Important Public Health Information – pg 2 Partnering with Patients and Staff / Enhancing Senior-Friendly Care / Message from President and CEO – pg 3 Healthy Happenings – pg 4 For more information, visit: www.ckha.on.ca
longer as reliant on CKHA’s ED services as he was in the past. He thanks many for encouraging him throughout his journey to leading a better quality life. “Velma (NNADAP) used to be a Drug and Alcohol Counsellor and she’d explain something to you with a certain way of reaching out to you without hurting your feelings. If it wasn’t for her and my Social Service Worker and not to mention some other people… you know it’s the little things that people express to you,” said Clifton.
A New Outlook
Being in better health means Clifton can continue to work within the community of Walpole Island, performing odd jobs and assisting his brother who is a well known duck hunting guide. In his spare time, he enjoys painting and sketching and his artwork can be found at the Walpole Island Heritage Centre.
“Now that I can start to see things more clearly, I don’t have those kinds of thoughts… thoughts where I didn’t care for the world and the world didn’t care about me either. At some time or another I knew I had to confront this,” said Clifton Tooshkenig, 58, a resident of Walpole Island First Nation. “But now that I see that there are people that care, it’s a whole different outlook for me. I know there’s help out there. I knew it was there, I just didn’t want to bother with it.”
CKHA and the CHC are partners in the coordination of primary care for complex patients within the acute and community settings – supporting seamless access to high quality care in Chatham-Kent. Together, the organizations have identified clinical outpatient services that are better suited for delivery by community based primary care organizations and have made great progress in moving select outpatient programs into the community where they are needed. This integrated partnership means patients with complex needs are receiving care in the right place, at the right time and with the right provider. CKHA is proud to partner with the CHC and is committed to supporting health system integration to better serve our patients and the community.
As a patient with multiple complex conditions due to years of binge drinking, Clifton was a frequent visitor to Chatham-Kent Health Alliance’s (CKHA) Sydenham Campus, Emergency Department (ED) where he received supportive care. Suffering from heart and bowel problems, and a diagnosis of pancreatitis, trips to the ED became a regular occurrence in his life. “For 42 years I drank heavy… the doctors can’t believe how hard I drank and that I’m still here,” Clifton continued, “My mother always spoke to us about the way we should live. But the life out there, that’s all I really knew.” As a high user of the Sydenham ED, Clifton was identified through the Chatham-Kent Health Link to ensure he received timely, coordinated and individualized care to better manage his multiple conditions. The Health Link brings together local healthcare providers for greater collaboration in the care of patients with complex conditions. As a coordinating partner in the Health Link, CKHA identified Clifton as a frequent user of its services and in partnership with the Chatham-Kent Community Health Centre (CHC), transitioned him to the appropriate community provider. Clifton now receives primary care at the CHC’s Walpole Island site with a healthcare team who support him in a patient-centred care plan, reducing his need to rely on CKHA’s ED.
“But now that I see that there are people that care, it’s a whole different outlook for me. I know there’s help out there. I knew it was there, I just didn’t want to bother with it.” Receiving care close to home at the Walpole Island CHC has benefitted Clifton where today he regularly visits his primary care doctor, Dr. Chawla. Providing an encouraging voice to stay on track with his care plan and goals, Dr. Chawla has been attentive to his individual needs. After years of traveling between Chatham and Sarnia for mental health services, Clifton appreciates the ability to also receive counselling services at the CHC. And as part of his individualized care plan, he visits a Physiotherapist within the same location, who helps him with regular exercises and access to therapeutic equipment. Health Links collaborates with existing partners across the health system in various sectors such as family care providers, hospitals, community healthcare centres, longterm care and home care. Improved coordination across the system means complex patients will be supported by a team of providers at all levels of the healthcare system. The CHC reflects this approach by building strong partnerships with community organizations on Walpole Island, such as Social Services and Home & Community Care. As a client of Home & Community Care, Clifton benefits from these partnerships, receiving referrals between the CHC and Home & Community Care who take a circle of care approach. At Home & Community Care, a Nurse, Case Manager and Social Service Worker assist in his care plan and provide amenities such as transportation when he’s referred to a Specialist Physician. Clifton’s renewed outlook can be contributed to the support from an integrated team of healthcare providers. From his care at the CHC to Home & Community Care, to his time spent in the National Native Alcohol and Drug Abuse Program (NNADAP), Clifton is no Title translation provided by Tiffany Myers from Bkejwanong Territory commonly known as Walpole Island.
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CKHA is proud to partner with CK Public Health on health promotion and illness prevention.
