Connect December 2009 by Eastern Health

December 2009

Contributors

Living Healthy: Committed for Life

Proud of Our People Lab/Medicine Program Focuses on Employee Recognition

Inch by Inch, Row by Row Gardens Help Communities Grow

Breaking Barriers Aboriginal Patient Navigators

Through the Eyes of the Storm

Tossing out the Tape New Handover Report Improves Patient Safety and Clinical Efficiency

Becoming More Fiscally Responsible

Supporting a Breastfeeding Culture

For the Love of the Job

Connect is published by the Employee Communications department of Eastern Health. Connect is printed internally by Printing Services. Please address any comments or suggestions to Jeanette Oâ&#x20AC;&#x2122;Keefe, Editor: Employee Communications Administrative Office Waterford Bridge Road St. John's, NL A1E 4J8 777-1425 jeanette.okeefe@easternhealth.ca

Recognition, whether it’s big or small, is a powerful thing. It makes people feel proud and brings them together in a positive way.

Editor’s Note Photography by Phil Simms

s I was sitting at my computer one quiet afternoon in July, the sound of voices down the hall caught my attention. There was laughter, chatter, and suddenly two voices burst into song… it was the Happy Birthday song. There was cake, more laughter, and a heartfelt thank you from the birthday girl. Recognition, whether it’s big or small, is a powerful thing. It makes people feel proud and brings them together in a positive way. It is also an important piece of a bigger picture for employees of Eastern Health. In order to provide the best services possible to the people we serve, we must have highly qualified employees who are happy to be here and are treated like valued members of the team. Eastern Health recognizes the value of its employees and is taking steps to make the workplace a healthier, happier place to be. In 2008, a People Plan was

developed for Eastern Health, which will guide the organization towards building a healthy and sustainable workforce now and in the years to come. Included in the plan are things like the Healthy Workplace Initiative, Recognition Program, a Diversity Strategy, policies around creating a more Respectful Workplace, and much more. This issue is filled with stories about the people that make Eastern Health a place to be proud of. Read it, share it with others, and feel free to email me with feedback or to share possible story ideas. Thanks to all those who shared their stories in this issue.

Jeanette O’Keefe Editor

To view the People Plan visit:

http://intranet.easternhealth.ca and click on the Human Resources Tab.

Contributors 1

Amada Hancock Human Resources, Program and Policy Development St. John’s

Lynnette McCarthy Woodrow 5E, St. Clare’s St. John’s

Angela Lawrence Strategic Communications St. John’s

Susan Bonnell Employee Communications St. John’s

Deborah Collins Strategic Communications St. John’s

Jeanette O’Keefe Employee Communications St. John’s

Robyn Lush Employee Communications St. John’s

Living Healthy: Committed for Life by JEANETTE O’KEEFE

ome people get motivated by a serious health issue. Others find motivation in a friend or coworker. For nurse Stephanie Day-Reid it was her 20-year class reunion. “I had a goal to lose 35 pounds by July,” says Stephanie. “I didn’t lose 35 pounds but I lost 31 and since then I’ve got a little over 40 gone.” Stephanie will be the first to admit she has had a long history of gaining and losing weight. But as she approaches her 40th birthday, she knows it’s even more important to get healthy and stay that way. “It’s a whole lifestyle change, you can’t look at it as a diet,” says Stephanie who works at the Placentia Health Centre. “You have to do it for the rest of your life.”

Eating healthy, following the Weight Watchers points program, and making exercise (particularly walking) part of her daily routine have helped Stephanie maintain a healthy lifestyle. “I feel a lot better,” she says. “And having support from coworkers and friends has been great.” Staff members at the Placentia Health Centre support each other by sharing ideas, recipes, and exercise tips. But making the commitment isn’t always easy. “Stress at work, sometimes 12 hour shifts and not having supper if you’re busy in Emerge,” says Stephanie. “You still have to eat and you don’t always make good choices.” Stephanie adds that the weather can sometimes deter you from getting outside to exercise, so you should have a back-up plan. “I have the Wii Fit and the Wii Personal Trainer which I love,” she says. “The Wii Fit is more fun but it’s still good exercise.” Whatever your motivation might be to get healthy, Stephanie’s advice is to “stick with it and have patience.” If you know someone in your area who has committed to living a healthier lifestyle, email jeanette.okeefe@easternhealth.ca

December 2009

Proud of Our People Lab/Medicine Program Focuses on Employee Recognition by JEANETTE O’KEEFE Photography by Hubert Best egina Jones didn’t see it coming. She was going about her day-to-day tasks as a laboratory technologist when she got called to the director’s

office. “I was blown away, I really was,” says Regina who has been working at the Health Sciences Biochemistry Lab since it opened in 1978. “You go about your daily business and you do your job, but you don’t realize how that’s affecting people.”

