Hospital News 2015 January Edition by Hospital News

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Canada's Health Care Newspaper JANUARY 2015 | VOLUME 28, ISSUE 1 | www.hospitalnews.com

MAKING STAFF WELLNESS A TOP PRIORITY

INSIDE From the CEO's desk..........................13 Ethics ..................................................15

Travel ...................................................18 Continuing Medical Education (CME) for health care professionals. Human resource programs implemented to Nursing Pulse .....................................19 manage stress in the workplace and attract and retain health care staff. Health and safety issues for health care professionals. Evidence matters ............................... 21 Quality work environment initiatives and outcomes. Careers ...............................................22

The

world is their ER H l h professionals Health f i l on the front lines of humanitarian aid Story on page 6

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PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Health care providers join forces

to save patient’s life By Lauren Hayes f you ask Leila Rahafrouz to tell you her story, she’ll tell you her strongest memory is suffering from a bad bout of the flu. Feeling weak and dizzy, she sent her husband a text message, “come home soon.” Leila’s next memory picks up four weeks later in a recovery room in London Health Sciences Centre’s University Hospital. “Each day is a gift,” says Leila, an Iranian-born wife and mother. “Enjoy your life today, because you may not be here tomorrow.” This past March, Leila went to the Milton District Hospital’s Emergency Department with flu-like symptoms. As her health began to rapidly decline, she was admitted to the Intensive Care Unit. An ultrasound revealed a build-up of fluid surrounding Leila’s heart. Leila was transferred to the Cardiac Care Centre at Trillium Health Partners’ Credit Valley Hospital. There, Cardiologist Dr. Janarthan Nikhil discovered Leila’s condition was worse than expected. Not only was there fluid surrounding Leila’s heart, but her heart muscles were severely weakened – a condition known as myopericarditis. Leila’s heart was barely able to pump blood through her body. The team of doctors and nurses at Trillium Health Partners worked fast to control the situation as it became apparent that Leila would need extracorporeal membrane oxygenation (ECMO). Essentially, ECMO bypasses the heart and lungs to oxygenate the blood until the heart is well enough to function on its own again. This treatment is only available at Regional Transplant Centres. Calls were placed immediately to get Leila the treatment she was in desperate need of. The closest centre, a hospital in Toronto, could not accommodate Leila’s needs as it had two heart transplants scheduled. London’s University Hospital was the next option. The only obstacle was getting Leila there in time. Typically a simple transfer by air ambulance, bad weather forced the Ornge helicopter to stay grounded. Peel Regional Paramedic Services would have to make the journey by ground, with Ornge paramedics and Dr. Nikhil in tow.

Leila Rahafrouz and family thank the team that saved her life. “This is a story where there were so many factors working against us,” says Dr. Nikhil. “We had a lot of people invested and working together to support this patient to overcome the dire circumstances. A case like this is extremely rare. We all felt that we needed to do everything possible to give this patient every chance to survive.” Just 12 minutes into their two-hour journey from Mississauga to London, Leila went into cardiac arrest. Under standard conditions, paramedics would have taken the patient to the closest Emergency Department, which would have meant returning to the Milton District Hospital. The team of health care workers knew Leila’s only chance of survival was to get to University Hospital. Over the next two hours, EMS workers alternated performing CPR, keeping Leila alive until they reached their destination.

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"Leila's experience shows the difference [CPR] makes," says Peel Regional Paramedic Services Chief Peter Dundas. "The continuous, good quality chest compressions paramedics delivered kept blood and oxygen flowing well enough so that our hospital health care partners could step in and continue delivering care that ultimately led to a remarkable recovery."

The influenza virus can be serious and deadly. Last year it caused approximately 5,000 hospitalizations and 500 deaths in Canada. The best way to prevent influenza and its spread is by getting the vaccine. University Hospital was ready and waiting for Leila’s arrival. ECMO was administered and Leila began her long road to recovery. Leila Rahafrouz knows just how lucky she is with her chances of survival low and odds of brain damage considerably high for the length of time CPR was performed. “I know the result could have been very different,” says Leila. “I cannot find the words to express my gratitude.” In November, the woman who survived against all odds met and thanked the team of health care professionals that saved her life. At Ornge’s Toronto hangar, Leila said an emotional thank you to the group of nearly 20 paramedics, doctors and nurses who worked tirelessly to keep her alive. Her story is one they will likely never forget. “The health care team involved in Leila’s case is a great example of how collabo-

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ration between emergency services can result in a positive outcome. We’re thrilled we were able to contribute alongside such professional and skilled staff,” says Ornge Chief Operating Officer Rob Giguere. Leila is on her way to making a full recovery, having spent four weeks in a coma state and two months on dialysis to normalize her kidney functions damaged by the ordeal. She has spent the past several months working towards regaining the quality of life she had before her illness. In late November, Leila returned to work as a substitute teacher with the Peel District School Board. This experience has left two lasting impressions on Leila – the first is to be grateful for your life each and every day. The second is to protect yourself and others from the influenza virus by getting vaccinated. Viral infections are among the most common causes for myopericarditis and Leila tested positive for influenza. The influenza virus can be serious and deadly. Last year it caused approximately 5,000 hospitalizations and 500 deaths in Canada. The best way to prevent influenza and its spread is by getting the vaccine. Leila had heard a lot of misinformation about the influenza vaccine and after experiencing such a life-threatening ordeal she urges others to get informed. “Getting the vaccine is safer than getting the flu,” says Leila. “The flu is more than just the sniffles, it can be a matter of life or death. It was for me.” Health care professionals recommend getting vaccinated early in flu season, however, it is never too late to get H vaccinated. ■ Lauren Hayes is a communications coordinator at Trillium Health Partners. www.hospitalnews.com

In Brief

College launches consultations on policies and transparency by-laws The College of Physicians and Surgeons of Ontario has launched a series of consultations on important issues affecting physicians and patients. The issues include draft policies on Human Rights, End-of-Life Care and Consent to Treatment, as well as a number of by-law changes that could make more information about physicians available to the public. "The consultations are an opportunity for the public and others to provide the College with insight and feedback to ensure the policies reflect current standards and are consistent with our mandate to protect the public," says College President Dr. Carol Leet. The public can now provide input around proposed new policies in a number of areas, including: • Professional Obligations and Human Rights – Sets expectations to provide health services without discrimination, and to accommodate individuals who may face barriers to accessing care. Under the proposed policy, physicians would be required to refer patients to other doctors for services they object to on moral or religious grounds. • Planning for and Providing Quality End-of-Life Care – Updates the College's professional expectations of physicians and provides guidance on a range of issues relating to quality end-of-life care. Under the proposed policy, there are new communications guidelines for end-of-life care. • The updated Consent to Treatment policy sets our expectations of physicians and provides guidance regarding their obligations to obtain consent prior to providing treatment. Increasing the amount of physicianspecific information that is available to the public has been a College priority for more than two years. As part of that initiative, the College is seeking public input on new transparency by-laws that would see additional information posted on the public register, such as information resulting from the investigative process that is not currently public. The proposal also includes adding information which may be obtained elsewhere, but is not always easy to access, such as criminal charges against physicians and whether they have licences in other jurisdictions. "While the College has always been a leader with respect to our transparency practices, we believe that providing access to additional physician-specific information may help patients make informed choices and enhance our accountability to the public," says Dr. Leet. For more information, and to participate in the consultation, please consult the CPSO website at http://www.cpso. on.ca/Policies-and-Publications/ConH sultations.. ■ www.hospitalnews.com

Over 230,000 Ontario adults seriouly considered

suicide in 2013 Results from an ongoing survey conducted by the Centre for Addiction and Mental Health (CAMH) show that 2.2 per cent – over 230,000 Ontario adults – seriously contemplated suicide in the last year. The 2013 report is based on responses from 3,021 adults age 18 and older from across Ontario. First introduced in 1977, the CAMH Monitor is the longest ongoing representative survey of adult mental health and substance use trends in Canada. Results also revealed a significant

overall increase in self-rated poor mental health, from 4.7 per cent in 2003 to 7.1 per cent in 2013 – this translates to an estimated 716,000 Ontario adults in 2013. This increase was especially evident during the past five years among those aged 18 to 29, rising from approximately three per cent in 2009 to 12 per cent in 2013. "We are noticing higher rates of selfreported poor mental health among young adults," said Dr. Hamilton. "This is a troubling trend and is generally consistent with what we're seeing in the re-

search we conduct among Ontario adolescents. This could be an indication that young adults and youth transitioning to adulthood need more support from family, friends, and health professionals when it comes to their mental health and overall wellbeing." Other findings include: • Rates of cannabis use up signiﬁcantly • Non-medical prescription opioid use declining • Daily alcohol use increasing H Fewer Ontario adults smoke tobacco. ■

Comprehensive new analysis calls for improvements in end-of-life care Health Quality Ontario’s new report ‘End-of-Life Health Care in Ontario’, is a first of its kind for the province because it is an exhaustive analysis involving multiple studies. The report addresses specifically, based on the evidence, where the health system must improve to ensure the best end-of-life quality care for Ontarians. It highlights the need for an increased number of health professionals trained in palliative care as well as the need to demedicalize death and dying in Ontario by encouraging productive, informed conversations about end-of-life care between patients, their loved ones, and their care providers. The report also calls for improvements to care for all people nearing the end of their lives or within their last year of life, irrespective of the underlying disease. While Canada currently ranks relatively high on an international index measuring "quality of death," there are still hundreds

of thousands of Canadians without access to coordinated end-of-life care. End-of-life care will become an increasingly pertinent issue. By 2026, due to an aging population, the number of Canadians dying each year will increase by 40 per cent to 330,000 people. Each of these deaths will affect the well-being of an average of five other people – families and loved ones – or in excess of 1.6 million. End-of-Life Health Care in Ontario includes in its background materials a survey demonstrating that 70 per cent of hospitalized Canadian elderly patients wanted comfort measures as opposed to life-prolonging treatment. However, more than half of these patients were admitted to intensive care units. Key highlights in the report include: •Deciding Where to Die; Home or Hospital? Certain places of death may be more appropriate or desirable for those at the end of their lives.

•Discussing Care Planning: Research suggests that patient care planning discussions, which include the desired direction of a patient's care and advance care planning, are associated with improved quality of care and patient and family satisfaction •Building Consistent Team-Based Models of Care: The delivery of healthcare to people as they near the end of their lives is particularly important, especially with regard to quality of life •Understanding Cardiopulmonary Resuscitation (CPR): Understanding the impact of CPR on patients at the end-of-life is important, as some may prefer to not undergo this intervention if they are provided with accurate information on their quality of life after receiving it. •De-medicalizing death and dying: The report also provides evidence to support the need for a broader public discussion about the normalization and de-medicalH ization of death and dying. ■

Discovery of novel drug target may lead to better treatment for schizophrenia Scientists at the Centre for Addiction and Mental Health (CAMH) have identified a novel drug target that could lead to the development of better antipsychotic medications. Dr. Fang Liu, senior scientist in CAMH's Campbell Family Mental Health Research Institute and professor in the Department of Psychiatry, University of Toronto, and her team published their results online in the journal Neuron. Current treatment for patients with schizophrenia involves taking medications that block or interfere with the action of the neurotransmitter dopamine, which acts on dopamine D2 receptors in the brain. However, because this D2-blocking action may cause un-

wanted side-effects, such as slow gait, stiffness and tremor, Dr. Liu and her team looked for new ways to interfere with the action of D2 receptors, without causing these side-effects. Dr. Liu and colleagues showed that the D2 receptor could combine with a protein called the Disrupted-In-Schizophrenia (DISC1) protein. Then, they showed that levels of this combined protein were higher in post-mortem brain tissues of deceased patients with schizophrenia, suggesting it was associated with the illness. Delving even further, the researchers identified the regions where the two proteins bound together. With this information, they were

able to generate a peptide to disrupt the binding of the two proteins, speculating that it may reduce symptoms. In animal models of schizophrenia, they were able to demonstrate that this disruption led to antipsychotic effects, comparable to commonly used antipsychotic medications, but without their side-effects. "The most exciting aspect of our finding is not the antipsychotic effect of this peptide, which all current antipsychotics have, but rather the possibility of a lack of the side-effects in humans compared to current medications", says Dr. Liu. "We hope that it will lead to a better treatment for schizophrenia patients who experience side-effects from H current medications." ■ JANUARY 2015 HOSPITAL NEWS

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UPCOMING DEADLINES FEBRUARY 2015 ISSUE EDITORIAL JAN 9 ADVERTISING: DISPLAY JAN 23 CAREER JAN 27 MONTHLY FOCUS: Facilities Management and Design/ Health Technology/Greening Healthcare/Infection Control:

Innovative and efficient health care design, the greening of healthcare and facilities management. An update on the impact of information technology on health care delivery. Advancements in infection control. + CHAIR INFECTION CONTROL SUPPLEMENT

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Geriatric medicine, aging-related health issues and senior friendly strategies. Best practices in care transitions that improve patient flow through the continuum of care. Programs and advancements designed to keep patients at home. Care in rural and remote settings: enablers, barriers and approaches. Rehabilitation techniques for a variety of injuries and diseases. + LONG TERM CARE SUPPLEMENT

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A new breed of

health care leader By Alex Munter

leven years ago I handed in my city hall parking pass, keys to my office and headed to a nearby coffee shop to meet friends on my last workday as an Ottawa City Councillor. It’s been a decade of growth for me as I’ve applied lessons I learned as an elected official to the world of health and social services management. For many Ottawa residents, the most noticeable thing I did in the last 11 years may have been the months I spent running for mayor in 2006. But that was actually a detour for me – most of the last ten years have been spent at the University of Ottawa and then in CEO roles at the Youth Services Bureau, Champlain Local Health Integration Network and, for the past two years, the Children’s Hospital of Eastern Ontario. Moving from politics to management required me to recalibrate my instincts. For instance, in politics, what you say often matters more than what you do. Politicians are evaluated by electors as much on their effort as on their accomplishments. The opposite is true in management. While communications is crucial, it’s not enough. People are watching closely for consistency and coherence. Actions really do speak louder than words. As Costco Canada’s top boss Louise Wendling tells her managers, “don’t promise what you can’t deliver.” This is not always the prevailing ethic in politics. Politics is a feedback-rich environment. Telling a politician what you think is encouraged. As I moved to management, I found out just how few people tell the boss what they’re really thinking, especially the new boss. At first, I felt like a cat whose whiskers had been cut off. I went from a world where everybody was constantly telling me what they thought to one where almost no one did. So I learned you have to create those opportunities through developing open relationships with your closest advisors and creating systems to collect feedback more broadly. I also had to learn the difference between intrinsic and extrinsic motivation – in other words, doing something because

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There are other skills from politics that have served me well. All politicians keenly understand that they have to earn and re-earn the confidence of the people who elected them. It’s an ethic I’ve taken with me into organizational leadership – the ongoing effort to mobilize staff requires you to maintain their trust and confidence. As Louise Wendling says: “a title doesn’t give you anything, you’ve got to earn their respect.” While it’s a cliché that communications is central to leadership, it’s also true. Dale Schattenkirk, who trains health care organizations in those Lean manufacturing processes, is clear: “As a manager, your one output is communications.” And communications isn’t just about what you say, how consistently you repeat it, but also how well you listen and what systems you put in place to gather input. Politics is a remarkable training ground for all of that. I used to go door-to-door. Now I hang out at the frontline, meet with new employees on the first anniversary of their employment, spend time in all parts of the hospital. In a similar vein, politics is a team sport. No one’s ever been elected on their own; it takes the support of a great many people to make that possible. Smart politicians have the humility and insight to understand that and therefore they support and foster their teams. Almost nothing is more important to the success of any organization than this ethic, one which I’ve tried to bring to all the organizations I have had the privilege to lead. I was drawn to local government by the desire to “do something” not to “be somebody”. I still have that chance. I am grateful to the local residents who comprise the boards of directors of YSB, the LHIN and CHEO. They entrusted their organizations to someone with a lot of energy, lots of experience but a rather unusual CV. Steve Jobs once said “The only way to do great work is to love what you do.” Eleven years after leaving city hall, I feel blessed to H have that opportunity. ■ Alex Munter is President and CEO of The Children’s Hospital of Eastern Ontario.

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you inherently care about it versus doing something because there is an external reward. Mobilizing staff and volunteers in politics is about speaking to their intrinsic motivations, tapping into what they believe in. In a mission-driven organization like CHEO, there is enormous intrinsic motivation as people have made a life choice to help kids and families be their healthiest. Indeed we’ve built our CHEO next strategic plan for the future based on our people’s passion to make a difference. But, as in any other workplace, external motivations matter too – salary, working conditions, autonomy. I’ve learnt that while the cause is crucial, it’s not enough. I’ve had to learn to pay more attention to the extrinsic motivations that keep people going. Other parts of this transition have felt quite natural. Jack Kitts, CEO of The Ottawa Hospital, says that a hospital CEO will ideally spend 30 per cent of their time facing outward – advocating with government and policymakers, doing fund-raising, connecting with community partners and dealing with the media. Obviously, these elements of the job came easy. Last year, sitting at a table of organizations working in child and youth services, I realized I was one of the veterans there – I had been at that same table representing first the city, then Youth Services Bureau and now CHEO. You know you are hitting middle age when you suddenly are part of the corporate memory. Responsible for the city’s health and social services budgets through the cutbacks of the 1990’s also equipped me well for the current environment in the health care system. Hospital budgets in Ontario have been frozen for the first time in nearly 20 years, leading to tough choices and trade-offs. Making it through this period of change will require sticking to our values, remembering what matters most and innovating in how we work. At CHEO, for example, our new integrated electronic health record, developing new models of care with community partners and adapting Lean processes from manufacturing are examples of how we are taking on this challenge.

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Doing things better without adding hours to the day

Focus

By Emily Holton

hange is all around us! Thousands of passionate people at St. Michael’s Hospital are working right now on countless projects and initiatives to improve the

Six questions to ask before planning and implementing a change 1. Are the end users involved in designing, testing, revising and implementing the change? 2. Does the change initiative align with the organization’s and/or team’s values and goals and has the rollout been planned effectively? 3. Are the required resources (training, equipment, time, personnel) for making the change known and will they be made available? 4. How much workload (cognitive, physical, time) is associated with the initiative? 5. How complex is the initiative? 6. What degree of evidence and belief is there that this initiative will lead to the intended outcome?

way they do what they do, while at the same time actually doing their work. “I see great enthusiasm for quality improvement in every corner of the hospital, and together we’ve achieved so much,” says Dr. Chris Hayes, medical director of quality and performance. “But I also see that this work can add extra time and effort, on top of the already busy work that we do to care for patients. It can lead to overburdening of providers and contribute to quality improvement – and other change initiatives – not being successful.” Dr. Hayes took these concerns to the Institute for Healthcare Improvement in Boston where he spent a one-year Harkness Fellowship researching the best way to design and implement quality improvement projects. “To succeed, the people who are implementing the changes need to be able to reliably do the new tasks and see value in what they are being asked to do,” explains Dr. Hayes. “There needs to be the right balance between how valuable the outcome will be, and how much cognitive and physical work it will take to get there.” It’s not a complicated recipe, but Dr. Hayes said people tend to go through a lot of trial and error – and exhaustion – trying to get it right.

Dr. Chris Hayes is a staff physician in the MSICU as well as medical director of quality and performance. Dr. Hayes conducted a literature review, site visits, expert interviews and focus groups. He distilled what he learned into six main questions to ask, including one about extra workload, before planning and implementing a change. He developed the Highly Adoptable Improvement model and tool to help determine exactly how likely a change initiative is to succeed, or if further thought is needed. “I piloted the assessment tool with 16 improvement advisers from the Institute for Healthcare Improvement,” says Dr.

Photo credit: Yuri Markarov

Hayes. “They all took it back to their institutions, and tried it out on their quality projects. They said the model was intuitive, clear and useful, and it opened their eyes to why some projects just weren’t getting anywhere. They all said they’d keep using the tool.” Learn more and download the tool at H www.highlyadoptableqi.com. ■ Emily Holton is a Senior Communications Advisor at St. Michael's Hospital.

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PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES Garoua-Boulai District Hospital, MSF tent, Cameroon. MSF nurse Gervais changes the bandages of a patient transferred from the MSF hospital in Bouar.

Cover story By Tricia Newport

n 1985, at the age of 10 years old, I saw my first picture of a malnourished child. It was a child from Ethiopia during the famine. The image shattered my reality, and made me realize there was a lot going on in the world that I didn't know about. The image stayed in my mind, and drove me to become a nurse, and to eventually work for Médecins Sans Frontières / Doctors Without Borders (MSF).

Every time I return to work in Canada, I bask in the multi-disciplinary collaboration, in the access to resources and in the social safety net that more or less ensures access to healthcare to our clients Today I'm heading home from Cameroon, having completed my 6th mission with MSF. Ever since my first mission in 2009, the return home has always been a time for reflection. A time to think of how privileged I am to work for MSF, and to have the life that I do. It is also a time to reflect on the stories and the people I met during the mission.

When I first arrived in Cameroon, fourmonths ago, I did a tour of the 120 bed MSF malnutrition treatment hospital. The hospital was full and the first person I saw was a completely emaciated, motionless older boy lying outside on a mattress. His name was Awaloo, and I thought he was dead. Thankfully he was not. Awaloo is a 12 year old refugee from Central African Republic (CAR). When he arrived at the hospital he was unconscious and severely malnourished. He tested positive for HIV and was started on ARVs, but he didn't start to get better right away. For months his poor little body was wracked by infection after infection. Eventually the infections subsided, and Awaloo began to gain weight. First he was able to sit up, and soon he was even able to hold his own cup of therapeutic milk. And he smiled practically all of the time, as though he knew a special secret. Four months after his admission into the hospital, Awaloo is getting ready to go home. He is now a skinny 12 year old boy, who walks around the hospital with a big smile on his face – a far cry from the boy I thought was dead when I first visited the hospital four months ago. He has become a very beloved patient in the hospital, with the staff sharing a sense of pride that they played a part in the miracle of Awaloo being alive and healthy. And as I think about going home and my future, I also think about Awaloo going home and his future. Awaloo’s family lives in a village on the border of Cameroon and the Central African Republic. The village houses thousands of refugees who fled to

At some point, everyone can use a hand.

Cameroon seeking safety from the widespread slaughtering of muslims in CAR. While the village is relatively safe, there are constant reminders of the menace that lurks on the other side of the border. One night, a refugee crossed over the border into CAR, in search of better pasture for his goats. He was beheaded, and the next day the rebels responsible for the killing paraded around Awaloo’s village, proudly

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carrying the head. When I think of how hard Awaloo has worked over the past four months to be alive, it makes me sick to think how his life, or the life of others, could be so quickly, brutally and senselessly taken away. And it is not only Awaloo’s physical safety that will be a concern once he returns home. MSF runs a health centre in his village, and for the next few months we can be sure he will receive his monthly supply of ARVs. But once MSF leaves, there is no guarantee that the government’s HIV program will be able to continue supplying the drugs. And without the drugs, Awaloo will die. Later this month, after some intense rest, I will return to work as a home care nurse in the Yukon. Since I began working for MSF, my appreciation for the health care system in Canada has grown exponentially. I know that there are problems with the system, but I also see the strengths. Every time I return to work in Canada, I bask in the multi-disciplinary collaboration, in the access to resources and in the social safety net that more or less ensures access to healthcare to our clients. I think of Awaloo, and all of the other people I have met over the years. I think how different their lives would be if they had access to the type of healthcare we have in Canada. When I began working with MSF in 2009, I had no idea what awaited me. Since that time, not only have I been provided with high quality training opportunities (MSF supported me in obtaining my Masters of Public Health), I have also become part of the MSF community. I am returning home exhausted, but I know that there is a community waiting to support me.

