Regina Leader Post Health Care Providers Week 2016

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HEALTH CARE PROVIDERS WEEK

REGINA LEADER-POST

H E A LT H C A R E PROVIDERS WEEK OCT. 23-30

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IMPROVING ACCESS TO CARE Health care remains a priority for Sask. government JONATHAN HAMELIN

Since the Saskatchewan Party was first sworn into office in 2007, the government has shown a healthy commitment to the people of Saskatchewan.

There has been a 50 per cent increase in health care spending since 2007, highlighted by a record investment of $5.17 billion in the 2016-17 Health Budget (an increase of $57.4 million, or 1.1 per cent, over 2015-16).

“Overall, we knew that Saskatchewan could be much better when it came to health care. Instead of being mediocre, we have tried to be innovative and to improve our system by always putting the patient first,” said recently appointed Health Minister Jim Reiter.

“Saskatchewan had a health system that had few nurses, physicians and the worst surgical wait times in Canada. We knew we could do better. That’s why there are now 650 more doctors and 3,200 more nurses of every designation working in Saskatchewan compared to 2007. We knew Saskatchewan had the dubious distinction of having the longest surgical wait times in Canada; we now have the shortest surgical wait times. We haven’t been ideological in how to achieve better results in our health care system.”

The government has indicated that the $5.17 billion 2016-17 budget will include investments in health care infrastructure, improving access to care, and reducing wait times for surgery and diagnostic services for Saskatchewan people.

In terms of infrastructure, there

will be a 25 per cent increase for capital maintenance across the province, while capital funding will be provided for a power plant upgrade at Saskatoon Royal University Hospital, electrical renewal projects at Regina’s General and Pasqua hospitals and the completion of construction at the Kelvington Integrated Care Facility.

“It’s our priority to provide a comfortable, safe and wellmaintained environment for our patients, residents and staff and our government will continue to pri-

Saskatchewan. In the private-pay system, every time someone buys an MRI in the province, one must be given free of charge to someone on the public waiting list within 14 days.

The government has also campaigned on the promise of expanding private-pay services to CT scans. Legislation that expands private-pay services to CT scans has been introduced in the Legislative Assembly and Reiter said it’s expected to pass in the coming months.

Our vision is for Saskatchewan to become a leader in the country in meeting the Canadian Association of Emergency Physicians’ guidelines for safe, appropriate and timely emergency room care.

M I N I S T E R O F H E A LT H J I M R E I T E R

oritize improvements in this area,” Reiter said.

To reduce wait times for surgery and diagnostic services, the government is allocating $20 million in targeted funding to increase the number of surgeries performed in 2016. Going beyond funding, Reiter said the government will continue focusing on innovative approaches. In 2016, the government has added CT service in Estevan and MRI service in Moose Jaw, while passing private-pay MRI legislation to assist in improving specialized medical imaging capacity in

When it comes to access to care, Reiter said the government is hoping to build on the success it has experienced in reducing surgical wait times and has “set its sights” on reducing waiting times in the emergency department by 60 per cent by March 2019. To improve access for patients and reduce emergency room waits, the government is planning to make improvements in areas like primary health care, specialist consults, diagnostics, mental health and addictions, long-term care, home care and acute care.

Honourable Jim Reiter, Minister of Health

“Our vision is for Saskatchewan to become a leader in the country in meeting the Canadian Association of Emergency Physicians’ guidelines for safe, appropriate and timely emergency room care,” Reiter said.

When the budget was unveiled, the government announced that a special commissioner will be appointed to recommend options for fewer health regions and more effective and efficient delivery of province-wide services. It was announced in August, however, that it will instead be a threemember advisory panel that will examine the province’s 12 regional health authorities (RHAs) and provide their advice on a structure that includes fewer health regions.

Consisting of Dr. Dennis Kendel (CEO of the Physician Recruitment Agency of Saskatchewan), Brenda Abrametz (Chair of the Prince Albert Parkland RHA) and Tyler Bragg (CEO of Pinnacle Financial Services and former chair of the Cypress RHA), the panel is to conduct a several-month review that includes input from the public in

the form of written submissions and consultations with key health system stakeholders.

“Ultimately, the three advisory panel members we chose represent three different parts of Saskatchewan (south, Saskatoon, and Prince Albert/north) and came with different experiences within the health care system. I look forward to the upcoming recommendations from the advisory panel, and especially look forward to improving our health care system and continuing to put the patient first,” said Reiter.

