Spring 2012
A C C E S S
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Finding Hope in Paradise A New Treatment Centre is Announced for Youth with Mental Health Needs
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Bariatic Surgery Comes to Eastern Health
Q U A L I T Y
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S A F E T Y
Not Another Fire Drill!
P O P U L A T I O N
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H E A L T H
Better Health...B4UR Pregnaant U-Turn Centre Oers New Direction to Conception Bay North Residents
S U S T A I N A B I L I T Y
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A Prescription for Ethics Medical, Moral Dilemmas through the Ethics Lens
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L O O P
Stories from Around the Region
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The Friendship Corner
Connect is published by the Corporate Communications department of Eastern Health. Connect is printed internally by Printing Services. Please address any comments or suggestions to Susan Bonnell, Editor: Corporate Communications Administrative Office Waterford Bridge Road St. John's, NL A1E 4J8 (709) 777-1412 susan.bonnell@easternhealth.ca
Contributors 1
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Michelle Whelan Corporate Communications St. John’s
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Zelda Burt Corporate Communications St. John’s
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Phil Simms Corporate Communications St. John’s
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Deborah Collins Corporate Communications St. John’s
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Maria Driscoll Health Promotion St. John’s
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Susan Bonnell Corporate Communications St. John’s
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Angela Lawrence Corporate Communications St. John’s
4 Cover Photography by Phil Simms On the Cover: All Hazards Emergency Planning Coordinators - Blair Hogan, Darryl Prosper, Devin Reid
A C C E S S
A New Treatment Centre is Announced for Youth with Mental Health Needs by DEBORAH COLLINS Photography by Phil Simms
usan Macleod has spent her professional life cutting through the complexities of mental health needs to find the most practical and effective solutions. To her, perhaps one of the most practical solutions to date is now underway - a treatment centre for youth with complex mental health needs. Currently a manager with Eastern Health’s Mental Health and Addictions program, Susan will assume the role of Program Manager at the Youth Treatment Centre when it opens. Susan says the Centre will serve youth from a wide variety of backgrounds and who struggle with an array of complex mental health issues. “Some may have a diagnosis such as depression, bipolar disorder, conduct
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disorder or attention deficit hyperactivity disorder (ADHD). They may have a combination of mental health issues that cause them to experience selfharming behaviour or thoughts of suicide. “Some of these young people may have experienced trauma, abuse or have serious conflict within their family and may have trouble coping as a result,” adds Susan. “Many of them will not have experienced success in the regular school system due to their particular issues or challenges and may have major gaps in their learning.” Most of these young people already receive mental health services in the community; however, due to the seriousness of their issues they require a more intensive treatment environment.
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SUSAN MACLEOD
This is a giant step forward and I’m proud to be a part of it. The average length of stay at the new Centre will be six months; however, some may stay longer, depending on their individual needs. The Youth Treatment Centre will be located in Paradise on the site of the former Paradise Elementary school. The tender for phase one of the construction project was awarded in November, 2011. The Centre will be staffed 24 hours a day, with a minimum of one staff person for every two
youth. Staff will also work closely with their families, too, to ensure that when they return home following treatment, the transition is positive. “It will be important to give families the tools they need to continue to support their children,” adds Susan. In addition to the program manager, the Centre will include staff from a number of specialized clinical fields including child and youth care, nursing, psychology, psychiatry, social work and occupational therapy, as well as
professionals in recreation, art and music therapy and from the public school system. The Centre will provide a safe environment for young people, offering structure and routine, and using everyday life experiences as a guide to daily living and coping skills. The treatment program will include individual, group and family counseling. Young people will attend school on site with learning goals based on individual needs and also engage in therapeutic recreation, art and music therapy.
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A C C E S S
CONCEPTUAL DRAWINGS
Working with Government to Improve Access The provincial government’s investment in enhancing mental health services in the province aligns closely with one of Eastern Health’s strategic priorities for the next three years: that of increasing access to health services. “This program will go a long way to ensure most young people who need this level of intensive treatment will get it while remaining in this province, close to their families, their communities and other support systems,” says Beverley Clarke, Vice President responsible for Mental Health and Addictions. “It’s also important to keep in mind that the care offered at this facility, while significant, will be just one component of a continuum of community-based mental health services designed to meet the needs of youth in this province.”
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Susan MacLeod agrees. As she prepares to take the helm at the Treatment Centre in Paradise, her excitement shows. “You know, it is our children who will benefit from these enhancements to our mental health and addictions program. This is a giant step forward and I’m proud to be a part of it.”