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MSF exists to save lives by providing medical aid where it is needed most – in armed conflicts, epidemics, famines and natural disasters. All these situations call for a rapid response with specialised medical and logistical help. But, we also run longer-term projects, tackling health crises and supporting people where the need is greatest. We currently have projects running in over 70 countries.

Working for Médecins Sans Frontières/ Doctors Without Borders More than 30,000 people working for Médecins Sans Frontières/Doctors Without Borders (MSF) provide medical aid in close to 70 countries around the world. Most of the organization’s staff is hired locally. From Canada, MSF sends about 240 fieldworkers each year. MSF recruits both medical and non-medical staff to work in its projects. Medical fieldworkers include physicians, surgeons, nurses, midwives, obstetricians, anesthesiologists and laboratory specialists. A typical MSF mission lasts six to 12 months, though a field project may be of shorter duration for emergencies or for needs driven by particular circumstances. Photographer: Laurence Hoenig/MSF.

Since I began working with MSF, I have been provided with incredible professional and personal opportunities. As a nurse with MSF my role is much broader than it would be ever in Canada – with MSF, nurses can be responsible for training staff, managing pharmacies, recruiting and scheduling staff, implementing programs, collecting and analyzing program statistics etc. Working with MSF I have met amazingly resilient people, with stories that would seem unfathomable to most. And, I have never left a mission without an overwhelming gratitude for the life I was born in to, and all of the privileges that I have. Tonight as I prepare to return home to

the Yukon wilderness, I think of the differences in what awaits me and what awaits Awaloo in our journeys home, and I am filled with both gratitude and painful sadness. I will never cease to be in wonder of how I had the luck and privilege to be born H into this life. ■ Tricia Newport is a nurse from Whitehorse who has done six missions with MSF (in Djibouti, Democratic Republic of Congo, Niger (twice), Chad and Cameroon. In between missions she works at a hospital in Whitehorse. She completed a Masters in public health this year.

Professional development MSF is committed to the ongoing professional development of its field workers. It provides them with access to various types of training that build the skills and knowledge required to fulfill its mandate. Training programs can range from language training, to sophisticated medical treatments and protocols, to management and leadership best practices, and a host

of other possibilities relevant to the medical and professional support streams. Salary and Benefits MSF salaries are set so as to reflect the humanitarian spirit of volunteerism while recognizing the high level of professional expertise provided by field staff. Monthly gross salary is approximately $1,907, with subsequent increases based on expertise and experience. Canadians working in the field with MSF receive a Canadian contract in which all required taxes and contributions are deducted. Fieldworkers receive a number of benefits such as pre-departure training, round-trip transportation, accommodation and daily per diem in the field, paid vacation, medical insurance and psychological support after returning to Canada. More information about working for MSF and how to apply can be found on MSF Canada’s website: www.msf.ca The organization also holds regular recruitment information events around Canada and organizes recruitment webinars.

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Focus

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Caring for the caregiver: Quality of Work and Life Program at Sunnybrook By Marilyn Reddick

esponding to life and death situations is part of the job description at Sunnybrook, Canada’s largest trauma centre. Our staff look after some of the country’s most critically ill and injured patients, and we have learned that we must take care of the caregivers who take care of our patients and their families. Our Quality of Work and Life Program “cares for the caregiver”, an approach that enables staff to come to work in the best possible mental and physical condition. I’m often asked how we achieve this with over 10,000 staff, physicians and volunteers. I believe that a dual focus is most powerful. This means not just a high quality of life while working, but also making sure there are programs to assist in the personal lives of employees. Creating a family-friendly work environment and an onsite community is a major focus. With onsite daycare, maternity leave top-up and the option of flexible work schedules, Sunnybrook understands the importance of helping our employees balance work and family commitments. Parental top-up is also available for new fathers and adoptive parents, as well as a convenient daycare facility at our largest campus for those returning to work.

The Life Stages Program looks at supporting staff from being a student to parenthood to retirement. Commonly requested areas include staff concerned about elderly parents, those financing their first home purchase or paying their children’s university tuition feeds. We need our staff to remain safe, healthy and well. A range of safety programs and annual wellness options, including two 24/7 fitness centres, help us to look after our staff so they, in turn, can look after our patients and their families when it matters most. Just realizing that you can have fun at work is important. Hospital basketball, soccer and hockey teams build spirit, as do staff barbeques and an annual golf tournament. Our Restorative Lunch Break focuses on something entirely non-medical, like making chocolate, or gardening tips, with the goal of recharging your batteries. Spiritual care is just as important for many employees, and Sunnybrook has a Muslim prayer room, a synagogue and a chapel. Retaining the country’s best employees is linked with encouraging each and every staff person to live and grow their career at the hospital. The Sunnybrook Leadership Institute develops and supports emergent, experienced and expert leaders across

Photo credit: Doug Nicholson

Marilyn Reddick believes that creating a family-friendly work environment and an onsite community is integral to ensuring a high quality of life for staff at work and at home. the hospital. Recognizing that learning is an ongoing process, our Continuing Education Support Fund offsets the cost of education. Lastly, celebrating and recognizing excellence is key. Award programs, like the Schulich Awards for Nursing and Clinical Excellence, or the Bertin Awards for service and clerical staff, recognize staff helping others above and beyond what is expected. As well, daily Sunnybrook Moments certificates are presented to staff making a difference in the lives of patients and families. Caring for our caregivers is part of our culture, it builds staff resiliency

to work in this challenging but rewarding work environment. Every day, I’m proud to come to work at Sunnybrook. I tell people that I have the best job. I have the privilege of supporting people who do amazing things to H save lives. ■ Marilyn Reddick is Vice President, Human Resources and Organizational Development at Sunnybrook Health Sciences Centre in Toronto, which has been named as one of Canada’s Top 100 Employers for six years straight.

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Trillium Gift of Life Network is enhancing physician leadership in organ donation, a practice that has contributed to recent improvement in performance in the United Kingdom and Australia. Trillium Gift of Life Network: Regional Medical Leads Chief Medical Officer of Health, Dr. Sonny Dhanani: The Hospital for Sick Children, Children’s Hospital of Eastern Ontario Dr. Eli Malus: Thunder Bay Regional Health Sciences Centre, Lake of the Woods District Hospital, Bluewater Health, Cambridge Memorial Hospital, Chatham-Kent Health Alliance, Grand River Hospital, Guelph General Hospital, St. Mary’s General Hospitals, Windsor Regional Hospital, University Health Network, Leamington District Memorial Hospital Dr. Ian Bell: Southlake Regional Health Centre, Muskoka Algonquin Healthcare, Collingwood General and Marine Hospital, Brant Community Healthcare System, London Health Sciences Centre, Niagara Health System, Sault Area Hospital, Grey Bruce Health Services, Huron Perth Healthcare Alliance, St. Thomas Elgin General Hospital, Woodstock Hospital, Norfolk General Hospital Dr. Andrew Healey: St. Michael’s Hospital, Mount Sinai Hospital, St. Joseph’s Health Centre Toronto, Trillium Health Partners, William Osler Health Centre, Halton Healthcare Services Corporation, Joseph Brant Memorial Hospital, Georgian Bay General Hospital, Hamilton Health Sciences, St. Joseph’s Healthcare Hamilton, Headwaters Healthcare Centre Dr. Karim Soliman: Humber River Hospital, Lakeridge Heatlh, Mackenzie Health, Markham Stouffville Hospital, North York General Hospital, Rouge Valley Health System (Ajax & Centenary), Sunnybrook Health Sciences Centre, The Scarborough Hospital, Toronto East General Hospital, Orillia Soldiers Memorial Hospital, Royal Victoria Hospital, Timmins and District Hospital Health Sciences North, Kirkland and District Hospital, St. Joseph’s General Hospital Dr. Mike Hartwick: Brockville General Hospital, Cornwall Community Hospital, Kingston General Hospital, University of Ottawa Heart Institute, The Ottawa Hospital, Pembroke Regional Hospital, Peterborough Regional Health Centre, Queensway Carleton Hospital, Quinte Healthcare Corporation, Hopital Montfort, Northumberland Hills Hospital, Ross Memorial Hospital, North Bay Regional Hospital www.hospitalnews.com

Focus

Physicians engaged to lead on organ donation in Ontario By Leona Hollingsworth

rgan and tissue donation benefits society as a whole. It gives a second chance at life to patients waiting for transplantation and positively contributes to the lives of their families and friends. It also is a source of comfort to many donor families as they grieve the loss of a loved one. Trillium Gift of Life Network (TGLN), the agency charged with coordinating the donation and transplant system in Ontario, is enhancing physician leadership in donation, a practice that has contributed to recent improvements in performance in the United Kingdom and Australia. Spain, a world leader in donation, touts physician leadership and accountability as key components of their system. Hoping to replicate the success of these international models, TGLN has appointed specially trained critical care physicians to support donation in Ontario hospitals. Five Regional Medical Leads will form the basis of a network of expertise, providing education to physicians and assisting with adoption of donation best practices, offering clinical and administrative support and ensuring that every opportunity to save lives is identified and appropriately pursued. For physicians inside hospitals where a potential donation case is not a regular occurrence, the Medical Leads are more experienced peers available to them for consultation and advice. “One in four Ontarians is now a registered donor, the landscape is shifting,”

says Ronnie Gavsie, President and CEO of Trillium Gift of Life Network. “We have to ensure that families are given the opportunity to honour their loved ones’ donation wishes or make the choice on their loved ones’ behalf to save lives. By increasing the number of physicians formally engaged in organ and tissue donation within Ontario hospitals, we are building a positive culture of donation in the province.”

Trillium Gift of Life Network has appointed specially trained critical care physicians to support donation in Ontario hospitals. The five Regional Medical Leads were chosen because of their demonstrated interest in and commitment to organ and tissue donation. They report to TGLN’s Chief Medical Officer and are responsible for improving the process of donation within their assigned group of hospitals. Donation performance data, by hospital, is updated quarterly on the Trillium Gift of Life Network website: www.giftoflife.on.ca. The next phase in enhancing Ontario’s organ and tissue donation program will

identify donation physicians to champion donation within their individual hospitals. Hospital Donation Physicians (HDP), are expected to be in place throughout the province by spring 2015, will promote a culture of donation inside their hospital. “When donation is a possibility, we want to make sure we offer grieving families everything they need to take advantage of the opportunity to let their loved one live on, as part of a respectful approach to end of life care,” says Dr. Sonny Dhanani, Chief Medical Officer of Donation for TGLN. “These physicians are shepherds of the process, collaborating with donation teams and sharing expertise to help save lives.” The reality is that the opportunity for organ donation is rare. While everyone has the potential to be an organ and/or tissue donor, a person is five times more likely to need an organ transplant during their lifetime than to have the opportunity to donate one. On average, only three per cent of hospital deaths occur in circumstances that may lead to organ donation, because of the need to sustain a patient on a ventilator. By enhancing the ability to recognize potential donation opportunities, Trillium Gift of Life Network, in collaboration with hospitals, will continue to increase organ H and tissue donation rates in Ontario. ■ Leona Hollingsworth is the Senior Media Relations Advisor at Trillium Gift of Life Network.

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JANUARY 2015 HOSPITAL NEWS

10 Focus

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

How our hospital is recruiting and retaining top talent By David Musyj

t Canadian hospitals, the pressure to control expenses while at the same time, recruit and retain the best talent is getting more and more difficult. One solution that Windsor Regional Hospital has implemented is working very well. It’s called “unlimited vacation”. Yes, unlimited vacation! No maximum limit! All that employees need to do is receive prior approval, as they always did, from their direct supervisor. Windsor Regional Hospital offered this concept to its 300 non-unionized staff over three years because it was faced with two large issues. First, employees with plenty of vacation time coming to them did not take all of their entitlement. Typically, an employee’s vacation entitlement is directly tied to years of service. As years of service increase, so does vacation. This can be a problem since people need vacations to recharge and remain productive. Often people did not take their full entitlement in order to have a reserve number of paid days off in case of an emergency. They did not want to get into a position where a family issue or a special vacation opportunity arose and their entitlement had run out. The benefit you’re going to get from that employee coming back to the work envi-

bare minimum vacation entitlement. This generally was far less than they were receiving from their former employer. We could not offer them more because individuals who worked with us for years would not be pleased if a new member received more vacation than they received when they were hired.

HOSPITAL NEWS JANUARY 2015

Initially, our unlimited vacation policy evoked skepticism. Critics said it couldn’t be done at a hospital and that only “those progressive tech companies” could do it.

ronment makes it all worthwhile because, they’re going to give 110 per cent when they are back, as opposed to, “I missed it and I had to work.” Second, and just as troubling, was when we tried to recruit new talent to our team. We were stuck with having to offer them a

Initially, our unlimited vacation policy evoked skepticism. Critics said it couldn’t be done at a hospital and that only “those progressive tech companies” could do it. Some employees, those who like structure and rules, also had trouble grasping the concept. They worried the new policy would be abused or that they would lose their vacation. However, the majority of em-

ployees embraced it. No one has been abusing the privilege. Now, Windsor Regional Hospital has far greater teamwork than in the past where you used to have someone state, “I get four weeks, five weeks of paid vacation. I’m taking it and I’m gone!” Now, what we are seeing is far more employees, because it’s flexible, leaning on and supporting each other; the teamwork that it is creating is phenomenal. Recruitment has been amazing. We lost a lot of strong talent in the past due to vacation entitlement. Fortunately, those days are over. The most gratifying part of our unlimited vacation policy is a letter I received from an employee. She told me her son had a track meet one afternoon. In the past, she would not attend her son’s track meet because she did not want to use a vacation day or even a half day. This time, she asked for the day off and went to the meet. At the event, her son ran and won his race. She was there to embrace him and he told her the best part of the day was that she was there to witness the race. For H myself, this is priceless. ■ David Musyj is President and CEO of Windsor Regional Hospital.

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INSIDE

SPECIAL PROFESSIONAL DEVELOPMENT SUPPLEMENT See page P12

Focus 11

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL AL EDUCATION/HUMAN RESOURCE RESOURCES ES

Making staff wellness a top priority By Donna Danyluk r. William Chen is in between surgical cases so he grabs his pager and quickly leaves the operating room. Will he make it back in time for his next surgery? His colleagues are not concerned because they know he’s just one floor down at the onsite Wellness Centre at Barrie’s Royal Victoria Regional Health Centre (RVH). If he has 10 minutes between cases he will run a mile on the treadmill and if he has a longer turnover time he will workout to an entire Insanity exercise video. Fresh, invigorated and feeling great, Dr. Chen will once again don his scrubs and head up to the operating room. “Places like this are crucial in a health centre. We have been given an amazing machine called our body and it is meant for movement. It was not made to sit at a desk all day,” says Dr. Chen, a family physician and surgical assistant at RVH. “Let me just put it out there – no one likes exercising – at least when you start. But then, as you reap the benefits, you love it more and you become addicted to it like I am.” As Dr. Chen jumps on a Stairmaster for a lighter workout, the door to the Wellness Centre swings wide open and six radiation therapists walk through. Dressed in workout gear with water bottles in hand, they methodically place blue exercise mats on the floor while a colleague turns on the television. No sitting and watching a midday talk show for these medical professionals, they are here to workout. In fact, the idea of sitting scares Greg Chapler just a little. The radiation therapist said he has read way too many articles on ‘sitting being the new smoking’ and since being re-assigned from clinical duties to treatment planning, he’s been doing nothing but sitting. When you are a radiation therapist working directly with the patients you are always in motion, but in planning you are sitting in front of a computer all day and that got me motivated to get moving,” says Chapler. “The timing was perfect for us because the Wellness Centre had just opened. We hit the jackpot when they installed the TV and we could workout to DVDs.” Dr. Chen and Chapler both have the right prescription for a healthy life. Being active for at least 150 minutes per week can help reduce the risk of premature death, heart disease, stroke, high blood pressure, certain types of cancer, Type 2 diabetes, osteoporosis and obesity, and can lead to improved fitness strength and mental health. “After I work-out here I go back to my computer feeling super good – energized, healthy and alert,” says Chapler. “When people take care of themselves they can take better take of their patients.” Standing at the back of the room taking it all in is Iris Laycock. As the Health and Wellness Coordinator with RVH’s Organizational Effectiveness department and a tri-athlete herself, seeing all this activity is a dream come true. Laycock is also a member of the Health and Wellness Committee which www.hospitalnews.com

was instrumental in ensuring RVH’s Phasee 1 Expansion was designed with room forr a staff gym. Currently 586 staff, 23 volun-teers and 37 physicians use the Wellnesss Centre on a regular basis. “The Wellness Centre opened in Sep-tember 2012 along with our expansion,, dedicating 1,000 square feet to the well-ness of RVH staff, physicians and volun-teers at no cost to them,” says Laycock.. “Just by spending a short period of timee in the Wellness Centre, participants aree rejuvenated, energized and ready to gett back to their departments to provide exceptional patient care. Even 10 minutes on the treadmill can make a huge difference.” RVH’s success is workplace wellness has not gone unnoticed. For the second year in a row RVH has been awarded a Gold level Quality Healthcare Workplace Award from the Ontario Hospital Associaeve tion (OHA) at its annual Health Achieve conference. The Wellness Centre is one ntre of the many initiatives the health centre has implemented to improve the qualityy of work life for staff. EO, Janice Skot, RVH’s president and CEO, ess, is a huge advocate for health and wellness, booking exercise time in her calendar like ned any other important meeting.“We opened eeda Wellness Centre at RVH based on feedback from staff, physicians and volunteers. ers. We want to create an inspiring, engaging ging and healthy workplace and the onsite Wellness Centre is one of the steps we’ve taken ken to achieve that goal,” says Skot. “I know w in nd it healthcare our days can be so hectic and really is a struggle to include some exercise cise or relaxation, but we hope this Wellness ness Centre will help our staff achieve their own personal goal for work-life balance. I truly ruly believe that when we are at our healthiest iest ality we can provide the best and safest quality care for our patients. This centre is their heir space for mind, body and spirit renewal, wal, H to and I fully encourage everyone at RVH make the most of it.” Last year RVH took staff wellnesss to the next level by creating the New yearNew You program. The five-week program helped staff, physicians and volunteer focus on one aspect of wellness a week, from smoking cessation, nutrition, mental health, cancer screening and prevention to the final week which focused on random acts of kindness. This month the program begins again with the theme “Make This Your Year.” Chapler has already made it his year and so how does he feel after he finishes what he calls a ‘doozy of a workout video’? “I feel super good, awake again and healthy – I have lots of energy.” The video ends and it’s time for the radiation team to get back to work. And not a moment too soon, because as they walk out the door another team arrives for their weekly exercise session. Out come the blue mats again and that H makes Laycock smile. ■ Donna Danyluk is with the Corporate Communications department at Royal Victoria Regional Health Centre (RVH) in Barrie.

1. Dr. William Chen, a Barrie family physician and surgical assistant at RVH, makes time for a workout inbetween cases. 2. Iris Laycock , Health and Wellness Coordinator with RVH’s Organizational Effectiveness department and a tri-athlete herself, enjoys a workout in the Wellness Centre. 3. The idea of sitting all day scares radiation therapist Greg Chapler, so he makes a point of heading to the on-site Wellness Centre at Royal Victoria Regional Health Centre for a workout at least a couple times a week. JANUARY 2015 HOSPITAL NEWS

INSIDE 12 Focus

SPECIAL PROFESSIONAL DEVELOPMENT SUPPLEMENT See page P12

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Students as agents for change through quality improvement By Florentina Teoderascu few years ago, a pediatric patient in the intensive care unit at The Hospital for Sick Children (SickKids) in Toronto was inappropriately treated for low potassium because of a mislabelled blood specimen. Fortunately, frontline staff identified this error and the patient suffered no adverse consequences. This incident created longlasting impact, providing an excellent opportunity for a quality improvement (QI) intervention at the hospital, which treats more than 215,000 children every year. The lessons learned following this incident made a difference. And isn’t that why we enter medicine, to make a difference? In this situation, making a difference meant optimizing health care processes in order to recognize the potential for medical errors before these risks ever become a reality. The concepts of improving patient safety are something I studied through the Institute for Healthcare Improvement (IHI) Open School. I joined the IHI Open School Chapter at the University of Toronto shortly after starting medical school and I was fortunate to become involved with this quality improvement project at SickKids. Quality improvement work in healthcare, I learned, reflects the collective efforts of interprofessional teams, and aims to evaluate current processes, identify areas requiring improvement, and set forth initiatives to improve safety, efficiency, and overall patient satisfaction. The IHI recognizes the importance of QI skills and knowledge among young health care professionals, and provides opportunities for students of all health professions to participate in QI work through practical experiences, workshops, seminars, and online courses.

The motivation to improve

As Team Leader on the QI project at SickKids, I collaborated with the quality improvement and clinical teams, and led an interprofessional team composed of medicine, nursing, and engineering students. We aimed to reduce the rate of mislabelled specimens in the Pediatric Intensive Care Unit (PICU) and the Cardiac Critical Care Unit (CCCU) by implementing sustainable measures for preventing these errors in the future. Statistically, the rate of mislabelled specimens at the time of the SickKids incident was extremely low given the volume of products sent to the lab. (Providers could send more than 7,000 products to the lab in a given month.) However, each incident of a mislabelled specimen had the potential to cause devastating effects on the pediatric patient, their family, and the entire health care team. The enormous impact of a preventable error served as the primary motivator for our efforts to improve overall patient safety. The initial step of the project involved analyzing safety reports from previous years. The monthly incidence of mislabelled specimens was more than twice the hospital target. After careful examination of the process, our team identified that the root cause of the problem was that multiple staff members were involved in the blood collection process. In order to effectively address this issue, we recognized that frontline staff engagement was vital for implementing sustainable change.

From idea to improvement

A multidisciplinary Mislabelled Specimen Team was assembled. Using input and support from frontline clinical staff, we

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Medical student Florentina Teoderascu poses with the storyboard outlining her award winning quality improvement project at The Hospital for Sick Children. designed the One-Person-Process (OPP) – a standardized work protocol in which the blood collection process would be carried out by one person, from start to finish. We aimed to reduce the rate of mislabelled specimens from four specimens to two within a 12-month time period, our ultimate goal being to reduce mislabelled specimen to zero.

Quality improvement work in healthcare, I learned, reflects the collective efforts of interprofessional teams, and aims to evaluate current processes, identify areas requiring improvement, and set forth initiatives to improve safety. We then transitioned to testing changes on a small scale using Plan-Do-Study-Act (PDSA) cycles, part of the Model for Improvement methodology that IHI uses to guide improvement. The PDSAs involved implementing a department-wide One-Person-Protocol education program, studying adherence to the protocol after program completion, investigating reasons for which the program did not reach 100 per cent success, and implementing changes to the patient labelling system in order to address the limitations of our protocol. Our outcome measurements in the project included the number of monthly mislabelled specimens and the frequency of blood collections using the OPP protocol. At the end of six months, the number of mislabelled specimens decreased by 50 per cent, and the frequency of blood col-

lections successfully completed by one person increased by 32 per cent. This improvement project taught me that engagement of frontline staff provides a fertile climate for improving quality and patient safety. In addition, staff-driven solutions, peer-to-peer education, and ongoing evaluations are powerful tools for generating change. I plan to continue to pursue my passion for QI and patient safety at the University of Toronto as project coordinator for QI initiatives at various Toronto-based hospitals. I recently joined the QI committee for a student-run primarycare community clinic in Toronto, which focuses on addressing underserved populations. I am hoping to further develop my QI skills throughout medical school and to continuously partake in opportunities that will strengthen my ability to deliver effective care to future communities.

