A publication for Staff and Physicians of IH
A message from Chris Mazurkewich, Interior Health’s CEO.
Wellness wisdom for work.
Committed to a better way.
QIPS Unit Leader Program making a difference for patients.
Impacts of Automated Shift Callout one year later.
Dr. Bill Nelems leaves a legacy of leadership, care, and compassion.
Introducing the St’at’imc Nation, the seventh of eight Nation profiles.
Staff-submitted photos of places where we live and work.
Snapshots of our staff in action and trending health-care videos.
On the cover: Jessica Bridgeman, Nurse Hero Award recipient. Story p. 20.
The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: IHAcommunications@interiorhealth.ca Editors: Amanda Fisher, Ingeborg Keyser Layout & Design: Kara Visinski IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Erin Toews, Breanna Traynor, Tracy Watson
Every person matters
President & CEO Chris Mazurkewich
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hange has been a constant in health care for as long as I can remember, but the pace of it has increased considerably over the last decade. Looking at Interior Health specifically, and reflecting back on my 30-year career, I have never seen a health authority manage so many externally driven change initiatives as we have in the past year alone, while simultaneously facing the mandate to transform primary and community care. At times, we may think our health-care system in B.C. is the only one being called upon to improve, but we are seeing significant change in other regions as well. Saskatchewan has started down the road of consolidation with plans to become one provincial health authority later this year. In Winnipeg, there are also changes afoot to improve ED flow in a move being called the biggest health-care revamp in a generation (see Healing Our Health System). It’s not change for the sake of change; it’s about continuous improvement to ensure the long-term sustainability of health care across our country. We need to acknowledge that in IH by reflecting on the tremendous improvements we’ve made over the years, from adding new services to expanding or redesigning existing ones. There are several recent examples that come to mind. In early April, we received confirmation
that we met the Ministry of Health’s surgical targets for 2016/17. Congratulations go out to our surgical teams across IH for their efforts to help us meet the target of having no more than five per cent of patients waiting more than 40 weeks for surgery by March 31. At present, IH has achieved a measure of 4.3 per cent of patients waiting, a significant reduction that shows we are continuing to provide quality service to our patients while improving the timeliness of it.
IH leaders for a Cultural Safety Forum in Williams Lake where we heard from Secwepemc and Tsilhqo’tin community members who had encountered racism when they tried to access health care. It was important to hear these heartfelt and emotional stories firsthand. But this is about more than listening. It’s incumbent on us to do something – to make change happen by using the tools we have to reach our staff and physicians and help them learn about culturally safe care and cultural humility. A Declaration of Commitment was signed as an important step toward embedding these dimensions of quality and safety in our IH programs and services. See this story on page 14.
I know this was no small feat on the part of physicians, staff, and leadership at our hospitals. They were issued a challenge and they exceeded expectations despite roadblocks that were sometimes put in their way. My thanks to all for persevering and for continuing to stay focused on Last but not least, I would like to improving the patient experience. highlight the ICU teams from IH who participated in a national, year-long In the last month, we also participated collaborative to improve patient in two important events that solidify our experiences and outcomes in intensive commitment to improving health care for care. They were able to show leadership our First Nations and Aboriginal people. in sharing some “head start” learning because of work already done here in IH. The first was the signing of a three-year Well done to all involved! protocol agreement with the First Nations Health Authority to address disparities Our communities and the people we and inequalities in the health status of serve benefit from our efforts – I know First Nations people in the Interior that from the visits I make to sites across Region. A special part of the event was IH, the staff kudos we receive, and from a blanket ceremony, which was an the great progress we have made as a honour to be a part of because it signifies team. This proven track record is part of an opportunity for us to work together in our culture and it is also what will a good way on shared goals. continue to set us up for success going forward, no matter what changes come Then, on May 3, I was joined by other our way.