For additional information on the Youth Treatment Centre in Paradise, contact Susan MacLeod at 752-4950 or Susan.MacLeod@easternhealth.ca
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Bariatric Surgery Comes to Eastern Health by ZELDA BURT
besity can interfere with many of life’s simple pleasures, like taking a walk in the park and playing with your children. But more than a nuisance, being severely overweight puts anyone at risk for heart disease, cancer, diabetes hypertension, arthritis, sleep apnea, and depression. People across the province who have previously attempted serious, non-surgical weight reduction and have failed may now be eligible for elective bariatric surgery. Bariatric surgery includes a number of operations designed to help patients who are severely overweight lose and keep off large amounts of weight, alleviate health complications and improve their quality of life.
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“Bariatric surgery is not a cure for obesity,” says Dr. Darrell Boone, one of Eastern Health’s bariatric surgeons. “It is a weight loss tool that must be accompanied by a lifelong commitment to improve one’s diet and exercise routine. Without the commitment and motivation, failure to lose weight or the possibility of weight regain can occur.” The elective procedure currently being offered by Eastern Health is called laparoscopic sleeve gastrectomy. This procedure involves the removal of nearly 80 per cent of the stomach, which reduces the hormones that trigger hunger and appetite and leads to weight loss by limiting the amount of food a person can eat.
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A C C E S S
Program Up and Running Eastern Health’s Bariatric Surgery program started on May 20, 2011 The surgical team performed only a select number of surgeries as the service was being introduced. The full service began in August 2011, with two planned surgeries almost every week since then. To date, the team has performed nearly 40 weight-loss operations. Eastern Health and its surgical team takes great pride in offering not only state-of-the-art procedures, but comprehensive nutritional counseling, medical advice and continued support during the weight loss process. The team consists of two surgeons, a nurse practitioner, a dietician and an interdisciplinary inpatient team on 4NB at the Health Sciences Centre. The program also offers a monthly support group aimed at helping patients problem-solve common behavioural and emotional challenges faced when undertaking such a drastic weight loss endeavor. “Our Bariatric Surgery program offers modern surgical techniques, with a stable, dedicated support staff that can help offer more positive health outcomes to our patients,” adds Dr. Boone. “We are proud to offer Newfoundlanders and Labradorians access to a surgical program that addresses the importance of healthy living.”
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What does bariatric mean? Bariatric is the word used to describe the field of medicine or surgery that deals with obesity and its complications. Bariatric surgery is also known as weight loss surgery. What is laproscopic sleeve gastrectomy (LSG)? Sleeve gastrectomy is a restrictive weight loss procedure whereby 80 per cent of the left side of the stomach is removed leaving a smaller, sleeve-shaped stomach approximately the size and shape of a banana. The stomach functions the same, but the amount of food a person can eat is reduced. The laproscopic approach to this weight loss surgery involves the use of minimally invasive techniques, which are associated with fewer complications and better outcomes than traditional open techniques. Is sleeve gastrectomy reversible? No. It cannot be undone. Is there a cost? When the surgery is determined to be medically necessary, MCP covers the costs for residents of Newfoundland and Labrador. What are the criteria? Patients must be referred by their family doctor and must meet the following criteria: • Between the ages of 18 and 70 • Body Mass Index (BMI) between 40 kg/m2 and 60 kg/m2 • Tried non-surgical weight loss efforts in the past (diet and exercise) • Deemed medically, psychologically and emotionally prepared for surgery • Committed and motivated to carry out what is expected of them during the program • Competent to consent to the surgery • Not pregnant or planning a pregnancy within 24 months of surgery • Recognize that lifelong healthy lifestyle habits are essential for weight loss success
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Not Another
DRILL! ire safety is everyone’s business. At Eastern Health we are required to hold a specified number of fire drills each year by the Fire Code of Canada - one drill per eight hour shift per quarter for hospitals and long term care sites, and two per year per shift for other community and administration sites. That may seem like a lot of drills, but when you consider the benefits of practice and the potential risks of not knowing what to do in a fire, the benefits far outweigh the disruption. Recently, we sat down with Blair Hogan, Area Coordinator - All Hazards Emergency Management, to discuss fire safety.
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With fire drills on a regular basis won’t people just become desensitized to the alarm? You’d think so but, no, the opposite actually happens. When drilling doesn’t occur people tend to ignore the
by MICHELLE WHELAN Photography by Phil Simms
fire alarms. When fire drills occur on a regular basis and are used as the platform for education people actually become more sensitized to it. But they are so inconvenient! Yes, they can be, though not nearly as inconvenient as when a real fire occurs and people don’t know what to do. Has that ever happened? Just last February at the Health Sciences Centre, there was a fire in the dumpster just outside the garbage room. Smoke and heat came back into the building by way of the garbage chute setting off both the alarm and a sprinkler head. Thanks to some quick thinking from security personnel and the site clinical manager, nothing serious occurred.
