Tara Jeji, seen from the chest up, wearing a pink collared shirt, short brown hair, and smilingI advocate for equal access for all individuals to enable community participation and citizenship.

Omar Khan, seen from the chest up, wearing a grey button up, short black hair, and smilingI am an organizer and advocate working with underserved communities, specifically refugees and refugee claimants. I connect with families all across the GTA and work primarily in the Thorncliffe Park and Flemingdon Park area.

I advocate for residents and agency employees. I coordinate a resident-lead group called Engaged Communities that focuses on youth development, mobilizing and amplifying community voices, particularly youth and newcomer voices. I am also a caregiver for my mom who has an autoimmune brain condition. This has inspired me to advocate for caregivers too.

Bee Lee Soh, seen from the shoulders up, wearing a blue sweater, long black hair, glasses, and smiling

In the eighties, I came to Canada alone as a visa student with no English. Then I became an immigrant after working as a live in nanny/ domestic housekeeping job under the immigration caregiver program. And finally rooted as a Canadian citizen with no regrets.

The life journey in Canada is bitter and sweet! New bonds friendships, churches and communities cares, unexpected adopted parents…discrimination, inequity, injustice…poverty, homeless, hunger…has paved latter part of my life as an anti-poverty activist, fighting to have policy/ systemic changes to make peoples lives better!

Alies Maybee, seen from the shoulders up, wearing a grey shirt, glasses, and smilingI grew up in Quebec with a Dutch mother, and an English Canadian father who died when I was 12. I have two birth sons, a chosen son who came to us as a 16 year old refugee from Sudan and four grandchildren. I took care of my mother who died a few years ago of dementia in the Netherlands.

I advocate for changing health systems and information to centre on the person and for inclusive patient/public engagement so that our health system can serve all people fairly.

Desiree Mensah, seen from the waist up, wearing a black turtleneck, long black hair, and smilingI was raised by a single mother who had recently immigrated to Canada from Ghana. As a first-generation child, I have seen the difficulties of transitioning into Canadian culture/workforce and the struggles of raising a family on a single income. I am a black woman and a member of the invisible disability community.

I am a proud advocate of providing equitable health services especially for lower socioeconomic communities. I hope to continue to provide awareness on racism, feminism, sexual assault, systemic inequalities, mental health and well being.

Linda Monteith Gradiner, seen from the waist up, wearing a patterned shirt, short brown hair, and smilingI am a woman and a senior who lives with schizoaffective disorder. I became ill in my teens and spent years trying to find help in the siloed and disjointed mental health system in Ontario. I now spend my days promoting understanding and support for those with psychotic illnesses.

A veteran of the mental health system in Ontario, I advocate better and more timely mental health services in addition to the right to literacy for all.

Mursal Wusawi, seen from the neck up, wearing a yellow hijabI am a woman from a minority religion. I came to Canada from a country where women and children are the most vulnerable population. I am a human rights especially women and children’s rights defender. I advocate for women empowerment, gender equity & gender equality.

I want to make sure that everyone has access to high-quality services in an equitable manner without any decimation and abuse.

Mar Rathbone, seen from the chest up, wearing a white shirt, yellow neckalce, and smilingI am a middle-aged, indigenous woman. My reserve is the Crees of Waskaganish First Nations. I was a part of the Sixties Scoop when indigenous people were taken away from their families and raised in non-indigenous homes. I worked at Anishnawbe Health as an outreach worker.

I advocate for eliminating racism and discrimination towards all races and cultures. I am a promoter of showing love and kindness towards all people. I believe in equality for all people because we are all unique in our own ways, and we all have something special to offer the world.

Jill Robinson, seen from the shoulders up, wearing a polka dot shirt, short black and grey hair and smilingI am a black woman of mixed heritage and culture. I am a single parent to a transgender daughter who lives on the spectrum and caregiver to her and my 91 year old mother who suffers from many ailments.

I advocate for social responsibility and I want to make sure that the healthcare system in Ontario and Canada works for everyone.

Ambreen Sayani, seen from the chest up, wearing a black blazer, long black hair, and smilingI am woman, person of colour and from a religious minority. I moved to Canada in 2014 with two young kids and aging parents. I am often sandwiched between caring for both of these generations as their health, social and emotional needs are different yet intertwined.

I advocate for fairness and equity – all of us need access to the right resources, tools and opportunities so that we can thrive and live a healthy life.

Staceyan Sterling, seen from the chest up, wearing a white blouse, long black, curled, hair and smilingI am a black female, mother, spouse, life-long learner, servant leader, immigrant, and Canadian. I have lived in Toronto Canada most of my life and enjoy telling new Canadians about their roots that made this country. Grade 6 was my life-defining year. It’s the year I noticed a child’s physical response to learning, the year I found and read little Anne Frank’s diary and wept alone in the back corners of the library, overwhelmed at the extent of evil and injustice in this world. I decide there and then that one has the choice to be a destroyer or a healer. I chose the latter, and have lived a life of service, love, joy, peace, and advocacy.

Dean Wardak, seen from the waist up, wearing a black graphic t-shirt and smilingI was born on July 18, 1992 in Toronto. I have Filipino, Polish and Canadian-Indigenous heritage. I am a quadriplegic due to a Spinal Cord Injury (SCI) and Acquired Brain Injury (ABI) suffered in a motor vehicle accident. I spent a year recovering in three different hospitals after my accident.

I advocate for people living with disabilities because I experience the issues with accessibility, discrimination, social support, transportation, employment and more.

Kelly Wu

My parents and I immigrated to Hong Kong from Richmond Hill, Ontario, when I was 7 years old. I can speak Cantonese fluently, but do not know how to read or write in Chinese. I’ve lived in Amsterdam, Vientiane, and Bogotá for school and work. 
I believe housing is a human right. I advocate for the elimination of homelessness and to make housing safe and affordable for all. 

WIHV & The National Research Council of Canada Industrial Research Assistance Program

WIHV advises small to medium sized digital and virtual health enterprises on how their advances in technology can be used across our health care system. Supported by the National Research Council of Canada Industrial Research Assistance Program (NRC-IRAP), we provide guidance on:

  • Whether a tool is clinically valid and how it could be integrated within the healthcare system.
  • Potential customers and relevant stakeholders.
  • Clinical, institutional and governmental priorities that could have an impact.
  • Evaluation methodologies and how to generate an appropriate base of evidence.
  • Existing opportunities to spread and scale tools across the health care system.

To pitch your ideas to a team of clinicians, researchers, policy, health system and business experts, you must:

  • Be an incorporated, for-profit company
  • Operate in Canada
  • Have less than 500 employees
  • Have at least one non-business owner on your payroll
  • Operate in the digital or virtual health space

If you are interested in being considered for this program, review these details (.pdf) 

If you would like to connect with us please email Nida Shah at nida.shah@wchospital.ca