“It was a very tumultuous time and morale was pretty low in the lab,” explains Lynn. “[The Commission of Inquiry] affected the lab very personally but it affected the whole organization. It got to the point where there was no pride in the organization, people were afraid to say where they worked.” Lynn knew she needed to do something to recognize her staff for their work and to demonstrate their value to the program and to the organization as a whole. She enlisted the help of Josee Dumas, organizational strategist in charge of Eastern Health’s recognition program. Together they came up with a plan which focused informal recognition and the development of an awards program.

Informal Recognition

In July of 2009 Regina was the first recipient of the Laboratory Medicine program’s newly developed Award of Distinction. The award is part of a larger recognition plan for the Laboratory Medicine program.

How it Began Lynn Wade took on the challenging role of Director, Laboratory Medicine in November of 2008, right after the Commission of Inquiry into Hormone Receptor Testing.

Lynn asked Josee to meet with managers in the lab to provide information about informal recognition and to provide low cost recognition ideas. “I really do believe that it’s the informal stuff,” says Lynn. “It’s the little email you get from your boss or from one of your coworkers.” As part of Lynn’s more informal approach to recognition, she has been focusing on getting out from behind her desk to meet with her front line staff face-to-face across the region. “I’ve gone through just about

It’s another opportunity to recognize the value of their input. There’s lots of ways to do it, it doesn’t have to be a fancy presentation, you know, it’s just a cup of coffee.

December 2009

I was very honoured that my coworkers would nominate me for such an award. every major site and I’ve set up what I call Coffee with the Director,” she says. “It’s another opportunity to recognize the value of their input. There’s lots of ways to do it, it doesn’t have to be a fancy presentation, you know, it’s just a cup of coffee.” Lynn’s commitment to recognition doesn’t stop at workplace achievements. “I have note cards that I keep in my drawer. If I read or hear that someone has done something, like ran a marathon, I’ll congratulate them personally if I see them, or send them a note,” says Lynn. “It’s not just about work, it’s about the importance of them and their lives outside of work too.”

Peer Recognition In an effort to promote peer recognition, Lynn and Josee developed the Laboratory Medicine Award of Distinction. This award recognizes employees who excel in their performance and contribute to the quality and efficient operations of the Laboratory Medicine department. The award is given twice a year, is open to all staff in the program, and is based on a peer nomination process. “Being one of the more senior people on staff, I was very honoured that my coworkers would nominate me for such an award,” says Regina. “We’ve never had anything like this before so it’s definitely a step in the right direction.” Lynn says the positive feedback she has received so far is encouraging and she adds “If the employees come to believe that this is a sincere process then they will embrace it, I really believe that they will.”

Eastern Health’s Recognition Program Josee Dumas has been working on building the Eastern Health recognition program along with the help of a small regional working group. The program started in November of 2007 with the first service and retirement awards. Since that time the working group has been developing a more comprehensive program which includes the development of informal recognition training for managers; a recognition week (tentatively scheduled for April 2010); CEO award; safety award; healthy workplace award; and much more. “Employees can expect to see more from the recognition program in the coming months,” says Josee. “We have been working hard over the past couple of years to develop the program and the various awards, and also identifying ways we can help managers and employees get better at recognizing each other on a dayto-day basis because that’s just as important.”

To read more about the recognition program, visit the Healthy Workplace section of the intranet and click on Proud of Our People, or contact Josee Dumas at 777-3208.

Inch by Inch, Row by Row - Gardens Help Communities Grow by ROBYN LUSH

December 2009

id you know that some residents in the Burin Peninsula must travel over 40km to get to the nearest grocery store? That produce which has to travel further to reach remote communities is not always fresh or as full of nutrients… if it gets there at all. It’s food for thought even if you’re lucky enough to be able to “pop over” to your favourite grocery store (or stores) to pick-up fresh veggies for your tasty pot of soup. Added to that is the fact that in our modern fast-paced society where fast food is king and food prepared fast is all you see on t.v., the little garden patch so faithfully tended by your parents or grandparents is in danger of becoming a thing of the past. But some communities are fighting back. Groups like the Burin Peninsula Environmental Reform Committee (BPERC) are partnering with organizations like Eastern Health to create community gardens. In April 2009, BPERC was one of the community groups

