The Orkin Lab<\/span><\/h1><\/h1><\/div>Our research program <\/span>focuses on studying and optimizing care delivery and health outcomes for children with medical complexity (CMC) and their families.<\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div>Studies<\/h2><\/h2><\/div><\/i><\/span><\/div>ADAPT: Assessing and Developing an Adapted navigator role to support Parents during neonatal Transition.<\/h2><\/div><\/div>\nADAPT<\/strong>: A<\/u>ssessing and D<\/u>eveloping an A<\/u>dapted navigator role to support P<\/u>arents during neonatal T<\/u>ransition.<\/p>\n\n- Our team designed the Coached, Coordinated, Enhanced Neonatal Transition (CCENT \u2013 see below for additional details) randomized controlled trial aimed to empower parents of high-risk infants transitioning from Neonatal Intensive Care Unit (NICU) to home. Using a multi-phased, theory-based approach, this study will explore how to adapt the CCENT intervention to optimize the effectiveness and implementation of the navigator role.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/i><\/span><\/div>
Coached Coordinated Enhanced Neonatal Transition Study (CCENT) <\/h2><\/div><\/div>\nThe CCENT study is evaluating a novel bundled intervention for parents of high-risk infants delivered by a nurse navigator who provides:<\/div>\n\n- coaching and psychosocial support within an Acceptance and Commitment Therapy (ACT) framework,<\/li>\n
- care coordination, and<\/li>\n
- anticipatory education around the care for a medically complex infant.<\/li>\n<\/ol>\nCCENT is running at SickKids (lead site), Sunnybrook Health Sciences Centre, Mount Sinai Hospital, The Ottawa Hospital, CHEO, BC Children\u2019s Hospital, and McGill University Health Centre. CCENT is supported by a CIHR grant and the CHILD-BRIGHT Network.<\/div>\n
For more information visit the CHILD-BRIGHT<\/b> Website<\/u>.<\/a><\/p>\n<\/div><\/div><\/div><\/i><\/span><\/div>Transition to Adult primary care for youth with medical Complexity through the use of Telemedicine (TACT)<\/h2><\/div><\/div>\nThe primary objective of the TACT study is to assess the feasibility of implementing a virtual care transition visit between the family, Complex Care team, and family doctor to support adolescents transitioning to primary care from the SickKids Complex Care Program. The TACT study is supported by the SickKids Paediatric Consultants Partnership\u2019s Grants for Creative Professional Activity.<\/div>\n<\/div><\/div><\/div><\/i><\/span><\/div>Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children with Medical Complexity<\/h2><\/div><\/div>\nCaring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children with Medical Complexity<\/p>\n
\n- The aim of this study is to determine the feasibility of a multicomponent model to support caregiver mental health needs within a hospital-based paediatric Complex Care Program. A quantitative and qualitative feasibility assessment will be undertaken to inform the decision to proceed with a randomized controlled trial to assess the effect of this model.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/i><\/span><\/div>
Understanding the psychiatrist role in caring for caregivers of children with medical complexity: A retrospective chart review<\/h2><\/div><\/div>\nUnderstanding the psychiatrist role in caring for caregivers of children with medical complexity: A retrospective chart review<\/p>\n
\n- The overarching goal for this study is to evaluate the psychiatrist role in caring for caregivers of CMC and the clinical recommendations associated with diagnostic assessment and treatment for this population.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/i><\/span><\/div>
Adult Psychiatric Support for Parents of Children with Medical Complexity<\/h2><\/div><\/div>\nThis study is evaluating the feasibility of a novel collaboration between the Complex Care team at SickKids and an adult-oriented psychiatrist at Women\u2019s College Hospital in order to increase access to psychiatric services for parents of children with medical complexity.<\/div>\n<\/div><\/div><\/div><\/i><\/span><\/div>Optimizing the Management of Pain and Irritability in Children with Severe Neurological Impairments (PIOU)<\/h2><\/div><\/div>\nThis study is testing a new integrated clinical pathway called the PIUO Pathway, as a protocol to identify treatable causes of pain and irritability in children with multiple disabilities and limited communication. In this study, we will use a waitlist-controlled RCT design, with 120 children randomized to PIUO Pathway or waitlist (standard care) treatment arms. SickKids is one of four centres participating in the PIUO study.<\/p>\n<\/div><\/div><\/div>