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efore Jamie Baldwin addressed a roomful of Interior Health and First Nations leaders, he turned to his tiny mother, handed her an eagle feather and leaned down to kiss her forehead. Jamie was there to speak on behalf of Inez Sellars, sharing incidents of racism and neglect encountered on her health-care journey. He said she, her family, and her Soda Creek First Nation community near Williams Lake want her story told in hopes it will help educate people and ensure no one else endures a similar experience. “She is a proud, beautiful, independent woman,” said Jamie, as he described the devastating impact her 18 months in the system had on Inez and her family. It is Inez’s story that gave rise to the Williams Lake Cultural Safety and Humility Forum on May 3 and 4. The forum drew together representatives of Interior Health, First Nations Health Authority, and band and health leaders of the First Nations communities in and around Williams Lake. Many heartbreaking stories were offered by community members including one from a couple who took the leaders along the winding path of their adult son’s mental health illness and the health and justice system’s failure to respond in a way that might have prevented his eventual
Painful
truths Committed to better way total collapse. “I don’t want to see anyone else’s child suffer in this way,” said the man’s father. “If not for the support from our Chief and council, our son would probably be dead. If not for them, I would have been lost (in the maze of bureaucracy).” With these stories fresh in their minds, all the leaders in the room stepped forward to physically demonstrate their commitment to embedding cultural safety and humility into the health-care system. Then, each one, including 13 Chiefs and four representatives from the two health authorities, signed the Declaration of Commitment. The Declaration sets out the guiding principles of cultural safety including: identifying opportunities together, engaging in open and honest dialogue, raising problems without fear of reprisal, and
leading and enabling actions to embed cultural safety and humility in the Williams Lake hospital and Community Health Services.
Day 2 of the forum brought together the working groups from all the organizations to map out a course of action for going forward. Each table tackled questions about what a culturally safe and humble health-care system looks like Interior Health CEO Chris Mazurkewich expressed his and the actions needed to get there. Participants included appreciation for everyone’s courage in sharing their stories. a wide breadth of representation from emergency department, home health, lab, switchboard, diagnostic “You shared from your hearts and you opened our hearts imaging, surgical services, critical care, health information as we heard from you,” he said, adding this day was not management, physicians, research, inpatient care, and just about Interior Health listening, but also about making allied health. the changes that are needed. One recurring message from many speakers was the “It won’t happen in one day, but we do have the tools to importance of traditional medicine to First Nations people. reach people and help them learn about providing culturally safe care and learning cultural humility.” “Western medicine and traditional medicine are on an even keel in our communities. One does not outweigh the other. Susan Brown, IH Vice President and Chief Operating Our health is not just physical; there is an emotional and a Officer, Hospital and Communities, also acknowledged the spiritual component. This must be accepted and honoured importance of hearing these stories firsthand. by health-care providers.” “It starts here today and with us. When things don’t go well, it’s important that we communicate with each other.” Soda Creek Chief Donna Dixon expressed hope that by everyone working together, “we can create a new ending that will come with some respect and dignity” for these stories. “Until the Declaration is implemented in our health facilities and begins to positively change the health care provided to our people, cultural safety is just a phrase, words put together with no meaning. Thank you for being here to start the beginning of these very important discussions.”
Both sessions were facilitated by FNHA Manager of Engagement and Coordination Mark Matthew and Interior Health Cultural Safety Educator Vanessa Mitchell. They will collate the themes and plans will be made for further gatherings to ensure the work toward change continues to move forward. Copies of the Declaration of Commitment will be posted in highly visible locations at IH health sites in the Cariboo. “It is our expectation that all our First Nation’s patients will feel comfortable coming to any Interior Health site and be treated in a culturally appropriate manner,” says Interior Health’s CEO.
Dr. Evan Adams, FNHA Chief Medical Officer, said that cultural humility is an essential tool for practitioners working with First Nations and Indigenous peoples to ensure quality responsive care. “Cultural humility and cultural safety is a path to quality in the provincial health system. The declaration is more than just words, for First Nations and Indigenous people utilizing the health system, it can be a critical determination of health outcomes,” he said. “When health staff are aware of historic and ongoing colonial impacts on health, they can approach First Nations peoples with a better understanding of the root causes of illness.” Dr. Adams called the Declaration of Commitment a “high stakes, high impact issue” for the FNHA.
Above: Interior Health CEO Chris Mazurkewich signs the Declaration of Commitment, along with representatives from the First Nations Health Authority and Chiefs from Williams Lake and surrounding Aboriginal communities. Left: Soda Creek Elder Inez Sellars, third from left, was a guest at the Williams Lake Cultural Safety and Humility Forum where her son, Jamie Baldwin, second from left, shared her difficult experience with the health-care system. Her niece Marjorie Sellars, left, and Soda Creek community health manager Georgina Mortenson also supported her.