awarded funding through the Eastern Health Community Development Fund. Tammy Greening, Co-Chair of the Eastern Wellness Coalition and EH wellness consultant in Clarenville, worked closely with BPERC through the applications process. She believes that vehicles like the Community Development Fund breathe real life into our vision of Healthy People, Healthy Communities. “The funding we provided helped this group create an organic community garden in Burin! That not only means access to healthier foods, but gets people active, provides a place to socialize and gives people a sense of accomplishment.” Kim Armstrong, Executive Director of BPERC, agrees. “Tammy was so open and contributed ideas that really helped bring the garden to life. Now there is a real interest in the garden. It’s a hands-on environment where generations can learn to work with each other. I have seen kids

The funding we provided helped this group create an organic community garden in Burin! That not only means access to healthier foods, but gets people active, provides a place to socialize and gives people a sense of accomplishment.

working with seniors and whole families getting involved. We’re even working with school groups.” That’s not to say there haven’t been challenges. By the time BPERC secured the land and all the funding, the garden did not get started until late June, a short growing season for this province. Then came Hurricane Bill. A full 1/3 of the garden was washed away in the deluge of rain Bill brought to the Burin Peninsula. But the group persevered – they installed raised beds, improved the drainage system, and created a rainwater collection system. Sam Newman, garden coordinator, laughs when he recalls the biggest lesson he learned through this whole process. “Never trust the soil! We tested the PH level when we began and everything looked great. But when we had our first bit of rain, the ground became hard as cement - too much acid in the soil. Since then I’ve been sockin-it to her with lime, compost and manure!” While still in its infancy, the garden has earned some real successes. They’ve produced a small crop; word of mouth has helped news of the garden spread through the community and the region; and local hobby gardeners have jumped in to help with much-needed advice. Larger garden centre’s like Roger’s donated a small plot of land in Creston (near Marystown) for the use of school groups and interested individuals. And most importantly, there is a line-up of people interested in getting involved next year. If you would like the chance to grow your own veggies, there are still some garden plots available for this spring. As Kim says, “There’s nothing better than the peaceful satisfaction of knowing that you grew the food you are eating or feeding to your family.” To secure your own plot, or to volunteer your skills or services, contact BPERC at 709-279-4124 or visit the website: www.greenburin.ca

December 2009

Breaking Barriers by AMANDA HANCOCK Photography by Hubert Best

mells different... sounds different... looks different. We all miss the familiarity and security of our own homes while in hospital. Feeling comforted by someone or something can help make the experience a little less stressful. Far from their community and culture, aboriginal patients may feel particularly isolated during a hospital stay in St. John’s. In an effort to break barriers and help aboriginal patients make their way through the acute care system, two aboriginal patient navigators have been hired as

part of a pilot patient navigator program at Eastern Health. “We are here to act as liaisons and fill in the gaps for aboriginal patients who are far away from their homes and families,” says Paula Delaney, a member of the Miawpukek First Nation, and the first patient navigator to be hired. “Some of them are in hospital for a long time. They do not have access to basic services that other patients’ close-by friends or family members can provide for them.”

They have broken down organizational barriers by streamlining referral processes and scheduling; this improves clinical outcomes and increases patient satisfaction.

Working with the Northern Inter-Tribal Health Authority and the Saskatchewan Association of Health Organizations has exposed Paula to the nature of the challenges in aboriginal health. Paula is keenly interested in human rights issues and aboriginal traditional medicine. “We advocate for holistic wellness. We emphasize the importance of aboriginal traditions and values – elder involvement, extended care, family space and collective decision-making,” says Paula. Katie Dicker began navigating while working as a clerk in the nursing station in Nain, Labrador where she arranged appointments for patients in larger centres including St. John’s, Goose Bay, Corner Brook, St. Anthony and Halifax. In June of 2009, Katie relocated to St. John’s to be on the ground for aboriginal persons during their interactions with the acute care system. “Before coming here, I would see the challenges on the other end,” says Katie. “Some patients are scared to travel on an airplane to a city where no one speaks their language. They feel totally lost when they get here. Some have difficulty making it from the airport to the hospital.”

