Grant program 2010 – Overview

Collaborative research (Cr)
Risk management program development (Rmpd)
Community-based project (Cr or Rmpd)

About the CMPA

The CMPA protects the professional integrity of doctors by providing services including legal defence, indemnification, risk management, educational programs and advice. In addition, we promote and support medico-legal and practical measures likely to improve the practice of medicine.

The CMPA is funded and operated on a not-for-profit basis for physicians, by physicians. Its membership comprises most practising physicians in Canada.

About the grant

For 2010, the Council of the CMPA approved two funding budgets—one in support of collaborative research projects and one in support of risk management program development.

The CMPA offers to support collaborative research projects and risk management program development with grants ranging from $10,000 to $50,000 to a maximum of $200,000.00 for the year 2010.

The Council approved funding to a maximum of $50,000.00 to support similar community-based projects. Eligibility for this funding will be extended to projects in collaborative research and risk management program development designed and conducted in community-based settings. The purpose of community-based projects is to encourage community physicians, previously with limited or no involvement in research activities, to become involved in risk management and patient safety research projects to benefit their practices and communities.

The risk management and educational efforts of the CMPA have historically been largely focused on physician members. The current approach in patient safety recognizes the broader impact that system issues have in contributing to adverse outcomes. Therefore, the CMPA this year is encouraging submissions for research project and risk management educational program development that promise to improve patient care and safety, and that decrease medico-legal risks in the varied health care settings and within interdisciplinary health care teams.

Specifically, the CMPA supports research leading to the creation of new knowledge or the translation of existing knowledge into improved patient safety and better quality of health care for Canadians. The CMPA also supports the development of effective educational programs that address known risks and that are likely to reduce the incidence of adverse events. Examples of the types of proposals that are encouraged in 2010 are:

• Projects ensuring the continuity of good patient care between physicians and multiple health care providers in and between the hospital, clinic and office settings;
• Projects that improve patient safety in the office;
• Projects that improve office practice and collaborative team care.

However, all proposals for collaborative research, risk management program development, and community projects that will enable physicians to improve the safety of their patients in health care are welcome.

About the committee and policies

SELECTION PROCESS

The Grant Selection Committee will be the Research, Education and Risk Management Committee of the CMPA. It is constituted according to the bylaw of the Association from elected members of council.

Staff members of the Association will assist the committee in the process of soliciting, collecting and evaluating submissions.

External reviewers may be included on the selection committee at the discretion of the committee to assist with the evaluation and selection process.

CURRENT GRANT SELECTION COMMITTEE MEMBERS

Dr Barbara Brennan Councillor (Chair)	Dr Gordon Crawford Councillor
Dr David Shragge Councillor	Dr Kaveh Shojania (Non-Council)
Dr Debra Boyce Councillor	Dr William Tucker President (ex officio)
Dr Susan Chafe Councillor
Dr Douglas Bell Managing Director, Risk Management Services, Staff	Dr Gordon Wallace Director, Education, Risk Management Services Staff
Mrs Elise Amyot Director, Research, Risk Management Services Staff	Ms Jean Johnstone Project Administrator, Research, Risk Management Services Staff

TERMS OF ENGAGEMENT

Members of the Grant Selection Committee who are also councillors must follow the terms of reference for a CMPA councillor.

The Grant Selection Committee may at its discretion invite non-committee members to assist with the evaluation and review of any/all applications.

ROLES OF THE GRANT SELECTION COMMITTEE MEMBERS

CHAIR AND COMMITTEE MEMBERS

Together, the Chair and Grant Selection Committee are responsible for ensuring that applications received by the committee are reviewed for evaluation.

Responsibilities:

• Identify external reviewers, as needed, to assist the committee;
• Identify the committee members who shall review and read each application;
• Propose additional committee members for a meeting to replace regular committee members who cannot attend the meeting (e.g., conflict of interest), if they feel that the committee does not have sufficient expertise for one or more applications, or if the number of applications received is too great for the current committee members alone to handle. Invitees may attend the meeting, in whole or in part, or participate by teleconference depending upon the number of applications they are asked to review and their availability; and
• Notify applicants of the results.

