Steven Marc Friedman MD,MPH
Associate Professor
DFCM - Emergency Medicine Division
Dr. Steven Marc Friedman
Location
Toronto General Hospital
RFE G-S434
200 Elizabeth Street
Toronto, ON, M5G 2C4
Accepting
CREMS Students
Research Interests
Emergency Medicine, Health Policy, Health Service Delivery, Patient Safety, Public Health, Social Determinants, Survey Methods, Quantitative Data Analysis, Cycling Safety

Dr. Steven Marc Friedman is Assistant Director (Research) at UHN Emergency Medicine, and Associate Professor, DFCM, Faculty of Medicine, University of Toronto. He completed his medical training at the University of Toronto and McMaster University, and an MPH at Harvard University, where he focused on health care management and research methods.

Dr. Friedman's core research interests and scholarly publications relate to clinical practice, barriers to care in the emergency department (ED), and cycling safety and injury prevention. The overarching operational aim of his work has been to develop an emergency medicine program that mentors young physician researchers in emergency medicine.

Typical projects focusing on physician-related barriers to care have included a Canada-wide study of physician practice variability and deviation from best practice in subcutaneous abscess management; a Canada-wide study of physician compliance with notifiable disease reporting requirements; a Canada-wide study of resident perceptions regarding personal on-call and procedural competence, adverse events and reporting these to supervisors; a study of interruptions and communication barriers in the ED; and, the clinical impact of discrepant diagnostic imaging reporting and reinterpretation. Patient-focused studies have explored patients who leave the ED without being seen; health-consumer perceptions regarding queue-jumping and preferential access; barriers to patient follow-up with specialty clinics after discharge from the ED; patient dignity and privacy in the ED; and patient comprehension and compliance with ED discharge instructions in a multicultural health setting.

Projects relating to cycling safety and injury prevention have included a control-matched survey of Toronto bike-share users exploring cycling safety practices, barriers to helmet use, and impressions regarding proposed remedies to increase helmet use; a multi-centered collaboration exploration cycling injuries and the built environment; and an evidence-based review of Canadian cycling injuries and safety policy, leading to co-authorship of the Canadian Association of Emergency Physicians Position Paper on Cycling Safety.

Dr. Friedman is Co-I and Emergency Medicine Lead on Seamless Care Optimizing the Patient Experience (SCOPE) – A multidisciplinary, primary care practice-based Intervention to reduce ED visits and hospitalization for complex patients. He is also Co-I ad Emergency Medicine Lead on an evaluation of a birth cohort hepatitis C screening program in an academic emergency department and different community settings in Toronto.

Dr. Friedman is Director of STAR-EM, the UHN Summer Teaching and Research in Emergency Medicine Program at University Health Network, Toronto.

Research/Teaching

Research Synopsis

My research interests have focused on quality and barriers to care in the emergency department (ED).  Typical projects focusing on physician-related barriers to care have included a Canada-wide study of physician compliance with notifiable disease reporting requirements; a Canada-wide study of resident perceptions regarding personal on-call and procedural competence, adverse events and reporting these to supervisors; a study of interruptions and communication barriers in the emergency department; and clinical impact of discrepant diagnostic imaging reporting and reinterpretation. 

Patient-focused studies have explored cycling safety, helmet use and injury prevention; patients who leave the ED without being seen; health-consumer perceptions regarding queue-jumping and preferential access; barriers to patient follow-up with specialty clinics after discharge from the ED; patient dignity and privacy in the ED; and patient comprehension and compliance with ED discharge instructions in a multicultural health setting.

Grants

1) SCOPE Study: Seamless Care to Optimize the Patient Experience (SCOPE) 
Funding source: Bridges Program – Faculty of Medicine, University of Toronto & MOHLTC
Type of Grant: Operating Grant
Total amount: approx. $250,000/yr – two year duration
Support period: 04/2012- 04/2014
Principal Applicant: Dr. Gillian Hawker (PI), Noah Ivers, Ross Baker. David Frost, Irfan Dhalla, Steven Marc Friedman
Role:  Co-Investigator / Emergency Medicine Principle.

2) Implementation of the Canadian C-Spine Rule by Emergency Department Nurses
Funding Source: CAHO - Council of Academic Hospitals of Ontario
Type of Grant: Operating Grant
Total amount: $ 377,732
Support Period:  11/2010 - 11/2014
Principal Applicant: Ian Stiell MD, MSc and the CCR ARTIC Investigators Group
Role: Co-Investigator, UHN Emergency Medicine Principle


3) ACUTE Study: Acute Congestive Heart Failure Urgent and Transitional Care Evaluation 
Funding source: CIHR; HSFc
Type of Grant: Operating Grant
Total amount (requested): $662,188
Support period: 04/2011- 03/2014
Principal Applicant: Douglas S. Lee: Co-Investigator- University Health Network: Dr. Steven Friedman
Role:  Co-Investigator and Site-director, University Health Network – for this multi-centered study.