The third Kamloops class of the QIPS Unit Leader Program included a wide variety of participants from acute, tertiary mental health, home health, community health, public health, and residential care.
Driving quality from the frontline QIPS Unit Leader Program making a difference for patients
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ou know the adage about the best-laid plans – no matter how carefully something is crafted, it may not work when it’s put into practice.
In health care, it’s usually those who work directly with patients who know this to be true. “In theory, it’s really great, but here we are at the frontline and it doesn’t always work,” says Kamloops nurse Lesley Thellend. “That’s why I was so interested to be part of the QIPS Unit Leader Program – you feel like you’re a part of the change. You feel that your suggestions for improvement are considered and even adopted.” The goal of the Quality Improvement and Patient Safety Unit Leader (QIPS UL) Program is to empower clinicians to make system improvements in their work – as it’s the
people closest to the care delivery who often know best what will benefit both care team and patients alike. The program started in 2013 at Royal Inland Hospital (RIH) in Kamloops, where it was led by the IH West Quality Improvement and Patient Safety team. Three cohorts in Kamloops have now been completed, with the most recent class of 20 participants including nursing, allied health, and pharmacy staff from acute, tertiary mental health, home health, community health, public health, and residential care. In 2016, the QIPS UL Program also branched out to Vernon, where six participants from the Vernon Jubilee Hospital Oncology Unit worked on four successful improvement projects. Planning is now underway to introduce QIPS UL to other areas of IH.
“Each QIPS UL participant chooses a project that will make a positive difference for their patients, clients, and residents; and is supported by clinical leadership, senior leadership, and their team. Participants are provided with education and ongoing support from Quality Improvement consultants,” says Naomi Erickson, Manager for Quality and Patient Safety, IH West. “I am always impressed by the variety of interesting projects and networking opportunities that come out of the program. This work embeds the concepts of continuous quality improvement and delivery of high-quality care into their daily work.” Projects over the years have included: improving patient access to COPD education in the community; enhancing the quality of discharge from the Pathway to Home program; improving patient involvement in care planning; building resilience with staff and residents; improving delirium documentation; and enhancing triage/reassess role clarification.
The fruits of Lesley’s labours can be found throughout RIH. She has provided education on the units in quick but lively 15-minute sessions, which is beneficial to busy staff who can’t get away for a more formal workshop. She also created quick-reference posters that are now seen on the floors, and an education package that RIH’s clinical practice educators give to new hires, so staff feel more comfortable working with renal medications. She also travelled to Cariboo Memorial Hospital in Williams Lake, where she gave presentations not only to staff on the wards, but also to both CMH and family physicians. And now, even though her QIPS UL Program is complete, she’s working on an i-Learn module that will go IH wide.
Lesley’s project was called “To Pee or Not to Pee – improving medication safety in admitted renal patients with a glomerular filtration rate (GFR) of less than 30 per cent.” For the laymen among us, that means a patient with chronic kidney disease, or those on peritoneal dialysis or hemodialysis, whose kidneys were functioning at less than 30 per cent. If these patients were given the wrong medication, or even given too many fluids, it could be life-threatening. Lesley joined Interior Health in 2010, first working in the Ashcroft ER and then as a float nurse at Royal Inland Hospital. In 2011, she completed her renal specialty and added that to her float rotations.
Renal nurse Lesley Thellend displays the quick-reference poster she made as part of her QIPS Unit Leader Program project to improve medication safety in admitted renal patients. The posters hang throughout Royal Inland Hospital.
“What I found, floating around floors, was a discrepancy in knowledge about renal medications – when patients should be getting them, which ones they shouldn’t get, and when to ask the physician for a dosage adjustment,” says Lesley, who also earned a critical-care specialty in 2015. She began educating her colleagues as she went, but wondered if she could do more. Renal manager Lauren Kembel suggested she apply for the QIPS Unit Leader Program. Lesley came to the program with only a germ of an idea to improve medication safety for renal patients, but she didn’t know where to begin. The Quality Improvement consultants taught her the skills to make changes, and Lauren and Dr. Joslyn Conley, an RIH nephrologist, supported her by providing clinical advice and removing any barriers to the process on the ground.