A Bit of History The first record of patient navigation is from the early 1990’s when Harold Freeman of New York designated navigators to bridge the gaps in cancer care. The idea didn’t take long to catch on above the border and across the system. Nova Scotia and Quebec formalized their patient navigation program in the early 2000’s. In 2007, there was a series of national patient navigation workshops as the concept started to take hold across the country. Thanks to a contribution from Health Canada’s Aboriginal Health Transition Fund, the support of the Provincial Department of Health and Community Services, and a collaborative partnership with the St. John’s Native Friendship Centre, Eastern Health has brought the concept right here to Newfoundland and Labrador! The need is clear. According to the National Aboriginal Health Organization, almost one half of First Nations and Inuit feel their health services are unequal to those received by other Canadians.1 On average, aboriginal populations display higher rates of smoking, obesity, and diabetes.

December 2009

In 2002 and 2005, local research studies2 were undertaken to examine the difficulties experienced by aboriginal persons when interacting with the mainstream hospital systems in St. John’s. This demonstrated that the challenges experienced by aboriginal persons while accessing these services were related to communication and culture. This led to misinformation about diagnosis and treatment and negatively impacted patient safety and satisfaction. Dietary requirements, family accommodations, and traditional practices continue to be challenging issues for aboriginal patients during their hospital stay.

How is it working? Patient navigation programs in other provinces have improved the quality and coordination of care and exceeded the expectations of families, physicians, and health professionals. They have broken down organizational barriers by streamlining referral processes and scheduling; this improves clinical outcomes and increases patient satisfaction. As barriers to care increase – be they cultural, communicative, or linguistic – so, too, do the potential benefits of patient navigation services. Paula and Katie are located on the first floor of the Health Science Centre and report to the Clinical Efficiency division of Adult Acute Care (St. John’s). They are connected to the aboriginal community and work closely with the St. John’s Native Friendship Centre. In addition to acting as liaisons for individual aboriginal patients to improve holistic care, they will work towards improving policies, programs, and services for all patients.

As part of the Diversity Enhancement Project funded by the Department of Citizenship and Immigration Canada, Diversity and Inclusion Awareness sessions are now available for all staff. Attend these sessions to find out why our communities are becoming more diverse and how this affects the workplace. Learn what Eastern Health is doing about diversity and understand the importance of embracing the unique characteristics of individuals. Arrange a session for your staff, office, floor, ward or unit by contacting: Amanda Hancock, Diversity Coordinator HR Program and Policy Development Phone: (709)777-3276 Email: amanda.hancock@easternhealth.ca

Aboriginal Health Infostructure: A Paradigm Shift in Information & Service Governance. Better Information For Self-Determination in Health. Valerie Gideon, PhD. Director, First Nations Centre National Aboriginal Health Organization.

St. John’s Native Friendship Centre Association, Division of Community Health, Faculty of Medicine. (2002). Building Bridges Study. Cultural Diversity Working Group, Eastern Health (2005) The Report on Cultural Sensitivity.

Through the Eyes of a by DEBORAH COLLINS

six-hour window of opportunity. That’s what it came down to in Placentia in the late afternoon of August 23, 2009. Just six hours in which to decide whether or not to evacuate the Placentia Health Centre and the adjoining Lion’s Manor Nursing Home – and execute the plan. The 5:00pm weather forecast was the key factor. A prediction of high tides, combined with a storm surge and wind gusts up to 100km per hour could mean flooding for low-lying areas of Placentia, where the hospital and nursing home are located. The town was eyeing a state of emergency – and residents were on high alert. So were senior staff at the health care facilities. They’d watched the situation closely all day. By 7:00 pm,

Judy O’Keefe, the Director of Integrated Health Services was on site, preparing for the possibility of evacuation. Shortly afterwards, the Manager of Acute and Long Term Care arrived. Sandra Gear assessed the units to determine how best and how quickly they could evacuate the 74 long term care residents and three acute care patients—if the call was made. At 9:00 pm, off-duty staff members were officially called back to work, though many had already shown up to offer assistance. At eleven minutes past nine, Placentia Mayor Bill Hogan declared a state of emergency – and at approximately 9:30 pm Eastern Health made the decision to evacuate the Placentia Health Centre and Nursing Home.

December 2009

Photography by Ed Vincent

This evacuation was a first for me, and you always wonder if this kind of thing can be done. But a crisis brings out the best in people. They were almost upbeat as they worked together to do what was necessary. Staff flew into action – packing mattresses, bedding, crash carts, medical charts, EKG machines, IV pumps and food supplies. Judy O’Keefe praised the strong sense of teamwork at play that night. “Evacuation is a worst-case scenario, but whatever needed to be done, got done.” By 10:00 pm, the evacuation had begun. Acute care patients were moved to Carbonear General Hospital as well as the Freshwater Community Centre. Patients of the Protective Care Unit were transferred to a temporary home at St. Anne’s School in Dunville, while other long term care residents went to the Community Centre in Freshwater.