Where to go from here?

Attending the IHI 26th Annual National Forum on Quality Improvement in Health Care in December 2014, an international conference that brings together thousands of health care professionals, showed me that improving the patient experience, reducing medical errors, and enhancing the level of work satisfaction experienced by health care professionals serve as motivators for change all across the globe. It is not enough for students to recognize health care challenges. Students need to be empowered with the tools and support necessary to effectively address these limitations. Partaking in quality improvement education is a crucial first step towards delivering the health care changes H needed for a better tomorrow. ■ Florentina Teoderascu, BHSc(Hon), MD Candidate University of Toronto, Faculty of Medicine. www.hospitalnews.com

THE 13TH ANNUAL

Professional Development & Education SUPPLEMENT

Professional Development and Education

Dementia Care:

Third edition of training in Gentle Persuasive Approach launched By Sarah Shields

cquiring the proper form of care for a loved one living with dementia can seem overwhelming and often times hopeless. All methods of rehabilitation are not created equally, which is why finding experienced, compassionate, and effective health care providers is an essential step on the road to a better quality of life for all. The Gentle Persuasive Approach (GPA®) in Dementia Care seeks to prepare health care workers with the knowledge, understanding, and skill to deliver person-centered dementia care through interactive hands-on training. GPA has been a staple at Hamilton Health Sciences since 2010 when the Centre for Healthcare Optimization Research and Delivery (CHORD) funded the education of all clinical and support staff at the Juravinski and Hamilton General hospitals. To date over 1,600 HHS employees have completed the GPA program. “Staff at our hospital site have participated in GPA workshops for 10 years now,” says Esther Coker, clinical nurse specialist, Medically Complex Care, St. Peter’s Hospital, Hamilton Health Sciences. “It was very rewarding at our recent GPA Recharged sessions to hear staff, who attended a prior GPA workshop, describe the impact of their ongoing practice of GPA and its relevance in their daily care

of patients. Many spoke of being able to enter the world of their patients, look beyond the behaviors they were seeing, and respond to the patients’ underlying emotions, such as loneliness and fear. They gave examples of validating these feelings, rather than dismissing them, and then went on to explain how they joined in their patients’ reality and often successfully redirected them before their behaviors escalated.” The Advanced Gerontological Education department (based at St. Peter’s hospital) is getting set to launch the 3rd Edition of training in 2015 called, Gentle Persuasive Approach to Dementia Care: Supporting Persons with Responsive Behaviors. The 3rd Edition of GPA is a comprehensive program offering educational training for health care workers on personhood, brain changes associated with dementia, communication skills, and behavior management techniques. Case studies also provide participants with an opportunity to apply their new skills to respond quickly and effectively to challenging behaviors. The updated program features streamlined manuals and education tools for health care providers – including whiteboard animations, updated techniques photos, new video demonstrations, supportive graphics and visuals, concise module summaries, embedded video clips and a number of additional support tools. Al-

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To learn more, or to register now, go to www.oha.com/conferences.

HOSPITAL NEWS JANUARY 2015

though the GPA program has undergone multiple updates since its first introduction, the goal of the program remains the same: assist care providers to develop confidence in their ability to provide compassionate and safe dementia care during a patients’ behavioral episodes. “The introduction of GPA to the acute care setting at Hamilton Health Sciences has significantly increased the confidence and competence in our staff when caring for patients with dementia and/or responsive behaviors,” says Karen Robinson, clinical manager, Oncology and Hematology, Juravinski Hospital Cancer Centre, Hamilton Health Sciences. “Our staff have had the opportunity to

learn how to manage these behaviors in a respectful and caring way and use fewer physical or mechanical restraints, whenever possible. The new modules have also introduced discussions involving patients suffering with acute delirium. Based on our staff feedback, I am confident this program has provided our staff with the knowledge and tools required to support challenging behaviors and provide an appropriate plan of care to provide the best patient outcome.” For further information on GPA and the launch of the 3rd Edition, please visit www. H ageinc.ca. ■ Sarah Shields is a Public Relations Specialist at Hamilton Health Sciences.

Succeeding swiftly with the help of George Brown College secured a full-time position as Medical Like others who have followed one of Administration Assistant to a cardiologist the many paths available under the at TGH. Continuing Education umbrella at George “The courses gave me skills I wouldn’t Brown, Candice Tardiff started the have had otherwise,” Candice says. “They Medical Office Assistant Certificate with prepare you. I use the terminology and the intention of broadening her skill set transcription skills every single day.” and launching a new career. At the time, Today, Candice couldn’t be more she was working as a receptionist at a vet pleased with the way things turned out clinic but felt stuck. because she loves the autonomy and “In the vet world, it’s very hard to responsibility of move up,” her new career. she says. “When I “You’re either “ ... once I finished the finished the a receptionist, certificate, I a technician or certificate, it just threw thought I’d be the doctor, and I me years ahead to what I doing casual didn’t want to be work, filling in a technician or wanted to do.” for people or the doctor.” doing temp jobs When she was for years before midway through I could actually get somewhere. But it the certificate requirements, Candice seems that, once I finished the certificate, started volunteering at Toronto General it just threw me years ahead to what I Hospital (TGH). Soon after, she picked up wanted to do. I didn’t think that, right paid shifts at a few of the hospital’s clinics away, I’d be someone’s medical assistant. and quickly became a ward clerk. I never thought that that would happen Candice graduated in November 2013 for me. I definitely love where I am now.” and, by February 2014, she had already

To learn more about the Medical Ofﬁce Assistant Certiﬁcate, visit coned.georgebrown.ca/health. www.hospitalnews.com

Professional Development and Education

Simulation is revolutionizing education How CAMH is leveraging simulation-based education to address mental health and addiction care By John Gilson

he treatment of mental illness and addiction is an important issue in the Province of Ontario, directly or indirectly affecting one in five residents. The challenge may seem outright daunting, but one hospital – the Centre for Addiction and Mental Health (CAMH) – is creatively tackling this issue through simulation. In the process, CAMH is positioning itself as a leader in mental health training.

Medical Psychiatry Alliance

CAMH is scheduled to build its first simulation centre in 2020. The new simulation centre will help students and professionals learn and test new approaches to treating physical and mental illness using simulated patients in realistic scenarios. The new simulation centre is part of a larger initiative, called the Medical Psychiatry Alliance, which seeks to help up to 500,000 people who are either at risk of, or living with, both physical and mental illnesses. CAMH, along with The Government of Ontario, The Hospital for Sick Children, Trillium Health Partners, the University of Toronto and a private donor, are providing a total of $60 million in funds towards the Medical Psychiatry Alliance.

Dr. Daniel Blumberger, Medical Head of Temerty Centre for Therapeutic Brain Intervention at CAMH, poses with a simulation 'manikin'. Dr. Ivan Silver, Vice-President of Education at CAMH says, “As far as we are aware, we will be building the first simulation centre and program worldwide focusing specifically on enhancing mental

health and addiction care and education. We expect that everyone involved in care delivery, including staff, students, faculty, clients and their families will benefit from this innovative learning modality.”

The CAMH simulation program in general is seen as a critical element of the Medical Psychiatric Alliance. Continued on page P6

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JANUARY 2015 HOSPITAL NEWS

Professional Development and Education

New training program highlights unique needs of older patients By Todd Leach and Kelly Connelly new geriatric training course developed by The Michener Institute for Applied Health Sciences in partnership with Baycrest Health Sciences aims to prepare the next generation of health care professionals for the unique needs and care challenges of older patients. Working With Seniors: A Primer for Healthcare Providers is available to students enrolled in Michenerâ&#x20AC;&#x2122;s applied health sciences programs who go on to careers in fields such as diagnostic imaging, nuclear imaging, medical radiation and respiratory therapy. The program brings together Michenerâ&#x20AC;&#x2122;s expertise in responsive curriculum design and development with Baycrestâ&#x20AC;&#x2122;s world-renowned expertise in geriatric medicine, care and research â&#x20AC;&#x201C; to create a one-of-a-kind education experience for young professionals embarking on careers in healthcare. â&#x20AC;&#x153;As an academic partner of the Ministry of Health and Long-Term Care, our mandate is to be a responsive provider of educational solutions that meet current and emerging needs within the health system,â&#x20AC;? says Maureen Adamson, President and CEO of The Michener Institute.

In 2012, the Ministry of Health and Long-Term Care developed a Seniors Strategy for Ontario, which included publication of the landmark report authored by Dr. Samir Sinha entitled, â&#x20AC;&#x153;Living Longer, Living Wellâ&#x20AC;?. The strategy was developed to prepare the provinceâ&#x20AC;&#x2122;s health system for the rising number of older patients requiring care. Currently, about every second patient admitted to hospital in Ontario is a senior. By 2034, the number of seniors in Ontario will have doubled, with the expectation that the demand for healthcare among seniors will increase dramatically. Education is considered an important part of the solution. â&#x20AC;&#x153;This has been a truly gratifying partnership utilizing our mutual strengths,â&#x20AC;? says Dr. David Conn, Vice-President of Education at Baycrest, and Co-Chair of the Canadian Coalition for Seniorsâ&#x20AC;&#x2122; Mental Health. â&#x20AC;&#x153;Together weâ&#x20AC;&#x2122;ve created a leading educational product that will help cultivate the clinical knowledge and skills required of health professionals caring for seniors.â&#x20AC;? The intensive week-long program â&#x20AC;&#x201C; now incorporated into Michenerâ&#x20AC;&#x2122;s summer semester â&#x20AC;&#x201C; combines flexible learning formats, such as e-learning modules, with simulation experiences including interact-

Practice for CHIMAâ&#x20AC;&#x2122;s 5H[PVUHS *LY[PĂ&#x201E; JH[PVU ,_HT with online learning college Sydney, NS Âś 7YLWHYPUN MVY [OL 5H[PVUHS *LY[PĂ&#x201E; JH[PVU ,_HT 5*, [V LHYU [OL */04 JYLKLU[PHS JHU IL PU[PTPKH[PUN )\[ H ZJOVVS PU :`KUL` 5V]H :JV[PH OHZ I\PS[ H TL[OVK [V OLSW `V\ WYLWHYL! [OL 4VJR ,_HT ;OL *LU[YL MVY +PZ[HUJL ,K\JH[PVU *+ ,+ PZ [OL JYLH[VY VM [OL Ă&#x201E; YZ[ /LHS[O 0UMVYTH[PVU 4HUHNLTLU[ /04 WYVNYHT H]HPSHISL LU[PYLS` VUSPUL ;OLPY `LHY KPWSVTH WYVNYHT PUJS\KLZ [OL TVJR L_HT HUK P[ OHZ WYV]LK PU]HS\HISL MVY Z[\KLU[Z ,]LY` *+ ,+ /04 Z[\KLU[ ^OV JOHSSLUNLK [OL 5*, L_HT [OPZ 5V]LTILY OHZ Z\JJLZZM\SS` HJOPL]LK [OLPY */04 KLZPNUH[PVU Â¸;OL TVJR L_HT OLSWLK TL PKLU[PM` HYLHZ MVY PTWYV]LTLU[ HUK P[ WYLWHYLK TL PU OHUKSPUN H NY\LSSPUN MV\Y OV\Y L_HT ^P[OV\[ YLZVY[PUN [V WHUPJ Âš ZH`Z (ILS .HSHWH[L */04 *+ ,+ /04 NYHK\H[L Â¸0 ^HZ ZV OHWW` [V ZLL [OL LTHPS [OH[ ZHPK 0 WHZZLK ;OHUR `V\ *+ ,+ Âš (UV[OLY Z[\KLU[ 3H\YH (UKLYZVU ZH`Z Â¸B;OL TVJR L_HTD ^HZ HU L_[YLTLS` ]HS\HISL SLHYUPUN [VVS ILJH\ZL P[ HSSV^LK TL [V PKLU[PM` T` ^LHRLY Z\IQLJ[ HYLHZ ZV 0 ^HZ HISL [V MVJ\Z T` Z[\K`PUN VU [OVZL HYLHZ [OH[ ULLKLK PTWYV]LTLU[ Âš ;OL TVJR L_HT PZ ZV LMMLJ[P]L PU MHJ[ [OH[ *+ ,+ÂťZ ZWPUVMM ^LIZP[L 3LHYU0[6USPUL5V^ JVT 3065 PZ UV^ VMMLYPUN [OL ZHTL 4VJR 5*, ,_HT [V HU`VUL WYLWHYPUN MVY [OL YLHS [OPUN ( UVTPUHS LU[Y` MLL NYHU[Z `V\ HJJLZZ [V H ZPT\SH[PVU L_HT ^P[O X\LZ[PVUZ [OH[ HYL ZPTPSHY [V [OL 5*, L_HT :L]LYHS [PTLK H[[LTW[Z HYL PUJS\KLK NP]PUN `V\ WSLU[` VM YLOLHYZHS PU HK]HUJL VM `V\Y JLY[PĂ&#x201E; JH[PVU H[[LTW[ >P[O [OL Z\JJLZZ VM [OPZ Ă&#x201E; YZ[ Â¸SLHYU P[ VUSPUL UV^Âš WYVQLJ[ *+ ,+ PU[LUKZ [V L_WHUK [OLPY 3065 WYVMLZZPVUHS HUK WLYZVUHS KL]LSVWTLU[ VMMLYPUNZ PU [OL UL^ `LHY H[ www.learnitonlinenow.com

HOSPITAL NEWS JANUARY 2015

Michener student wears an aging simulation suit, which restricts mobility and vision, to appreciate the experiences of frail seniors. ing directly with seniors, observing and participating in scenarios, and wearing an innovative frail aging simulation suit. The curriculum is designed to provide students with first-hand perspectives and experiences of the challenges that seniors often encounter during medical appointments and other interactions with health care professionals.

The curriculum is designed to provide students with firsthand perspectives and experiences of the challenges that seniors often encounter during medical appointments and other interactions with health care professionals. â&#x20AC;&#x153;The competency framework for this new program starts with the seniorsâ&#x20AC;&#x2122; voices,â&#x20AC;? says Gillian Nichol, Director of Continuing Education and project lead with the Working with Seniors program at Michener. â&#x20AC;&#x153;This really is a â&#x20AC;&#x2DC;patients firstâ&#x20AC;&#x2122; approach, and respects the opinions and perspectives of seniors as experts in their own care, reinforcing the whole concept of â&#x20AC;&#x2DC;nothing about me without meâ&#x20AC;&#x2122;.â&#x20AC;? Members of a seniorsâ&#x20AC;&#x2122; advisory council from a local community health centre were active participants in the programâ&#x20AC;&#x2122;s development. Members from a seniorsâ&#x20AC;&#x2122; acting troupe, known as ACT II, also played an important part â&#x20AC;&#x201C; role-playing real-world patient and care provider scenarios for students to both observe and engage in directly.

Results from the first cohort of 270 fulltime students who took the pilot program last summer were encouraging. Nearly all of the participants reported that their knowledge and understanding of older adults had improved considerably. This included greater awareness for respecting seniorsâ&#x20AC;&#x2122; autonomy, creating senior-friendly environments, and being adaptive and responsive to the individual needs and wishes of seniors. â&#x20AC;&#x153;It was an eye-opening experience,â&#x20AC;? says Elizabeth Pickles, a Medical Laboratory Sciences Program student, now in her clinical placement in Ottawa, who was among the first cohort of students to go through the program. â&#x20AC;&#x153;The scenarios were particularly valuable as they gave me a chance to apply what I learned in a simulated setting; a hands-on experience working directly with seniors that I wouldnâ&#x20AC;&#x2122;t have had an opportunity to do otherwise. It reinforced the importance of customizing your approach around the needs of each patient. Something as simple as providing instructions one step at a time for someone who may be in pain, or have mobility or vision challenges, could go a long way to making them feel comfortable and have a positive impact on their clinical experience.â&#x20AC;? Michener has now integrated the program permanently into its curriculum so that all students will enter their chosen career fields with basic competencies in working with seniors in a health care setting. Michener and Baycrest hope to extend the curriculum to Michener graduates and general entry-to-practice health care proH fessionals in the near future. â&#x2013; Todd Leach works in communications at The Michener Institute for Applied Health Sciences, and Kelly Connelly in communications at Baycrest Health Sciences. www.hospitalnews.com

Professional Development and Education

Online 2-Year Diploma Program 1st HIM Diploma Program in Canada available entirely online!

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Excellent gateway program for individuals who are not currently working in healthcare

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The Health Information Management program at the Centre for Distance Education provides the foundational education pathway from no related experience to HIM professional for any student regardless of education and experience. Certification as an HIM professional requires successfully challenging the National Certification Exam. We not only cover the cost of this exam, but also provide a mock exam with unlimited attempts to better prepare our students. In addition, CHIMA Student Membership is part of enrollment. In fact, we are extremely proud to announce that in November of 2014, each of the Health Information Management students who challenged CHIMAs National Certification Exam was successful! These students can now use the credential of CHIM after their name. Sandra Cotton, CD-ED HIM Program Co-Ordinator, is rightly very proud of her students’ success. “These students worked hard for 2 years to achieve this status”, she says. “Their success reflects positively on their dedication to their schoolwork, time management and organizational skills.”

I am m so pro proud to be a graduate of the Health InformaManagement (HIM) program at the Centre for tion Manag Distance Education (CD-ED). Along with the exceptional education received at CD-ED, I gained valuable practical experiences and professional connections through the required professional practices. The administration and instructors were interminably dedicated in supporting and understanding me in every possible way they could in furthering my education. The hybrid design of the program couldn’t be more convenient. I was able to study remotely around my own schedule, while still benefiting from the practical, hands-on experience of working in a real employment setting before graduation.

“Since completion of the program, I have started a rewarding professional career in Health Information Management.”

The classes were intense at times, but knowing that it would be over in 2 years helped me to get through it one day at a time. The 25 hours per week devoted to this course were well worth it. I was adequately prepared for the National Certification Examination and I passed it. Since completion of the program, I have started a rewarding professional career in Health Information Management. Thank you to the hard-working, understanding dedicated g and d dicated instructors at CD-ED. I would strongly recommend ecommend this program to anybody. Valerie Salmon-Laylor, CHIM

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JANUARY 2015 HOSPITAL NEWS

Professional Development and Education

Simulation Continued from page P3 The program enables: • The practice of the use of new screening and diagnostic tools exploring complexities of mental and physical symptomology and treatment; • Specialized clinical training for medical students and interprofessional teams; • Research exploring effective clinical and teaching practices; • Impact curriculum development and innovation at the medical school; and • Supporting innovative practices in the delivery of psychiatrics care at home.

Working with SIM-one

CAMH hired SIM-one in 2013 to conduct a needs analysis for the construction of a new simulation centre that will contain flexible and multi-purpose space, in a safe and welcoming learning environment. During this consulting work, SIM-one provided analysis and developed an initial strategy for developing the functional aspects for the simulation programs and centre, including identifying the initial approaches and services it will support. "It was an exhilarating experience to bring a consultation team to support CAMH's groundbreaking simulation program," says Dr. Bruce Ballon, Director of Education, SIM-one. "CAMH's simulation program will be interprofessional and inclusive of family and patients in its educational endeavours. With CAMH fully embracing the values of collaboration, communication and innovation, this pro-

gram has great potential for international impact."

A creative approach to simulation

While the addition of an interprofessional simulation centre is considered key in CAMH’s strategic plan to develop interprofessional learning spaces, the hospital sees simulation more broadly. “I see a real potential for simulation to improve the student experience at CAMH. Our students and faculty need to see what they are doing, both as learners and as educators. By having a culture where critical reflection and meaningful feedback are seen as essential elements in the learning process, we hope our students have an enhanced experience here,” says Dr. Nirula, who leads a diverse education team responsible for faculty development, knowledge exchange, innovative educational curriculum development, and simulation training. Even though CAMH currently lacks a brick-and-mortar sim centre, the hospital makes the most of its resources. For example, CAMH employs a distributed model that makes maximum use of in situ simulation through a number of video observation units integrated across a number of clinical areas within the hospital. The hospital is currently installing a video observation system (VOS) throughout its facilities. These units provide the ability to remotely observe, supervise and control sessions for the purpose of education, supervision and

training, leading to advancements in client care, improvements in the quality of supervision and enhancements in interprofessional collaboration. When constructed, CAMH’s simulation centre will act as a central hub to the distributed model of the video units in situ. Within the physical simulation centre, the hospital will provide a safe learning environment to mirror clinical settings (e.g., enable the practice of complex skills such as team-based code white responses, CPR, etc.) while also being highly flexible to configure the space to support the multitude of communication-based training programs.

The new simulation centre will help students and professionals learn and test new approaches to treating physical and mental illness using simulated patients in realistic scenarios.

Spreading its sim reach

CAMH has become much more active in the world of simulation. Last year, the hospital hosted its inaugural SIM Week, a weeklong event that featured Israeli simulationist Dr. Amitai Ziv as the primary pre-

senter. This successful event generated a lot of internal interest at CAMH on the role of simulation in quality patient care and safety. SIM Week-related events focused on consultations across a variety of areas, such as geriatrics psychiatry, Access CAMH, and interprofessional education (IPE), and were presented at different venues. View Dr. Ziv on the CAMH Education Blog: http://www.camheducation. ca/2013/12/12/simweek_videos/ CAMH is also providing simulationbased training to external clients, including its Preventing and Managing Aggressive Behaviour (PMAB) program. The course features online modules, a 1-day intensive workshop, simulation scenarios and a debrief.

Revolutionizing education

Dr. Silver is very excited about the future: “Learning through simulation provides unique and profound opportunities for all participants to be observed and to receive feedback on so many aspects of the important work that we do day to day with our clients and their families. I am confident that our new simulation training program, the use of distributed video observations rooms throughout our campus and the building of the simulation centre will revolutionize education and knowledge exchange at CAMH.” For more information on CAMH Education, please visit http://www.camh.ca/ en/education. ■ H John Gilson works in communications at SIM-one.

Emergency Management for Health Care Certiﬁcate

Education in Social and Community Services

Focused speciﬁcally on emergency planning and preparedness for hospitals and health care institutions, the Ontario Hospital Association’s new Emergency Management for Health Care Certiﬁcate is an emergency management credential recognized in health care settings in both Ontario and beyond. www.oha.com/EmergencyManagement

Do you want to serve your community or your country? Protect the public or come to the aid of people in need? Whatever your motivation might be, Humber’s School of Social and Community Services goes above and beyond education with critical work placements, extensive industry partnerships and a solid reputation in the fields of criminal justice, human services and fire services. A career in human services is about supporting people who may have experienced a crisis or who are considered at-risk or marginalized in some way. Humber has the faculty, labs and real-life work experience that students need. “Our instructors have a wonderful combination of life experience and academic preparation,” says Gina Antonacci, the school’s dean. Using the latest in digital technology, FAAC simulators create life-like situations to train students in driving skills and conflict resolution. A 180-degree conflict-resolution simulator helps build skills for those students who will need to deal professionally with people in crisis. The school has also launched a new postgraduate certificate in Addictions and Mental Health. “Our graduates go out there and do their best in a way that says to the community, I’m here to support, engage, help and grow,” says Antonacci. Students in the program acquire best practice skills for working in the field. Humber graduates could find employment across a wide variety of social service settings. Visit communityservices.humber.ca

HOSPITAL NEWS JANUARY 2015

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Professional Development and Education

RN/RPNs upgrade skills to better care for those suffering from mental health issues

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1 Smetanin et al. (2011). The life and economic impact of major mental illnesses in Canada: 2011-2041. 2 Statistics Canada (2013). Canadian Community Health Survey â&#x20AC;&#x201C; Mental Health

ADDICTIONS & MENTAL HEALTH POSTGRADUATE CERTIFICATE

The Addictions and Mental Health postgraduate program at Humber will empower you with the knowledge and skills you need for a rewarding career. Learn to deliver responsive, culturally relevant, client-centered assessment and treatment to diverse individuals and groups. Practice ways to effectively collaborate and transform lives as a valuable part of a professional support team.

communityservices.humber.ca

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JANUARY 2015 HOSPITAL NEWS

Professional Development and Education

Training future health care providers By Jennifer Garland t’s a busy night at Campbellford Memorial Hospital and Bachelor of Science in Nursing degree program student Rebecca Butler is gaining some valuable hands on experience caring for patients in the hospital’s special care unit. Butler is in her second last semester as a nursing student at the Trent/Fleming School of Nursing based at Trent University in Peterborough. To gain her degree in Nursing, she must complete a 300 hour placement that gives her, under the guidance of a preceptor, an opportunity to integrate, synthesize and evaluate nursing knowledge and skills in a real setting.

