Facebook Pixel Code
Paediatric Medicine
Paediatric Medicine

Norman Saunders Complex Care Initiative - Grant Competition


An endowment fund was established by friends and family of the late Dr. Norman Saunders to recognize his contributions to the care of children and their families in his primary care paediatric office as well as at The Hospital for Sick Children (SickKids) throughout his distinguished career.  The purpose of this endowment, known as the Norman Saunders Complex Care Initiative (NSCCI) was to stimulate and support research and academic discovery related to the clinical care of children with multiple and complex health challenges.

As part of this initiative, beginning in 2007 a sum of $50,000 per year was made available to support research addressing important questions relating to the clinical care of the growing population of complex care patients.  This grant competition was open to all faculty affiliated with the University of Toronto and was administered through the Division of Paediatric Medicine in the Department of Paediatrics and the Research Institute at SickKids. See below for a list of research projects funded over the last 10 years.

In 2018 it was felt that the annual research grant competition should become a national resource to provide a new opportunity for the growing number of clinicians in the field of paediatric complex care across Canada, to apply for funds to support their research and academic projects. Dr. Saunders was a visionary who knew that we could do better in caring for these children with medical complexity and their families. It is in keeping with his wishes that we hope to broaden the impact of funding through his philanthropic NSCCI endowment.


To promote innovative, interdisciplinary research related to the broad area of complex care in children's health. The Norman Saunders Complex Care Initiative fund has designated approximately $100,000 to be used annually to provide clinicians in the field of paediatric complex care in Canada with grant funding to pursue research ideas that are currently not the targeted areas of conventional funding agencies. This money would be used to fund a stand-alone project or may be used as seed money to pursue a pilot project that would then be funded by a larger granting agency. Projects eligible for funding from a disease specific granting agency or industry will not be considered.

General information

Criteria for award

Grant applications should be focused on children with medical complexity, defined as children who share the following four characteristics:

  • presence of one or more complex chronic conditions that are often multisystem and severe
  • have a functional limitation that is often significant and impacts their daily lives, often causing the child to be reliant on technology such as feeding tubes and tracheostomies
  • high health-care utilization, requiring specialized care and services from different providers in  multiple sectors
  • caregivers identify high healthcare service needs e.g. care provision in the home and care coordination which can have significant social and financial impacts of the family

**Note: Applications that specifically relate to patient populations that primarily have an underlying diagnosis with firmly established advocacy and support groups outside of ‘complex care’ and access to other funding sources (e.g. childhood cancer, cystic fibrosis, transplant patients) will not be considered for this competition.

Targeted issues

Funding aims to provide more knowledge/awareness/tools to improve care to CC population through projects which relate to a range of relevant domains/activities including:

  • Developing/testing/piloting novel models of care e.g. medical home
  • Enhancing care coordination
  • Defining/measuring/improving outcomes
  • Addressing health systems issues
  • Quality of life
  • Designing/evaluating therapeutic interventions


Physicians, nurses, allied health professionals, researchers and trainees who are affiliated with an academic health science centre or university in Canada. New and junior investigators are encouraged to apply.

Application Guidelines

Applicants should submit their applications as follows:

  • Submission is electronic ONLY and must be sent as a single PDF file
  • The submission should be presented in one PDF file containing:
    • Three single-spaced pages, please do not exceed the page limit - only 3 pages will be evaluated. Use only 8.5" by 11" paper, printed on one side only, single space type no smaller than 12 points, a margin of one inch around the page is needed
    • Must include:
      • Rationale and objectives, including what is currently known and what the gaps in knowledge are
      • Expertise/qualifications of applicants essential for this study
      • Research question and research methods (design, measures, analysis)
      • Time-line and feasibility
      • Impact of study and relevance to the Norman Saunders Complex Care Initiative (see Background, Purpose, Criteria above)
      • Potential outcome and plan for knowledge translation and dissemination 
      • Maximum two pages of references with full titles
      • Maximum two figures
      • Maximum two reprints, manuscripts, etc. only if absolutely pertinent
      • One page budget justification (ineligible expenses: conference travel, standard office equipment, computer hardware, furniture) and personnel involved
      • Appropriate ethics protocols (these may follow application)
      • Letters of support (if appropriate)

Applications are to be emailed to: grantcomp.paedmed@sickkids.ca
Submission Deadline
: August 31, 2018.
* a decision will be made by the end of November 30,2018. Award recipients will be notified

For further information please contact:
Cindy Groff

Administrative Coordinator, Complex Care 
Paediatric Medicine

Review Process, Responsibility & Accountability

Composition or Review Committee:
Committee of at least seven members which may include:.

  • Committee: Chair (to be decided from amongst the committee members)
  • A representative member from the Division of Paediatric Medicine, SickKids
  • A senior scientist from the Research Institute, SickKids
  • A representative from Holland Bloorview Kids Rehab
  • An Allied Health Professional
  • A member of Dr. Norman Saunders’ family
  • A patient representative
  • A complex care clinician from outside of Toronto
  • Ad hoc reviewers may be invited depending on topics submitted for review

Peer-review process and evaluative criteria:
In general, the CIHR peer review process and ranking scales will be followed.