Reflecting later on the urgency of that night, Sandra Gear said “This evacuation was a first for me, and you always wonder if this kind of thing can be done. But a crisis brings out the best in people. They were almost upbeat as they worked together to do what was necessary.” O’Keefe agreed. “Our staff was just excellent. I witnessed many encounters with our residents and patients that were really reassuring. Our residents felt safe because the staff was so calm and confident. Many were not cognitively aware of what was happening – but those who were, took their cues from our staff.” By 2:00 am on August 24th, the last of the long term

care residents had been transported and tucked in at the school gymnasium. Meanwhile, a temporary emergency hospital had been established at the Freshwater Community Centre in the event of other medical emergencies in the region. By that time, the weather showed signs of improving and ultimately, a flood was averted. By 9:30 am, after a good breakfast in their ‘home away from home,’ the residents were brought back to Lion’s Manor. Throughout the whole process, families of the patients and residents were informed of the decisions as they unfolded, and expressed appreciation for how everything was

handled, stating they felt their loved ones were ‘safe and secure.’ As with all large and sudden undertakings, it was a learning experience for all involved. “Hindsight is 20/20,” says Sandra Gear. The need for alternative forms of communication given the impact of weather on cell phones; the need for additional ambulances and other specialized forms of transportation; and more immediate access to oncall lists in the region were some of the lessons taught by a blowhard named Bill. Judy O’Keefe says, “I was born and raised in Placentia. I’m used to flooding and have vivid memories of dories in the backyard! That

night, it came very close again and highlighted the need to be prepared.” Five hundred years of living next to the North Atlantic have taught Newfoundlanders a healthy respect for unpredictable waters and the need to pull together in a storm. Health care workers and the community at large joined forces to meet an urgent need on the night of August 23rd and proved just how much could be accomplished on short notice with equal parts of compassion, courage and commitment. Whether in the eye - or the wake - of a hurricane, that may be greatest lesson of all.

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Tossing Out the Tape New Handover Report Improves Patient Safety and Clinical Efficiency by LYNETTE MCCARTHY WOODROW Photography by Hubert Best

I think it has made changeover of report more efficient and effective. It takes less time and there are less call bells.

taff in the Surgery program at St. Clare’s Mercy Hospital are tossing out cassette tapes.

Although you won’t see iPods or iPod shuffles replacing those tapes, what you will see is a team that has embraced a new model of care resulting in improved patient safety and clinical efficiency. “It’s great,” says Michelle Chaisson, staff nurse 6 West (6W). “I love it because we don’t waste time listening to unnecessary information. We get to the bedside quicker so patient care is less rushed.”

Finding a Solution Until recently, nurses were using cassette tapes to record end of shift reports for the oncoming shift. Over the years, nurses have identified many issues with the taped report. There has been a lack of consistency in the content (as there are often poorly established unit guidelines), and the report is often not standardized. In addition, a traditional taped end of shift report is often lengthy and has been shown to delay care for patients, which can ultimately compromise their safety (Penney, 2008). To address these organizational and patient safety issues, in December of 2008 the nurses and patient care coordinator on 6W at St. Clare’s decided to find a solution. Two important documents assisted the staff of 6W in determining a course of action: Accreditation Canada’s (2006) required organizational practices for patient safety; and a literature review completed by Jennifer Penney, Project Coordinator (Adult Acute Care, St. John’s region). Accreditation Canada recommends that the communication between service/care providers be improved to ensure timely transfer of accurate information. Penney’s report also highlighted a number of models. A committee made up of unit nurses, a patient care co-coordinator, and a clinical educator decided on a

model called Handover Report. This model uses standardized written tools and verbal communication to meet Accreditation Canada’s required organizational practices in the provision of accurate, safe and high quality care. To implement this model, the staff on 6W developed a written report form. Within weeks, the model was successfully implemented. Patient care coordinator (6W), Maud Crowley, says “I think it has made changeover of report more efficient and effective. It takes less time and there are less call bells. The nurses are at the bedside quicker making a safer environment for our patients. The nurses certainly like it and it has made a significant improvement to our unit.” Staff nurse (6W) Erin Burton agrees. “Basic nursing care and initial assessments are completed before breakfast, making our shifts more organized,” she says. “We get our breaks and leave work on time”.