I like to teach and help people and this is good exposure for the student. I want this to be a positive experience so they can look forward to their job as a nurse. “Mentorship is hugely valuable in nursing and is one of the most important aspects in learning how to be a nurse. Nothing replaces having the ability to ask

questions in the moment as things unfold, and having people support me in building my confidence in making decisions and having the confidence to make clinical decisions that are in the best interests of our patients. This is not something you learn reading in a book,” says Rebecca. Rebecca is particularly appreciative of the investment of time and expertise her preceptor Jennifer Woods, a Registered Nurse at Campbellford Memorial Hospital is making in her future. “The nursing team here works very hard. I am grateful for the time Jennifer and the other nurses are taking to teach me when they already have full schedules. They are helping me to learn so I can be a better nurse,” she says. Rebecca also values the breadth and depth of experience she is gaining by working in a smaller, team-oriented environment offered by Campbellford, where everyone pitches in to support each other and patients. “There are a lot of benefits of being in a smaller hospital. It is a more personal environment. You get to know people better, do more and see more. People are very welcoming at Campbellford. People seek me out when there is something different happening so I can experience new things. I also appreciate the opportunity to support others and contribute when things get a little crazy,” says Rebecca. For Jennifer the experience is equally gratifying. “I know how important it is to have a good experience as a student. As a preceptor, we learn a lot about our-

See Public Health from a New Vantage Point The Schulich School of Medicine & Dentistry at Western University now offers a Master of Public Health (MPH) Program. This interfaculty, professional program offers you an innovative educational experience unlike any other across North America. The 12-month, intensive, case-based program develops leaders to become agents of change, who create healthy and sustainable communities. With real-world public health cases, you will be immersed in some of the most signiﬁcant and complex public health crises that our globe has experienced and be challenged to decide on an appropriate course of action. Your previous work experience will help shape your learnings and bring a unique perspective to class discussions. This will allow you to see public health from a new vantage point. With a 12-week practicum and career placement assistance, MPH students receive the support they need to successfully achieve their academic and professional goals.

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HOSPITAL NEWS JANUARY 2015

Nursing student Rebecca Butler (left) is completing her nursing preceptor credit at Campbellford Memorial Hospital under the mentorship of Jennifer Woods, Registered Nurse (right). selves. We understand what our strengths are and we are also challenged by the questions they ask. I like to teach and help people and this is good exposure for the student. I want this to be a positive experience so they can look forward to their job as a nurse. This is an important placement as it is the last placement on their journey to become an independent nurse. We offer them guidance and support to prepare them to be independent,” explains Jennifer.

Mentorship is hugely valuable in nursing and is one of the most important aspects in learning how to be a nurse. This is an important placement as it is the last placement on their journey to become an independent nurse. “I am really proud our nursing team members, like Jennifer, who are taking the extra time and making an effort to give back or ‘pay it forward.’ We are a compassionate profession and it is heartening to see that compassion extend to each other as well as our patients with this kind of partnership and mentoring,” says Jan Raine, Chief Nursing Officer at Campbellford Memorial Hospital. A small hospital also offers the student a chance to work with a variety of patients. “Here at Campbellford, there are a wide variety of patients including cardiac, post-operative, long-term care and palliative and our students have an opportunity

to support them in terms of patient care, providing medication, doing assessments and monitoring their recovery following surgery,” Jennifer says. “Our partnership with Campbellford Memorial Hospital is one of many we have with hospitals providing clinical experience for nursing students who are required to have a certain number of clinical hours before graduation,” explains Cyndi Gilmer, Assistant Professor at Trent/Fleming School of Nursing. “These experiences are invaluable for our students. At Campbellford Memorial Hospital, students like Rebecca see the full patient experience and the complete picture of that person under their care. The whole unit typically knows who the patient is – they are a complete person with relationships that extend into the community. Our students get the real flavour of that person behind the paper and diagnosis. For example, what you read about a dying person versus what you experience with a dying person is very different. The lived experience jumps off the page and becomes a real exchange between two human beings – and that kind of experience is invaluable,” she says. “Preceptors like Jennifer are teaching students to be advocates and leaders and are helping them connect the dots in patient care. We are very fortunate to have senior nurses like Jennifer who are willing to take students like Rebecca under their wing so they can soon fly on their own, ultimately sharing their experience with the next generation of nurses,” says Cyndi. “This experience has motivated me to be a preceptor in the future and I would definitely recommend a smaller hospital like Campbellford Memorial Hospital for other students looking for a placement,” H Rebecca concludes. ■ Jennifer Garland is a Communications Consultant, Campbellford Memorial Hospital. www.hospitalnews.com

Professional Development and Education

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JANUARY 2015 HOSPITAL NEWS

P10 Professional Development and Education

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Whether youâ&#x20AC;&#x2122;re looking to learn or refresh skills or simply get an update on recent developments, consider OsgoodePDâ&#x20AC;&#x2122;s rich and diverse programs. We provide a number of non-degree seminars, certificate programs and workshops for health care professionals, including the areas of law relevant for nurses, hospital liability, privacy and information management, long-term care and mental health law.

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â&#x20AC;&#x153;This phenomenal course stimulates and encourages me to go back to my hospital to review and determine if we have the right policies and procedures in place.â&#x20AC;? Barbara Guidolin, Vice-President, Patient Services and Chief Nursing Executive, Georgian Bay General Hospital (The Osgoode Certificate in Health Law)

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â&#x20AC;&#x153;Well organized. Dynamic and knowledgeable presenters. I would recommend this to all health professionals and legal counsel who work in liability, risk management and patient safety.â&#x20AC;? Deborah Perry, Risk Management Consultant, Eastern Health (The Osgoode Certificate in Clinical Risk, Negligence and Claims Management in Health Care) â&#x20AC;&#x153;The whole program was phenomenal. Best continuing education course Iâ&#x20AC;&#x2122;ve been to in a long time.â&#x20AC;? Natalie Peladeau, Clinical Nurse Specialist â&#x20AC;&#x201C; Psychiatry, Mount Sinai Hospital Toronto, Georgian Bay General Hospital (The Osgoode Certificate in Mental Health Law)

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LEARN MORE www.mcmaster-health.ca Centre for Continuing Education | McMaster University | 905-525-9140 ext. 24321 | mcmastercce.ca

Expand your knowledge and your resumĂŠ with Professional Recognition Programs As the profession adapts to the rapidly changing delivery of health care, medical laboratory professionals are expected to keep current with the knowledge and skills necessary to perform to the highest professional standards. Whether mandated by a regulatory body, an employer, or simply personal interest, the CSMLS provides opportunities to recognize your professional development activities.

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HOSPITAL NEWS JANUARY 2015

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SPECIAL PROFESSIONAL DEVELOPMENT SUPPLEMENT Professional Development and Education P11

EXPERIENCE. WHAT’S POSSIBLE. McMaster Centre for Continuing Education

HEALTH INFORMATION MANAGEMENT Diploma HEALTH INFORMATICS Diploma HEALTH INFORMATION SYSTEMS Certificate of Completion Expand your industry and professional knowledge with our diploma and certificate programs. Enhance your skills and discover how you can take full advantage of health information technology. This is a part-time, online program that is flexible to your schedule and accessible from anywhere.

LEARN MORE Join us on April 8 for an online information session. Register and learn more about the program at www.mcmaster-health.ca or speak to one of our advisors today at 905-525-9140 ext. 24321 or 1-800-463-6223.

Centre for Continuing Education | McMaster University | 905-525-9140 ext. 24321 | mcmastercce.ca

Enhance Your Skills and Get Recognized with CSMLS CSMLS offers three programs designed to enhance and recognize your knowledge and skills. CSMLS Knowledge Certificates • Discipline-specific and interdisciplinary certificates • Three knowledge levels (basic, advanced and refresher) Professional Enhancement Program (PEP) • 60 professional development hours over two years • Can include formal courses, participation on workplace committees or publication of scientific or lab-related articles Certificate of Continuing Professional Studies (CPS) • Advanced level continuing education courses • 15 credits over 10 years required

csmls.org/enhance www.hospitalnews.com

JANUARY 2015 HOSPITAL NEWS

SPECIAL PROFESSIONAL DEVELOPMENT SUPPLEMENT P12 Professional Development and Education

New online portal to HIV education resources Serves as gateway to latest clinical research and practices By Caroline Dobuzinskis he Clinical Education and Training Program at the BC Centre for Excellence in HIV/AIDS (BC-CfE) has launched a new website that serves as an easy-to-access portal to valuable informational and scholarly resources. Created to provide educational information regarding HIV to clinicians and health care professionals in BC, the site has a wealth of free tools and information for patients and their caregivers. The BC-CfE’s Clinical Education and Training Program is designed to improve HIV/AIDS clinical care and treatment through personalized learning, tailored to the individual needs of HIV patients. The program’s website includes events and training programs available both online – such as informative videos, webinars, and online courses – and in clinical settings – such as Preceptorship programs. Training is offered to health care professionals, allied health professionals, community frontline workers and health science students throughout British Columbia and Canada. For the use of patients and their families, there are lists of resources and community-based supports in British Columbia, searchable by region. For physicians looking for accredited education in the treatment and care of those living with HIV and AIDS, the BC-CfE Clinical Education website serves as a link to the Preceptorship postgraduate program

Dr. Silvia Guillemi, Director of the BC-CfE Clinical Education and Training Program, observes a patient at the IDC clinic as Dr. Kali Gartner, a R3 Family Practice resident, looks on. at the University of British Columbia’s Department of Family Practice. Designed for family physicians and family practice residents, the program consists of rotations at the Immunodeficiency Clinic (IDC) and other related clinics at St. Paul’s Hospital. Preceptors get hands-on, specialized,

Millennials and the workplace

Paul Juniper Director, Queen’s IRC

Hospital teams are no strangers to change. Evolving technology means better diagnoses and treatments, but also the need to constantly learn about new techniques for care. Our workforce is also evolving, as boomers retire and millennials (those born between 1981-94) begin to move into management roles. What does that mean for human resource professionals? Recent studies indicate that trust, transparency and respect are key factors in recruiting and retaining these younger workers. They place great value on work-life balance and expect to move easily between jobs and companies. Their comfort level with technology is far greater than previous generations. Given millennials will make up half of the workforce by 2020, what are you doing now to create a work environment that will attract the talent required to provide optimal care to your communities? How will you minimize turnover and nurture leaders? How will you recruit the skilled employees who can evolve in concert with medical advances? Researchers are constantly developing new practices to improve care for patients. Human Resource professionals should do the same for those who use these tools. Paul Juniper is the Director of Queen’s Industrial Relations Centre (IRC), a Centre within Queen’s University that provides evidence-based and practitioner-focused programs to give human resource, labour relations and organization development professionals the skills they need to lead change. For information about IRC programs, visit irc.queensu.ca

HOSPITAL NEWS JANUARY 2015

and varied experience in the primary care of HIV patients in the IDC under the direction of an experienced HIV physician, within the primary care clinic and in elective HIV specialist clinics, the outpatient pharmacy, inpatient activities, research clinics and teaching rounds. “We are very excited to be launching the Clinical Education website as a pathway to accessible resources, educational programs, and information on the treatment of those with HIV,” says Dr. Silvia Guillemi, director of the BC-CfE Clinical Education and Training Program and assistant medical director at IDC. “HIV is now chronic, manageable illness and many HIV patients are currently treated by primary care providers. Through Treatment as Prevention, we can help to stop the spread of HIV. For this reason, and for improving the health and wellbeing of their patients, it is critical for health care professionals to stay on top of the latest research and clinical advances in treatment and care. We at the BC-CFE provide training and educational resources for family physicians and other primary care providers, ensuring patients can receive state-of-the-art care in their own communities.”

Created to provide educational information regarding HIV to clinicians and health care professionals in BC, the site has a wealth of free tools and information... The website is a valuable tool for health care professionals to stay in the know on the latest events, news and updates in HIV treatment, guidelines and research. Critical reviews of research literature on HIV are available through the IDC Journal Club. The website hosts recorded videos of various educational events, ranging from biweekly clinical rounds for hospital staff (HIV Care Rounds) to monthly public lectures featuring speakers working in the field of HIV/AIDS from various health and

medical disciplines, as well as research perspectives (Forefront Lectures). Videos of the HIV/Antiretroviral Updates, hosted by the BC-CfE on a biannual basis and open to the public, are also archived. Accredited by the College of Family Physicians of Canada, the presentations by leading local and international experts cover the latest clinical findings and research related to the management of HIV-positive individuals. Physicians and other healthcare professionals can also access online courses developed by the experts at the BC-CfE, free of charge. For physicians and nurse practitioners, the HIV Diagnosis and Management course provides an epidemiological and clinical overview of HIV treatment, and is accredited by the College of Family Physicians of Canada. The HIV Treatment Information for Support Workers is an introduction to HIV care designed for allied healthcare professionals and community workers. A new online course on interprofessional HIV care for nurses, allied professionals and community workers is under development and will be launched in spring 2015. Healthcare providers and communities affected by HIV across B.C. and Canada can access the HIV/AIDS Webinar Learning Series, which is a partnership between the Positive Living B.C. and the BC-CfE. Broadcast live every three to four months, these one-hour online sessions – offered free of charge – provide an opportunity for providers and communities in remote rural regions to access information about HIV and to interact with experts at the BC-CfE. Videos of previous webinars are also available on the website. Sign up for updates on webinars by following this link: http://tinyurl.com/clinicaledu Visit the Clinical Education website today: http://education.cfenet.ubc.ca/ For more information about any of the Clinical Education programs at the BC Centre for Excellence in HIV/AIDS, please H contact us at Education@cfenet.ubc.ca. ■ Caroline Dobuzinskis is a communications coordinator at the BC Centre for Excellence in HIV/AIDS. www.hospitalnews.com

SPECIAL PROFESSIONAL DEVELOPMENT SUPPLEMENT Professional Development and Education P13

INDUSTRIAL RELATIONS CENTRE Professional Development

Your workplace is changing . . . are you?

Like most work environments today, hospitals are dealing with constant change. New millennials in the workforce are seeking different rewards than their older co-workers, and evolving technology is changing the way we all do our jobs. How do we adapt to these shifts and build teams that foster collaboration and a patientcentered approach to care?

We offer a wide range of one-day, multi-day and custom programs that give you the skills you need to navigate through a sea of change, including:

Queen’s University Industrial Relations Centre (IRC) programs tackle that challenge head on, using evidencebased tools and hands-on activities to help you design processes and practices that result in a positive work environment and a shared vision.

■

Our facilitators bring real-world experience to the table, as well as access to mentoring beyond the classroom and valuable networking opportunities with colleagues. Make 2015 a year of positive approaches to your changing world. Visit our website to download our program planner, or contact one of our professionals to discuss how we can support you and your teams.

■ ■ ■

■ ■ ■ ■

Labour Relations Foundations Building Trust in the Workplace NEW Strategic Workforce Planning Designing Change NEW Managing Unionized Environments Building Smart Teams Mastering Fact Finding and Investigation Coaching Skills NEW To learn more about these and other programs contact us today. Call toll free 1-888-858-7838 Email irc@queensu.ca Web irc.queensu.ca

Download our Spring 2015 - Spring 2016 Program Planner at: irc.queensu.ca www.hospitalnews.com

JANUARY 2015 HOSPITAL NEWS

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P14 Professional Development and Education

Giving leaders what they need to succeed By Shamena Maharaj hen Elizabeth McLaney started in a director role at Sunnybrook Health Sciences Centre, it was an exciting â&#x20AC;&#x201C; albeit daunting â&#x20AC;&#x201C; time. â&#x20AC;&#x153;I was thrilled about starting in my new role, but with more than 10,000 staff working across three campuses I knew that it would take a while to settle in and get to know the â&#x20AC;&#x2DC;lay of the landâ&#x20AC;&#x2122;,â&#x20AC;? says McLaney, Sunnybrookâ&#x20AC;&#x2122;s Director of Interprofessional Education. â&#x20AC;&#x153;When I heard that there would be a program starting for Managers and Directors who were new to the organization, I was delighted.â&#x20AC;? A new pilot â&#x20AC;&#x201C; the Management Excellence Program (MExP) â&#x20AC;&#x201C; is underway to help managers and directors who are either new

to their roles or, (like McLaney), are new to Sunnybrook â&#x20AC;&#x201C; make a successful transition. This pilot is part of the Sunnybrook Leadership Institute, which prepares new and existing leaders to transition into their leadership role as quickly as possible. â&#x20AC;&#x153;Orientation gave me the start I needed, and I was really excited to have this added chance to connect with leaders from the various hospital departments who would be able to let us know about their processes and priorities,â&#x20AC;? McLaney adds. â&#x20AC;&#x153;I also thought it would be a great way to put names and faces together and to start to build relationships.â&#x20AC;? Key elements of the MExP program include: Self Leadership, Operations, Strategy and Leading Change, Employee and Labour Relations, Accountability and Crucial Conversations.

The Sunnybrook Leadership Institute prepares new and existing leaders to transition into their leadership role as quickly as possible. â&#x20AC;&#x153;New leaders often have to deal with interpersonal and team conflict while influencing others when emotions and stakes are high. In this program they are given the tools to effectively have these conversations in a non-confrontational way,â&#x20AC;? explains Surjeet Rai-Lewis, Organizational Development & Leadership Associate. After participating in Crucial Conversations as part of the MExP program, McLaney says that the course content

helps create a common language and framework within the organization for talking when the stakes are high. â&#x20AC;&#x153;To me, the most powerful part of the Crucial Conversations approach is acknowledging, labeling and checking in with others about the stories we create as we make sense of the world around us,â&#x20AC;? she says. â&#x20AC;&#x153;When you see someone reacting in a certain way itâ&#x20AC;&#x2122;s easy to think you know why â&#x20AC;&#x201C; to guess at their emotions or intentions â&#x20AC;&#x201C; crucial conversations provides the tools to separate facts from stories and help us to truly understand another perH sonâ&#x20AC;&#x2122;s perspective.â&#x20AC;? â&#x2013; Shamena Maharaj is Director, Human Resources, Organizational Development & Leadership at Sunnybrook Health Sciences Centre in Toronto, which has been named as one of Canadaâ&#x20AC;&#x2122;s top 100 Employers.

Carpenters Local 27 and Local 675 offer three-day practical course

Decrease Cost. Increase Efficiency. The Ontario Hospital Association in partnership with the Leading Edge Group now offer a suite of online and in-class lean education and training programs to help you and your organization decrease cost while increasing efficiency, quality and safety. Programs include: Lean Yellow, Green and Black Belt, Six Sigma, Value Stream Mapping and 5S for Health Care Get started today at www.oha.com/Lean

HOSPITAL NEWS JANUARY 2015

s hospital renovation and expansion programs ramp up across Ontario, contractors face increased pressure to get the construction job done on time and â&#x20AC;&#x201C; most importantly -- without contaminating hospital operations. It is the reason Carpenters Local 27 and Local 675 in Woodbridge have teamed XS WR RIIHU D WKUHH GD\ SUDFWLFDO FRXUVH IRU WKH UDQN DQG Ă&#x20AC;OH RQ FRQVWUXFWLRQ LQ hospitals. â&#x20AC;&#x153;If a contractor is not dealing with infection control, they could be putting patients at health risk,â&#x20AC;? says Anthony Simone, one of three instructors teaching the course called Construction ICRA: Best Practices in Healthcare Construction. Simone says contractors could see their contracts suspended or terminated if they donâ&#x20AC;&#x2122;t meet stringent infection control protocols. 7KH Ă&#x20AC;UVW RI LWV NLQG LQ 2QWDULR WKH FRXUVH FRYHUV VXFK LVVXHV DV DVEHVWRV OHDG PROG VLOLFD EORRG ERUQH SDWKRJHQV DQG RWKHU KRVSLWDO VSHFLĂ&#x20AC;F FRQFHUQV ,GHQWLĂ&#x20AC;FDWLRQ DQG FODVVLĂ&#x20AC;FDWLRQ RI ZRUN DUHDV WKDW PLQLPL]H ULVNV LOOQHVV DQG LQMXU\ are part of the curriculum. Installation methods of different types of containment HQFORVXUHV LQFOXGLQJ VRIWZDOO DQG KDUGZDOO XVLQJ DLU V\VWHPV ZLWK +(3$ Ă&#x20AC;OWHUV DUH also covered. It is taught on a demand basis at the Interior Finishing Systems Training Centre in Woodbridge. It was developed by the International Brotherhood of Carpenters at its training centre in Las Vegas. â&#x20AC;&#x153;HAIâ&#x20AC;&#x2122;s (healthcare-associated infections) had reached an alarming rate in the U.S. and insurance costs were impacting all healthcare providers,â&#x20AC;? Mike Yorke, president of Carpenters Local 27. â&#x20AC;&#x153;The timing is right to implement it here.â&#x20AC;? +DMLUD +DIHH] LQIHFWLRQ FRQWURO SUDFWLWLRQHU 7RURQWR (DVW *HQHUDO +RVSLWDO 7(*+ VHHV WKH PHULWV RI WKH FRXUVH &RQWUDFWRUV PHHWLQJ LQIHFWLRQ FRQWURO REOLJDWLRQV Â´GHĂ&#x20AC;QLWHO\ JHW QRWLFHGÂľ E\ KRVSLWDO DGPLQLVWUDWLRQV

www.hospitalnews.com

Professional Development and Education P15

Infection Control Risk Assessment ICRA BEST PRACTICES IN HEALTH CARE CONSTRUCTION

CARPENTERS

STOP CONTAMINATION IN ITS TRACKS!!!!

&ALLIED WORKERS LOCAL 27

The Carpenters union is at the leading edge of new advances in worker training to control risks, minimize hazards and complete projects on time. Ensure a safe facility and that ICRA protocols are met! Our highly trained members are your best resource in addressing concerns about HAI!

Carpenters Local 27 Training Trust Fund Inc. 420 Rowntree Dairy Rd Woodbridge, ON L4L 9T2 Tel: 905-652-5507 Fax: 905-652-5506 www.carpenterstraining.ca www.hospitalnews.com

Carpenters and Allied Workers Local 27 222 Rowntree Dairy Rd Woodbridge, ON L4L 9T2 Tel: 905-652-4140 Fax: 905-652-4139 Email: organizing@thecarpentersunion.ca or visit us at www.carpenterslocal27.ca

IFSTC 60 Sharer Road Woodbridge, Ontario L4L 8P4 Tel: 416.740.5411 Fax: 905.265.2041 www.ifstc.com JANUARY 2015 HOSPITAL NEWS

P16 Professional Development and Education

Continuing medical education: Leading the way for cardiovascular care By Jane Kitchen

ardiologist Dr. Jason Burstein is delivering a presentation on Multi-Vessel Coronary Artery Disease to a crowded house at Rouge Valley Centenary hospital campus, which is home to the Central East Regional Cardiac Care Centre for ScarboroughDurham. His talk today is part of weekly cardiovascular rounds, offered every Tuesday morning. However, his audience extends far beyond those in attendance in the hospital.

