Researcher Blog: Dr Remi Bec – Discovering Canada Post 2

Remi Bec blog post 2

Welcome to the second in a series of researcher blog posts on Remi Bec’s mission to share his experience of Designing in Health with Canadian researchers. The first post can be found here

About the author

After studying model making and space design in France, Remi Bec completed a PhD exploring the use of games to promote physical activity. Following this, Remi was seconded to the Translating Knowledge to Action team (TK2A – part of the CLAHRC YH) where he was the design researcher lead based at the Royal Hallamshire Hospital. He has now returned to  Lab4Living where he is leading on the ‘Play‘ theme within the 100-year Life project. 

Aside from his researcher post at Sheffield Hallam University, he is also director, founder of a social enterprise, GoFit4Fun CIC, which delivers services in the community to fight social exclusion and sedentary behaviours through the co-creation and play of games.

In this post:

Meeting wicked new people, visiting an amazing campus (with two exhibition spaces, an archive library, and a first nation students room) with a breath-taking view, develop a first understanding of designing in health in Canada, and the use of drugs on this continent!

Our main contact and host at Emily Carr University was Andrew Siu, the Strategic Advisor at the Health Design Lab. Andrew kindly took the time to give us a tour around the new campus which comprises workshops with the traditional wood work machines (lathe, sanding machines, CNC, 3D printers (e.g. Ultimakers, SLS) etc. to produce all sorts of prototypes (mainly product and furniture). Two cafes were also available (with nice vegan pizzas!) as well as exhibition galleries that could be booked by external artists / organisations. A spacious library combining concrete, wooden structure and furniture, punctuated by plants, was also very inspiring.

The Emily Carr university campus

The Emily Carr university campus

Within it, an archive room with all sorts of books available to anyone to consult on site. Some of the books spoke about the history of BC and about aboriginal history and culture. I knew little about the first nations and I was also even more keen to learn about them when I saw that the campus comprised a room specifically dedicated to the aboriginals students.

The Aboriginal room at the Emily Carr University Campus

The Aboriginal room at the Emily Carr University Campus

This room could be used in different ways, for instance to retreat / group together to conduct ceremonies, practice / speak their language, and teach mutual skill learning (e.g. weaving). We ended the tour by meeting the lovely Lisa Boulton, Manager at the Health Design lab, and Nadia Beyzaei, coordinator.

Then we started to talk. And talk. And some of the sections to come will speak more about what we started to talk about 😉.

A visual produced by Emily Carr University students in protest to building the pipeline

A first understanding of the world of Design in Health and Health in British Columbia

Top news: Tailoring the message we had to deliver for a Health Canadian audience

Our next meeting gave us an opportunity to explore a little more of Vancouver, and one of their most popular locations – a coffee shop; although this one wasn’t Vegan…! We met with the last member of the Health Design Lab team at Emily Carr University: their Director, Caylee Raber!  I met Caylee at the Design4Health2018 conference (organised and hosted by the Lab4Living in Sheffield). Her husband, Eric Marriott, a physiotherapist who works in a clinic and in the community also joined us. Fruitful conversation about how the healthcare system works in Canada – e.g. in BC, physiotherapists are all private and the education system in British Columbia trains about 80 of them a year against 120 alone in Sheffield! The Health Design Lab being the first lab and only Design in Health lab in British Columbia, we gathered great insights from Caylee about how design research is understood in Canada. Combined with the conversation we had with Michael Foundation, it helped us a lot to frame our workshop / presentation for the Quality Forum 2020 conference. We were so thankful to Caylee who took the time out of her maternity leave to come and meet us (and treat us with delicious doughnuts!). Caylee is a dedicated individual who can’t actually stop herself working even when on maternal leave, so I met her again many times (including at our workshop!), along with her sister and her dad! The Rabers are great!

Cheryl and myself with Andrew Siu and Lisa Boulton from The Health Design team

Cheryl and myself with Andrew Siu and Lisa Boulton from The Health Design team

An additional insight that helped shape our understanding of research in Canada was #Day1 at the Quality Forum conference organised by the Patient Safety and Quality Council. There I met Skye Barbic, Assistant Professor at the Department of Occupational Science and Occupational Therapy at the University of British Columbia. It was interesting to hear how research works and about the differences between EU & Canada. The benchmark criteria to receive funding seems to be more discussable in Canada, allowing researchers to explain why such criteria hasn’t been made and to focus on the strength of what was done to receive more funding.