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given area. An action card will outline what staff are to do if the fire is in or not in their particular area as well as what to do at each stage. Your manager is responsible to see to it that their area has one and that staff are given appropriate orientation concerning Code Red preparation. BLAIR HOGAN
What went wrong? Every time garbage is put into the chute the door is supposed to be closed and bolted. Also, the door to the entire garbage room should be kept closed at all times. This is to keep fire and smoke contained in the dumpster or the garbage room. Unfortunately, the chute door was not closed in this case. In addition, we also found that some smoke barrier doors were propped open. These seems like small and insignificant things, but they can have very important and significant consequences if not followed. But if we all work in different areas how do we know what to do specifically for our situation? Good question. You should refer to the action card, a one-sheet list of instructions to be followed in a
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How much orientation do I need? Every employee of Eastern Health must be given an orientation to the emergency codes in a general fashion and then you should be provided with more site specific orientation. Perhaps the most important, though, is the orientation provided at the department or unit level. Our Code Red policy requires that each new employee receive this orientation within five days or shifts of arrival for work. Then, all employees are to have this repeated at least once every two years. Then, of course, there are the drills. You know, the most important part of the drill is what is to happen afterward. At the end of each drill staff should be debriefed by the manager or supervisor or the Fire Warden on how the drill went. During this time you get a refresher on the action card, using a Fire Drill Report as the guide.
What is a Fire Drill Report? This is an official form available on the intranet. Using this tool allows the non-expert to conduct and follow up on a fire drill appropriately. Once the drill and follow up is completed the form is filled out and names of participants are added. A copy is sent to the respective area coordinator for the Health Emergency Management program. All Hazards is now part of the new Health Emergency Management program, a sub-division of Protection Services. We are now partners with Regional Security. Our staff are working hard to help set up and support site committees, develop plan templates and other tools, and provide training to staff. It’s a very big task, but it’s also very important. So we continue to work with some very good people on the ground, especially our Fire Wardens. So, who is the Fire Warden? Well, it could be you! You can volunteer for this role or your manager can appoint you to it. Basically, the Fire Warden takes the lead in a defined area, such as a nursing unit, office suite or department. This individual would ensure that orientation and drills are taking place and they also
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provide direction to the staff during a Code Red event. It is not nearly as involved as it sounds, but it is even more important than people realize. Together with the site Fire Marshal, who has the lead Code Red role for the site, they make up what is called the Fire Safety Team. The Health Emergency Management Program provides a short but informative training session for those filling these roles and we remain in place to provide support always.
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Wow! I didn’t realize what was involved. Yes, fire safety is really important for our organization. We promise our clients that we will care for them in a safe environment, and we promise our staff that they will work in one, too. At Eastern Health we say “safety is everyone’s responsibility.” And so we drill and do exercises regularly to keep the issue in people’s minds. Practice will not only raise the comfort level for dealing with emergencies but will enhance people’s ability to function under the stress of a real event.
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P O P U L A T I O N
H E A L T H
Better Health... B4 UR
by MARIA O’DRISCOLL
ou are probably aware that it is important for women to stay healthy during pregnancy. But did you know a woman's health before she gets pregnant also affects her future baby? Issues such as the importance of folic acid, quitting smoking and drinking and maintaining a healthy weight during pregnancy are critical to a women’s overall health and in turn a healthy pregnancy. Despite the national and international focus on having a healthy
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pregnancy, specialists in this province have noted important issues that need to be addressed. “Thirty per cent of our patients are either obese or morbidly obese,” says Dr. Nick Kum of Children and Women’s Health. “This in and of itself can give rise to a lot of problems – problems with conception, or if they are able to conceive, problems and complications with the pregnancy.”
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The fact is, increasing levels of morbid obesity during pregnancy are contributing to increased high risk pregnancies and the likelihood of maternal death. The issues of “healthy pregnancy” are broad but both health promotion and prenatal specialists agree there is a need to develop a comprehensive approach to the promotion and delivery of preconception and prenatal health education and services.
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A healthy pregnancy takes planning and months of preparation.
