Evaluative Clinical Sciences

Education:

• B.Sc., 1987, biochemistry, Bishop's University, Canada
• MD, 1991, Queen's University, Canada
• CCFP, 1993, family medicine, Queen's University, Canada
• FRCPC, 1996, emergency medicine, Queen's University, Canada
• Fellowship, 1999, emergency medical services, Boston University/Boston EMS, U.S.
• Master of public health, 1999, Boston University, U.S.
  

Appointments and Affiliations:

• Associate scientist, Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program, Sunnybrook Research Institute
• Attending staff, emergency services, Sunnybrook Health Sciences Centre
• Professor, Department of Medicine, University of Toronto
• Member, Institute of Medical Sciences, U of T
• Medical Director, Toronto Paramedic Services

Research Focus:

• Evidence-based planning, decision-support and optimization of resource allocation in patient transport
• Implementation and evaluation of impact of community-based paramedic care
• Building interdisciplinary pathways to enhance community-based care for patients with chronic disease

Research Summary:

Dr. MacDonald's research is focused on using ‘big data’ to develop an operations-based approach to system performance improvement and evidence-based resource allocation. Working with interdisciplinary teams he is actively involved in development and ongoing refinements of systems that optimize ambulance dispatch to improve efficiencies and mitigate risk of ambulance non-availability.

Dr. MacDonald is also leading collaborations with hospital-based care teams to provide seamless post-discharge follow-up and ongoing community-based care for cohorts of patients with chronic illness. The intent is to provide time-sensitive interventions and create pathways to timely follow-up by patients’ health care teams, negating the need for transport to an emergency department. These patient-centred approaches benefit not only the patient, but also prevent ambulance offload delays and eases the burden on already overcrowded emergency departments.

Multidisciplinary areas of research allow Dr. MacDonald to assist and supervise graduate students in medical and nonmedical programs that focus on prehospital care and transport medicine research.

Selected Publications:
See current publications list at PubMed.

1. RD MacDonald (editor-in-chief).  Caroline’s Emergency Care in the Streets, 8th (Canadian) edition.  Burlington, MA:  Jones and Bartlett, 2021.
2. RD MacDonald, Yuen Chin Leong.  Articles that may change your practice:  prone position ventilation.  Air Medical Journal 2020;39(2):84-6.
3. I Miles, RD MacDonald, S Moore, J Ducharme.  Evaluation of pain management in medical transfer of trauma patients by air.  Canadian Journal of Emergency Medicine 2019;21(6):776-83.
4. A Zia, RD MacDonald, S Moore, J Ducharme, C Vaillancourt.  Assessment of pain management during air transport of intubated patients.  Air Medical Journal 2019;38(6):421-5.
5. JA Tijssen, T To, LJ Morrison, F Alnaji, RD MacDonald, C Cupido, K-S Lee, CS Parshuram.  Paediatric health care access in community health centres is associated with survival for critically ill children who undergo inter-facility transport: a province-wide observational study.  Paediatrics and Child Health 2019; pxz013, https://doi.org/10.1093/pch/pxz013.
6. WCW Giang, L Hui, B Donmez, M Ahghari, RD MacDonald.  Dispatch decision making in an air medical transport system.  Proceedings of the Human Factors and Ergonomics Society Annual Meeting 2016;60(1):259-63.
7. JM Singh, A Gunz, S Dhanani, M Ahghari, RD MacDonald.  Frequency, composition, and predictors of in-transit critical events during pediatric critical care transport.  Pediatric Critical Care Medicine 2016;17(10):984-91.
8. Z Merali, S Sharma, RD MacDonald, E Massicotte.  Emergent and urgent transfers to neurosurgical centers:  examining access in Ontario.  Prehospital Emergency Care 2015;20(2):1-9. doi: 10.3109/10903127.2015.1086847.