Important Information about
CK Public Health is 1 of 36 health units in Ontario. Our work is guided by the Health Promotion and Protection Act (HPPA, 1990). The main goal of health units is to provide the 3 Ps, which are:
Lowering the risk of illness to the public by inspecting restaurants, day cares, spas, pools and other public places. Another job is to check for risks and dangers from environmental sources such as animal bites (rabies), mosquitos (West Nile Virus) and ticks (Lyme disease). For those who drink well water, we provide water testing.
Sharing information with schools, workplaces and the community on how to stay healthy (e.g. Health Fairs, Workshops and Presentations). We create and support public policies to keep our community healthy. (e.g. smoking bylaw, tanning bed legislation, bike lanes).
Reducing the spread of illness by monitoring, treating and immunizing against infectious diseases (e.g. flu and school immunization clinics, Sexually Transmitted Infection testing/treatment). We also work to decrease the number of preventable injuries (e.g. road and bike safety, falls prevention in the elderly).
The mission of CK Public Health is to build a healthy community. Having a healthy community lowers the demand on other health services (e.g. doctor’s office, hospitals, walk-in clinics). This allows easier access to services for those who need them most.
Erie St. Clair Falls Prevention Mobile Clinic – A Story of Healthy Aging. June, age 91 years young, believes her well-being is a result of three things - keeping active, eating right and staying connected to others. She resides in one of Chatham-Kent’s residences for seniors and is thankful she is there. I had an opportunity to sit down and talk with June after she had attended a Falls Prevention Mobile Clinic earlier this year. Since she is a woman on the move, I was interested to learn her thoughts on healthy aging and her experience at the clinic. June shared she had always been busy working at various jobs, raising a family, golfing, and bingo. Having always been active, June joined various activities available through her residence and participates in exercise classes twice-a-week. June’s activities also extend beyond what is offered at her residence. She still goes for a one mile walk each day and gets on her stationary bike and cycles half-an-hour most days of the week. June commented, “it is so important to do things with others and keep busy. You need to do things like games and bingo to keep your brain working…you just feel more alive when you do!” The social connection gained through the various activities with others is good for the mind, body and soul. While she no longer has to prepare her meals, she still pays attention to what she eats. A slim waistline is not her concern, staying healthy is! June recognizes that maintaining a healthy diet and a healthy weight will have positive effects on her mobility. June learned of the Erie St. Clair Falls Prevention Mobile Clinic from a presentation at her residence. One of the biggest problems facing older adults is to lose their balance and fall. “At our age, we don’t recover like we used to”. She was very pleased with her experience and the opportunity to meet with so many health professionals. “They took such a great interest in my health and gave me lots of advice.” June has now added exercises the physiotherapist recommended to improve her balance to her daily routine, and admitted she does them most days of the week. The Falls Prevention Mobile Clinic consists of a team of health professionals who travel from community to community to carry out individual assessments that will identify those at risk of having a fall.
The clinic aims to: Assess what may be putting an individual at risk of having a fall. Educate individuals on how they can reduce the risk of having a fall. Connect individuals to community programs and health services that help maintain independence. During the assessment, participants meet with health professionals’ one-on-one to discuss specific things known to lead to falls. Nurses, Pharmacists, Occupational Therapists and Physiotherapists are some of the healthcare professionals who make up the team that runs the clinic. There is no cost to attend, and a full visit can last up to 2 hours. Recommendations are printed out and given to the participant. With consent, the family doctor will receive the same letter outlining the assessment results and recommendations. The Erie St. Clair Falls Prevention Mobile Clinic is designed for individuals who: • Are 60 years of age or older. • Have trouble getting around. • Live alone or in assisted living. • Have had a fall or near fall. • Want to maintain or improve balance. • Have a fear of falling.
The Erie St. Clair Falls Prevention Mobile Clinic is offered once-a-month in communities throughout Chatham-Kent. The health professionals at the clinic are from local agencies, including Victorian Order of Nurses, Chatham-Kent Community Health Centre, Windsor Essex Community Health Centre, and Chatham-Kent Public Health Unit, supported by the Erie St. Clair LHIN. For more information, call toll free 1-877-301-9790, or Laurel Cammaart at 519-352-7270, ext. 2456.
This article has been prepared by Laurel Cammaart, Public Health Nurse with Chatham-Kent Public Health. June’s story is a true story, only her name has been changed to keep her identity private. When asked if she would recommend the Erie St. Clair Falls Prevention Mobile Clinic to a friend, she said she certainly would.