<\/i><\/span><\/div>Connected Care Study<\/h2><\/div><\/div>\nThe Connected Care Program works in partnership with families as a multicomponent intervention tool that includes personalized technology, a bundled transition to home intervention, and 24\/7 virtual homecare nursing support that will lead to improved hospital-to-home transition of patients. Funded by the Canadian Institutes of Health Research involves the conduct of a prospective cohort study with an embedded health economic and qualitative analysis.<\/p>\n<\/div><\/div><\/div>
<\/div><\/div>Completed Studies<\/h2><\/h2><\/div><\/i><\/span><\/div>Patient-Facing Platform for Children with Medical Complexity <\/h2><\/div><\/div>\nThe objective of this study was to develop an online patient-facing platform to ease the burden of coordination of care for parents of CMC, begin to level the inequalities in access to information, and engage a diverse set of stakeholders to improve the care of CMC.<\/p>\n<\/div><\/div><\/div>
<\/i><\/span><\/div>The Hidden Danger: A surveillance study to describe the unintended health consequences of the COVID-19 pandemic <\/h2><\/div><\/div>\nThe primary objective of this study is to describe courses of care that were altered during the COVID-19 pandemic. The secondary objectives are to<\/p>\n
\n- identify thematic similarities between clinical cases to inform clinical practice change and<\/li>\n
- explore associated negative effect of health care delivery changes associated with the COVID-19 pandemic.<\/li>\n<\/ol>\n<\/div><\/div><\/div><\/i><\/span><\/div>
Housing Need Amongst Children with Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations<\/h2><\/div><\/div>\nThe objective of this descriptive study is to understand the prevalence and experience of housing need in children with medical complexity through surveys and qualitative interviews. The study aims to understand the relationship between CMC and housing need in order to develop a clinical role for early screening of housing risk and to inform appropriate housing interventions that meet the unique needs of this population.<\/p>\n<\/div><\/div><\/div>
<\/i><\/span><\/div>Get Involved!<\/h2><\/div><\/div>\nFor more information on our studies or how to join, please contact us.<\/a><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>People<\/h2><\/h2><\/div>![](\"https:\/\/lab.research.sickkids.ca\/orkin\/wp-content\/uploads\/sites\/106\/2021\/04\/julia-orkin-headshot-300.png\" "\\"julia-orkin-headshot-300\\"")
<\/span><\/div><\/div><\/div>Dr. Julia Orkin, MD, M.Sc., FRCP(C)<\/h3>\n
Medical Director, Complex Care Program<\/p>\n
Assistant Professor, University of Toronto<\/p>\n
Dr. Julia Orkin is a staff paediatrician at The Hospital for Sick Children (SickKids), Division of Paediatric Medicine and holds an Associate-Scientist Track position at SickKids Research Institute. She is the Medical Director of the Complex Care program<\/u><\/a> and Assistant Professor at the University of Toronto. She is the Paediatric Clinical Lead for Ontario Health GTA Region and is the Chair of the Community Paediatric Committee at the Canadian Paediatric Society. Her research focuses on innovations in care delivery for children with medical complexity and their families.<\/p>\nSee Julia’s SickKids staff profile<\/u><\/a><\/p>\n<\/div><\/div><\/div><\/div>