Drugs in Canada

Top news: How much the laboratories and pharmaceutical industry exert power on regulations of high dependency drugs (e.g. Opioids) as an ‘administrative way’ as opposed to discussing it with the patients and letting them know of the pros and cons of taking drugs vs not

I was really struck to see in Vancouver BC how much poverty there is. This is even more striking that the disparity is huge. Vancouver regroups some of the wealthiest people in the world – a lot of investment from China has recently enhanced this disparity – and there seems to be a huge gap between the rich and the poor. Statistics show that about 40% of the population in Vancouver is $200 away from falling under the poverty threshold and not being able to pay their bills – and hence being homeless. There is East Hastings St between Gastown and Chinatown that is a street where drug addicts (mainly crack and heroin addicts) reside. Drugs reinforcement is high in Canada however poverty being so high that the police forces let the drug users openly do drugs out there. It is very saddening to see that much poverty when Bentleys and Jaguar pass by and ignore reality to reach their high luxury flats in priceless glass towers located in the next block’s street.

East Hastings St between Gastown and Chinatown, where Class A drugs are tolerated

East Hastings St between Gastown and Chinatown, where Class A drugs are tolerated

Steve Tierney, a senior medical director at Southcentral Foundation in charge of Quality Improvement did a presentation during Day 2 at the Quality Forum conference. He spoke to his medical team to say that these are strong opioids so they should be used correctly. He told them ‘you can carry on giving these highly addictive opioids to anyone for pain relief or give it only to those at the end of life for dignity in death’. To him, having those frank conversations among oneself – E.g. Why am I giving these opioids? Are these people dying? No, so you shouldn’t give it to them – is there a way to encourage (self-)reflection which, from his perspective and experience, is enough to change people’s mind.

Opioids is a massive issue in Canada, as much in the street as in the hospital and there is a real need to reduce the production of these tablets, or at least give the choice to patients! Sylvain Bédard, from the Centre of Excellence for partnerships with Patients and the Public (CEPPP) and based at the Research Centre of the UdeM Hospital Centre (CRCHUM) in Montreal (Quebec), told a moving story regarding his experiences at the hospital, especially related to his second heart transplant. He was at a stage where after receiving the transplant, he was being administrated opioids to help him cope with the pain. He received the treatment for a few months but after that he was getting depressed and out of touch of reality. Sylvain had enough experience of healthcare and medicines to know that these symptoms were the side effects of the opioids he was receiving. He was therefore kept alive without having any quality of life. Is that worth it? This is a question that is personal and that will change from an individual to another. At that point, Sylvain was knowledgeable and brave enough to make the decision that he did not want the opioids anymore. He was ready to take the risks of not supporting the pain anymore with the counterpart of being able to have decent time with his closed ones. To him, if life goes on then it should be about quality. Sylvain was knowledgeable enough about the tablets he was given to make the decision to stop taking opioids but this was definitely not a default option, or an option at all. Like it was said by Steve Tierney, it seems that doctors in their training should empower patients with knowledge so that themselves can make informed decision, which seems only fair since it regards their life. And this is why Sylvain has now joined this CEPPP team.

Next time:

We deliver a workshop at the Quality Forum 2020 conference and realise that design researchers face a common issue when working in Health!

About this blog

This trip to Canada (Vancouver BC, and Montreal, Quebec) was made possible thanks to NIHR CLAHRC (TK2A theme) and Lab4Living (Sheffield Hallam University) in the UK. I, Dr Remi Bec, Design Researcher, relate in this summary my Canadian experience and therefore this entire content is my views and opinions only, not the ones of the funders. I also apologise for some of the content I relate since there might be elements of the stories that might not be fully accurate. Some details might have been forgotten or changed slightly but it is not to better fit my story – it is solely I have exchanged so much and interacted with so many people along the way that my little brain cannot retain it fully!