Partnering with Patients and Staff in the Delivery of Care
A Message from
Colin Patey, President & CEO
Partnering with patients and families in care delivery, design and decisions is one of the guiding principles of CKHA’s Strategic Plan. At CKHA, we consider patients as partners in their healthcare journey. A powerful way we can improve the patient experience is through Experienced Based Co-Design (EBD) - a concept that uses the experiences of patients and staff to design better healthcare services. In early March, approximately 25 people from across the organization (staff members, managers and patient experience advisors) participated in an EBD educational workshop to learn about the concept and its methodology. Ontario’s Action Plan for Healthcare 2.0 calls on providers at the frontlines of our system to help improve the patient experience and as a strategic priority, give patients opportunities to provide their perspectives on their care to help identify how the system can work better. The EBD concept and its methods offer opportunities for staff and patients to partner in the design of patient-centred services, improving the delivery of care. The day began with an introduction to EBD and showcased practical methods and tools used to capture patient experiences and the emotional journey. EBD provides greater depth and breadth of understanding than what can be provided through patient satisfaction surveying. The method can be categorized into four phases, using different tools throughout each phase: • Capture the experience – tools to help people tell their stories • Understand the experience – tools for understanding patient/staff experiences • Improve the experience – tools to turn the experience into action • Measure the improvement – tools for evaluating and measuring the improvement In the afternoon, case studies were examined and discussed along with a Capture and Understand exercise. Participants were encouraged to think about how they can integrate these tools into their everyday improvement work, how to begin brainstorming and source ideas for change. Examples of services that have been designed with patient needs at the forefront are shift handovers at the bedside, establishing 24/7 visiting hours, scheduling based on client and family convenience and giving patients access to their healthcare records. At CKHA, as we begin the 2016/17 year, the tools of EBD can be integrated into Quality Improvement initiatives as we continue to work with patients and families, partnering in the journey of care.
Enhancing Senior-Friendly Care CKHA is contributing to Ontario’s Senior-Friendly Care initiative with a new screening tool to promote early identification of delirium in older patients. Delirium occurs in 30 to 50 per cent of hospitalized older adults and in 50 per cent of patients with a hip fracture – making this an essential screening tool for Chatham-Kent’s aging population. An episode of delirium can lead to an increased length-of-stay in hospital, increased chances of institutionalization post-discharge, increased mortality while in hospital and increased mortality rates within one year of an episode of delirium. Supported by the Senior-Friendly Hospital Action Group, CKHA’s project team took part in Cohort One along with 42 other hospitals in this province-wide initiative to enhance senior-friendly care. CKHA’s team identified a problem: Delirium goes undetected in elderly patients on the Medicine unit, leading to increased Length-of-Stays and poor patient outcomes. The recognition of delirium in this patient population helped identify the need to develop a screening tool for early identification and to ensure appropriate early interventional strategies are in place. Early last year, the team began its plans for implementing the Confusion Assessment Method (CAM) screening tool for patients age 65 and over on the Medicine unit. Delirium education sessions were provided to Medicine unit staff as well as preparations for using the CAM screening method. By the fall, the roll-out of the CAM screening tool began with a goal to screen those age 65 and over for delirium within 24 hours of admission and daily thereafter. By December 2015, the unit achieved a 75 to 80 per cent compliance rate in using the CAM method. A post-educational survey shows staff on the unit feel more confident in interacting with patients experiencing an acute change in mental status. “Our team is performing exceptionally well since the introduction of this new screening tool,” said Kelly Christoff, Professional Practice, Nursing and Education Lead. “Daily audits show that staff on the Medicine unit are now reaching a 85 to 90 per cent compliance rate in screening patients within 24 hours of admission and on a daily basis after.” Ongoing monthly audits will continue throughout the year to test and monitor the sustainability of this new screening tool. Future goals are to expand the CAM tool throughout CKHA and with support, develop care pathways and order sets to support the treatment, intervention and prevention of this sometimes fatal problem.