In the budget, it was also announced the Saskatchewan Cancer Agency will receive more than $167 million in funding in this budget, which will help pay for the addition of 15 new cancer drugs that were approved last year. Meanwhile, the government is investing $500,000 to fulfill its commitment to expand robotic telemedicine in northern communities. This project allows health care professionals to connect with patients remotely and provide real-time assessment, diagnosis and patient management.

While Reiter is proud of the government’s record in health care, he said it’s the province’s frontline workers who truly deserve all the credit.

“Our healthcare workers drive the work that we do, and are at the front lines of patient care each and every day,” he said. “I want to thank all healthcare workers for the job they do every single day. Their commitment to patient-first care is extraordinary and I hope they all realize how much they are appreciated and respected by everyone in this province.”

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HEALTH CARE PROVIDERS WEEK

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RURAL DOCS SHARE THEIR STORIES

OCT. 23-30

What’s the life of a small-town doctor really like?

TOM EREMONDI

There are thousands of doctors working in small towns across Canada.

One of those physicians, Reginabased Dr. Paul Dhillon, decided to share some of their stories. Earlier this year, he released The Surprising Lives of Small-Town Doctors, a compilation of more than 40 stories from every province and territory in Canada.

Dr. Paul Dhillon was born in Victoria, attended the UBC in Vancouver and completed his medical training in the United Kingdom.

He came to Regina to complete his residency, part of which included working in communities outside of the city.

“I knew I wanted to work rurally,” he said, noting he accepted a retention bursary from the Saskatchewan Medical Association in 2013.

His current contract is to provide locum coverage – filling in for other physicians on leave. The position sees him travelling up to 500 km away from Regina to numerous small towns.

“It’s an awesome way to see the province,” he said, adding that he

takes time to explore each community he visits.

Through the position Dr. Dhillon has encountered many people and patients. One of those was the inspiration for his book. “She was a 92 year-old war bride, who was still living on her own and had fallen while feeding her cats. While treating her, we started chatting and I realized she had an incredible story.”

Dr. Dhillon said he knew that “as alone and isolated as a new rural physician can be, it is a gift to be able to share moments in the lives of Canadians. That moment – when my patient shared her stories with me – is the place where this book emotionally began.”

Dhillon also recognized he wasn’t alone in this experience. “I was chatting with a friend who is also a small-town doctor and we agreed for the need for doctors to have stories from other doctors. Then other physicians would know that they’re not the only ones in those isolated situations.

“We saw the value in helping other doctors understand that it’s normal to feel alone and to be scared while pushed to the limits of what they know.”

After working as a locum physician in rural Saskatchewan, Dr. Paul Dhillon realized there were other doctors with stories such as he’d encountered. He decided to collect their stories in The Surprising Lives of Small-Town Doctors.

S U PPLI E D

Dhillon, who is the author of two other self-published books, originally planned for The Surprising Lives of Small-Town Doctors to be just an e-book. “My friend encouraged me to take it farther so I started researching how to publish a book.

By then I’d had two or three stories so I sent them out to publishers.

“I was more than surprised when the University of Regina Press contacted me to say they were definitely interested.”

Dr. Dhillon said, with the publisher’s help, his book became “a huge project. They encouraged me to get more stories and I’m happy that I collected stories from every

province and territory.”

He noted, though, that collecting stories for the book was “difficult to do because of doctors’ busy schedules and because it was all done through email. I’d started with a list and once one doctor had committed, I’d ask them to refer me to their friends.”

Also serving as editor, Dhillon described this process as “herding stray cats. I had to get them to submit their pieces but also had to go back to them to suggest changes to their stories. That also was difficult.”

He stresses one particular hardship. “As a physician, I faced telling people they were sick or that a loved

one had passed away. It was almost as tough to tell my friend that his story had to be cut from the book.”

Reading the words of the doctors was rewarding, he said. “It was an incredible experience to read the stories. There are moving themes of doctors dealing with death and other tough situations. It was also a joy to read about their successes.

Overall, it was great to realize I’m not alone when I feel certain ways about what I face as a rural physician.”

Proceeds from sales of the book will be donated to Doctors Without Borders. For availability, check with your local bookstore.

TALKING THE TALK

Course teaches nurses how to communicate with patients J O NAT H A N H A M E L I N

When many students enter the College of Nursing at the University of Saskatchewan, they’re eager to learn how to walk the walk – whether it means inserting an IV needle, administering medication or performing physical assessments. However, there’s one course in particular that teaches them the importance of talking the talk.