Continuing Medical Education has long been a priority of the program and of Dr. Ricci, who has organized an annual cardiac CME event for 17 years. Using the videoconferencing capabilities of the Ontario Telemedicine Network (OTN), these rounds reach medical pro-

fessionals at several hospital sites across the vast geographical footprint of the Central East Local Heath Integration Network (LHIN). Dr. Joe Ricci, medical director of the regional program, says, “The program is very well-integrated, even though it is diverse and very large. Using the OTN has been part of the way we have accomplished this.” Dr. Ricci organizes the weekly rounds, planning out the presenters a year in advance. About half of the speakers are local physicians, who are affiliated with the program, and half are from other centres. The rounds are eligible for Continuing Medical Education (CME) credits. Rouge Valley provides documentation for those participating, including cardiologists, internists, general practitioners, registered nurses, allied health, technicians and other staff. Presentations are recorded and archived. Continuing Medical Education has long been a priority of the program and of Dr. Ricci, who has organized an annual cardiac CME event for 17 years. With an annual attendance of 200 family physicians from

Education at the intersection of health, business, and technology People become healthcare professionals to help make people better. The DeGroote School of Business at McMaster University is working hard to make healthcare better by helping health professionals and administrators attain the leadership and management skills they need to deliver care more effectively. The healthcare sector is burdened by business processes designed by clinicians and technology designed for business processes – not patients. Healthcare management sits at the intersection of health, business, and technology and the DeGroote School is able to draw on McMaster’s faculties of Engineering and Health Sciences to provide a truly interdisciplinary approach to health management. The variety of health management programs available at the DeGroote School means that there is something for everyone in the health sector. In addition to the well-known MBA specialization in Health Services Management, the School offers an MSc in eHealth, and Masters in Health Management, a PhD in health policy and a VXLWH RI KHDOWK VSHFLÀF OHDGHUVKLS DQG GHYHORSPHQW SURJUDPV IRU healthcare executives. More information about all of DeGroote’s programs can be found on the website: DeGrooteSchool.ca/programs

HOSPITAL NEWS JANUARY 2015

Dr. Joe Ricci, medical director of the Central East Regional Cardiac Care Centre for Scarborough-Durham, in the cardiac care learning centre with OTN connectivity. Scarborough and Durham Region each year, it is one of the largest and longest running cardiac CME events in Ontario. In addition, through the leadership of Dr. Narendra Singh and the regional program, the Rouge Valley Health System cardiac care program started weekly rounds for all physicians and staff 15 years ago, reaching 20-30 people weekly. “CME is important not just to physicians but for all health care professionals, as they share and learn best practices,” says Dr. Ricci. “This improves patient care and outcomes,” he adds.

Continuing medical education is important not just to physicians but for all health care professionals, as they share and learn best practices. Four years ago, the regional cardiac program with support from Glyn Boatswain, director of cardiac care and oncology, and Dr. Amelia McCutcheon, vice-president of cardiac, critical care, surgery and chief nurse executive, decided to use the resources of OTN to reach out strategically as the regional cardiac care centre through education to join their partner cardiovascular care providers in the Central East LHIN. OTN is a secure, private network, with the goal of improving access to care. With support of the hospital and industry, the education room in the cardiac care learning centre was reconfigured with OTN connectivity to multiple sites in the Central East LHIN. Scott Cowan, registered nurse, is the clinical telemedicine coordinator for the clinical and

educational telemedicine program and the program coordinator for Central East LHIN regional cardiovascular education. “The first broadcast from the regional centre was on Feb. 14, 2012,” says Cowan. “We had two other sites logged on, Lakeridge and Oshawa. Now we average at least seven sites a week, with more than 50 people participating. The majority of all hospitals in the region have some OTN capability. Our goal as a regional centre is to get every one of these sites to log on for weekly rounds,” he adds. Dr. Ricci says, “The same infrastructure has allowed us to improve our cardiovascular patient care services.” Rouge Valley Health System is the manager of the Central East LHIN regional cardiovascular rehabilitation service. Rouge Valley uses the OTN network, and the live webcast to support the regional cardiovascular rehabilitation service and its 10 sites across the LHIN. “We have this infrastructure right across the LHIN,” says Dr. Ricci. “This information exchange can also be of great use to our exercise therapists, who help our cardiovascular patients on their road to recovery.” Soon, the reach of these cardiovascular rounds will extend even further. Primary care physicians who join a newly developed regional education network will be able to watch the rounds live as part of a webcast from as desktop or laptop, and not be committed to attending at an OTNcapable site. Because of a registration process, those watching will also be eligible for CME credits. Those on the network will also be able to view any of the more than 100 archived presentations at their convenience, which Rouge Valley stores in a virtual library. For more information on the rounds and how to register to participate online, email H cardiacrounds@rougevalley.ca. ■ Jane Kitchen is a communications specialist at Rouge Valley Health System. www.hospitalnews.com

Professional Development and Education P17

www.hospitalnews.com

JANUARY 2015 HOSPITAL NEWS

P18 Professional Development and Education

Oncology nursing leaders: Developed through specialized learning and direct practice By Jumana Nuri, Jiahui Wong and Deyan Kostovski

ore and more Canadians are living with cancer and the complexity of their care continues to steadily increase. Health care professionals all across the country are being confronted with the challenge of staying current with the latest advancements in cancer and palliative care, and having the confidence to deliver the high quality care that is expected of them. The de Souza Institute is proving to be an extremely valuable resource for care givers, cancer patients and their families. Since its inception in 2008, de Souza has provided ongoing educational support and career counselling to thousands of nurses across Ontario and in 2013, the mandate was expanded to include other health care professionals, such as pharmacists, social workers and therapists. What is so special about de Souza is how it combines theoretical course work with a clinical fellowship. The courses are organized in four domains: Treatment and Delivery of Evidence Based Care, Therapeutic and Supportive Relationships, Developing Professional Practice

and Leadership, and Patient Teaching and Coaching. In order to obtain a de Souza Designation participants must complete at least one course from each of the four domains and a 75 hour clinical fellowship. The most recent de Souza Nurse Designates include Tammy Powell, Christine Hipgrave and Valrie Hursefield. As a registered nurse with over 25 years of experience, Tammy works in St. Catharines at the Niagara Health System and has witnessed the increased demand for cancer care in her community. The Niagara Health System redevelopment expanded the range of cancer services that are now available in the Niagara Region. Tammyâ&#x20AC;&#x2122;s de Souza experience has equipped her with the skills and confidence required for the new chemotherapy program in St. Catharines. In Barrie, radiation oncology nurse Christine Hipgrave will use her de Souza training that included a clinical fellowship at Princess Margaret Cancer Centre and Simcoe Muskoka Regional Cancer Centre to promote a holistic approach to cancer care for patients receiving radiation therapy and introduce a survivorship model for patients and families. Valrie is a Clinical Nurse Educator from Etobicoke General Hospital, she is a strong

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Mar 6

Experience Based Design: Integrating the Patient Voice

The Chang School offers part-time degree completion programs in Health Information Management and Health Services Management, a post-diploma BScN degree for regisWHUHG QXUVHV DQG SURIHVVLRQDO FHUWLĂ&#x20AC; FDWH SURJUDPV LQ $GYDQFHG 1XUVLQJ /HDGHUVKLS DQG 0DQDJHPHQW $GYDQFHG 6DIHW\ 0DQDJHPHQW $GYDQFLQJ WKH $2'$ 3ULQFLSOHV DQG 3UDFWLFHV RI $FFHVVLELOLW\ &RPPXQLW\ (QJDJHPHQW /HDGHUVKLS DQG 'HYHORSPHQW )RRG Security; Gerontology; Health Informatics; Health Services Management; Health Studies; 0HQWDO +HDOWK DQG $GGLFWLRQV DQG 2FFXSDWLRQDO +HDOWK DQG 6DIHW\ &RXUVHV DUH RIIHUHG LQ IRUPDWV WKDW PHHW WKH QHHGV RI \RXU EXV\ OLIHVW\OH Â˛ RXU Ă H[LEOH DFFHVVLEOH SURJUDPPLQJ LV DYDLODEOH RQ FDPSXV RU RQOLQH IURP \RXU KRPH RU RIĂ&#x20AC; FH /RFDWHG LQ GRZQWRZQ 7RURQWR FORVH WR VHYHUDO PDMRU KRVSLWDOV KHDOWK FDUH SURYLGHUV DQG research facilities, Ryerson University is in a unique position to offer the most current and relevant health education.

Apr 20 Organizational Intelligence: Practical Information Strategies for Health Care Professionals Apr 29 Conference for & 30 Administrative Professionals

Weâ&#x20AC;&#x2122;ve always got something just right for you. For our complete list of programs, go to www.oha.com/education.

HOSPITAL NEWS JANUARY 2015

care planning strategies or understanding the latest evidence in palliative care approaches. To remedy this, Valrie leveraged her de Souza experience to develop an interdisciplinary staff training program that incorporates advance care planning

Transform your health care career with professional development opportunities from The G. Raymond Chang School of Continuing Education at Ryerson University (ryerson.ca/ce). The Chang School is Canadaâ&#x20AC;&#x2122;s foremost provider of university-based adult education, facilitating access to Ryersonâ&#x20AC;&#x2122;s renowned, professionally relevant courses and programs. Our dynamic and innovative learning opportunities can help you advance your career in some of Canadaâ&#x20AC;&#x2122;s most in-demand health care jobs.

Thatâ&#x20AC;&#x2122;s how many educational opportunities we offer every year. Delivered by subject-matter experts, continually updated and attended by more than 45,000 health care professionals annually, our programs cover the content you want and need at every stage of your career.

advocate for incorporating palliative care approaches in acute care hospitals. Valrie recognized the challenges health care providers face with outlining advance

Valrie is a Clinical Nurse Educator from Etobicoke General Hospital.

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Christine Hipgrave is a radiation oncology nurse at Princess Margaret Cancer Centre and Simcoe Muskoka Regional Cancer Centre.

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ryerson.ca/ce/healthcare www.hospitalnews.com

Professional Development and Education P19 discussions with patients and families during their admission. These are only three shining examples of the impact that de Souza is having on care givers and their patients. Technology has helped advance the way in which we care for patients and it has also opened the door in how nurses and other health care professionals can invest in their professional development. â&#x20AC;&#x153;All health care professionals are challenged to keep pace with new evidence and approaches to treatment.â&#x20AC;? said Dr. Mary Jane Esplen, Director of de Souza Institute. â&#x20AC;&#x153;These recent â&#x20AC;&#x153;de Souza designatesâ&#x20AC;? are health care professionals who despite years of experience, recognize the need for ongoing updates and training in order to deliver quality care, and are held in high regard.â&#x20AC;? Irrespective or where you live and work, it could be a rural area or an urban centre, it could be a regional cancer centre or an acute care hospital, continuing education is the key to addressing the complexity of cancer care. de Souza courses are available on line and cover a full range of cancer care topics, from cancer prevention and treatment to palliation and survivorship. The online course calendar outlines the various enrolment opportunities, enabling health care practitioners to choose the courses they want and when they want to complete them. Accessing evidence based and clinically relevant educational materials is at your fingertips and only a few clicks away. For more information visit www.desouH zainstitute.com â&#x2013; Jiahui Wong is Manager, Curriculum and Program Evaluation and Jumana Nuri is business development assistant at The de Souza Institute. Deyan Kostovski is a media and PR specialist.

New scholarship at Trillium Health Partners

ong-time Mississauga resident Maria Racioppo was honoured with a very special birthday present on Monday when over 100 members of her family gathered for a surprise tribute. Known for her extremely generous spirit and passion for education, Mrs. Racioppoâ&#x20AC;&#x2122;s family decided to honour their matriarch with a special scholarship for employees of Trillium Health Partners, where she had worked for over 14 years. To date, the family has raised close to $500,000 for the scholarship, led by a $100,000 donation from Dr. Dante Morra, Mrs. Racioppoâ&#x20AC;&#x2122;s nephew, and who is Chief of Staff of Trillium Health Partners. â&#x20AC;&#x153;We are extremely proud to partner with the Foundation to establish the Maria Racioppo Scholarship for Integrative Care at Trillium Health Partners,â&#x20AC;? says her son, Carlo. â&#x20AC;&#x153;This hospital is very dear to our motherâ&#x20AC;&#x2122;s heart. Here, she worked hard

Advance Your Health Career Ryerson Universityâ&#x20AC;&#x2122;s G. Raymond Chang School of Continuing Education offers several health-related courses and programs for professionals seeking to advance their health careers. These dynamic and innovative learning opportunities can help you launch your career in some of Canadaâ&#x20AC;&#x2122;s most in-demand health care jobs. Courses are offered in formats that meet the needs of your busy lifestyle.

Health Informatics

Health Studies

Health Services Management

and loved every minute. She understood how vital a hospital is to a community and how every single person who works there has a role to ensure every patient is treated with kindness and compassion.â&#x20AC;? The Maria Racioppo Scholarship will be a yearly endowment that will support innovative, integrated health care thinking and collaboration from all levels of Trillium Health Partnersâ&#x20AC;&#x2122; staff. Winners will have the opportunity to share and conduct applied research towards implementing one of their own innovative ideas â&#x20AC;&#x201C; inspired by their interaction with patients â&#x20AC;&#x201C; that will advance patient-centred care at Trillium Health Partners. With special research and innovation time at the hospitalâ&#x20AC;&#x2122;s Institute for Better Health, winners will also have the opportunity for mentorship and collaboration with the Instituteâ&#x20AC;&#x2122;s research and innovation experts. â&#x20AC;&#x153;Maria is our familyâ&#x20AC;&#x2122;s matriarch and

performed much self-sacrifice to provide for her family and ensure that they had opportunities of discovery that were unavailable to her,â&#x20AC;? says Dr. Morra. â&#x20AC;&#x153;The Maria Racioppo Scholarship honours my auntâ&#x20AC;&#x2122;s vision and pioneering spirit, and recognizes her courage and commitment to future generations of her family so that they could have the freedom to choose their professions and achieve excellence in their chosen endeavours.â&#x20AC;? â&#x20AC;&#x153;The Foundation is very proud to play a role in launching a truly innovative and important scholarship program with far reaching benefits,â&#x20AC;? says Steve Hoscheit, president and CEO of Trillium Health Partners Foundation. â&#x20AC;&#x153;The creation and endowment of this scholarship is a tangible example of how Trillium Health Partners is leading the way in the delivery of comprehensive, high quality effective, patient-centred health care into the H twenty-first century â&#x20AC;&#x201C; and beyond. â&#x2013;

TRANSFORM: YOUR NURSING CAREER AT THE CHANG SCHOOL AT RYERSON UNIVERSITY s !CCESS mEXIBLE SCHEDULING AND DELIVERY OPTIONS FOR COURSES LEADING TO A "3C. FOR NURSES s 'AIN SKILLS AND KNOWLEDGE TO BE BETTER POSITIONED FOR LEADERSHIP AND MANAGEMENT ROLES NURSING PROGRAMS AND CERTIFICATE s 0ART TIME 0OST $IPLOMA "3C. $EGREE FOR 2.S s 0OST BACCALAUREATE #ERTIlCATE IN !DVANCED .URSING ,EADERSHIP AND -ANAGEMENT

0LEASE VISIT ryerson.ca/ce/nursingprograms FOR MORE DETAILS

ryerson.ca/ce/health www.hospitalnews.com

JANUARY 2015 HOSPITAL NEWS

P20 Professional Development and Education

New partnership bridges complementary therapies and western medicine By Julie Dowdie t’s estimated that nearly three quarters of Canadians will use some form of complementary and alternative medicine (CAM) in their lifetime. This can include many different practices and products, such as chiropractic treatment, acupuncture, herbal remedies, or traditional Chinese medicine. Many are doing so without discussing their choice with a conventional health care professional. However, what is not well known is how patients are using CAM therapies and how they may interact with other treatments they are receiving. On October 17, The Scarborough Hospital, in partnership with the University of Toronto, launched the Centre for Integrative Medicine; a “living laboratory” that will help patients make informed, evidence-based choices about the safe and effective use of CAM therapies as part of their health care. “From a clinical perspective, The Scarborough Hospital is a natural partner for this new Centre,” says Robert Biron, President and CEO of The Scarborough Hospital. “We have a longstanding focus on interprofessional care, innovation and incorporating research and best practice into every aspect of our health care delivery. Our strength in treating and supporting patients with chronic diseases will add signifi-

cant value to the new Centre. Our hospital is home to one of the largest nephrology programs in North America and we serve a community that has a high propensity for diabetes. Some of our programs, such as mental health, already use complementary therapies in the treatment of patients, such as meditation, tai chi and yoga.

The Centre for Integrative Medicine brings together researchers from the University of Toronto’s Leslie Dan Faculty of Pharmacy and Faculty of Medicine alongside the health care professionals at The Scarborough Hospital And perhaps the greatest strength we bring to this partnership is our health care team – not only their diversity that mirrors the community, but a culture that is openminded to explore new ways of delivering health care in a holistic way.” Robert also notes that many individuals in Scarborough’s multicultural community, and in particular in its large Asian community, are already using CAM therapies, another important benefit in the hospital’s partnership on the Centre. The Centre for Integrative Medicine brings together researchers from the

University of Toronto’s Leslie Dan Faculty of Pharmacy and Faculty of Medicine alongside the health care professionals at The Scarborough Hospital, harnessing the considerable expertise of both organizations. The University of Toronto will lead the scientific research and The Scarborough Hospital will establish a “clinical hub” at its Birchmount campus that will help patients manage their day-to-day health with an emphasis on disease prevention, health promotion and chronic disease management. Together, this approach will ensure that the knowledge gained in the lab is put into action at the bedside and that the lessons learned from patients’ use of CAM inform future research. “Already, the Centre for Integrative Medicine has attracted considerable interest from our extended community who recognize the important contribution it can make to improve our system of care here at home and around the world,” said Professor Catharine Whiteside, Dean of the Faculty of Medicine and Vice Provost, Relations with Health Care Institutions at the University of Toronto. “Thanks to the generous support of KY and Betty Ho, we have been able to establish a Chair in this important field. But with further support, we can establish a Centre that the Scarborough community deserves and that is representative of the world-class research for which the University of Toronto is known.” Professor Heather Boon, Dean of the

Leslie Dan Faculty of Pharmacy at the University of Toronto, adds, “Because an overwhelming number of Canadians are using complementary and alternative medicines, it is critical that we understand how these products and therapies work and how they interact with conventional care practices and medications. By undertaking a rigorous scientific evaluation of these therapies, we will be in a better position to understand what works – and what doesn’t – and provide the evidence necessary to guide their proper use to a patient base that is eager to utilize these products.” Professor Lynda Balneaves will lead the Centre as the inaugural Director and Chair. Lynda is a talented and award-winning researcher who has been investigating complementary and alternative medicine for 20 years. The first phase of the Centre’s development, which is already underway, will focus on consulting the local community to ensure it serves the needs of this area. This phase will establish the strong foundations needed for effective clinical care and research. By next spring, the Centre will use the findings from the initial phase to launch a series of pilot projects in the Scarborough community to address these needs and announce its long-term plans. For more information about the Centre for Integrative Medicine, visit www.toronH to-cim.ca. ■ Julie Dowdie is a Communications Officer at The Scarborough Hospital

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HOSPITAL NEWS JANUARY 2015

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Professional Development and Education P21

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JANUARY 2015 HOSPITAL NEWS

P22 Professional Development and Education

Teaching the next generation By Sarah Quadri Magnotta s a third year University of Toronto medical student, handson caring for patients is important to Elie Sader. That’s why he chose Humber River Hospital (HRH) for his general surgery rotation last November. “When I was deciding where to go, my colleagues highly recommended Humber River because of the unique, direct learning opportunities that would allow me to spend more time with patients,” says Sader, a graduate of McGill and Oxford Universities. “They were right. I’ve scrubbed in with the whole general surgery team and I’ve learned so much.” Sader is one of hundreds of students benefitting from Humber River’s Medical Education Department – a department that has seen great expansion in the last two years. In addition to coordinating the teaching of students across many areas of medicine and surgery in the hospital, the Department also deals with numerous requests from international students and medical professionals looking to learn from HRH physicians.

“At Humber River, education is fundamental to our mission, vision and values,” says Dr. Ray Martin, the hospital’s VicePresident of Medical and Academic Affairs. “We have formal medical education affiliations with the University of Toronto and Queen’s University, and are extremely dedicated to teaching the next generation,” he adds. “When learners are present in the hospital it improves the quality of patient care – that’s a priority for us and one of the reasons we are so committed to our students.” Humber River takes pride in its longtime affiliation with the University of Toronto, which has seen numerous medical students, residents and fellows train with HRH physicians and staff in many departments, including General Surgery, Emergency, Anesthesia, Paediatrics, Obstetrics, Internal Medicine and Vascular Surgery, to name a few. “Humber River serves as a tremendous training ground at all levels,” says Dr. James Rutka, R.S. McLaughlin Professor and Chair, Department of Surgery at the University of Toronto. “The reputation and teaching of the surgical staff is exemplary and our students can’t wait to learn

Dr. John Hagen (left), Humber River Chief of Surgery and his team are providing medical students like Elie Sader (right) with a unique hands-on learning approach that allows them to spend quality time caring for patients. at Humber River. We see our relationship with the hospital as extremely valuable and we look forward to building on this relationship for many years to come.” “It’s been a phenomenal success,” says Dr. David Latter, Vice-Chair of Education in the Department of Surgery at the University of Toronto. “Humber River Hospital is the most sought-after rotation for our students. As a community hospital Humber River is leading the way – everyone wants to go there,” he adds.

When learners are present in the hospital it improves the quality of patient care – that’s a priority for us and one of the reasons we are so committed to our students.

The health care system is rapidly changing. Learn to change right along with it. With a wide range of in-class and online learning opportunities available, the Ontario Hospital Association’s (OHA) continuing education programs offer the tools health care professionals need to respond more effectively and immediately to the challenges facing a rapidly changing health care system. Visit www.oha.com/catalogue to download our 2015 Continuing Education Catalogue and ﬁnd out more about our roster of continuing education and professional development courses.

HOSPITAL NEWS JANUARY 2015

Humber River is equally as proud of its more recent collaboration with the medical school at Queen’s University, which chose Humber River as its Toronto partner almost two years ago. Since that time, Queen’s students have worked alongside HRH Pediatricians and Obstetricians and Gynecologists. Beginning next month, students will also begin rotations with the Hospital’s Department of Medicine. “Queen’s University School of Medicine is delighted to have developed a partnership with Humber River Hospital,” says Dr. Phil Wattam, Assistant Dean, Distributed Medical Education School of Medicine, Faculty of Health Sciences at Queen’s University. “Humber River Hospital, as an affiliate of the Queens Distributed Medical Education (DME) network, will now provide our undergraduate and postgraduate learners the opportunity to work and learn in a bustling urban setting. The exposure to a diverse ethnic and socioeconomic population will enrich their medical education and provides yet another opportunity to work one-on-one with experienced clinicians.”