  • Each application will be assigned to two-three reviewers for independent assessment
  • Each application will be evaluated on:

a) clinical relevance to complex care in children’s health,
b) scientific merit,
c) feasibility,
d) relevance to the intent of the Norman Saunders Complex Care Initiative

  • The scores given by the reviewers will be discussed at the reviewer committee meeting.
  • A consensus of scores and ranks will be reached; committee members with a conflict of interest with the applicants will be recused from the decision making regarding that grant.
  • The budget must be thoroughly justified as preference will be given to excellent projects with an economical but feasible budget that would allow for more than 2 projects/year to be funded.
  • Results including reviewers’ suggestions/feedback will be provided to applicants.

Responsibility & Accountability
The following is required of all funded applications:

  • Obtain REB approval from institutions involved
  • Begin funding within twelve months of receipt of funds
  • Submit annual progress report
  • Submit final report with a financial statement within six months of project completion
  • Return unused or remaining funds
  • Be prepared to present findings at a symposium to showcase projects funded by the NSCCI

Funded Projects


  • Development of a Conceptual Framework for Quality of Life in Children with Medical Complexity Nearing the End of Life – Kim Widger (PI)/ Dr. Adam Rapoport/ Sherri Adams / Dr. Jurg Streuli / Rose Steele.
  • Housing and Health: An Exploration of Housing need in Children with Medical Complexity (CMC) – Dr. Julia Orkin (PI)/ Dr. Eyal Cohen / Joanna Soscia / Kathy Netten / Kara Hounsell
  • Paediatric Tracheostomy Care: An evaluation of an innovative competency-based education program for community health care providers – Dr. Reshma Amin (PI)/ Dr. Julia Orkin (PI) / Stephanie Chu / Catharine Walsh / Krista Keilty / Sandra McKay.


  • Competence in Complex Care: A Multicenter Randomized Trial of Curricular Modules in the Care of Children with Medial Complexity for Paediatric Residents - Julia Orkin (PI)/ Kathleen Huth/ Sara Long-Gagne.*(Co-funded with a Paediatric Consultants Educational Scholarship Grant)
  • Exploring families and Health Care Providers (HCPs) Experiences Using a Cloud-based Care Plan for Children with Medical Complexity (CMC) - Sherri Adams (PI)/ Arti Desai.
  • The Experiences of Bereaved Family Caregivers with Advance Care Planning for Children with Medical Complexity - Julia Orkin (PI)/ Sarah Lord/ Reshma Amin.


  • The experiences and expectations of family caregivers and health care providers of advance care planning in children with medical complexity (CMC) – Dr. Reshma Amin (PI)/Dr. Julia Orkin
  • The role of whole genome sequencing as a diagnostic tool for children with medical complexity – Dr. Robyn Hayeems (PI)/Stephen Meyn
  • Getting to School: An investigation of Household Experiences with Disability in Childhood – Dr. Andrew Howard (PI)/Ron Builiung, Tim Ross


  • The exploring sleep study: A study exploring the experiences and perceptions of end-users in the development of SLEEP promoting intervention among family caregivers of children who depend on medical technology-Krista Keilty (PI)
  • Core set of outcomes for children with severe neuro-disability and gastrostomy tube dependency: a tool of standardized outcomes for clinical research and practice- Dr. Martin Offringa (PI)
  • The experience of caregivers of children with medical complexity receiving blenderized tube feeding: a qualitative study-Joanna Soscia (PI)/ Dr. Julia Orkin


  • An exploration of care mapping among families of children with medical complexity - Sherri Adams/Dr. Ronik Kanani (PI)
  • Exploring parent-health care provider decision making practices for children with complex health care needs receiving home care services: A pilot study using a multiple case-study design - Dr. Karen LeGrow/Dr. Eyal Cohen


  • The Development of a Tool to Assess Caregiver Knowledge and Skills Needed to Safely Care for Children Receiving Invasive Long-term Mechanical Ventilation at Home - Dr. Reshma Amin (PI)
  • Care to SLEEP Study - Dr. E. Cohen/Krista Keilty (PI)
  • Surgical interventions and outcomes of children with trisomy 13 and 18 in Ontario - Dr. Kate Nelson (PI)


  • Developing and evaluating a support network for families caring for medically complex children  - Dr. Barbara Muskat (PI)
  • “Joined Up” Government: Optimizing governance models to serve the needs of children with medical complexity  - Dr. Charlotte Moore Hepburn (PI)


  • The natural history of swallowing dysfunction in infants with dysphagia  - Sherna Marcus (PI)
  • The MASC (Medical and Social Complexity) Screening tool Derivation Study. Phase 1 – Tool Construction and pilot-testing (Yr. 2)  - Dr. Jonathon Maguire (PI)
  • A process evaluation of the Integrated Complex Care Model (ICCM)  - Dr. Shauna Kingsnorth (PI)


  • The MASC (Medical and Social Complexity) Screening tool Derivation Study. Phase 1 – Tool Construction and pilot-testing (Yr. 1)  - Dr. Jonathon Maguire (PI)
  • Parental perceptions of forgoing artificial nutrition and hydration during end-of-life care for their children  - Dr. Adam Rapoport (PI)
  • Songs of Children Said to be Silent  - Dr. Patricia McKeever (PI)


  • The usefulness of comprehensive care plans for children with special health care needs (CSHCN) - Sherri Adams (PI)
  • Anti-reflux procedures after gastrostomy in children with neurologic impairment:  A nested case-control study  - Dr. Sanjay Mahant (PI)
  • Collaborative community-based complex care coordination  - Dr. Eyal Cohen (PI)
  • Regional migration patterns of families of children with complex chronic conditions  - Dr. Astrid Guttmann (PI)