December 2009

Start Spreading the News As with all good news, word spread quickly throughout the hospital. In January of 2009, a committee was formed on 5 East (5E) at St. Clare’s to implement the Handover Report model. A unit-specific policy was created, including guidelines for the content of the written and verbal components of the report. Guidelines for completion of a safety round and evaluation of the model were also developed. Within two weeks, Handover Report was successfully implemented on 5E. Since then, it has been implemented and evaluated throughout the entire Surgery and Medicine programs of Eastern Health.

The handover format for transferring information between care providers has had many benefits. •

•

Evaluation: It’s a good thing The evaluation of the new report included an observational audit and a staff satisfaction survey. The audit looked at the written and within unit verbal reports for content. Staff were also questioned about the report they received from the off-going staff, their safety round practice, and the written report was assessed. The patient care plans (part 1) and the nursing census were also checked for updating. Feedback from nurses on their satisfaction was obtained through a survey. Table I Handover Report: Staff Satisfaction Survey Results (Surgery Program, Eastern Health)

•

It has decreased the delay in patient care, within the units, by up to 45 minutes. There has been a significant decrease in the number of call bells at the beginning of shifts. Patients are getting mobilized much earlier in the day. Staff from the Emergency Department and Recovery Room (St. Clare’s) have commented that units are better prepared to accept patient transfers earlier in the shift since this model was implemented. Nurses have also reported that they are very satisfied with this new format. One nurse noted on their survey “I feel life has become less complicated at work since we started Handover Report. I have more time to spend with my patients and at the end of the shift I am not exhausted.”

The combined satisfaction, of patients and staff, illustrates both the validity and the efficiency of this model.

References Accreditation Canada (2006) www.accreditation-canada.ca Accessed February 9, 2009. Penney, J. (2008). Literature review of nursing handover. Unpublished.

Becoming More Fi$cally Responsible

s individuals with homes, families, and all the expenses associated with that, we are constantly trying to find ways to save money and avoid increasing our overall debt. It’s not an easy task. There are some fixed costs that we can’t control, like the cost of maintaining our homes. However, there are things we could be doing to decrease our debt, save money, and become more fiscally responsible.

Some tips for becoming more fiscally responsible: • Understand where your money goes • Track and analyze your spending • Develop a spending plan • Don’t spend impulsively • Don’t create new or unnecessary debt • Do save for a better future Much like our own personal spending, as Eastern Health approaches the beginning of a new fiscal year, it seems fitting to take a look at our spending as an

organization and look for ways we could be doing a better job of saving money and decreasing our overall deficit. Jeanette O’Keefe recently sat down with Vickie Kaminski to discuss how we track and analyze our spending, and how we plan to make improvements for the future.

Do we track and analyze our spending? Vickie: “Absolutely. Eastern Health has budget analysts who are responsible for analyzing and tracking where and how our money gets spent throughout the organization. The director of Budgeting is then responsible for generating reports that are shared with the government on a regular basis.”

December 2009

Do we spend impulsively? Vickie: “No, as a government-funded organization we are accountable for the money we spend. However, there are times when we must make emergency purchases – for example when a critical piece of equipment malfunctions.”

Have we been creating new or unnecessary debt? Vickie: “Over the past year, there has been increased spending on things that we do have control over, and that could be improved. For example, taxis, couriers, catering, and professional fees have escalated. We are asking staff to help us reduce unnecessary costs in these areas. In addition absenteeism is increasing and is costing us more and more money. To help manage that we have implemented our Attendance Awareness Management Plan, making better use of our resources, materials and people will help us streamline our costs. We are committed to providing quality care to our patients, residents and clients. We will focus on those things we can do to decrease debt that will not have an impact on the services we provide.”

Where does our money go?

Are we saving for a better future? Vickie: “Each of us has a role to play in helping Eastern Health become more fiscally responsible. Of course, these measures are not meant to impact the quality of care we provide our patients, residents and clients. By making better use of the resources we have and reducing the inefficiencies that exist within the organization, we will be better able to fulfill our vision for the future - Healthy People, Healthy Communities.”

In 2008-09 we spent: Salaries Medical/Surgical Supplies Drugs Direct Client Care Grants- LTC Department Supplies Sundry Equipment Expenses Contracted Services Building and Grounds

$656,686,000 $48,746,000 $36,287,000 $113,280,000 $41,517,000 $56,792,000 $48,238,000 $26,845,000 $25,223,000 $25,177,000 $1,078,791,000

Supporting a Breastfeeding Culture by SUSAN BONNELL

Both mother and baby need to be provided with ongoing support to get used to breastfeeding. s champions go, Dolores McNeil and Debbie Crocker would put Rocky to shame. These two nurses, working in Eastern Health’s Health Promotion division, have been advocating for better breastfeeding policies and outcomes in the region and throughout the province during their entire careers. “Mom says I was supporting her breastfeeding when I was a young child,” says Dolores, parent and child health coordinator, with a grin. “I’m the third oldest of 10 and we were all breastfed - so feeding at the breast is what we knew. During my entire career with Public Health I have been lucky to be able to continue to protect, promote, and support breastfeeding as the normal way to feed a baby.”