Our research program <\/span>focuses on studying and optimizing care delivery and health outcomes for children with medical complexity (CMC) and their families.<\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div> ADAPT<\/strong>: A<\/u>ssessing and D<\/u>eveloping an A<\/u>dapted navigator role to support P<\/u>arents during neonatal T<\/u>ransition.<\/p>\n For more information visit the CHILD-BRIGHT<\/b> Website<\/u>.<\/a><\/p>\n<\/div><\/div><\/div> Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children with Medical Complexity<\/p>\n Understanding the psychiatrist role in caring for caregivers of children with medical complexity: A retrospective chart review<\/p>\n This study is testing a new integrated clinical pathway called the PIUO Pathway, as a protocol to identify treatable causes of pain and irritability in children with multiple disabilities and limited communication. In this study, we will use a waitlist-controlled RCT design, with 120 children randomized to PIUO Pathway or waitlist (standard care) treatment arms. SickKids is one of four centres participating in the PIUO study.<\/p>\n<\/div><\/div><\/div> The Connected Care Program works in partnership with families as a multicomponent intervention tool that includes personalized technology, a bundled transition to home intervention, and 24\/7 virtual homecare nursing support that will lead to improved hospital-to-home transition of patients. Funded by the Canadian Institutes of Health Research involves the conduct of a prospective cohort study with an embedded health economic and qualitative analysis.<\/p>\n<\/div><\/div><\/div> The objective of this study was to develop an online patient-facing platform to ease the burden of coordination of care for parents of CMC, begin to level the inequalities in access to information, and engage a diverse set of stakeholders to improve the care of CMC.<\/p>\n<\/div><\/div><\/div> The primary objective of this study is to describe courses of care that were altered during the COVID-19 pandemic. The secondary objectives are to<\/p>\n The objective of this descriptive study is to understand the prevalence and experience of housing need in children with medical complexity through surveys and qualitative interviews. The study aims to understand the relationship between CMC and housing need in order to develop a clinical role for early screening of housing risk and to inform appropriate housing interventions that meet the unique needs of this population.<\/p>\n<\/div><\/div><\/div> For more information on our studies or how to join, please contact us.<\/a><\/span><\/p>\n<\/div><\/div><\/div> Medical Director, Complex Care Program<\/p>\n Assistant Professor, University of Toronto<\/p>\n Dr. Julia Orkin is a staff paediatrician at The Hospital for Sick Children (SickKids), Division of Paediatric Medicine and holds an Associate-Scientist Track position at SickKids Research Institute. She is the Medical Director of the Complex Care program<\/u><\/a> and Assistant Professor at the University of Toronto. She is the Paediatric Clinical Lead for Ontario Health GTA Region and is the Chair of the Community Paediatric Committee at the Canadian Paediatric Society. Her research focuses on innovations in care delivery for children with medical complexity and their families.<\/p>\n See Julia’s SickKids staff profile<\/u><\/a><\/p>\n<\/div><\/div><\/div><\/div>Studies<\/h2><\/h2><\/div>
ADAPT: Assessing and Developing an Adapted navigator role to support Parents during neonatal Transition.<\/h2><\/div>
\n
Coached Coordinated Enhanced Neonatal Transition Study (CCENT) <\/h2><\/div>
\n
Transition to Adult primary care for youth with medical Complexity through the use of Telemedicine (TACT)<\/h2><\/div>
Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children with Medical Complexity<\/h2><\/div>
\n
Understanding the psychiatrist role in caring for caregivers of children with medical complexity: A retrospective chart review<\/h2><\/div>
\n
Adult Psychiatric Support for Parents of Children with Medical Complexity<\/h2><\/div>
Optimizing the Management of Pain and Irritability in Children with Severe Neurological Impairments (PIOU)<\/h2><\/div>
Connected Care Study<\/h2><\/div>
Completed Studies<\/h2><\/h2><\/div>
Patient-Facing Platform for Children with Medical Complexity <\/h2><\/div>
The Hidden Danger: A surveillance study to describe the unintended health consequences of the COVID-19 pandemic <\/h2><\/div>
\n
Housing Need Amongst Children with Medical Complexity: A Cross-Sectional Descriptive Study of Three Populations<\/h2><\/div>
Get Involved!<\/h2><\/div>
People<\/h2><\/h2><\/div>
<\/span><\/div><\/div><\/div>Dr. Julia Orkin, MD, M.Sc., FRCP(C)<\/h3>\n
![](\"https:\/\/lab.research.sickkids.ca\/orkin\/wp-content\/uploads\/sites\/106\/2021\/10\/rsz_screen_shot_2021-10-12_at_92945_am.png\" "\\"rsz_screen_shot_2021-10-12_at_92945_am\\"")
<\/span><\/div>