Supporting Women In an effort to increase awareness of the risks associated with obesity during pregnancy and the benefits of preparing for a healthy pregnancy among women of child bearing age, Eastern Health has developed a preconception health promotion initiative called B4UR Pregnant. As a part of this initiative, resources are available for use by physicians, nurse practitioners and their patients. A healthy pregnancy takes planning and months of preparation. And for women with pre-existing health concerns, such as diabetes, hypertension, and obesity, the preparation period can be even longer, taking years. Lorraine Burrage, Program Coordinator of the Newfoundland Provincial Perinatal Program, recognizes the need to take action early. “Health care professionals must seize every moment to reinforce simple yet significant messages that can help prepare a woman for pregnancy,” says Lorraine. “Every contact with these women should be used to reinforce the need for a planned pregnancy and quality care.” After holding focus groups with women of reproductive age throughout the Eastern Health region, it was determined that there is a general lack of
understanding about the importance of preparing for a pregnancy. Unless women are actively attempting to become pregnant, there is little to no thought about how an individual’s health before they become pregnant may affect them and their unborn child. Women in the focus group said they would like to receive information about how to prepare for a healthy pregnancy. They stated the most trustworthy source they would turn to is their physicians and other health care providers. It is also interesting to note women did understand that health care professionals don’t have time to discuss a lot of these issues in a clinic setting. But they did state they would like the health care provider to give them information they could read on their own time, or direct them to a reliable source of online information. The women said if their health care provider directly gave them the information they would take it more seriously than if the information is just available for them to grab in a waiting room. Women also said they liked online sources of information, but they are unsure what websites to trust when they search for health topics online.
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P O P U L A T I O N
H E A L T H
Based on discussions with women and health care providers Eastern Health has developed the following materials: A preconception health screening checklist. Women are to fill out the checklist while they are waiting to meet with their health care provider and give it to the health care provider when they meet face to face. The health care provider can then use it as a discussion tool and to see if there are any areas of concern when it comes to preconception health. A preconception health screening checklist guide designed for health care providers. This guide covers all the topics on the checklist that is to be completed by clients. The health care provider can assess the women’s checklist and refer to the physicians guide if they need information. The Is there a baby in your future? Plan for it. booklet. This is a booklet with general health tips for women who do see a baby in their future. The health care provider would provide this booklet to women who indicate on the checklist that they do see a baby in their future. It covers topics such as parenting, stress, physical activity, nutrition, smoking, breastfeeding, etc. The booklet also points women to reliable sources of online health information, including eastern health B4UR Pregnant website. A Does your body weight matter if there is a baby in your future? factsheet. The fact sheet discusses why achieving a healthier body weight
is an important factor to consider if there is a baby in your future. The health care provider would provide this fact sheet to women who indicate on the checklist that they do see a baby in their future. The fact sheet gives tips on healthy eating, active living and mental wellbeing. The factsheet also points women to reliable sources of online health information. A preconception health poster to be displayed in health care provider offices and waiting rooms. The poster prompts women to talk to their health care provider and request materials associated with the B4UR Pregnant project. The poster again points women to Eastern Health’s B4UR Pregnant website. A general health postcard to be provided by health care providers to clients who indicate on the checklist that they do not see a baby in their future. This postcard includes facts about the number of unplanned pregnancies, the importance of taking multi-vitamins with folic acid and links to reliable sources of online health information. All of these materials and more are available on the Eastern Health website at www.easternhealth.ca/B4URPregnant. Physicians and Nurse Practitioners can order these resources for their offices and clinics through the Health Promotion Resources centre by contacting Tracy Costello at 709229-1578.
Preconception health refers to a state of complete physical, mental and social well-being, rather than the mere absence of disease, prior to the start of a pregnancy (World Health Organization). The promotion of preconception health must be thought of as health practices of women and men throughout their reproductive years. Promoting preconception health is made difficult by the fact that the preconception period is not neatly defined and that almost 50 per cent of pregnancies are unplanned.
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P R O M O T I O N
U-Turn Centre Offers New Direction to Conception Bay North Residents by SUSAN BONNELL Photography by Phil Simms
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hat do you do when an addiction has you at the end of the road? Residents in the Carbonear area now have a place to turn, thanks to a community effort that epitomizes Eastern Health’s vision of Healthy People, Healthy Communities; shows our “connectedness” value in action; and breathes life into our strategic priorities. “There’s no doubt about it,” says Beverley Clarke, Vice-President responsible for Mental Health and Addictions and Community Health Services, “the U-Turn Centre in Carbonear demonstrates the ideal in fullcontinuum health care service delivery.” U-Turn’s Facebook page describes the centre as “a non-profit organization that is committed to helping individuals through the process of addiction recovery.” But if you ask Jeff Bourne, U-Turn is the fulfillment of a dream, and “a pile of talk” turned into action! Jeff is a recovering alcoholic and drug addict from the Trinity Conception area whose own life path through addictions has landed him as the driving force behind the U-Turn Centre. On any given day, Jeff and wife Tammy can be found talking to people who drop in, arranging rides to the Recovery Centre in St. John’s, and connecting addicts from all walks of life with community, legal and health care supports. When asked if he is proud of the Centre and what he has been a part of accomplishing Jeff beams, but he is quick to add, “You know, when you’re in recovery, you got to be humble.” “People like Jeff and Tammy Bourne really do the lion’s share of work,” contends Pastoral Care Clinician Curt Clark. Curt is one of a dedicated group of individuals who have been working for the last decade on bringing pastoral care – usually the domain of hospitals and longterm care facilities – into the community. “The pastoral care service we offer in rural Avalon is the first of its kind in Canada, and likely in North
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America,” says Curt. “No one else is making this community healthpastoral care connection. “We really see the value of that partnership, because community churches have a lot of resources that they can use to partner with Eastern Health, from volunteers to shovel driveways to offering food and rides – it’s all part in parcel of spiritual counseling.”