“It speaks volumes that an organization as impressive as Queen’s University chose Humber River as its Toronto affiliate,” says Martin. “We are thrilled with the partnership and share Queen’s University’s commitment to excellence. It’s a strong endorsement of the quality of our Medical Education program, and of the experience students receive at our hospital.” That experience is extraordinary because of the HRH physicians who make the learning possible. Among them is Dr. John Hagen, Humber River’s Chief of Surgery. Dr. Hagen has received multiple teaching awards from the University of Toronto, including the 2010 Robert Mustard Award for the teaching of general surgery residents and fellows; the Bruce Tovee Award from the Department of Surgery in 2013; and the 2014 Award for Excellence in Community Based Teaching from the Faculty of Medicine. Just last month, Hagen was awarded the 2014 Mentor of the Year Award for Region Three by the Royal College of Physicians and Surgeons of Canada. This is the second year in a row that a Humber River physician has won a prestigious Royal College award. Last year, Dr. Narendra Singh – also involved in Humber’s Medical Education program – received the Prix d’excellence for Region Three. This award recognizes a physician who is a role model for excellence in patient care, and who has made significant contributions in providing outstanding care to patients and the community. “Humber River is the first hospital in 10 years to have two physicians win Royal College awards consecutively,” says Martin. “This is remarkable and speaks to the depth and quality of our team,” he added. For Sader, that team provided him with the experience of a lifetime. “It’s a privilege to be able to learn this way. When you get this kind of mentoring you learn much faster – it’s a one-of-a-kind H experience.” ■ Sarah Quadri Magnotta is a Senior Writer/ Communications Specialist at Humber River Hospital. www.hospitalnews.com

Professional Development and Education P23

Sought after Health Careers Include Chiropractic $OZD\V DW WKH IRUHIURQW RI KHDOWK FDUH HGXFDWLRQ LV 'Âˇ<RXYLOOH &ROOHJH LQ %XIIDOR ZKHUH WKH\ KDYH EHHQ SURYLGLQJ HGXFDWLRQ LQ WKLV YLWDO Ă&#x20AC;HOG VLQFH WKH V 7KHLU H[FHOOHQW UHSXWDWLRQ ORFDOO\ DQG QDWLRQDOO\ DWWUDFWV VWXGHQWV IURP DOO RYHU WKH ZRUOG 7RGD\ 'Âˇ<RXYLOOH RIIHUV D 'RFWRU RI &KLURSUDFWLF SURJUDP ZLWK ERWK XQGHUJUDGXDWH DQG JUDGXDWH HQWU\ RSWLRQV (VWDEOLVKHG LQ DV WKH RQO\ FKLURSUDFWLF GHJUHH SURJUDP WKDW LV WUDGLWLRQDO DOOLHG KHDOWK IRFXVHG WKLV XQLTXH SURJUDP RIIHUV HQWU\ WR KLJK VFKRRO JUDGXDWHV WUDQVIHU VWXGHQWV DQG DW WKH SURIHVVLRQDO OHYHO 'Âˇ<RXYLOOHÂˇV FKLURSUDFWLF SURJUDP JLYHV VWXGHQWV D XQLTXH RSSRUWXQLW\ WR EH SDUW RI DQ LQWHJUDWHG FXUULFXOXP E\ FROODERUDWLRQ ZLWK SURJUDPV LQ QXUVLQJ SKDUPDF\ SK\VLFDO WKHUDS\ RFFXSDWLRQDO WKHUDS\ SK\VLFLDQ DVVLVWDQW DQG GLHWHWLFV SUHSDULQJ VWXGHQWV IRU D ZRUOG RI FRRUGLQDWHG KHDOWK FDUH 'Âˇ<RXYLOOH RIIHUV H[FHSWLRQDO IDFLOLWLHV DQG VWDWH RI WKH DUW WHFKQRORJ\ WR VWXGHQWV LQ WKH SURJUDP +DQGV RQ FOLQLFDO LQWHUQVKLSV ZLWK URWDWLRQV WKURXJK IRXU VLWHV RIIHUV D YDULHW\ RI FOLQLFDO VHWWLQJ H[SHULHQFHV QRW IRXQG LQ RWKHU SURJUDPV :LWK VFKRODUVKLSV DYDLODEOH DW ERWK WKH XQGHUJUDGXDWH DQG JUDGXDWH OHYHO LQFOXGLQJ D WXLWLRQ GLVFRXQW IRU DOO &DQDGLDQ FLWL]HQV 'Âˇ<RXYLOOH RIIHUV DQ H[FHOOHQW HGXFDWLRQDO RSSRUWXQLW\ DW DQ DIIRUGDEOH FRVW )RXQGHG LQ 'Âˇ<RXYLOOH LV D SULYDWH FR HGXFDWLRQDO FROOHJH RIIHULQJ EDFKHORUÂˇV PDVWHUÂˇV DQG GRFWRUDO SURJUDPV LQ D ZLGH YDULHW\ RI Ă&#x20AC;HOGV 'Âˇ<RXYLOOH KDV EXLOW DQ LQWHUQDWLRQDO UHSXWDWLRQ IRU SUHSDULQJ RXU VWXGHQWV IRU WKH FKDOOHQJHV RI WKH ZRUNLQJ ZRUOG SDUWLFXODUO\ LQ WKH KHDOWK FDUH Ă&#x20AC;HOG

EMOTIONAL CONTROL DIFFICULT PERSONALITIES

SPECIAL SEMINAR TO BE HELD

DifďŹ cult personalities can be hostile, obnoxious, and even dangerous. Such personalities need to control their emotions. The scientiďŹ cally based six-hour seminar, â&#x20AC;&#x153;Emotional Control/DifďŹ cult Personalitiesâ&#x20AC;? examines the origins of difďŹ cult personalities and provides suggestions for coping with such individuals. The course examines how speciďŹ ed brain chemicals are linked to such conditions as being disagreeable, introverted, or hostile. The course examines the neurological basis of violent eruptions. The course offers the top ten psychological strategies for coping with difďŹ cult personalities. It looks at how different drugs affect emotions. It examines how nutrition can play a role in emotional control. The seminar looks at how anxiety and sleeplessness affect personality. It examines such matters as spousal abuse and bad inter-personal relationships. The course reviews the difference between physical pain and emotional pain. The course covers the role of antidepressants in coping with emotional control. It shows how to minimize the risks of such medications. The seminar will be presented by one of North Americaâ&#x20AC;&#x2122;s leading psychologists, Dr. Jeff Auerbach (Ph.D.). The seminar will be presented four times in the Province of Ontario: Tue., Apr. 28, 2015, at the Hilton Gardens, 1870 Matheson Blvd., Mississauga Wed., Apr. 29, 2015, Best Western Lamplighter Inn, 591 Wellington Rd. S., London Thu., Apr. 30, 2015, Monte Carlo Inn, 7255 Warden Ave., Markham Fri., May 1, 2015, The Old Mill, 21 Old Mill Rd., Toronto On each date, the seminar times will be 8:30AM to 3:30PM. The seminar is sponsored by the Biomed Corporation, North Americaâ&#x20AC;&#x2122;s largest provider of live seminars for health professionals. Biomed neither solicits nor receives any gifts or grants from any entity.

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To obtain more information about the seminar, please contact Biomed, Suite 228, 3219 Yonge Street, Toronto, ON M4N 2L3. Ph 1.877.246.6336 or 925.602.6140 Fax 925.687.0860 E-mail info@biocorp.com Visit Biomedâ&#x20AC;&#x2122;s web site at www.biomedglobal.com

Graduate School

take your career to the next level UNDERGRADUATE PROGRAMS Dietetics (5-yr. BS/MS) Exercise and Sports Studies (BS) Health Analytics (BS) Health Services Management (BS) Nursing (2-yr. RN to BSN) Nursing (4-yr. BSN) Pharmacy Physical Therapy program Pre-Dental / Medical / Veterinary MASTERâ&#x20AC;&#x2122;S PROGRAMS Community Health Nursing Ä&#x2018;ĆŤ 2 * ! ĆŤ (%*% (ĆŤ 1./%*# Ä&#x2018;ĆŤ 1 0%+* Ä&#x2018;ĆŤ * #!)!*0 Family Nurse Practitioner Occupational Therapy Physician Assistant

THE U.S. UNIVERSITY STUDY OPTION HEALTH CARE PROGRAMS for

High School Students Transfer Students University Students Graduate Students Working Professionals www.hospitalnews.com

DOCTORAL PROGRAMS Chiropractic (7-yr. BS + DC) Health Administration (Ed.D.) Nursing Practice (DNP) Pharmacy (PharmD) Physical Therapy (DPT) ADVANCED CERTIFICATES Clinical Research Associate Family Nurse Practitioner (post-master's certiďŹ cate) Health Services Administration Long-Term Care Administration Nursing and Health-Related Professions Education

716.829.8400 www.dyc.edu JANUARY 2015 HOSPITAL NEWS

P24 Professional Development and Education BIOMED PRESENTS...

EMOTIONAL CONTROL DIFFICULT PERSONALITIES A Seminar for Health Professionals TUITION $109.00 (CANADIAN)

Instructor:

Jeff Auerbach, Psy.D.

The seminar registration period is from 7:45 AM to 8:15 AM. The seminar will begin at 8:30 AM. A lunch (on own) break will take place from 11:30 AM to 12:20 PM. The course will adjourn at 3:30 PM, when course compleWLRQ FHUWLÂżFDWHV ZLOO EH GLVWULEXWHG Registration: 7:45 AM â&#x20AC;&#x201C; 8:30 AM Morning Lecture: 8:30 AM â&#x20AC;&#x201C; 10:00 AM z Broken Brains and Damaged Psyches: Will We Ever Be Happy Again? z Overreactions: Reality Vs. Perception. The Natural-Nurture â&#x20AC;&#x153;Milkshake.â&#x20AC;? z The Story of Stress, Productivity, and Mutual Bullying. z An OCEAN of Neurotransmitters: +RZ 6SHFLÂżF ,PEDODQFHV LQ WKH %UDLQ $IIHFW 2SHQQHVV &RQVFLHQWLRXVQHVV ([WURYHUVLRQ $JUHHDEOHQHVV DQG 1HXURWLFLVP z When Human Brains Abide by Primitive Impulses and Emotions.Recognizing and Avoiding Road Rage. z Violent Eruptions: Lessons Learned from the Attacks at Virginia Tech, Columbine, Arizona, Fort Hood, Aurora, and Wisconsin. Mid-Morning Lecture: 10:00 AM â&#x20AC;&#x201C; 11:30 AM z Diet and Human Emotions: Many Nutrients to Assimilate. z Committing Dangerous Patients: Legal and Professional Obligations. z Preserving Oneâ&#x20AC;&#x2122;s Own Personal Complexity and Psychological Health in the Modern World. z Overcoming Instincts: How We Learn to Suppress Competition and Concentrate on Cooperation. z Dealing with Uncooperative Persons and Patients. z The Top Ten Psychological Strategies IRU 'LIÂżFXOW 3DWLHQWV &XVWRPHUV &R :RUNHUV DQG )DPLO\ 0HPEHUV z Feelings of Connectedness and Bliss. 'RHV (OHFWULFDO $FWLYLW\ RI WKH %UDLQ 5HĂ&#x20AC;HFW 6SLULWXDOLW\ DQG 0HDQLQJIXOQHVV" 7KH %LRORJLFDO %DVLV RI 6SLULWXDO 3XUVXLWV Lunch: 11:30 AM â&#x20AC;&#x201C; 12:20 PM Afternoon Lecture: 12:20 PM â&#x20AC;&#x201C; 2:00 PM z Dopamine: Pleasure, Reality, Depths of Despair, and Addiction. z Dopamine in Cluster A Disorders (Paranoid, Schizoid, and Schyztypal). How Old Age is Aggravated by Anxiety and Depression. Terminal Agitation and Delirium in Dying Patients. z Are Opioids Overprescribed, and Is There a Way to Reduce Dependence on Psychiatric Medications? z Norepinephrine and Focusing, Learning, and Attentiveness.When Cluster C Personality Disorders (Dependent and Obsessive-Compulsive) Become a Threat. z Childhood Issues in an Adult: (QWLWOHPHQW DQG 5HZDUG 'HÂżFLHQF\ 2SSRVLWLRQDO 'HÂżDQW 'LVRUGHU z Cluster B Personality Disorders and Mood Instability. The Role of Serotonin in Dramatic Behavior: From Narcissism to Self-Cutting. Mid-Afternoon Lecture: 2:00 PM â&#x20AC;&#x201C; 3:20 PM z Choosing the Most Effective Antidepressants and Minimizing Risks. z Anxiety and Sleeplessness: Melatonin, GABA, and Norepinephrine. Why Human Beings Seem to Be â&#x20AC;&#x153;Sentencedâ&#x20AC;? to a Life of Anxiety. z The Role of Nutrition in the Brain: Lobster, Buckwheat, and Cashews. z Dental Medications: What Is the Appropriate Use of Such Medications in Patients Suffering from Emotional Dysfunction? z Chronic Emotional Pain vs. Chronic Physical Pain. z Spousal Abuse: Why Do People Stay in Bad Relationships? Evaluation, Questions, and Answers: 3:20 PM â&#x20AC;&#x201C; 3:30 PM

6 CONTACT HOURS / www.biomedglobal.com

MEETING TIMES & LOCATIONS MISSISSAUGA, ON

LONDON, ON

Tue., April 28, 2015 8:30 AM to 3:30 PM Hilton Garden Inn Toronto 1870 Matheson Boulevard Mississauga, ON

TORONTO, ON

Thu., April 30, 2015 8:30 AM to 3:30 PM Monte Carlo Inn 7255 Warden Avenue Markham, ON

Fri., May 1, 2015 8:30 AM to 3:30 PM The Old Mill 21 Old Mill Road Toronto, ON

CHEQUES: $109.00 (CANADIAN) with pre-registration. $134.00 (CANADIAN) at the door if space remains. CREDIT CARDS: Most credit-card charges will be processed in Canadian dollars. Some charges will be in U.S. dollars at the prevailing exchange rate. Note: some Canadian banks may add a small service charge for using a credit card. The tuition includes all applicable Canadian taxes. At the seminar, participants will receive a complete course syllabus. Tuition payment receipt will also be available at the seminar.

ACCREDITATION

7KLV SURJUDP LV GHVLJQHG WR SURYLGH QXUVHV ZLWK WKH ODWHVW VFLHQWLÂżF DQG clinical information and to upgrade their professional skills. Numerous registered nurses in Canada and the United States have completed these courses. This activity is co-provided with INR. Biomed is an approved provider of continuing nursing education by the Arizona Nurses Association, an accredited approver by the American Nurses Credentialing Centerâ&#x20AC;&#x2122;s Commission on Accreditation.

PHARMACISTS

Pharmacists successfully completing this course will receive FRXUVH FRPSOHWLRQ FHUWLÂżFDWHV %LRPHG LV DFFUHGLWHG E\ WKH $FFUHGLWDtion Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The ACPE universal activity number (UAN) for this course is 0212-9999-15-001-L01-P. This is a knowledge-based CPE activity.

DIETITIANS

CPE

Biomed, under Provider Number BI001, is a Continuing Profes- Accredited Provider sional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDâ&#x20AC;&#x2122;s) and dietetic technicians, registered (DTRâ&#x20AC;&#x2122;s) will receive 6 hours worth of continuing professional education units (CPEUâ&#x20AC;&#x2122;s) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. CDR is the credentialing agency for the Academy of Nutrition and Dietetics (AND).

PSYCHOLOGISTS

&RXUVH FRPSOHWLRQ FHUWLÂżFDWHV ZLOO EH GLVWULEXWHG WR SV\FKRORJLVWV FRPSOHWing this program. This activity is co-provided with INR. INR is approved by the American Psychological Association to sponsor continuing education for psychologists. INR maintains responsibility for this program and its content.

SOCIAL WORKERS

This activity is co-provided with INR. Social Workers completing this SURJUDP ZLOO UHFHLYH FRXUVH FRPSOHWLRQ FHUWLÂżFDWHV 7KLV SURJUDP LV DSSURYHG by the National Association of Social Workers (Provider #886502971-1393) for 6 social work continuing education contact hours.

Dr. Jeff Auerbach (Psy.D.) is a part-time psychologist-lecturer with a private practice for INR. Dr. Auerbach holds a Doctor of Psychology in clinical psychology. He specializes in relationship and communications issues. He also specializes in matters relating to bullying and self-defense. Dr. Auerbach is currently in private practice and frequently conducts seminars for health professionals. Dr. Auerbachâ&#x20AC;&#x2122;s latest book is â&#x20AC;&#x153;Irritating the Ones You Love.â&#x20AC;? Biomed reserves the right to change instructors without prior notice. Every instructor is either a compensated employee or independent contractor of Biomed.

LEARNING OBJECTIVES Participants completing this course will be able to: 1) outline clinical approaches to emotionally unstable and uncooperative patients. 2) discuss pharmacological, dietary, and lifestyle interventions that can promote normal neurotransmitter levels. 3) determine in patients suffering from emotional dysfunction, the appropriate XVH RI VSHFLÂżHG GHQWDO PHGLFDWLRQV 4) list evidence-based strategies that might reduce the risk of unstable behavior. 5) apply tools for making effective judgments and emotional responses. DVVHVV WKH ULVN DQG EHQHÂżWV RI PHGLFDWLRQV XVHG WR WUHDW SV\FKLDWULF SDWLHQWV 7) describe, for this course, the implications for dentistry, mental health, and other health professions

SPONSOR %LRPHG LV D VFLHQWLÂżF RUJDQL]DWLRQ GHGLFDWHG WR UHVHDUFK DQG HGXFDWLRQ LQ VFLHQFH DQG medicine. Since 1994, Biomed has been giving educational seminars to Canadian healthcare professionals. Biomed neither solicits nor receives gifts or grants from any entity. 6SHFLÂżFDOO\ %LRPHG WDNHV QR IXQGV IURP SKDUPDFHXWLFDO IRRG RU LQVXUDQFH FRPSDQLHV Biomed has no ties to any commercial organizations and sells no products of any kind, except educational materials. Neither Biomed nor any Biomed instructor has a PDWHULDO RU RWKHU ÂżQDQFLDO UHODWLRQVKLS ZLWK DQ\ KHDOWK FDUH UHODWHG EXVLQHVV RU DQ\ other entity which has products or services that may be discussed in the program. Biomed does not solicit or receive any gifts from any source and has no connection with any religious or political entities. Biomedâ&#x20AC;&#x2122;s telephone number is: (925) 602-6140. Biomedâ&#x20AC;&#x2122;s fax number is: (925) 363-7798. Biomedâ&#x20AC;&#x2122;s website is, www.biomedglobal.com. Biomedâ&#x20AC;&#x2122;s corporate headquartersâ&#x20AC;&#x2122; address is: Biomed, P.O. Box 5727, Concord, CA 94524-0727, USA. Biomedâ&#x20AC;&#x2122;s GST Number is: 89506 2842.

There are four ways to register: Online: www.biomedglobal.com By mail: Complete and return the Registration Form below. By phone: Register toll-free with Visa, MasterCard, American ExpressÂŽ, or DiscoverÂŽ by calling

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For information about seminars in other provinces, please call 1-877-246-6336 or (925) 602-6140.

REGISTRATION INFORMATION Individuals registering by Visa, MasterCard, American ExpressÂŽ, or DiscoverÂŽ will be charged at the prevailing exchange rate. If the credit card account is with a Canadian bank, the USA tuition will be converted into the equivalent amount in Canadian dollars (approximately $109.00) and will appear on the customerâ&#x20AC;&#x2122;s bill as such. The rate of exchange used will be the one prevailing at the time of the transaction. Please register early and arrive before the scheduled start time. Space is limited. Attendees requiring special accommodation must advise Biomed in writing at least 50 days in advance and provide proof of disability. Registrations are subject to cancellation after the scheduled start time. A transfer at no cost can be made from one seminar location to another if space is available. Registrants cancelling up to 72 hours before a seminar will receive a tuition refund less a $35.00 (CANADIAN) administrative fee or, if requested, a full-value voucher, good for one year, for a future seminar. Other cancellation requests will only be honored with a voucher. Cancellation or voucher requests must be made in writing. If a seminar cannot be held for reasons beyond the control of the sponsor (e.g., acts of God), the registrant will receive free admission to a rescheduled seminar or a full-value voucher, good for one year, for a future seminar. A $35.00 (CANADIAN) service charge applies to each returned cheque. Nonpayment of full tuition may, at the sponsorâ&#x20AC;&#x2122;s option, result in cancellation of CE credits issued. The tuition includes all applicable Canadian taxes. At the seminar, course participants will receive a complete syllabus. Tuition payment receipt will also be available at the seminar. A $15.00 fee will be charged for the issuance of a GXSOLFDWH FHUWLÂżFDWH )HHV VXEMHFW WR FKDQJH ZLWKRXW QRWLFH

REGISTRATION FORM Tue., April 28, 2015 (Mississauga, ON) Wed., April 29, 2015 (London, ON)

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Check for $109.00 (CANADIAN) (Make payable to BIOMED GENERAL) Charge the equivalent of $109.00 (CANADIAN) to my Visa MasterCard American ExpressÂŽ DiscoverÂŽ Most credit-card charges will be processed in Canadian dollars. Some charges will be in U.S. dollars at the prevailing exchange rate.

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HOSPITAL NEWS JANUARY 2015

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From the CEO's Desk 13

At Hôpital Montfort, continuing education has its dedicated centre

Hôpital Montfort, a 289-bed university teaching hospital affiliated with the University of Ottawa, delivers short-term primary and secondary healthcare in French and English to over 1.2 million residents of Eastern Ontario. Montfort is the only Francophone teaching health care institution in Ontario. By Dr Bernard Leduc n 2010, we decided to focus and coordinate all of our continuing education activities, which led to the creation of a dedicated in-house centre. We called it Prométhée – from the ancient Greece myth of Prometheus, who brought the knowledge of fire to humans. Fast forward to 2014 and our young Prométhée has been shortlisted by the Institute of Public Administration Canada for the IPAC/Deloitte Public Sector Leadership Awards in the Health Care Organization category. Hospitals are complex organizations and we quickly found that a centre like Prométhée is crucial. Delivering high quality care not only requires participation of many very skillful people, but also their collaboration of very skillful teams who share a deep culture of compassion and dedication. Health care professionals also need to apply rigorous norms, protocols and regulations. This can only be achieved with a strong educational process. Everyone considers education to be an important piece of the puzzle in day-to-day operations, however most hospitals continue to educate staff through several and sometimes poorly coordinated bodies. Examples where doctors will only teach other doctors and nurses will only educate other nurses are common. Other departments such as Human resources, Planning and development as well as Quality management might also create their own training programs. Despite the hard work involved, this type of education is done in silos and therefore limits the capacity to act as an organic and adaptive body. Prométhée, our centre for continuing professional development, provided the answer to this challenge. In 2010, when we started looking for a model to guide our planning process, we could not find anything in Ontario or elsewhere in Canada that compared to what we envisioned. Internationally, we found two significant models: one in Florida and the other in Switzerland. We also held many conversations with leaders in health education and all of them talked about the impact of poor coordination between medical and nursing educations. They complained about the fragmentation of general training and employee orientation. In their mind, a deep transformation within the health care sector was needed. Tradition, as much as internal competition, promotes the “silos” approach to continuing education; it took a lot of courage and determination to break the mold. We wanted a unique centre responsible for all learning activities from the general orientation of new employees to seminars aimed at improving leadership skills, in addition to providing nursing and medical continuing education, without forgetting any mandatory training. This centre would become a place for everyone to learn together. www.hospitalnews.com

Strong commitment and continued support from the senior management team was essential as everyone played a crucial role. Today, medical specialists and advanced practice nurses work together with education specialists to develop curriculums; our HR people or our infection control team collaborate to develop new scenarios for simulation and to design nurses’ education sessions as well as web-based modules. It was decided that the program must be geared toward inter-professional continuing development and must also integrate adverse and near-miss events reported to our hospital’s quality group as the starting point of new simulation’s scenarios. As an example, Prométhée recently developed a web-based learning module to explain how everyone in the organization should welcome patients, their families, and internal clients. At the same time, the module also promotes good practices around hand hygiene and the double identification of patients. We attained major milestones during our journey: • Coordination of the general orientation for new employees as well as the nursing orientation; • Creation of an award-winning simulation lab; • Development of our Leadership Institute, IDEAL, a major initiative in our organizational transformation process. Each one of these milestones was accomplished with the collaboration of all the stakeholders involved. Prométhée is funded by the transfer of the training budgets from all the other sectors and investing more money in educational expertise, new technologies such as high fidelity androids, and spaces adapted for experiential learning. As an organization, we decided to commit almost two per cent of our total budget into professional continuing development, even under tight financial circumstances. Through the years, a new level of adaptability and responsiveness has been reached. New training can be developed and implemented quickly. For example, in less than two months during the summer of 2014, more than 200 professionals from the Emergency Department and the Mental Health Program were able to train toward a certification on Violent Behavior Management. This shows how better educational planning can ensure an appropriate flow of knowledge, at the right time for the right people. External recognition received by Prométhée since its launch, less than five years ago, includes the purchase of online modules and in-class sessions by other health organizations. The Centre’s simulation lab received a five-year accreditation from the Royal College of Physicians and Surgeons of Canada (RCPSC) – the youngest entity to receive the highest level of accredita-

Dr. Bernard Leduc tion issued by the RCPSC. Visitors from Accreditation Canada highlighted Prométhée as a strong feature of the hospital before granting us an Accreditation with exemplary standing. The Government of Ontario also asked for Prométhée’s team expertise for the translation and adaptation of learning content. We are proud of Prométhée’s latest achievement: being shortlisted for a 2014 IPAC/Deloitte Public Sector Leadership Awards. The award recognizes organizations that have demonstrated outstanding leadership by taking bold steps to improve

Canada, through advancement in public policy and management. The capacity of other health care organizations to use the same track depends greatly on their will to adopt this emerging vision. The first outcomes of Prométhée show how powerful a dedicated continuing education centre can be, even if it takes courage to challenge traditional methods, to break structural silos and to create a H strong and empowering structure. ■ Dr Bernard Leduc is the CEO of Hôpital Montfort.