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Today’s healthcare system is changing and increasingly becoming patient centred and even patient driven. This new system requires stronger collaboration across organizations and sectors to ensure continued and seamless access to quality care in the Chatham-Kent community. We rightfully face increasing pressure from patients and families to deliver accessible, high-quality, safe care within an environment of progressively diminishing financial resources. Our response is to lead these changes and to work with our health system partners and patients to redefine and improve the healthcare experience and outcomes across our catchment areas. An example of this can be found in the collaborative and meaningful capital plan that has been put forward to the LHIN for physical spaces that support timely access to high-quality care for the entire community we serve. We are proud of the proposal and believe that it will receive a timely and favourable response from both the Erie St. Clair LHIN and the Ministry of Health and Long-Term Care. At this time, we understand the proposal may not be what everyone would like to see. We also know that fear of the unknown can be difficult to reconcile. As H.P. Lovecraft so aptly said, “The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.” No one guarantees what the future holds but, we, along with our partners and clinical leaders, firmly believe that our plan improves access and quality-of-care for patients/clients across Chatham-Kent; provides for much needed collaborative, co-located and integrated space for service delivery in Chatham and Wallaceburg; and, utilizes our finite resources – human and fiscal – to the best extent possible throughout the health system. This best serves the taxpayer too.
“The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.” One thing we do know is that every time we have pushed ourselves beyond our traditional role, structures and comfort zones, patients reap the benefits. Strategies put in place in recent years, like the Health Link and integrated management with the ChathamKent Community Health Centres and Canadian Mental Health Association Lambton Kent, are having a positive impact on our patients and system outcomes. Clifton’s story, found on the cover page, is a prime example of how our efforts and commitment to work closely with our partners is changing health outcomes and improving the quality-of-life for individuals in our community today. We are actively reducing reliance on emergency services; providing what’s really needed through community-based interventions. It’s care at the right place, by the right provider. Our decisions are founded on evidence and in support of continued access to safe, quality and timely care for everyone we serve. When we get approvals from the LHIN and the Ministry, we will reduce some of the unknowns and, we hope, see space transformations in Chatham and a brand new, state-of-the-art facility opened in Wallaceburg. It will take our collective support, and at times courage, but together, we can create a better healthcare system for our community. Collaboration among healthcare providers is the future of healthcare. This we know for sure.
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JUST BOOK IT!
CKHA’s Hemodialysis Satellite Program in partnership with London Health Sciences Centre (LHSC) Renal Care Program leveraged videoconferencing technology to connect patients face-to-face while on dialysis with members of their LHSC healthcare team through the mobile Ontario Telemedicine Network (OTN). Now, patients have more chances to connect with their care team without leaving town.
Eligible women in Chatham-Kent, aged 50 to 54 are asked to ‘Just book it’ by scheduling their mammogram appointments through CKHA’s Ontario Breast Screening Program (OBSP). It only takes 5 minutes to book and less than 10 minutes to complete. Call CKHA at (519) 437-6089 to see if you are eligible and to book an appointment.
90% EXCEEDS TARGET RATES CKHA’s hand hygiene compliance rates have exceeded target rates (85% or greater) for the past 6 months with a January compliance rate of 90%.
58 EYE DONORS GAVE SIGHT TO 116 PEOPLE
NURSING JOB FAIR
Experienced Registered Nurses, Registered Practical Nurses, new graduates and nursing students attended CKHA’s Nursing Job Fair.
Showcasing CKHA and our local healthcare system, 19 members of the Canadian College of Health Leaders’ Southwest Ontario Chapter were invited to experience first hand, our culture of innovation through an interactive study tour and panel discussion.
And 6 multi-tissue donors have improved the lives of many more since CKHA has become a Trillium Gift of Life Network (TGLN) designated site.
EYES ARE ON US
CKHA saw 753 patients in the new daily out-patient Coronary Artery Disease (CAD) clinic over the last year.
At CKHA, we are very proud of the work we do and we believe that programs should be recognized when they have a positive effect in our community. These are just a few examples that show how working together can make our community a healthier one for all of us.
PREFILLED SYRINGES IMPROVE PATIENT SAFETY
Most doses of Low Molecular Weight Heparins (drugs used to prevent harmful blood clots) are now delivered in prefilled syringes, which reduce the risk of dosing errors.
PROVINCIAL & REGIONAL RECOGNITION Holly Earl-McCubbin, Mental Health & Addictions Therapist was awarded the Ontario Association of Social Workers (OASW) 2016 Inspirational Leaders Award for her contributions to the profession. Holly was also the recipient of the OASW Southwestern Branch’s Distinguished Social Work Service Award for 2015.
Over 70 Nurses and Students attended the Clinical Skills Refresher Day which provided a variety of learning opportunities for clinical staff where they honed their nursing skills to provide better patient care.
CKHA is exceeding the target of 4.2% compared with a provincial reference of 16.7% in reduced hospital readmissions.
Please consider a donation to the Foundation of CKHA. Call 519-436-2538 or visit www.foundationckha.com to make a gift in support of local healthcare today.
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