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The seeds for the U-Turn Centre were being sown in a number of places at the same time. Church groups, legacy organizations, individuals and government all had a general sense that there were significant addictions issues in this area. For one thing, says Curt, people like Jeff were talking openly about their struggles through addictions and recovery. “We came together to form the Community Addiction Awareness Committee: clergy, volunteers from the churches, Eastern Health addictions professionals, researchers, criminal justice representatives, probations officers and the Mounties,” says Curt. “We did a study which showed us that the abuse of certain prescription drugs in this area is way above the rest of the province.” Armed with this evidence, the
JEFF AND TAMMY BOURNE
The U-Turn Centre in Carbonear demonstrates the ideal in full-continuum health care service delivery.
committee identified needs and approached the government, who were more than willing to support this cause. Aside from the new treatment centre planned for the Harbour Grace area, government supported the development of a drop-in centre to connect people looking for help with health care providers, and to support addicts post-treatment through their recovery. U-Turn not only offers those connections but is also a base for many recovery groups and a “safe
haven” for people working their way past their addiction. Says Jeff: “You can only see your counselor for one hour in the day. Where do you go in between? That’s what this Centre does. It gives people a place to go to just be around other positive people. “On any given day, I’m calling the contacts I have throughout the system and saying to them, ‘listen I got someone here who needs to talk to a counselor right away,’ and it happens. You know, you could waste weeks going through hoops,
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but having this Centre makes those connections happen for people right away. “It’s a real good thing for people.” For Jeff and for all the Eastern Health staff and community supporters who are helping to make U-Turn a meaningful part of addictions recovery, the reason for all the hard work is easy. “I do what I do on behalf of someone who needs it. And listen; sometimes, I’m fighting for their life.”
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Time for a U-Turn? Do you feel as if you have reached the end of the road? Has your life become unmanageable? Maybe it's time to make a U-Turn and begin your new life!
The U-Turn Mission Our mission is to assist individuals who are struggling with addictions and provide support to families and communities by: • Providing a supportive and safe environment for all visitors to the centre. • Making referrals to professional services and advocating on behalf of individuals and families in need due to addiction issues. • Providing the opportunity for fun safe and clean activities for individuals, families and communities that highlight an addiction free lifestyle. Show your support for U-Turn by liking their Facebook page!
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At TD Insurance Meloche Monnex, we know how important it is to save wherever you can. As an employee of Eastern Health, you can enjoy preferred group rates on your home and auto insurance and other exclusive privileges, thanks to our partnership with your organization. You’ll also benefit from great coverage and outstanding service. We believe in making insurance easy to understand so you can choose your coverage with confidence.
– Kathy Li Satisfied client since 2010
Get an online quote at
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The TD Insurance Meloche Monnex home and auto insurance program is underwritten by PRIMMUM INSURANCE COMPANY. The program may be distributed by Meloche Monnex Insurance and Financial Services Inc. in Quebec and by Meloche Monnex Financial Services Inc. in the rest of Canada. Due to provincial legislation, our auto insurance program is not offered in British Columbia, Manitoba or Saskatchewan. *No purchase required. Contest organized jointly with Security National Insurance Company and open to members, employees and other eligible persons belonging to employer, professional and alumni groups which have an agreement with and are entitled to group rates from the organizers. Contest ends on January 31, 2013. 1 prize to be won. The winner may choose the prize between a Lexus RX 450h with all basic standard features including freight and pre-delivery inspection for a total value of $60,000 or $60,000 in Canadian funds. The winner will be responsible to pay for the sale taxes applicable to the vehicle. Skill-testing question required. Odds of winning depend on number of entries received. Complete contest rules available at www.group.tdinsurance.com/contest. ®/ The TD logo and other trade-marks are the property of The Toronto-Dominion Bank or a wholly-owned subsidiary, in Canada and/or other countries.