Debbie Crocker is now an international board certified lactation consultant, but she remembers what it was like to try to support and promote breastfeeding in the early days of her career: “I graduated from Nursing in 1973. Breastfeeding was not discussed during my training and it was not promoted as the normal way to feed a baby. It was the age of formula. We knew we needed to get away from carnation milk and, based on what we believed to be best practice, were encouraging and supporting families to use formula. “At that time there were few women choosing to breastfeed – in fact it was uncommon to have more than one woman on the postpartum unit that was

December 2009

breastfeeding. We did the best we could to support that mom, but largely it was her own willpower and family support that got her through the early days.” Debbie, Dolores and all the members of the Baby Friendly Initiative Steering Committee have dedicated much of their careers and personal time towards the protection and promotion of breastfeeding – and all the hard work is starting to pay off. This fall, Eastern Health approved a breastfeeding policy that, for the first time, sets out guidelines for our health care providers based on nationally and internationally approved principles.

years and beyond. “Breast milk is the most complete and safest food for baby,” adds Dolores. “Getting the best nutrition early leads to a healthier population in the future.” Both Dolores and Debbie know that big factors in breastfeeding for moms are early success, and lots of support. “Like other parenting decisions,” says Dolores, “breastfeeding is both rewarding and challenging. In the beginning, there can be many changes and

practical help to new moms in starting and continuing to breastfeed. “The regional policy will guide us and hold us accountable for our practices, set the standard of care based on evidence, and establish consistent care for all mothers and babies within Eastern Health.” Here’s an example of how coming together as one organization can benefit our population. “By implementing ‘Baby Friendly’ principles and practices

Research and Support “The Baby Friendly Initiative is not just about breastfeeding,” says Debbie “It's about providing a high standard of care that is based on research and evidence. We have always tried to provide the best possible care to our mothers and babies based on the information that we had. But as new research and evidence becomes available we are accountable to change our practice and not continue to do things just because we have always done it that way.” The World Health Organization and Health Canada recommend exclusive breastfeeding for six months and continued breastfeeding along with the introduction of appropriate complementary foods for up to two

DEBBIE CROCKER

Photography by Hubert Best much learning as mom and baby get to know each other outside the womb. “Both mother and baby need to be provided with ongoing support to get used to breastfeeding since it can take up to six weeks for breastfeeding to become established as a successful and enjoyable experience. “ That’s why it’s so important for Eastern Health to have a good policy that supports and provides

in all areas - acute and community - we are working together to support that common goal,” says Debbie. “There are so many factors that influence a woman's decision to begin, and continue, to breastfeed. The protection, promotion and support of breastfeeding requires a concerted effort and a consistent message from all of us. We are all working to achieve the same goal… a healthy mother and baby.”

Breast milk is the most complete and safest food for baby. Getting the best nutrition early leads to a healthier population in the future. Working Together: Bringing the Policy to Life What can be accomplished when everyone works together? A lot, according to best-practice experts on breastfeeding. By informing expectant women and their families about the risks associated with formula feeding, along with the benefits of breastfeeding in the hospital setting, and continuing that support when mom and baby go home, Eastern Health nurses are doing their part for this important initiative. The new breastfeeding policy clearly identifies the guidelines, and our staff are already bringing that policy to life. Community health nurse Lynnette Penney and obstetrics nurse Sharon Park are two great examples. When babies are born in Clarenville, one of the first faces they’re likely to see in the world is Sharon’s. “Breastfeeding encouragement starts the minute a baby is born,” says Sharon. “At birth, an infant is placed directly on the mother’s chest (if infant is stable) and