“I love that people are gaining from it,” she says. “It has raised awareness; people aren’t guessing, they’re asking questions.” Heather Cook, Executive Director, Hospitals and Communities, says the QIPS UL Program is making real differences within IH. “What is amazing about this work is the passion for quality that, once unleashed by participation in the QIPS Unit Leader Program, continues to improve the quality of care and service for patients,” Heather says. “The sky is the limit when passionate people who know and understand their work are given support and encouragement to drive quality.” To learn more about the QIPS Unit Leader Program, contact Naomi Erickson.
IH West staffing services team.
New technology improves staffing services
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ince the days of old, businesses around the world have needed to manage the ever changing element that is employees.
Whether it’s a business of two people or a business of 20,000 people, if an employee is unable to come to work, adjustments and adaptations must be made. However, it is the way that businesses manage these day-to-day staffing changes that makes them unique.
Then, one year ago, a new way to offer, bid-on, and fill shifts was born. May 6, 2017 marked the one year anniversary of the implementation of the Automated Shift Callout (ASC) system, a technology tool used to offer vacant shifts to IH employees. Automated Shift Callout enables staffing services to broadcast a shift offer to all eligible employees through automated phone calls, text messages, and emails. Employees then respond, via their preferred method, to express interest in the shift. Then, through the ASC system, the shift can be awarded.
At Interior Health, our Staffing Services department is divided into five regional offices, serving employees located in IH West, IH East, and IH Central (including north, central, and south Okanagan). This team of 147 people manages “This new technology has had an incredible impact on both the shifts for most of our unionized employees – more than our call centre staff and employees who are signed up to 18,000 people. use the system,” says Lee. “Previous to ASC, our short-call clerks would seldom get beyond filling the shift relief needs Over the years, managing the daily changes of this many for today, tomorrow, and maybe the next day. employees has taken a lot of manual work from call centre staff. In one month last year, for example, the Staffing “After a year of using ASC, we are seeing shifts awarded Services call centre placed more than 180,000 individual faster and a significant reduction in manual shift-offer calls. phone calls to fill short-call shifts (a shift vacancy within Staffing clerks can meet the immediate shift relief demands next seven days). Often, it would take phoning hundreds and up to 14 days in advance – making it easier, and giving of employees to fill a single shift. more time, for managers and relief employees to plan around the available work.” “Our call centre clerks were under constant pressure to meet the demand for short-call shifts,” says Lee Van Meter, Lee says that while ASC has provided a number of benefits, Corporate Director, IH Staffing Services. “The time the change in process has presented some challenges. dedicated to calls was daunting, but we were also running the risk of decreased quality of patient care as a result of “Using and adapting to a new technology has been a unfilled shifts.” learning curve for both users and schedulers,” says Lee.
“We are also hearing some staff say they miss the ‘person’ they used to speak with.” Another challenge Lee sees is that employees are receiving far more notifications. “Not only are we offering out far more shifts each day, we are able to do so in a number of ways – text message, automated phone call, and email. This means that a single employee may receive three different notifications for the same shift, which is why we encourage staff to manage their contact preference in the ASC Portal.”
one,” says Amy. “I like the convenience of ASC and its pretty user friendly, but I do miss the interaction with the call centre staff. It was nice getting to know them.” Employees who are signed up to receive shift offers through ASC can adjust when and how they wish to receive notifications, thus avoiding unwanted shift offers. This can be done through the ASC Employee Portal.
“Most people are using ASC and using it effectively,” says Lee. “Despite the learning curve, I think we are all very pleased with the technology and its positive impacts to Amy Richardson, Telemetry Nurse at Royal Inland Hospital, both staffing services, staff who are the users, and, in the says she receives multiple shift offers daily. end, the people for whom we care.” “I’ve signed up to receive both text messages and phone calls – I just text ‘yes’ to accept a shift and ‘no’ to decline
*Data collected April 1, 2016 - May 7, 2017
Staff using ASC can look for tips and tools on the Automated Shift Callout web page on InsideNet.
gone,
But never forgotten
Dr. Bill Nelems leaves lasting legacy
H
ealth care often attracts the brightest people – those with a passion for excellence who strive to help others.