S U S T A I N A B I L I T Y
A Prescription for Ethics
by DEBORAH COLLINS Photography by Phil Simms
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client of community health services requests a wheelchair. Health care professionals find no clinical need for this and know that to stop walking will mean a clear deterioration in the person’s health. They refuse to process the request, believing it goes against their standards of practice and code of ethics. The client complains loudly and publicly. And elderly man in a long-term care facility is placed on a restricted diet because he has difficulty swallowing. The man and his family ask that he be allowed to eat his favourite foods. Staff members know this means he may choke. The family persists, citing ‘quality of life’ in their loved one’s final years. Staff are torn between safety concerns and the distress of the resident. These are just two examples of situations health care professionals deal with on a regular basis. The answers are not always straightforward. In the first example, saying no was not easy; in the second, saying yes was hard. Every situation has its own context and relevant factors. So what do you do? Where do you turn? These days, more often than not, it’s to the Ethics Service at Eastern Health. Ethics refers to the basic moral values that help us understand what we should or should not do. Often values can conflict with one another. For example, most people value telling the truth. They also value acting in a way that will not harm other people. But, what if telling someone the truth about their medical condition could cause them harm? When two or more moral values conflict, an ethical decision must be made. At times, making health care decisions for yourself, for someone you love or for a patient you are taking care of can be very difficult. The Ethics Service can help you work through an ethical decision in a difficult case by providing an ethics consult.
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Simply put, an ethics consult is an opportunity to discuss an issue and decision in a controlled session organized by an ethics facilitator. You meet with professionals familiar with your situation who have experience dealing with the kind of decision you must make. They include medical ethicists, physicians, nurses, social workers and pastoral workers, among others. Those involved in the ethics consult will not tell you what to do, but will help you understand and resolve your conflicting values and feelings.
A Growing Need We have seen a steady growth in the need for an Ethics Service over the past two decades. The first ethics committees were established at some St. John’s hospitals in the 1970s and 80s. Although ethical considerations were always inherent in medical decisions, the first formal ethics consults were done in St. John’s around 1990. With the formation of the Health Care Corporation in the mid-90s, ethics committees became more involved with policy development
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JENNIFER FLYNN, DIANE SMYTH, RICK SINGLETON, CHRIS KAPOSY, RENEE SMITH AND RICH MAHER
We provide the support to make the tough choices a little easier. It’s the ethical thing to do. and review, ethics education and consultation on clinical and administrative cases. But the most dramatic growth has occurred in the last decade, according to Dr. Rick Singleton, Eastern Health’s Regional Director of Pastoral Care and Ethics. “A decade ago we were conducting maybe 10 consults per year,” says Rick. “In 2011, that number had jumped to more than 100. This growth reflects not only the formation of Eastern Health, which now
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encompasses acute care, long-term care and community care, but also the growing demand to include ethical considerations in clinical decisions.” The H1N1 pandemic in 2009 also played a key role in highlighting the importance of an ethics structure within the health care system. According to Rick, issues raised during the pandemic could not be resolved using a traditional approach that focused on the best interest of the individual. “The pandemic was a threat to the health and wellbeing of the general public,” says Rick, “and decisions had to be made based on the common good, not that of any one person.” Eastern Health’s Ethics Service developed a framework for making difficult ethical decisions, such as which groups should have priority when dealing with a limited supply of vaccine. It also helped to establish a
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framework for triaging patients in critical and acute care. Eastern Health also recruited people from the community to provide feedback on the pandemic’s framework for decision-making - the only health authority in the country to do so. This forward-thinking approach made our Ethics Service a leader in this field. Largely as a result of the pandemic experience, Eastern Health’s Ethics Service was expanded to lead the Provincial Health Ethics Network Newfoundland Labrador (PHENNL), with Rick Singleton as Director. PHENNL coordinates and supports ethics education, consultations, and policy review and development for all four of the province’s regional health authorities and the Department of Health and Community Services.