encouraged to snuggle between the breasts. Once the mother is stable and assessments are completed, our goal is to initiate breastfeeding within the first hour of life.” Breastfeeding support continues with teaching aids such as booklets for new moms. Various positions are taught and moms are trained to recognize a good latch. Infants rooming-in with their mothers is strongly encouraged to promote bonding and to help mothers recognize their infant's cues for feeding, and fathers are encouraged to play an active role in breastfeeding to provide the mother with the support and energy she needs to continue with exclusive breastfeeding for the first six months. Within a day of going home, new moms in the Clarenville area will hear from Lynnette. “A community health nurse's early visit to a new breastfeeding mom provides the necessary support to establish a positive breastfeeding experience,” says Lynnette. “Also, connecting moms with supportive peers is another way we help sustain breastfeeding in the community. Linking new moms with more experienced breastfeeding moms helps provide the new mom with the confidence and skills to continue even when it’s tough." Both nurses agree that the proper introduction and support to breastfeeding is critical to success for both mom and baby. “It requires a lot of time and patience from both the nurse and mother,” says Sharon. “We need to make sure that we are supportive and available during the initial phases of breastfeeding because it gives mothers the drive to continue and feelings of pride in their accomplishments.” Lynnette adds that “extending the education and support to moms and their families when they get home from hospital is one of the things I feel can truly make a difference.”

December 2009

For the

of the Job

by JEANETTE O’KEEFE Photography by Hubert Best

f you happen to be visiting 4SA at the Health Sciences Centre, it would be worth your while to stand back and watch as a dedicated team of employees from all disciplines works together like a well-oiled machine – shuffling around the corridors, checking in with patients, moving beds, cleaning rooms, and answering phones. It would also be worth your while to stop and chat with ward clerk Ruby Budden. Ruby has been working on 4SA for more than 30 years and you would be hard pressed to find anyone on that floor who doesn’t know her by name and speak

about her with the utmost respect. “She has the most wonderful, upbeat attitude of anyone I’ve met,“ says Kim Ghaney, division manager 4SA. “She loves her work, her co-workers and is a wealth of information.”

Work Environment As Ruby describes her work environment she is quick to point out that although she is always willing to help her coworkers with whatever is needed, her colleagues are equally supportive to her. “Our floor is a busy floor, it can be hectic,” says

Ruby goes beyond to help every staff member, patient and family member. Not only is Ruby a ward clerk, she is a friend. Ruby. “But I think most people realize that you are at work probably just as much as you’re at home and you’ve got to make it the best you can especially at busy times. I think the main thing on our floor is everybody helps one another. With me, I would do anything that they asked me to and in return others help me too. It works as a family unit and you work together.” Ruby’s duties cover everything from handling patient admissions, arranging beds, answering phones, patient discharges, and much more. “It changes from day to day and it’s always busy, you don’t’ stop in the 12 hours,” she says. “But I love my job, I love coming in to work, and I love the people I work with.” And no matter how busy Ruby’s day may be, her coworkers say she always has time to lend a hand and is always willing to stop and listen when someone needs to talk “Whether the topic is workrelated, or personal, talking to Ruby just makes you feel better,” says registered nurse Sherrie Norman. “She’s a true inspiration

to all of us, and we are so lucky to have her working with us.” Maxine Dawe, patient care coordinator on 4SA, has worked closely with Ruby for more than 25 years and says the two have shared many a laugh and tear with staff, patients, and families. “It’s amazing after all these years in health care how dedicated she continues to be,” says Maxine. “Ruby goes beyond to help every staff member, patient and family member. Not only is Ruby a ward clerk, she is a friend.”

The Recipe Ruby says the recipe for enjoying your work is really quite simple. Come to work with a positive attitude, respect your coworkers, add a healthy dose of hard work, and a bit of good old fashioned fun. “We have fun, for Halloween we’ll decorate the whole unit, we have mummies and we decorate for Christmas and everyone will say we have the best decorated floor in the hospital,” she says. “You have to put that little bit extra in.” And that little bit extra certainly goes a long way.

There was a time when 4SA was temporarily relocated to another area of the hospital. When the unit was preparing to move back, Ruby learned she may not be returning. Soon after that time Ruby was called to the director’s office and informed that several staff members and physicians had voiced their concerns that Ruby must return to 4SA with the rest of the team, and so she did. Ruby has never forgotten that time and the fact that her coworkers recognized the value of her work. That has resulted in strengthening the team atmosphere even further on 4SA. Janet Templeton, director of the Medicine program, describes Ruby as a “breath of fresh air” on 4SA. “Her pleasant and kind approach to patients, staff and visitors is always appreciated,” says Janet. Ruby says with a smile, “my motto is if you’re good to them they’re good to you, and the staff on 4SA has been more than good to me.”

To read more employee profiles, visit the loop section of the intranet:

http://intranet.easternhealth.ca/EH/loop.aspx December 2009