The College’s Nursing 204.3: Communication and Professional Relationships class, taught by Dr. Kelly Penz at the Regina Campus, focuses on establishing effective interpersonal communication practices between Registered Nurses (RN) and their patients.

“In health care, studies have shown that 70 per cent of ‘sentinel events’ – preventable adverse events that result in serious injury or death – have been linked to communication failure,” said Penz, who has been teaching nursing for over 10 years and has been with the College for the past five years.

“When communication goes wrong or there’s a lack of communication, that’s when patients are most at risk of harm.”

Penz’s class consists of interactive lectures combined with smaller breakout sessions. Through clinical storytelling and analysing different media reports, Penz tries to put everything into the current context of the health care environment to examine how it may influence the students in their future practice.

A strong focus in the class is on intrapersonal and interprofessional skills.

“Essentially, what I’m really trying to focus on is helping them

develop a knowledge and reflexivity of who they are. They need to understand their own inner voice, what it’s telling them and how their intrapersonal skills influence their interactions with other people,” Penz said.

“When it comes to interprofessional communication, they need to learn how to communicate as part of an effective, collaborative team.

They also need to learn how to become advocates for their patients and keep their patients safe from harm, recognizing preventable risk and actually acting before that harm occurs.”

Prior to becoming an instructor, Penz spent over three years as an RN at Saskatoon City Hospital. She often worked in environments with patients who had been diagnosed with a terminal illness and were receiving palliative and/or end of life care. According to her, it’s at

moments like these when nurses need to be able to effectively communicate.

“Sometimes, we’re sharing bad news with a patient, or I’ve experienced situations where a physician will tell a patient that his abdominal surgery was unsuccessful because a tumour was found. They might give that bad news and then walk out of the room,” Penz said. “It’s often the RNs who are going in and explaining things in more detail, and providing emotional support.

“In palliative care, what we often see are competing goals. For example, someone might be refusing chemotherapy; they say, ‘enough is enough. I don’t want to go through that anymore.’ A family member might say, ‘You can’t do that; you’re giving up.’ In those types of situations, you have to communicate and help guide them through this process without taking sides.”

5 KEYS TO EFFECTIVE COMMUNICATION 1. Build Trust: “It’s truly about the small things: introducing yourself by name, explaining your role, ensuring your patients knows what to expect.

There’s that fostering of trust that helps to create what we call therapeutic relationships. The goal is to make patients feel safe in your care,” said Penz.

2. Know Yourself: “You have to thoroughly examine yourself and realize what your personal biases or stereotypical beliefs are that may influence how you see your patients. You then need to figure out how you can challenge your thinking in new situations.”

3. Listen More: “Health care professionals tend to speak a lot. Sometimes, you have to be silent and let your patient have a chance to process – even if it’s just for five to 10 minutes. I know many nurses feel like they don’t have time because of heavy workloads, but it only takes small pieces of time for patients to feel listened to.”

4. Pace Information And Assess Comprehension: “Pacing information means attending to how quickly you’re speaking to a patient. Some patients have a high level of health literacy and others don’t. You really have to pace that information accordingly. Assessing comprehension goes along with that. You need to ensure your patients fully grasp what you’ve said and aren’t just nodding and smiling when you ask them if they understand.”

5. Refrain From Being The Expert: “In any health care discipline, you develop a level of expertise that grows over time. However, you can’t think of yourself as an expert. You need to acknowledge patients’ past experiences. They may have been hospitalized before and are coming in with their own knowledge. What can you learn from their expertise?

By showing a desire to hear their story and learn from it, you show them respect.”

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A student attends Dr. Kelly Penz’s class, which consists of interactive lectures combined with smaller breakout sessions. U N I VE RS I TY OF S AS KATCH E WAN

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H E A LT H C A R E PROVIDERS WEEK OCT. 23-30 Since establishing operations in Saskatchewan in 2012, STARS has flown more than 3,300 missions to 500 communities across the province.

STAR S

ANGEL IN THE SKY STARS Air Ambulance always at the ready

PAT REDIGER

At STARS Air Ambulance, employees are always on standby.

“You always have to make sure you’re ready because you don’t know when that next call is coming,” said Cindy Seidl, Saskatoon base director. “Members of the STARS air medical crew are on call at each base 24 hours-a-day, seven days-a-week, and are in the air approximately 10 minutes after accepting a call.”