CHAIR

The committee Chair is directly responsible for ensuring that the committee functions smoothly, effectively and objectively, according to CMPA's policies for the grants program and other policies that govern its committees. He/she establishes a positive, constructive, fair-minded environment in which the research and education proposals are to be evaluated. In addition to the duties shared with the Grant Selection Committee, the Chair:

• Must be knowledgeable of CMPA policies affecting the procedures of the Grant Selection Committee;
• Ensures that the Grant Selection Committee functions in accordance with CMPA policies and procedures;
• Ensures that opinions expressed by external reviewers are fully integrated into the discussion of each application for which they have been solicited;
• Ensures the involvement of the entire committee with recommendations for each grant when feasible and appropriate;
• Works with the support staff and project administrator to summarize the discussion of each application before the rating;
• Ensures that specific concerns of ethics, and of other CMPA requirements are addressed; and
• Appoints a delegate as Chair when he/she is unable to attend or leaves because of a conflict of interest.

GRANT SELECTION COMMITTEE MEMBERS

In addition to the duties shared with the Chairperson, Grant Selection Committee members shall:

• Support the Chairperson in his/her role during the committee meeting;
• Present points raised by the external reviewers that have not been raised by the internal reviewers and identify the external reviewer;

For applications that have been assigned to an individual, the committee member shall:

• Review the application in an objective, fair and unbiased fashion in accordance with CMPA policies, procedures and criteria;
• Record the evaluation according to the established assessment criteria and rating scale;
• Present the findings to the committee for review;
• Ensure notes are taken regarding the discussion of the application as it is proceeding and confirm any conclusions with the committee at the end of the review, making additions and modifications as advised; and
• Ensure that issues of ethics, eligibility, overlap and other concerns that need to be flagged for the attention of CMPA are raised at the committee meeting.

REVIEW NOTES

The purpose of committee members’ notes is to have a record of the determining factors, from the point of view of the committee, in the rating of the application.

The notes may include:

• The major strength(s), weakness(es) of the application
• The pivotal point(s) determining the rating i.e.:
  • Importance, impact, relevance to the health of Canadians;
  • Originality/innovation/novelty of concept or approach/clarity of objectives;
  • Research plan/procedural issues/feasibility/validity of model/efficiency;
  • Educational objectives/techniques/feasibility/evaluation;
  • Expertise and track record of applicant, co-applicants;
  • Environment, collaborators;
  • Quality of literature review;
• Explanation of significant budget and/or term reductions;
• Explanation of how the applicant could improve the proposal, if resubmission is encouraged.
• Points on what led the committee to accept or decline the submission.

The notes should not include:

• A summary of the proposal;
• Repetition of internal or external reviews;
• A recommendation for funding; nor
• The rating of the grant (number or descriptor, since after averaging of the ratings of individual committee members, the outcome may be different from the consensus rating).

CMPA support staff:

• Provide advice to the committee on CMPA policies;
• Keep notes on procedural aspects of the committee's functions;
• Record the consensus rating and budget recommendations made by the committee for each application;
• Record concerns raised by the committee on issues requiring further attention by staff, for example, overlap of funding, ethics, and eligibility; and
• Accept, acknowledge, process, track applications.

CONFLICT OF INTEREST

The committee must make every effort to ensure not only that its decisions are fair and objective, but also that this is apparent. No committee member with a conflict of interest may participate in the review of an application. As a result:

1. Committee members who have an application before the committee shall absent themselves from that meeting of the committee.
2. Committee members who:
   • are from the same immediate institution or company as the applicant, and who interact with the applicant in the course of their duties at the institution or company,
   • have collaborated, published or been a co-applicant with the applicant, within the last five years,
   • have been a student or supervisor of the applicant within the last ten years,
   • are a close personal friend or relative of the applicant,
   • have had long-standing scientific or personal differences with the applicant,
   • are in a position to gain or lose financially from the outcome of the application (e.g., hold stock in the company of an industry partner or a competitor) or
   • for some other reason feel that they cannot provide an objective review of the application must declare a conflict of interest and abstain from commenting and voting when such a proposal is up for review. The Chair is responsible for resolving areas of uncertainty and the decision of the Chair is final.