4)     Emergency Resident Perceptions Regarding Competence, Adverse Events and Reporting to Supervisors: A Nationwide Survey. Fifth Mediterranean Emergency Medicine Congress (MEMC V). Valencia, Spain Sept 16, 2009
  
Funding Agency: Department of Family and Community Medicine (DFCM), Faculty of Medicine, U of T 
Value: $ 1,500            
Term: 2009
Type of Grant: Travel Grant    
Role: Principle investigator.

5)  Bicyclists' Injuries and the Cycling Environment (the BICE Study)

Funding Agency: Heart and Stroke Foundation of Canada, and Canadian Institutes of Health Research
Value: $ 579,000            
Term: 2007 – 2010
Type of Grant: Operating Grant
Role: Co-investigator (Site-PI) for University Health Network

Publications and Awards

View PubMed search of this faculty member's recent publications.

Recent Publications

1. Helmet-Wearing Practices and Barriers in Toronto Bike-Share Users: a Case-Control Study.
Friedman SM, Adamson M, Cleiman P, Arenovich T, Oleksak K, Mohabir IM, Ta R, Reiter K.
CJEM. 2016; 18(1):28-36.
PubMed [journal]PMID: 26030137


2. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics.
Cripton PA, Shen H, Brubacher JR, Chipman M, Friedman SM, Harris MA, Winters M, Reynolds CC, Cusimano MD, Babul S, Teschke K.
BMJ open. 2015; 5(1):e006654.
PubMed [journal]PMID: 25564148 PMCID: PMC4289714


3.Evaluating the impact of environmental interventions across 2 countries: the International Bikeshare Impacts on Cycling and Collisions Study (IBICCS) Study protocol.
Fuller D, Gauvin L, Dubé AS, Winters M, Teschke K, Russo ET, Camden A, Mee C, Friedman SM.
BMC public health. 2014; 14:1103.
PubMed [journal]PMID: 25344774 PMCID: PMC4232659
Select item at position 5

4. CAEP Position Statement: Improving bicycle safety in Canada
Letovsky E, Rowe BH, Friedman SM, Snider C, Sullivan E.
Canadian Journal Emergency Medicine. 2014; 0(0):1-5.


5. Incidental findings of elevated random plasma glucose in the ED as a prompt for outpatient diabetes screening: a retrospective study.
Friedman SM, Vallipuram J, Baswick B.
BMJ open. 2013; 3(12):e003486.
PubMed [journal]PMID: 24353254 PMCID: PMC3884805

6. Route infrastructure and the risk of injuries to bicyclists: a case-crossover study.
Teschke K, Harris MA, Reynolds CC, Winters M, Babul S, Chipman M, Cusimano MD, Brubacher JR, Hunte G, Friedman SM, Monro M, Shen H, Vernich L, Cripton PA.
American journal of public health. 2012; 102(12):2336-43.
PubMed [journal]PMID: 23078480 PMCID: PMC3519333
Select item at position 10

7. Personal and trip characteristics associated with safety equipment use by injured adult bicyclists: a cross-sectional study.
Teschke K, Brubacher JR, Friedman SM, Cripton PA, Harris MA, Reynolds CC, Shen H, Monro M, Hunte G, Chipman M, Cusimano MD, Lea NS, Babul S, Winters M.
BMC public health. 2012; 12:765.


8. In support of a journey of metacognition.
Friedman S, Guo R.
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2011; 18(5):549-50.
PubMed [journal]PMID: 21569173


9. Perceptions of emergency medicine residents and fellows regarding competence, adverse events and reporting to supervisors: a national survey.
Friedman SM, Sowerby RJ, Guo R, Bandiera G.
CJEM. 2010; 12(6):491-9.
PubMed [journal]PMID: 21073775

Honours and Awards

2015, 2018 - Individual Teaching Excellence Award in Undergraduate Education,
       Wightman-Berris Academy,
       Faculty of Medicine, University of Toronto

2008 - Award for Research Excellence (2007),
       Department of Family and Community Medicine, 
       Faculty of Medicine, University of Toronto
                

2002, 2005 -Nomination - Undergraduate Education Teaching Award -
             Emergency Medicine, Faculty of Medicine, University of Toronto
      
                        
1996    Elected Student Commencement Speaker, 
            School of Public Health, Harvard University