Sadly we recently lost one of the best. Dr. Bill Nelems passed away on March 31 at age 77. Based on the response from the medical community, patients, and friends from around the world, it is clear his impact was far-reaching. Physiotherapist Jane Gates knew Dr. Nelems from her work at Kelowna General Hospital. Then in 2004 she was diagnosed with lung cancer and became a patient. “He had a way of making you feel like everything was going to be okay. He had done a Masters in psychology and believed 30 per cent of the success in treating cancer was the patient’s attitude and their outlook,” she recalls. “He treated everyone as an individual. He would look right at you and he made you feel like you were the most important person he was dealing with. That was his gift. “I remember one patient he had who was dying of cancer. He would visit him in the evenings and play chess with him. He was so comforting and so compassionate.” Dr. Nelems was a pioneer in the medical field. He became the province’s first thoracic surgeon and performed the country’s first lung transplant. He was the first in the world to use extracorporeal membrane oxygenation – now routinely used for treatment of advanced respiratory failure – in support of lung transplantation.
Dr. Bill Nelems – medical pioneer, dedicated humanitarian and friend to many – passed away on March 31 at age 77.
“Bill and I practiced together for more than 30 years, first as teacher and student, and then for the past 15 years in surgical practice together, with a shared passion for delivering thoracic surgical care to the interior and north of B.C.,” says Dr. Michael Humer, Kelowna-based thoracic surgeon. “We could not be where we are with care delivery without Bill’s inspirational leadership.” In 1997, Dr. Nelems helped establish and led the Cancer Centre in the Southern Interior and was key in recruiting several specialists to the area. He was also a compassionate leader in pain management and worked with the Okanagan Interventional Pain Clinic. Born in South Africa before moving to Canada, Dr. Nelems had strong ties to Africa. A passionate humanitarian, he played a key role in establishing the Okanagan-Zambia Health Initiative, a partnership between medical personnel in the Okanagan and countries in Africa. He marked his 70th birthday cycling 4,500 kilometres across Malawi, Zambia, Botswana, and South Africa to raise awareness about the partnership and its cause. Dr. Nelems was a professor emeritus at UBC, where the flag was lowered in recognition of his passing. Father to four daughters, he is described as a loving family man. Planning is underway for an event, likely to be held later in the summer, for the community and family to gather in celebration of his life. Details will be shared when available.
This is the seventh in a series of eight profiles of Aboriginal Nations within Interior Health. This month we feature the St’át’imc Nation.
Cranbrook Submitted by: Dianne Dilts
Kamloops Submitted by: Coranna Hardy
Castlegar Submitted by: Wayne Stupnikoff
Kelowna Submitted by: Jennifer Treger
Vernon Submitted by: Jundale Batbatan
First Nations Health Authority CEO Joe Gallagher and Interior Health CEO Chris Mazurkewich participate in a blanket ceremony after signing a threeyear protocol agreement committed to improving health outcomes for First Nations who live in the Interior Region. A blanket ceremony signified the opportunity for the two CEOs to work together in a good way on their shared goals. Seven First Nations governance representatives witnessed the signing of the protocol. Read the full story.
In Kamloops, Royal Inland Hospital’s Occupational Therapy department gets messy in the name of health and wellness at a recent team-building party. The OTs were grand winners of a contest by the RIH Foundation, in which $500 was put toward developing departmental health and wellness. Read the full story.
Jessica Bridgeman is a Harm Reduction Coordinator with Interior Health and has been instrumental in providing leadership and insight to the IH Overdose Response Team Section Leads who are working towards developing and implementing Safer Consumption Services (SCS) and Overdose Prevention Sites (ODPS). Jessica was nominated by her peers for the national 2017 Nurse Hero Contest and came in third out of 115 nominees. Read the full story.
Stigma against people who use drugs results in discrimination, impacts health, and contributes to overdoses. Sharing stories of people who use drugs can reduce stigma.
There are currently 65 nurse practitioners employed with Interior Health, 15 in Kamloops alone. Nurse practitioners are different from registered nurses. Do you know the difference?
The 33-foot motorhome provides harm-reduction services, including take-home naloxone and primary care services. Clients can receive support from staff while getting answers to any questions. To find out where in Kelowna this mobile unit is located, visit www.interiorhealthca/ODPS.