     The Chair is subject to the same conflict of interest guidelines as regular committee members.

     All committee members are asked to sign a form agreeing to abide by the confidentiality and conflict of interest policies when they join the committee. All external reviewers are sent a copy of the policies with the application(s) they are asked to review.

Review process

In the first stage of a two-stage application process, Letters of Intent (LOIs) are solicited for collaborative research and risk management program development projects. From these LOIs, a subset will be selected for preparation of a final proposal.

In the second stage of the process, a limited number of applicants will be invited to submit a full proposal.

We encourage modest proposals that will result in new information and practical approaches to patient safety and risk management education that can be applied broadly in the Canadian health care system.

Any proposal contemplating the use of CMPA data or resources will be considered on a case-by-case basis. If CMPA data is used, the CMPA must approve the validity and use of the data, and approve any paper for publication.

The committee will not provide individual critiques.

REVIEW AND ANNOUNCEMENT OF FINALISTS

The committee will review applications and make recommendations on their relative merits. The committee will decide which applications are to be supported. Inevitably, committee members will form opinions on current CMPA policies with regards to the Grant Program. The CMPA welcomes discussion and encourages the committee to set aside time for this purpose during their meetings, and as a result, may make recommendations for policy changes. However, committees may not make decisions that are in conflict with current CMPA established policies.

The number of grants to be awarded will depend on the nature and quality of applications received and the total funds available. It is within the committee's discretion not to award any grant(s) in any year. It is within the committee's discretion to establish the number of grants and the amount of each within the budget established by Council.

The committee will evaluate the LOIs received no later than March 15, 2010. Applicants will be notified of the disposition of their LOI no later than May 31, 2010.

Those full proposals that are solicited will be due no later than September 1, 2010. Grant recipients will be notified no later than November 1, 2010. Acceptance of the grant includes permission to publish, in CMPA publications, the Principal Investigator's name and affiliation and the title of the project.

REVIEW CYCLES

Announcement:	December 2009 CMPA Perspective
Letter of Intent due:	March 15, 2010 (5:00pm EST)
Review of LOI's:	March/April 2010
Proposals due:	September 1, 2010 (5:00pm EST)
Decision of committee:	October 2010
Notification of recipients:	November 1, 2010
Published in:	December 2010 CMPA Perspective

CONFIDENTIALITY

All information contained in applications, internal and external reviews and committee discussions is strictly confidential. Committee members must not discuss with applicants or reviewers any information relating to the review of a specific application, or offer opinions on the chances of success or failure. All requests for information on an application or a reviewer's report should be referred to the project administrator.

The identity of external reviewers and individual committee reviewers who assessed the applicant's particular application will not be provided to applicant.

ELIGIBILITY

The CMPA Council has approved the following general principles that will be considered by the Grant Selection Committee when reviewing applications.

Collaborative research projects (includes community-based projects)

• Develop new knowledge
• National relevance
• Prospective
• Multidisciplinary
• Collaborative
• Evidence-based
• Strategic value in improving patient safety and quality of care
• Confidentiality of patient and member information is paramount
• Shared funding encouraged
• Acknowledgement of the CMPA
• A budget must be submitted as part of an overall business plan
• At least one of the principal investigators (Project Leads) must be a CMPA member

Risk management program development (includes community-based projects)

• Multidisciplinary
• Evidence-based
• National relevance
• Strategic value in improving patient safety and quality of care
• Confidentiality of patient and member information is paramount
• Shared funding encouraged
• Acknowledgement of the CMPA
• The funding is for project development not for implementation
• A budget must be submitted as part of an overall business plan
• The program must be based on sound educational principles
• At least one of the principal investigators (Project Leads) must be a CMPA member

ASSESSMENT CRITERIA

Applicants and their involvement:

• The applicant group must include individuals from all relevant professional groups (multidisciplinary) and the participation of each must be specified;
• The applicant group's productivity, expertise, experience, and training allows the objectives of the research/educational program to be achieved;
• The commitment of the applicant group members during the proposed timeframe is appropriate;
• Potential conflict of interest among team members and the impact on the project are identified;
• The resources (facilities, staffing and equipment) are adequate; and
• The budget is appropriate.