Ethical Culture and Collaboration Rick says the contractual partnership with medical ethicists at Memorial University has also been a unique factor in the growth and success of the ethics service. “By opting to engage the armslength services of these ethicists who are not employees of Eastern Health,” says Rick, “we ensure the integrity of the process involving
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our sensitive clinical cases. We eliminate potential conflict of interest and facilitate a more ‘pure’ result in our ethics consults.” An ethics consult offers a number of significant benefits, including: • The resolution of an ethical dilemma and the moral distress that accompanies it; • The mediation of conflicts or differences of opinion that exist among the key parties; and, • The ability to track issues and trends in health care that often result in new guidelines, policies or education. One of the biggest challenges health care professionals sometimes face in the wake of an ethics consult is to stand back and watch patients, clients, residents or their families make choices against medical advice, or that seem not to
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be in their best interest for various other reasons. At those times, Rick says they are reassured by the fact that they have enabled those they serve to make the most informed choice possible, in consultation with all the experts involved in the person’s care. He says this represents an ethical partnership and culture that is fundamental to Eastern Health. “When people are able to participate in the discussion and the actual decision-making, it goes a long way to relieving the moral distress they feel when they know what needs to be done, but just can’t bring themselves to do it,” says Rick.” Partnering in their own care or that of their loved ones is a delicate balance between control and compassion. We provide the support to make the tough choices a little easier. “It’s the ethical thing to do.”
Eastern Health offers ethics services to patients, families and/or staff who need help in making difficult decisions about patient care. Please contact: Pastoral Care and Ethics Department General Hospital, Health Sciences Centre T: 709-777-8940 F: 709-777-7612 rick.singleton@easternhealth.ca renee.smith@easternhealth.ca
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In October of 2011, Eastern Health launched a poster campaign designed to reinforce the importance of two-way communication in healthcare. Help us Help You emphasizes how patients, clients and residents can communicate with their health professionals to help them deliver safe and effective care. Launched by the Quality and Risk Management Department during Patient Safety Week, the series of posters targets five key areas: Identification, Medications, Hand Hygiene, Falls and Being Proactive. According to Joy Maddigan, Director of Quality and Risk Management, healthcare professionals, patients, and families all need to share the message
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that good healthcare communication.
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“Whether during an initial visit to one of our healthcare facilities, discussing a course of treatment or waiting on a test result, all parties need to be engaged in the process,” says Joy. “Clear communication is vital to the safe care of our patients, residents and clients.” Quality and Safety has been identified as a primary focus in the strategic plan. Key objectives include promoting a healthy workplace and strengthening a culture of safety. Keeping safety at the forefront of all that we do has a direct impact on the quality of care we provide.
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Recognizing Long Service and Retirements In late-March and early-April, Eastern Health held a number of events throughout the region to recognize close to 1000 employees achieving significant career milestones. 555 employees marked 25, 30, 35, 40 and 45 years of service in 2011-2012, and 315 employees retired from Eastern Health. VP Marilyn Thompson has the Human Resources portfolio, and the accountability for employee recognition events. “We welcome the opportunity to celebrate employees for their significant contributions to health care in this province,” she said, stressing that “these events demonstrate the value we place on long service for the experience it adds to our health care team.” Staff recognized at events this year have contributed more than 24,700 years of service to the people of our province! In a statement to the media, President and CEO Vickie Kaminski expressed the importance of these years to our patients, residents and clients. “On behalf of the Eastern Health Board of Trustees and the Senior Executive,” she said, “I sincerely thank our employees for their years of dedicated service.”
CEO Awards Return for 2012 Do you know someone at Eastern Health whose commitment to excellence deserves to be recognized? Nominations are now open for Eastern Health’s CEO Award of Excellence program. The CEO Awards are designed to recognize our colleagues whose achievements in innovation, service, leadership, safety, community capacity building, mentoring and teamwork provide a shining example of what we strive to achieve as an organization. In 2011, Speech-Language Pathologist Gail Dick’s O’Keefe received the Award of Excellence for Innovation.
“The CEO Awards make you feel that the work that you do is being recognized and noticed,” says Gail. “It is very special to be recognized by your peers.” Gail was nominated for this award by her colleagues and friends in Speech-Language Pathology. They referenced her many innovative approaches to the work, including introducing new and specialized practice areas such as videostroboscopy and voice prosthesis. Gail recognizes that the CEO Awards draw attention to the excellent work being done in the organization. “We get recognition from the patients, but these awards bring that up to the level of management, which is great.” Nomination forms and details are available on both the intranet and the website, or by contact Josee Dumas in Human Resources, Policy and Program Development.