When lives are hanging in the balance, Seidl said that every second counts. Every day, STARS’ red helicopters are dispatched from its bases in Regina and Saskatoon to deliver the best in critical care to those living in rural communities, working in remote areas, travelling on highways or being transported from community hospitals to major medical facilities.

Since establishing operations in Saskatchewan in 2012, STARS has flown more than 3,300 missions to 500 communities across the province. The charitable, non-profit organization currently averages nearly three missions per day in Saskatchewan.

“It’s a very fulfilling job and everyone feels very fortunate to work for an organization where they get to help people every day,” said Seidl. “It’s great to work with our first responder, local EMS and health care partners in rural Saskatchewan. These people work tirelessly and a lot of times they’re volunteering in their community and serving the citizens of their community. To be able to provide them support and assistance with those critical patients when needed is very rewarding.”

Over half of the population in Western Canada is located hours away from a critical care centre. STARS, which also operates in Alberta and Manitoba, was founded in the 1980s by Dr. Greg Powell, who lost a young mother who was being transported from a rural area to Calgary by ground ambulance.

Seidl noted that STARS is an extension of 911 and is called to the scene of the accident based on a number of factors.

“If you’re driving along, witness a bad car accident and pull over and call 911, the operators will ask you a couple of questions to determine the severity. A multivehicle collision, where there are five or six patients, would be very overwhelming for any EMS (emergency medical services) system, not to mention a rural EMS system,” explained Seidl.

“If they determine it’s a severe event, STARS is put on pre-alert, which means there’s a potential call and we need to get ready to go,

or we’re automatically dispatched.

STARS has an optimal range of approximately 250 kilometres out and 250 kilometres back, so if the accident occurred further away than that it would be covered

by Saskatchewan Air Ambulance fixed-wing aircraft.”

Once activated, a STARS team – typically consisting of two pilots in the front and a critical care nurse and paramedic team in the back – departs to the scene. Upon arrival, Seidl said it’s all about landing safely and quickly assessing the situation.

“Once we arrive, the local fire department or RCMP will assist us in our landing procedures,” she said. “We then work with the local health care providers that are on scene – first responders and local EMS – to determine the number of patients and which are most critically ill and injured, and need to be transported first. One is optimal, but we do have the option of taking two patients if required.”

Once the patient has been secured inside the helicopter, they can be transported to a critical care centre for further treatment.

More often than not, however, treatment occurs right inside the helicopter, which Seidl said is “like a flying intensive care unit.”

“The helicopters bring a sophisticated medical environment directly to the patient. On board, a full array of medications and equipment is at the disposal of the air medical crew,” Seidl said.

“We can administer life-saving drugs, defibrillate a patient’s heart, transfuse blood, assist their breathing with a ventilator or even peer inside their body using portable ultrasound technology.”

The high quality of service STARS delivers is evident when reading the stories of some of their patients.

Weyburn’s John Froese was driving home from a work event via Highway 33 when the roads became icy and a vehicle in the opposite lane swerved and crashed into his. Froese was pinned inside his truck. STARS arrived on the scene and transported him to the Regina General Hospital, where he underwent three surgeries. Doctors discussed amputating Froese’s left leg, as it was broken in two places and the foot was almost severed. However, they were able to hold his leg together with plates and screws and reattach his foot, resulting in four steel plates and at least 20 screws.

Breanna Booy from Glaslyn was playing on her swing set when the wood frame crashed down on her head. A ground ambulance arrived quickly at the property – 67 kilometres north of North Battleford – and later rendezvoused

with STARS, which transported her to Royal University Hospital in Saskatoon, where she spent ten days in the pediatric intensive care unit before emerging from a coma.

Both incidents happened far

from major care centres, and a quick, smooth flight in a helicopter, coupled with a high quality of care en route were instrumental in optimizing the chance of a better outcome.

“At STARS, we refer to our for-

mer patients as our VIPs (Very Important Patients),” said Seidl.

“The stories they share are an inspiration to all of us, as we feel tremendous pride in knowing that we helped make a difference in their lives.”

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Health Care Provider Week SEIU-West members are the backbone of your health care provider team.

October 23 - 30, 2016

Whether it’s your community nursing home, hospital or home care services, the SEIU-West health care provider team is there to ensure you receive quality hands-on nursing care, reliable diagnostics, helpful therapy, safe facilities that are clean and nourishing meals to meet your medical and health care needs.

PurpleWorks.ca

Health Care Provider week is a time to recognize the value and full range of professional skills offered by your health care team.

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