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PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

(left) Martha Spencer is completing her final year of subspecialty training in geriatric medicine. (right) Medical resident David Sherman is one of only four physicians in the University of British Columbia’s subspecialty geriatric psychiatry program.

Next generation of doctors prepare for

‘silver tsunami’ By Kerry Blackadar

here’s a “silver tsunami” forming – and it’s set to hit the shores of British Columbia sooner than you think. “The silver tsunami is a real epidemiological phenomenon that we are only experiencing the first ripples of,” says medical resident David Sherman, one of only four physicians in the University of British Columbia’s subspecialty geriatric psychiatry program. “Our society is going to have the kind of aging population that we’ve never seen before.” Over the next 25 years, Canada’s baby boomer population will continue to reach age 65 and older and in B.C. – according to Statistics Canada – the senior population is set to exceed the national average. With this surge of aging ‘boomers,’ B.C.’s doctors will begin to see an increased number of complex cases – individuals faced with a myriad of medical, mobility, and psychological issues, ranging from dementia and depression through to anxiety. At the University of British Columbia’s Faculty of Medicine, subspecialty residency training programs, like geriatric medicine and geriatric psychiatry, have heard the sounding alarms and are equipping the next generation of doctors with specialized skills and knowledge to support the wave of aging baby boomers.

Community outreach a cornerstone of UBC residency training

Among this next generation of doctors is UBC’s Martha Spencer, completing her final year of subspecialty training in geriatric medicine. “I grew up as an only child and developed a very close relationship with my grandparents,” says Dr. Spencer, recalling summers spent on the open road with her parents and grandparents. “From an early age, I learned to relate to older people and that’s where my love of helping elderly people and geriatrics began.” Originally from Corner Brook, Newfoundland, Dr. Spencer says it was the HOSPITAL NEWS JANUARY 2015

focus on acute geriatric medicine that attracted her to UBC’s geriatric medicine subspecialty residency training program. Over the course of the two-year program, geriatric medicine residents, like Dr. Spencer, are exposed to a wide range of rotations in everything from in-hospital acute consultation, rehabilitation, community, and long-term care geriatrics. Residents also gain valuable experience conducting outreach in rural, remote and northern communities – including Prince Rupert, Haida Gwaii and Prince George.

Working in isolation: a thing of the past

It was this ‘team-based’ approach that drew Dr. Spencer to the profession in the first place. “I love working in a team – that’s one of things that I love so much about geriatrics,” says Dr. Spencer. “Because older patients can be very complex, you really can’t do it alone.” This sentiment is echoed by her colleagues in UBC’s geriatric psychiatry subspecialty training program, which gives

Over the course of the two-year program, geriatric medicine residents are exposed to a wide range of rotations in everything from in-hospital acute consultation, rehabilitation, community, and long-term care geriatrics. Dr. Lawrence Lo, program director of the geriatric medicine training program, says he sees these outreach experiences as vital to residents’ overall development. “It’s an eye-opening experience,” says Dr. Lo. “These outreach opportunities bring residents face-to-face with individuals who are in need of services and the hope is that it will impact how they advocate for patient populations going forward in their career.” For Dr. Spencer, it was an outreach trip to Haida Gwaii – a remote archipelago off the north coast of B.C. – that reinforced her understanding of the important role geriatricians play in the wider health care system, providing support to family physicians on the front-lines of patient care in rural and remote regions across the province. “Geriatricians work collaboratively with family doctors and can really help provide support with their more complex patients,” says Dr. Spencer, reflecting on her time in Haida Gwaii, where she worked alongside a local family doctor to conduct consultations with older patients in the community.

residents the tools and expertise to assess, diagnose and treat older patients with complex mental disorders. “At the end of the day, elderly patients have such complex issues and it’s difficult for anyone to work in isolation – multidisciplinary teams are needed to serve the aging population,” says Jeanine Marshall, who is completing UBC’s geriatric psychiatry training program in Victoria, B.C.

Training the next generation

The important role that specialists and subspecialists play in the overall healthcare system is widely recognized. “A sustainable health care system includes the training of specialty and subspecialty physicians,” says UBC’s Dr. Roger Wong, associate dean of postgraduate medical education. “The growth and demographics of B.C.’s population means that demand for physicians trained in subspecialties, particularly those who focus on medical conditions affecting the aging population, will continue to increase.” According to Martha Donnelly, the director of UBC’s geriatric psychiatry resi-

dency training program, readying the next generation of geriatric psychiatrists for the “tsunami” is what keeps her going. “We not only have a tsunami of older patients, we have tsunami of dementia,” says Dr. Donnelly, who built the university’s geriatric psychiatry program from the ground up and witnessed its official launch in 2012. “It’s very gratifying to be teaching the next generation.” And it’s not just about teaching residents to diagnose and treat the ‘textbook cases’ – it’s about teaching them to truly know the people they’re caring for. “I’ve often said to medical students: when I see a patient and take a history – it’s like reading a biography. These people have had very interesting lives – often 85, 90…sometimes 100 years of it. It’s extremely exciting to know about some else’s life and see that you can make a difference.” For UBC’s geriatric psychiatry resident, Dr. Paul Blackburn it’s making a difference that matters most. “Geriatric psychiatry allows me to advocate for older patients,” he says. “Elders are faced with enormous changes in their lives – they may be dealing with bereavement of spouses, retirement after decades of work, dementia, their own mortality – this is incredibly difficult for patients and families to face. And without a little bit of extra training and understanding of how everything fits together, these can be difficult issues for doctors to face.” UBC residents have received training in geriatric psychiatry through elective and fellowship opportunities since 1984. In 2012, when geriatric psychiatry was formally recognized as a subspecialty by the Royal College of Physicians and Surgeons of Canada, UBC was responsive and seized the opportunity to meet the province’s health needs – it was one of only a handful of medical schools across the nation to offer an accredited geriatric psychiatry H subspecialty residency training program. ■ Kerry Blackadar is a Communications Coordinator, UBC Faculty of Medicine. www.hospitalnews.com

Ethics 15

Staff engagement: What’s ethics got to do with it? By Jonathan Breslin, PhD

ngagement of staff members and physicians is a significant priority in many hospitals, and for good reason. At a high level, organizations with more engaged staff members and physicians perform better. Getting more specific, the research suggests that engagement has a direct influence on a wide range of human resource factors, including recruitment and retention, job performance, absenteeism, and morale. In the hospital context there is also a growing body of evidence linking engagement to important hospital outcomes, such as quality, patient safety, and patient satisfaction. All of this evidence supports the old adage, “A happy employee is a productive employee.” The challenge for hospitals is that there are a host of factors that contribute to a particular staff member’s or physician’s level of engagement, including wellness, education and training opportunities, effective teamwork, rewards and recognition, and so on. So how does ethics fit into this picture? One way that ethics is directly relevant to staff and physician engagement relates to the culture of the organization, specifically whether the organization lives its core values. There is extensive research in the business ethics literature showing that employees prefer to work for organizations that promote key ethical values and live those values on a day-to-day basis. This is an important contributor to feeling proud to work for an organization, which is a component of engagement.

toms of stress related specifically to the experience of being unable to carry out what one thinks is morally right, or to being put in a position where one feels forced to do or go along with something one thinks is morally wrong. There is extensive research on the prevalence of moral distress amongst nurses and other health care providers, showing not only that it is widely prevalent but also that it is directly linked to burnout, absenteeism, withdrawal, and turnover. There is even some recent re-

search demonstrating the prevalence of moral distress amongst health care managers. The recommendations that have emerged from this large body of research emphasize the importance of creating an organizational culture in which there are effective mechanisms for openly raising, discussing, and resolving (when possible) ethical issues. Although the link between ethics and engagement might not be obvious, for the reasons I’ve mentioned above hospital

leaders are strongly encouraged to think about the ethical cultures in their organizations and what improvements can be made in that area to help their staff and H physicians feel more engaged. ■ Jonathan Breslin PhD is an Ethicist for Southlake Regional Health Centre and Mackenzie Health and an Assistant Professor in the Institute of Health Policy, Management and Evaluation at The University of Toronto.

VS.

Of the 36 factors measured, the number one factor identified as having the greatest influence on engagement scores was, I feel I can trust this organization. A recent article in Healthcare Quarterly reported on results from the first wave of the Ontario Hospital AssociationNRC Picker Employee Experience Survey, which involved more than 10,000 employees in 16 Ontario hospitals. The results provide us with some incredibly valuable insight into hospital staff engagement on a large scale across the Province. One of the analyses conducted by the author was a regression analysis to identify which of the many factors contributing to engagement best explained the engagement scores. Of the 36 factors measured, the number one factor identified as having the greatest influence on engagement scores was, I feel I can trust this organization. Explaining the importance of this result the author notes that; “The key to unlocking higher levels of engagement is for managers at all levels to build trust with employees. Demonstrating basic respect, fairness and integrity in all dealings with staff is the basis for trust…A prerequisite in this regard is open communication.” The second way ethics is relevant to engagement is through the concept of moral distress, which I wrote about in a previous column. Moral distress refers to the sympwww.hospitalnews.com

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JANUARY 2015 HOSPITAL NEWS

16 Focus

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

A commitment to mental health at work By Priscilla Hsu

n Canada, one in five employees will be touched by a mental illness, with depression being one of the most common illnesses. A person’s mental health can impact their relationships, self-esteem, and even their ability to perform. As mental illness continues to be a growing concern for many organizations, a number of industry partners, launched the Wellth Management Mental Health at Work® Challenge to encourage employers to take action and address mental illness in the Canadian workforce. This challenge involves engaging managers and employees in a dialogue about mental health and reducing the stigma associated with mental health in the workplace. A recent global workplace survey commissioned by Wellth Management partner Lundbeck Canada and conducted by Ipsos Mori found that only 40 per cent of employees diagnosed with depression told their employer, which suggests people may not be seeking the support they need. If mental health can be addressed and destigmatized in the workplace, it can help make it easier for employees to get the right support to feel better, sooner.

The goal is to build positive dialogue about mental health in organizations right across Canada to encourage them to begin the process of implementing workplace mental health practices and policies. “Good health is not possible without good mental health, so it is good business to have employees who are psychologically healthy and safe, and have managers who are sensitive to employees’ mental health,” says Joseph Ricciuti, Co-Founder of Mental Health International and a Wellth Partner. “Our goal is to build positive dialogue about mental health in organizations right across Canada to encourage them to begin the process of implementing workplace mental health practices and policies.” The Wellth Management Mental Health at Work® Challenge and Excellence Canada’s award program serve as roadmaps for organizations in any sector to encourage, support and implement exemplary mental health-related programs in the workplace. North York General Hospital (NYGH) was one of three recipients of the prestigious 2014 Canada Awards for Excellence, Mental Health at Work®; winning the bronze award for its commitment to mental health-related programs in the workplace. The hospital was commended for enhancing its mental health promotions and initiatives that supported de-stigmatization and illness prevention for the well-being of staff, physicians and volunteers. In addition, NYGH was also recognized for its commitment to develop holistic mental health programs using an evidence-based approach. “We know our health care professionals need to be supported so they can then provide the best care possible for our patients and families,” says Dr. Tim Rutledge, President and CEO, NYGH. “Excellence Canada reviewed our programs, met with our staff, provided advice and recognized HOSPITAL NEWS JANUARY 2015

the tremendous impact we can have by focusing and addressing mental health in the workplace.” The following are just some initiatives North York General has implemented to support mental health in the workplace: •Revised Occupational Health, Safety and Wellness policy to recognize psychological health and safety. •Employee Assistance Program (EAP) provides staff and their families with support, resources and information for personal and/or work-life challenges; debrief sessions with a counsellor after a critical incident involving staff, units or departments; and training seminars for topics such as emotional eating, resiliency and compassion fatigue. • Anti-stigma campaign led by the Mental Health, Wellness and Diversity programs. The campaign includes an annual Mental

Health Art and Craft Show and diversity education events aimed at reducing stigma and barriers around mental illness, disabilities, ethnicities, religions and sexual orientations. In addition, with the national leadership of NYGH’s Chief of Psychiatry and Medical Director, Dr. Thomas Ungar, an e-learning module for health care professionals (mdcme.ca) and online interactive resources (mentalhealthminute.com) are available to all staff, physicians and volunteers. •Wellness and ﬁtness programs which include: mindfulness meditation, yoga and tai chi classes, Weight Watchers, training for organized external events (ex: Scotiabank Toronto Waterfront Marathon, Ride for Heart and CN Tower Climb), access to a 24-hour gym and massage chair, and health risk evaluations. •Wellness outreach program for shift staff

which provides energizing teas, healthy snacks and information about health promotion and wellness resources. Some of the new initiatives the hospital will be looking to expand in 2015 include the psychological health and safety risk index tool and further collaboration with the Mental Health and Diversity programs. With the support of Lundbeck Canada, the Wellth Management Partners are now travelling across Canada to support business leaders as they take action to implement the National Standard of Canada for Psychological Health and Safety in the Workplace. For more information about participating in the challenge visit: www.bestlifereH warded.com/ECC ■ Priscilla Hsu is a Communications Officer at North York General Hospital.

Working in West Africa:

How humanitarian missions impact career By Natalie Moncur

he largest Ebola outbreak in history continues to unfold in West Africa with the death toll rising daily. Financial resources are essential in the fight against Ebola, but so are human resources. For medical professionals, working in an Ebola Treatment Centre in West Africa is a unique opportunity to be involved in a response of an unprecedented scale that requires working in medical settings that differ greatly from those available in North America. Since September, the Canadian Red Cross has deployed aid workers to Sierra Leone to the Ebola Treatment Centre. These aid workers, many of whom are health care professionals, are not only using their expertise to provide essential medical care, but they are also expanding their knowledge and improving practices in responding to Ebola. “In the last few months, we have seen an increase in interest from healthcare workers wanting to go to West Africa to help with Ebola,” says Catherine LinoisDavidson, Manager, Talent Management and Acquisition for the Canadian Red Cross. “This is an opportunity for healthcare workers to provide critical help while learning how to work within a massive epidemic with limited resources.” For health delegates who have already worked in West Africa with the Red Cross, their reasons for going may differ slightly, but all are based on a recognized need, wanting to help and exploring areas of professional interest. “I’ve always had an interest in learning more about tropical medicine and infectious diseases,” says Dr. Lauralee Morris, who recently spent four weeks in Sierra Leone. “Those weren’t my sole motivators for going though. I realized while I was there how really valuable what I was doing was, and that became the motivation... I really had something to offer.” “Aid workers in West Africa learn how to work with significantly fewer resources,” says Linois-Davidson. “Quite often they are providing very basic care while

Kathy Mueller is an aid worker who has completed a mission in Kenema, Sierra Leone. She is standing in outside of the Ebola Treatment Centre. making the most out of very little in the Ebola Treatment Centre, and it’s teaching them how to treat effectively in a less than ideal setting.” Before being deployed, all aid workers undergo extensive training with the Red Cross. This training incudes a twoday course on the Ebola virus, learning to safely wear personal protective equipment and an overview of how to work in the environment. The training is essential to empowering aid workers and dispelling misinformation being shared about the virus. It also helps prepare workers for their role as mentors to local staff at the Ebola Treatment Centre “Many of the staff at the Ebola Treatment Centre are local workers who do not have the same resources,” says Linois-Davidson. “Red Cross delegates are there to work alongside local staff as colleagues. They are helping to set them up with basic health care skills that will benefit the community now and into the future.”

For Dr. Morris, the learning opportunity was mutual between herself and the local staff. “They are the brave ones,” she says. “I was there for a few weeks and then was able to come home. But, every day, the local doctors and nurses continue to work in the Ebola treatment centres, and they will continue to do so until this is over.” Deploying as an aid worker for the Red Cross in Sierra Leone presents some substantial opportunities. There are currently roles with the Canadian Red Cross for nurses, doctors, community health experts, psychosocial support workers and water and sanitation experts.. For more information on becoming a Red Cross delegate and how you can participate in the fight against Ebola, please visit www.redcross.ca/careers or email inH ternationalhr@redcross.ca. ■ Natalie Moncur works in Communications Advisor at The Canadian Red Cross – Ontario Zone. www.hospitalnews.com

Focus 17

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Employee engagement – An essential step towards better healthcare By Dr. Chris Bart n every hospital, each manager believes they lead in a manner that engages employees. No one goes to work thinking they want to manage poorly. Yet, we all know a manager that acts in a way that makes us – and their employees – cringe. But this article isn’t about the manager that could be the source of a brutal newspaper article. This article is about good managers. These people already do a good job relating to their employees yet they know they could do better. Hospitals have mission statements that are often inspirational and help to guide the actions and efforts of the employees. But in the everyday grind of the real world, delivering on that strategy day in and day out in a manner that will serve patients and their families, along with all other stakeholders in the hospital, is one of the most difficult and enduring problems faced by leaders. Research shows that regardless of the economic circumstances, having an engaged workforce – one that is enthusiastically willing to give more than just what is required to hold onto their jobs – contributes to better organizational performance. Consistent, flawless execution requires a dedicated and committed workforce that is passionately focused on achieving the aims and aspirations contained in the hospital’s mission statement. Conceptually, this all makes sense. But practically, it can be very difficult to do. Why? Because, according to a survey by The Conference Board, 55 percent of employees stated that they are dissatisfied with their jobs. Yet there is clear evidence that a significant relationship exists between the level of personal commitment (or “engagement”) an employee has towards their employer and organizational performance. Why are there such dramatically better results for firms with engaged employees? It’s because engaged employees are both passionate about their jobs and emotionally bonded to their organizations. They are willing to give that elusive ‘discretionary effort’ that drives a more intense strategic focus, higher efficiency and better productivity. Accordingly, eliminating workplace alienation and creating an engaged workforce have become the new mantras for building progressive companies. And it doesn’t need to be complicated. Concentrate on the following three actions.

Act 1: make sure they REALLY know what to do – and why

Be extremely clear about organizational goals embedded in the mission and vision statements and obsessively communicate to employees how their work – both collectively and individually – specifically contributes to them. Everyone wants to feel important and to feel that what they do matters. Those feelings are not always so easy to obtain, however, especially for persons performing those boring, routine and repetitive front line jobs. But it is the responsibility of the ‘nearest leader’ (i.e., the immediate supervisor) to help those www.hospitalnews.com

individuals see the ‘higher purpose’ in their work and that an organization is measured – through the eyes of both the patient and other stakeholders – on every single activity regardless how big or small. Everyone, therefore, is depending upon them to do their job with excellence or else the whole organization could fail. This needs to be very explicitly stated.

Act 2: Say “Thank You” – and mean it!

At the top of the list of practices that increase an organization’s level of employee engagement is expressing appreciation through the simple acts of regularly and sincerely thanking employees and praising them for their work. Publicly acknowledging exceptional work is considered especially important, though rewarding the routine and commonplace is also encouraged, such as for good at-

tendance. In the world of high engagement, kindness matters… A LOT!

Act 3: Development and training – the rewards THEY value

Finally, most employees want to know that they have avenues for advancement in their organizations – if they want them. This means there must be career development and training opportunities at every level in the hospital and supervisors should be required to regularly discuss ways to help interested employees achieve them. Nowhere is this more important than for employees at the bottom of the ladder. They especially need to know that someone is looking out for them and wanting to help them succeed. Great organizations search for ways to get the competitive edge. Many are overlooking an effective strategic weapon that

is standing right in front of them – their fellow workers. Creating an inspired and engaged workplace will not occur by happenstance. It requires a leadership team – at every single level of the organization – who understands and values its importance. And when you create this culture of engagement, it won’t be long before your hospital will be the envy of every health H care organization. ■ Dr. Chris Bart, FCPA., is the author of two very popular mission implementation and leadership books, “The Mission Driven Hospital” and “A Tale of Two Employees and the Person who wanted to Lead them”, which has been one of the Top Ten Best Selling Business Book in Canada for 10 consecutive years. He can be reached at www.corporatemissionsinc. com/best-sellers.

Better care for a better life

Canada-wide serious injury care with a local “touch” BAYSHORE HOME HEALTH delivers a wide range of nursing and attendant care to people with serious injuries, helping them regain their daily lives and reintegrate into their communities. Our nurses are specially trained to deal with clients who need advanced clinical care, while our personal support works perform many delegated tasks for individuals with catastrophic and non-catastrophic injures. They are supported by internal clinical experts and our National Care Team – a convenient, central contact point for workers’ compensation boards, insurers and government care programs, providing standardized client reporting and timely service. With 40-plus oces across Canada, we also oer a local “touch” when it comes to professional care for people with serious wounds, fractures, amputations and spinal cord/acquired brain injuries. To learn more, please call 1.866.265.1920.

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JANUARY 2015 HOSPITAL NEWS

18 Travel

Where to watch IN 2015 By Katie Parsons

ith the beginning of the new year, travel plans for 2015 are afoot. But with so many countries to choose from, where should you pick? Looking at the major events, trends and political changes around the world, our top five predictions for 2015 are Sri Lanka, Romania, Vietnam, Colombia and Oman. Here’s why you should put these on your list.

trend for experiential holidays continues to develop, cookery schools are popular with guests wanting to learn how to recreate their favourite dishes.

Colombia

Sri Lanka

For a relatively small country, there is a lot on offer in Sri Lanka. The country is excellent value for money and there are hotels to suit every taste and budget. There is a fascinating cultural heritage as well as wildlife, colonial towns and tropical beaches. With new hotels being built on the island’s east coast, and improvements to the infrastructure on the island’s southern and eastern coasts, as well as political stability, its popularity looks set to remain.