MERIT OF THE PROPOSAL

SCOPE AND PURPOSE

• Clearly defined overall and specific objectives (focused and realistic)
• Clear rationale of the overall effect of the expected benefits on patient safety and/or improved quality of care
• Specific clinical question(s) or educational objective(s) to be addressed by the collaborative research project
• Specific description of the patients/physicians/healthcare workers to whom the benefits of the risk management program development are meant to apply

ORIGINALITY AND INNOVATION (STATEMENT OF SIGNIFICANCE)

• Importance and original contributions to the field
• Notable innovation
• Impact on patient safety and/or quality of care
• Strategic value to CMPA and our members

APPLICABILITY

• Are there barriers to the application of the recommendations (organizational, costs implications)?
• Is the application of the recommendations general or limited?
• Would the recommendation require compliance (monitoring, audits)?

RIGOUR OF DESIGN

• Systematic and comprehensive literature review
• Critical assessment of the pertinent literature
• The design (experimental procedure, observational study, guideline development, etc.) is appropriate for the research objectives:
  • Sample size and sampling procedure (power and sensitivity testing)
  • Data collection methods are appropriate and up-to-date
  • Instrumentation is appropriate and up-to-date
  • Clear and appropriate hypotheses
  • Data analysis (appropriate statistical methodology and procedures, detailed statistical plan)
• The design (needs assessment, techniques, interactivity) is appropriate for the educational objectives
• A needs assessment will be performed
• Educational objectives stated and appropriate
• Instructional design sound
• Likely to change behaviour
• Identified target audience(s)
• Evaluation methodology and plan

CONSENT AND ETHICAL CONSIDERATIONS

• Consent explicitly obtained
• The patients' views and preferences are sought/considered
• If ethics approval is not required on the project, this must be stated. Proof of Ethics Committee approval is not required at the Letter of Intent stage
• Principal Investigators (Project Leads) are encouraged to obtain approval from an Ethics Committee prior to their submission to the CMPA

DISSEMINATION

• Is the research/educational program editorially independent from any other funding body?
• Are findings appropriate for open dissemination and critical appraisal?
• Does the plan of dissemination include translating findings into improved patient safety and quality of care?

RISK ASSESSMENT

• Provide a risk assessment of the project; include areas of vulnerability to the project's successful completion. Also include any risks to the CMPA, patients, or others.

FUNDING AND BUDGET JUSTIFICATION

The budget will need to include the following information where relevant:

• Eligibility of expenses (listed expenses are relevant to the goals of the project)
• Cost recovery will be decided on a case-by-case basis
• Research staff (trainees)
• Materials (biological, users fees, etc.)
• Supplies (computer software, access to database)
• Data analysis, printing, publication, dissemination costs
• Travel
• Assessment of potential overlap in funding
• Multimedia or other graphic production support

OTHER SOURCES OF FUNDING

The CMPA encourages other sources of funding but does not expect there will be duplication of funding for the same project.

The principles in assessing other sources of funding are:

1. Access to CMPA funds should be fair for all applicants, regardless of their other sources of funding;
2. Applications are evaluated according to the program's review criteria;
3. There must be no duplication of funding for the same research. However, when research programs are supported by multiple sources, the additional benefits of CMPA support must be well explained and justified.

Applicants must notify the CMPA of any co-funding, and approval of CMPA funding is conditional upon disclosure to CMPA and approval by CMPA of co-funding.

Cumulative funding from all sources should not exceed the total budget proposal for the research project/program development project.

RATING

Outstanding	4.5 – 5.0
Excellent	3.5 – 4.4
Good	2.5 – 3.4
Needs revision	2.0 – 2.4
Seriously flawed	0.0 – 1.9

APPEAL PROCESS

The decision of the committee is binding; there will be no appeal process.

TERMS OF SUPPORT

The CMPA offers to support research projects and risk management program development in 2010 for a period of one year.

The Research, Education and Risk Management Committee will not commit to any additional funding that goes beyond the year it was attributed.

STATUS REPORTS

Status Reports are due annually and upon completion of the project.