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Agnes Pratt Renews Wedding Day Memories Dubbed a ‘celebration of life in the heart of winter,’ residents and staff at the Agnes Pratt Nursing Home in St. John’s marked Valentine’s Day, 2012 with a lighthearted stroll down wedding aisles of years gone by. Dozens of wedding, bridesmaid and flower girl dresses were modeled by employees and residents alike, as they reminisced about wedding celebrations, some of which dated back more than 70 years. Housekeepers and nursing staff were transformed into ‘wedding belles’ as they modeled dressing belonging to various residents; while residents like Caroline Snow got to wear a wedding
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dress courtesy of a staff member – unlike her actual wedding day 50 years ago, when she wore a suit. The fashion show was organized by the Recreational Therapy Program at Agnes Pratt to celebrate love and life – and to give those who live and work at the nursing home a boost during the long, dark days of winter. “Planning for this event has been a lot of fun, and that in itself is therapeutic,” said Recreation Therapist Kim Conran. “We are a community here at Agnes Pratt and celebrations like this one create special moments and memories for all those involved.” The oldest dress belonged to Lily May Hunter. The 98 year old resident from a tiny fishing community near Salvage married her husband
Thomas in 1940. She watched in delight as receptionist Joanne Buckingham modeled it 72 years later. Tuxedoed male employees escorted the ‘brides and bridesmaids,’ who were given full beauty treatments by students of the Woodford Training College. Those in attendance reminisced over original wedding photos – and posed for new ones as well! Winter blahs dissolved in a sea of sequins and tulle as residents, staff and visiting family members created new memories out of old and proved that shared fun is always in fashion.
MY STORY... by Lisa Clarke
The Friendship Corner Group, April
MENTAL HEALTH NURSE CASE MANAGER
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THE FRIENDSHIP CORNER My caseload consists of individuals with severe and persistent mental illness. In most interactions with my clients, a recurring theme of social isolation, disconnectedness, and boredom became evident. In talking with other members of the team, we were able to identify a number of people who have expressed loneliness and difficulty meeting and interacting with others. Clients would often say: “I just want to meet people,” or “I want a friend,” or “I wish I had someplace to go.” This need for normalized behaviour is also well documented throughout the literature and has clear benefits for clients, communities, and society at large. An idea was born, and we set about to make it a reality.
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ME!
In August 2010, we held our first group meeting of the new Friendship Corner at the SPLASH Centre in Harbour Grace. Since then, we have been meeting twice monthly on Monday, from 5:00 to 7:00 p.m. We have 33 people registered, and 21 attend regularly. While not every group member has been diagnosed with a mental illness, many of them suffer with complex mental health issues as well as psychosocial and socioeconomic difficulties. Attendance is open and members are invited to attend those sessions they are interested in. A calendar is sent to group members relaying any pertinent information on upcoming sessions. Each meeting consists of at least two concurrent activities followed by a group meal. We do things like walking,
and I’m r, e n or C ip sh d n e ri F icipate rt pa I’m very proucdliof ly e v ra b o h w s t proud of my ryensession. each and eve basketball, tennis, badminton, baseball and soccer. We’ve had a pool tournament, cooking classes, crafts, movies and cards and games. The participants have also really enjoyed presentation we have arranged for them on everything from physical fitness and money management to sexual health. This year, we started a book club whereby group members choose a book, they have several weeks to read it, and an appointed leader then leads a discussion and the group chooses the next book. This is going extremely well and several members participate. This spring, we were also fortunate enough to be awarded a Lighthouse Grant that allows us to participate in “out & about” activities. For instance, this summer we were able to charter a bus and take group members to a local bowling alley. This was our first outing and was thoroughly enjoyed by participants. We have sufficient funding to provide outings seasonally throughout this year. Some ideas for upcoming activities include swimming, theatre, and at the participant’s request - a repeat bowling activity! We have also planned an education day for consumers and families. The event will take place this spring with guest speakers presenting on a wide range of topics from recovery to the benefits of community involvement and socialization. Our hope is to offer a wide array of topics from both formalized presentations and interactive groups to booth displays. I would also like to note that for our Christmas session we wanted to do something special. A local church group agreed to prepare and serve a hot turkey dinner to participants and their invited guest. We also provided a small gift to each member and participated in some Christmas-themed games. It went beautifully! Obviously, offering this kind of group is not without its challenges. The rural Avalon area, while
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well populated in comparison to other rural Newfoundland areas, has major transportation challenges. Unfortunately, we have no access to public transportation. The only transportation options available are private transport and taxi. Most of our clients lack the social supports required to have access to a car - basically, they have no one willing or able to take them to group and then pick them up two hours later. Most do not own a vehicle, and they couldn’t afford a taxi which could potentially run $15 to $65 one way. Needless to say our job was to work with clients to identify available options, advocate for support and funding, and to find creative ways to help get them to group. We found that a letter of support from a psychiatrist identifying the need for group participation was quite beneficial. In some cases, clients were being approved for transportation through HRLE while other group members have arranged a carpool. We also approached “Communities Against Violence”, and they supported our request for $500 which is used to offset transportation costs for some members. I’m very proud of Friendship Corner, and I’m proud of my clients who bravely participate each and every session. They chose the name of the group themselves, which I believe speaks to the importance it carries for them. I believe the Friendship Corner is an excellent example of our strategic priorities in action.
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