Oman

Combining breathtaking landscapes with a fascinating culture, Oman is perhaps the least known destination in the Middle East. But with the recent visit of Prince Harry, and new luxury hotels opening up, this looks set to change. From mag-

HOSPITAL NEWS JANUARY 2015

nificent forts and palaces to rolling sand dunes and mountain ranges interspersed with lush wadis, Oman has a lot to offer with a relatively short flight time and minimal jet lag. The guaranteed sunshine during the British winter makes it a great destination for a New Year break.

Vietnam

As tourists are familiar with Thailand and all that it offers, increasing numbers are looking to explore elsewhere in the region. Vietnam has an interesting history and culture and is seeing more investment in its infrastructure, with the launch of an additional direct flight from London next summer and new hotels opening. As the

As Latin American countries continue to soar in popularity, travellers are looking for lesser explored destinations for their holidays. Still largely untouched by mass tourism, Colombia is fast becoming popular. From Andean peaks and the lush Amazon basin, to tropical coastline and unspoilt beaches, there is a diverse mix of landscapes, colonial heritage and interesting towns and cities.

Romania

Not many people know that the Prince of Wales owns a collection of houses in Transylvania, which he bought to help to preserve the cultural heritage of this little known part of Europe. Available for tourists to stay in, the houses give a unique glimpse into life in an 18th century Saxon village. The country has a wealth of sights to explore, including painted monasteries, dramatic castles and palaces, medieval H towns and beautiful scenery. ■ Katie Parsons is the PR Manager at Cox & Kings. Reprinted with permission from www.aluxurytravelblog.com

www.hospitalnews.com

Nursing Pulse 19

An appetite for advocacy By Melissa Di Costanzo or 90 years, the Registered Nursesâ&#x20AC;&#x2122; Association of Ontario (RNAO) has advocated for healthy public policy, promoted excellence in nursing practice, increased nursesâ&#x20AC;&#x2122; contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. Many of RNAOâ&#x20AC;&#x2122;s advocacy efforts can be traced back to frontline registered nurses, nurse practitioners and nursing students who have stood up and spoken out on issues that are important to them. This is the story of one courageous member who drew attention to elder abuse. Six years ago, on May 25, 2008, a client kicked over a pail of water at Cornwallâ&#x20AC;&#x2122;s Glen Stor Dun Lodge, a 132-bed long-term-care home located just steps from the St. Lawrence River. An employee responded by tying the residentâ&#x20AC;&#x2122;s shoelaces to a nearby table. A nurse came into the room and untied the client. But the employee grabbed the resident by the shoulders, pulled him up in his chair, and began to force-feed the man. The nurse documented the incident and the employee received additional education and was suspended for five days. Diane Shay, an RN of over 20 years, was the City of Cornwallâ&#x20AC;&#x2122;s health and safety officer at the time. The case came to her attention several days after the incident.

Now on long-term disability, Shay isnâ&#x20AC;&#x2122;t sure sheâ&#x20AC;&#x2122;ll return to work again. She paid a heavy price for doing the right thing. In 2013, she was diagnosed with benign multiple sclerosis, with prominent symptoms related to workplace stress. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s been devastating. Iâ&#x20AC;&#x2122;ve lost something that I love doing,â&#x20AC;? she says of a career cut short. Still, she stands by her decision, saying â&#x20AC;&#x153;there was never a question, ever,â&#x20AC;? that abuse had taken place. As a nurse â&#x20AC;&#x153;you always have a responsibility to report,â&#x20AC;? she says. â&#x20AC;&#x153;(For me), there was never a choice.â&#x20AC;? Shay wasnâ&#x20AC;&#x2122;t the first and wonâ&#x20AC;&#x2122;t be the last RN to blow the whistle on elder abuse. RNAO plans to continue raising awareness around the issue and its BPG. â&#x20AC;&#x153;What scares me (is) nurses who are going to be afraid to come forward...whoâ&#x20AC;&#x2122;s the advocate now?â&#x20AC;? Shay says. â&#x20AC;&#x153;Thatâ&#x20AC;&#x2122;s H why I continue to fight.â&#x20AC;? â&#x2013;

Many of RNAOâ&#x20AC;&#x2122;s advocacy efforts can be traced back to frontline registered nurses, nurse practitioners and nursing students who have stood up and spoken out on issues that are important to them.

Familiar with the lodgeâ&#x20AC;&#x2122;s non-abuse policy, and aware that any instance of resident abuse has to be reported to the police and Ontarioâ&#x20AC;&#x2122;s Ministry of Health, Shay brought the matter to Robert Menagh, the cityâ&#x20AC;&#x2122;s human resources manager at the time. According to court documents, Menagh told Shay to â&#x20AC;&#x153;be carefulâ&#x20AC;? about what she does and to â&#x20AC;&#x153;just leave it.â&#x20AC;? Stunned, Shay then approached lodge administrator, Donna Derouchie, urging her to report the incident to the ministry. Derouchie said she couldnâ&#x20AC;&#x2122;t establish that what had occurred was abuse, and did not report it at that time. After repeated pleas to Menagh and Derouchie to report the incident, Shay took matters into her own hands and called the ministry on June 11, 2008, one day after Derouchie was also in touch with the ministry (a fact unknown to Shay at the time). The ordeal continued to escalate when Shay, a city employee for 18 years, was accused of being insubordinate and disloyal. Feeling intimidated, she reminded Menagh www.hospitalnews.com

of the cityâ&#x20AC;&#x2122;s whistleblower policy, which he later accused her of misunderstanding. Shay remembers driving into work in tears, and driving home in tears. â&#x20AC;&#x153;I didnâ&#x20AC;&#x2122;t know what was going to happen next, or how I was going toâ&#x20AC;Śdo my job.â&#x20AC;? She began to have difficulty concentrating. Muscle spasms and numbness in her hands and face followed. â&#x20AC;&#x153;The stress really started to get to me,â&#x20AC;? she says, adding she went on medical leave in September 2008. Six months later, Shay was fired. As a member of RNAO, she called the association looking for support, and received it through the Legal Assistance Program offered to members. RNAO â&#x20AC;&#x153;supported me and believed me from day one,â&#x20AC;? she says. â&#x20AC;&#x153;It was the best feeling.â&#x20AC;? Shay retained a lawyer, filed a civil lawsuit against the city, and was eventually reinstated. Then, in a separate case that was settled in 2011, the Ministry of Health laid charges for illegal retaliation against the City of Cornwall and Menagh. In October 2011, the city pleaded guilty, was fined $15,000, and was required to pay $3,750 to the Victim/Witness Assistance Program. RNAO responded with a media release, praising the outcome of the case, and Shayâ&#x20AC;&#x2122;s courage to stand up for residentsâ&#x20AC;&#x2122; rights. That same year, elder abuse was on RNAOâ&#x20AC;&#x2122;s radar. The association launched an initiative, in partnership with the Canadian Nurses Association, called the Prevention of Elder Abuse Centres of Excellence (PEACE) initiative. Ten long-term care homes across the country signed up for the project, which helped nurses and other health-care professionals better identify and report elder abuse. Although preventing elder abuse was already part of RNAOâ&#x20AC;&#x2122;s work, Shayâ&#x20AC;&#x2122;s case catapulted it into the spotlight. One year after PEACE was launched, the federal government provided RNAO with support to create a best practice guideline (BPG) that addresses abuse and neglect of older adults. It was released in the summer of 2014. Shay, who sits on the Canadian Standards Associationâ&#x20AC;&#x2122;s working group charged

with developing whistleblower guidelines, was pleased to hear about RNAOâ&#x20AC;&#x2122;s BPG, and continues to call for stronger consequences if elder abuse occurs, and if an employee raises concern. â&#x20AC;&#x153;Canadaâ&#x20AC;&#x2122;s in a sad state of affairs when it comes to whistleblowing,â&#x20AC;? she says. â&#x20AC;&#x153;The (provinceâ&#x20AC;&#x2122;s) ministry of health has to get its act together.â&#x20AC;?

Melissa Di Costanzo is communications officer/writer for RNAO, the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. This article originally published in the September/October 2014 issue of Registered Nurse Journal, the bi-monthly publication of the Registered Nursesâ&#x20AC;&#x2122; Association of Ontario (RNAO).

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Registration Fee

Michael Fraleigh Partner, Fogler, Rubinoff LLP

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JANUARY 2015 HOSPITAL NEWS

20 Focus

HEALTH TECHNOLOGY

Digital technology is changing medical practice and turning lives around By Dr. Shafiq Qaadri t is a frustration for every health care professional. We work so hard to help our patients, but despite our best efforts, too many patients with chronic diseases continue to decline. I’m thinking of one of my patients, Phil, who is a 53-yearold with high blood pressure. When I first diagnosed Phil a few years ago, he did not make the lifestyle changes I urged him to make and he even stopped taking his medication after a few months. He claimed he felt fine, so why take it? It seemed obvious to me that Phil had not really heard me when I explained hypertension to him – otherwise, why would such a bright man make such a foolish mistake?

This is a new way of practising medicine – medicine for the digital age. Instead of making it more impersonal, which you might expect, it is doing the opposite. So here is what I’ve done to turn things around. I use NexJ Health Pro with Phil, and many of my patients, to improve the effectiveness of my education efforts. It is a tablet app that uses plain language and infographics to make learning easy, whatever the patient’s level of health literacy. After getting the code from connectedwellness. com I downloaded the app for free onto my iPad from the App Store. It includes teaching presentations or decks of various lengths (from 2 to 10 minutes) on a wide

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range of conditions and treatments, all peer-reviewed. Earlier this year, I took Phil through the hypertension deck and used the audio feature that recorded our conversation. I told him I would send him the deck with the audio recording, so he didn’t have to worry about trying to remember everything we said. I could immediately see that Phil was more relaxed and engaged than ever before. He leaned in to look at the infographics. I got him to actually touch the screen and circle some of his risk factors, and I wrote his blood pressure right on the deck so it was personalized to him. After the appointment, I sent Phil his deck (in video form and as a PDF for printing) along with some Heart and Stroke Foundation and Hypertension Canada attachments. Phil received an email from NexJ Connected Wellness with instructions on how to log in and access the information I had sent. Phil told me that one of the first things he did with his new Connected Wellness account was invite his wife and kids to his circle of care. Since I had enrolled him, I was automatically a member. Phil told me being able to share the deck made it easier for his family to understand his condition and the lifestyle changes he was going to have to make. I believe the chance to have a second review at home also improved his own comprehension. He printed the Action Plan I created for him and put it on his fridge for the entire family to see. Phil has begun taking his medication regularly now that he understands why he needs it, but he is still struggling with the lifestyle changes he needs to make. Those old habits are hard to break. At our next appointment, I will urge him to sign up for personal health coaching. Using the NexJ Health Coach app, he

Dr. Shafiq Qaadri

will be able to track all of his biometrics including blood pressure and exercise. He can even set up his Connected Wellness account to sync to his Fitbit device so it automatically captures the number of steps he takes each day. I’d also like to see Phil use NexJ Health Coach to track his meals and start food journals. He will photograph his plate before each meal and answer simple questions about the portion size, healthiness, how satisfied he feels after, etc. This may even motivate Phil’s wife – the family cook – to prepare healthier meals for her family. Phil’s tracked data will be saved in his Connected Wellness account. Those of us in his circle of care will be able to follow his progress, and his coach will message him with support and encouragement when he needs it. Over time, Phil will see the direct

relationship between his behaviour and his health. For many patients, this can have a significant impact on motivating them to maintain behavior changes over the long term. This is a new way of practising medicine – medicine for the digital age. Instead of making it more impersonal, which you might expect, it is doing the opposite. My relationships with my patients are stronger. They are actively managing their health in a way I have never seen before. My time is used more efficiently and I’m just plain happier – I’m no longer wasting my words and wondering why my patients are not H responding. ■ Dr. Shafiq Qaadri is a Toronto family physician and member of provincial parliament for Etobicoke North.

Huge growth in Canadian doctors use of information technology M

ore Canadian physicians than ever are embracing information technology. New data from the 2014 National Physician Survey (NPS) shows significant increases in the use of information technology since previous surveys in 2007 and 2010. Seventy-five per cent of physicians report using electronic records to enter or retrieve clinical patient notes on a laptop or desktop. The number has tripled from 26 per cent in 2007.

“A huge growth in the use of information technology is taking place across Canada,” says Dr. Cecil Rorabeck, President of the Royal College of Physicians and Surgeons of Canada. “Doctors are not only using information technology more, but finding it enhances their ability to provide high-quality patient care.” Sixty-five percent of physicians reported seeing better or much better quality of care since the implementation of electronic records, a rise of nine percentage points from last year. Physicians in Alberta, British

Columbia and Ontario were most likely to report using electronic records at close to 81 per cent in each according to the NPS findings. Cancer specialists had very high usage with radiation oncologists at 96 per cent, medical oncologists at 97 per cent and family physicians at 77 per cent. “It's great to see more family physicians moving to electronic record systems and electronic tools,” says Dr. Garey Mazowita, College of Family Physicians of Canada President. Continued on page 22 www.hospitalnews.com

Evidence Matters 21

Continuing Medical Education and CADTH:

Effective CME from an unexpected source By Dr. Janice Mann ontinuing medical education, or CME, has come a long way in recent years. At one time CME, also known as ‘continuing professional development’ (CPD), took place mostly at large conferences and meetings with didactic presentations. Only a few providers of CME existed. Today, CME can take place anywhere – including at home while wearing pajamas – and can take on almost any form, from podcasts to Facebook groups. And continuing medical education is no longer limited to only those officially in the medical field. Mini medical schools offer talks to the general public to increase their health knowledge, and the #FOAMed movement (Free Open Access Meducation – Medical education for anyone, anywhere, anytime) focuses on freely available medical education resources for all, on the web. This evolution of CME has allowed organizations such as CADTH – an independent agency that finds and summarizes the research on drugs, medical devices, and procedures – to offer CME activities to clinicians in both traditional and non-traditional ways.

CADTH has partnered with The Canadian Medical Association Journal (CMAJ) to produce quick “True and False” quizzes based on CADTH research for doctors and other health care providers. For busy clinicians, there isn’t always time to attend a lecture or a conference to get the latest information on drugs, medical devices, and procedures. For this reason, CADTH has partnered with The Canadian Medical Association Journal (CMAJ) to produce quick “True and False” quizzes based on CADTH research for doctors and other health care providers. These quizzes allow clinicians to test their knowledge on issues relevant to their practice and read up-to-date evidence and information on the topic – taking only a minute or two out of their busy day. The quizzes appear on the homepage of CMAJ – www.cmaj.ca – and are updated regularly. All of the CMAJ quizzes – from CADTH, as well as Choosing Wisely Canada and the Canadian Task Force on Preventive Health Care – are available for review anytime in the quiz archives on the CMAJ website: http://www. cmaj.ca/site/misc/poll_archives.xhtml. Here are just a few of the True/False statements you can find there: True or false: Warfarin is no longer the drug of choice for preventing stroke in patients with atrial fibrillation. www.hospitalnews.com

True or false: All sexually active women less than 25 years of age should be offered chlamydia screening. True or false: Probiotics may be effective in preventing and treating some gastrointestinal disorders. This quick learning opportunity is proving to be quite popular, with some quizzes already racking up over 600 responses to the True/False question. For a more formal CME opportunity in which CME credits can be earned, CADTH has partnered with the Canadian Medical Association (CMA) to offer Optimal Prescribing modules. Developed by the CMA in collaboration with CADTH and based on CADTH research, the 12 accredited online CME modules cover key issues in safely and effectively prescribing drugs or classes of drugs. After completing each module and answering questions, 0.5 Mainpro credits can be claimed from the College of Family Physicians of Canada. Optimal Prescribing module topics include: • Choosing the best ADHD medication for your patient • New oral anticoagulants: optimal use in patients with atrial fibrillation • Opioids for chronic pain CMA members can access the Optimal Prescribing modules on the CMA website. For pharmacists and other health care professionals, CADTH has developed a workshop accredited by the Canadian Council on Continuing Education in Pharmacy – Critical Appraisal 101. This workshop geared to those without a strong research background provides information, assessment tools, and hands-on training from critical appraisal experts at CADTH. It teaches participants how to effectively read and interpret the medical literature including randomized controlled trials, systematic reviews, clinical practice guidelines, and qualitative studies. For more information or to set up a workshop, you can contact a CADTH Liaison Officer in your area: www.cadth.ca/liaison. Even helping CADTH by providing feedback on our projects that are underway can earn family physicians and specialists CME credits. And feedback from clinicians helps to ensure that CADTH evidence reviews are relevant to clinical practice. Our calls for feedback come via the CADTH E-Alert, and you can subscribe at www.cadth.ca/subscribe. Keeping up with the latest evidence on drugs, medical devices, and procedures as well as earning the necessary CME credits can be a challenge for busy clinicians. CADTH is just one of the organizations in Canada working to make these tasks a little easier. If you’d like more information about CADTH; our evidence on a variety of drugs, devices, or procedures; or our CME opportunities visit www.cadth. ca, follow us on Twitter: @CADTH_ACMTS, or talk to our Liaison Officer in your H region. ■ Dr. Janice Mann is a Knowledge Mobilization Officer, CADTH @JustSayIt_MD.

Educational & Industry Events To list your event, send information to “events@hospitalnews.com”.

We try to list all events and information but due to space constraints and demand, we cannot guarantee it. To promote your event in a larger, customized format please send enquiries to “advertising@hospitalnews.com” Q January 6-9, 2015 2015 International CES Las Vegas, NV United States Website: www.cesweb.org Q January 27-28, 2015 11th Annual Mobile Healthcare Summit Eaton Chelsea, Toronto Website: www.mobilehealthsummit.ca Q January 29-31, 2015 Better Breathing Conference Toronto Marriott Downtown, Toronto Website: www.betterbreathing.ca Q February 19th – 20th, 2015 UofT Nursing, Centre for Professional Development presents: The Institute on Advancing Pain Assessment and Management 155 College Street, Toronto ON Website: http://bloomberg.nursing.utoronto.ca/pd/professionaldevelopment/pain-institute Q February 25-26, 2015 National Canadian Forensic Nursing Conference Renaissance Horbourside, Toronto Website: www.healthcareconferences.ca Q March 4-5, 2015 Offshore and remote Workplace Health Conference Sheraton Hotel, St. Johns, Newfoundland Website: www.healthcareconferences.ca Q March 7th, 2015 UofT Nursing, Centre for Professional Development presents: PeriAnaesthesia Review Course 155 College Street, Toronto ON Website: http://bloomberg.nursing.utoronto.ca/pd/professionaldevelopment/perianaesthesia Q March 23-24, 2015 Canadian Hip Fracture Management Conference Renaissance Downtown, Toronto Website: www.healthcareconferences.ca Q March 30 – April 1, 2015 Together We Care (ORCA & OLTCA Annual Convention & Trade Show) Metro Toronto Convention Centre, Toronto Website: www.togetherwecare2014.ca Q April 12, 2015 HIMSS15 (HIMSS Annual Conference) McCormick Place, Chicago, IL United States Website: www.himss.org Q April 19-21, 2015 HPCO (Hospice Palliative Care Ontario) Annual Conference Toronto Sheraton Parkway Toronto North, Richmond Hill Website: www.hpco.ca Q April 27-28, 2015 2nd Annual National Telemedicine Conference Renaissance Downtown, Toronto Website: www.healthcareconferences.ca Q May 5-6, 2015 Human Resource Strategies for Healthcare Toronto Website: www.healthhrcanada.com Q May 29-30, 2015 Global Telehealth 2015 Metro Toronto Convention Centre, Toronto Website: www.coachorg.com Q May 31- June 3, 2015 eHealth Metro Toronto Convention Centre, Toronto Website: www.e-healthconference.com

To see even more healthcare industry events, please visit our website www.hospitalnews.com/events JANUARY 2015 HOSPITAL NEWS

22 Focus

HEALTH TECHNOLOGY

Information technology Continued from page 20

â&#x20AC;&#x153;The benefits include faster access to test results and reviews of medication lists and interactions, and that means more timely healthcare for our patients. Going forward it will be important to enhance issues related to technical support, system compatibility and privacy requirements to ensure maximum efficiency of the technology.â&#x20AC;? Most frequent benefits that were quoted include identifying lab results, ability to access a patient's chart remotely, being alerted to critical test results or to potential medication warnings. Electronic tools used by physicians other than EMRs are also on the rise. The most frequent use of electronic tools is the access to lab/diagnostic test results â&#x20AC;&#x201C; 80 per cent compared to 38 in 2010. Fiftyeight per cent of physicians use electronic tools to review what medications are being taken by a patient and 45 per cent to provide warnings for drug interactions as well as for referrals to other physicians. Physicians reported several challenges in accessing information: 52 per cent reported technical glitches, 46 per cent with compatibility issues with other systems and 26 per cent complaining about firewall or security issues. â&#x20AC;&#x153;Adoption of information technology among physicians has reached a tipping point, and we're starting to see significant improvement on quality and efficiency of care as a result,â&#x20AC;? says Dr. Cindy Forbes, President-elect of the Canadian Medical Association. â&#x20AC;&#x153;However, governments still need to keep their â&#x20AC;&#x2DC;pedal to the metalâ&#x20AC;&#x2122; and continue to financially support physician

The NPS is implemented collaboratively by the College of Family Physicians of Canada, Canadian Medical Association and Royal College of Physicians and Surgeons of Canada. The 2014 NPS website (nationalphysiciansurvey.ca) includes results by province, specialty and certain demographic characteristics of the responders.

Highlights in numbers

efforts to implement EMRs so that we may fully unlock the promise of digital health system-wide.â&#x20AC;? The 2014 survey builds on the previous surveys with a focus on use of information technology by physicians of Canada. This year, more than 10,000 licensed physicians

from across the country completed the online electronic survey. Since 2004, the NPS has been the largest census survey in Canada that gathers the opinions of physicians, medical residents and students on a wide range of health care issues.

Careers

â&#x20AC;˘ An increasing number of physicians can access their electronic records at their office, clinic or community health centre (64%) and from a hospital (62%). â&#x20AC;˘ Exclusive use of electronic systems was most prevalent in Alberta (40%), followed by Saskatchewan, British Columbia and Ontario at 35% each. â&#x20AC;˘ The use of electronic records as a tool to manage a patient's chronic condition is also increasingly commonâ&#x20AC;&#x201C; 82% of family physicians and 68% of other specialists who treat chronic conditions use electronic record to help them do so. â&#x20AC;˘ 25% of Canadian physicians report using telehealth/telemedicine technologies in their practice, up from 13 per cent for similar services 10 years ago. Newfoundland and Labrador leads the country in usage of telemedicine for consulting with other providers at 56 per cent. â&#x20AC;˘ Twenty-nine percent of physicians report using electronic records exclusively over paper. At 42%, family physicians were more likely to have gone completely electronic as well as other specialities such as anatomical pathologists (45%) and diagH nostic radiologists (51%). â&#x2013;

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PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Careers Join today!

Focus 23

DEADLINE FOR FEBRUARY 2015 ISSUE: JANUARY 27, 2015 VIEW CAREER ADS AT:

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www.bayshore.ca JANUARY 2015 HOSPITAL NEWS

24 Focus

PROFESSIONAL DEVELOPMENT/CONTINUING MEDICAL EDUCATION/HUMAN RESOURCES

Donâ&#x20AC;&#x2122;t Miss A Special CHAIR Supplement on Infection Control in the February Edition of Hospital News 'PS BEWFSUJTJOH JOGPSNBUJPO FNBJM

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