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Dan Willock, a fantastic BGH volunteer and grateful patient.

Tanya Barnett, RN and Dr. Johathan Leclerc — two of the many exceptional health care providers who took great care of Dan.

Dan Willock, one of Belleville General Hospital’s outstanding Auxiliary volunteers, has used many of the hospital’s services over the years. The wonderful care he received during his last visit to the BGH Emergency Department prompted Dan to nominate some individuals as Hospital Heroes. Dan also donated $175 towards the purchase of much-needed equipment for the Emergency Department and plans to continue donating over time. “The exceptional care given to me by Marisa Mielke, Chelsea Webster and Tanya Barnett – gifted nurses – brought me much relief and comfort. Dr. Leclerc was outstanding in his thorough testing and great knowledge of what procedures were necessary for my recovery. A very special thank you to this team of expert caregivers.”

Moose FM Radiothon Rocked! Amazing support from the North Hastings community during this year’s Moose FM Radiothon! Thanks to donors, Moose FM and our incredible volunteers, $20,950 was raised for North Hastings Hospital! “Lots and lots of thanks to everyone — local folk, cottage and visitor folk and many businesses who contributed,” said Debbie Speck, Past President, North Hastings District Hospital Auxiliary and Radiothon convenor. “Our hospital is an important factor in the life of our town and will continue to be in the coming years. We are so fortunate to be part of a community that cares about getting the best possible health care!”


Quinte 4 ACE unit better supporting discharged patients When patients leave the hospital they’re provided a discharge care plan that instructs them on what to do once they’re home (pick up their prescriptions, make an appointment with their family doctor, etc.) Ideally, patients will follow the care plan and continue recovering at home, but sometimes that isn’t the case and patients end up back in hospital. The Quinte 4 ACE (Acute Care for Elders) unit at Belleville General Hospital is now taking steps to ensure patients are better supported at home after being discharged. Using a tool called LACE, the care team can identify patients that are at risk for readmission to hospital within 30 days of discharge. The LACE tool takes into consideration the following factors:  Length of stay  Acuity of the admission (whether the patient was admitted through the emergency department vs. elective admission)  Comorbidity of the patient (what chronic diseases the patient has)  Emergency department utilization (number of Emergency visits in the past Quinte 4 Patient Care Lead, Joyce Brant, calling discharged patients six months) to ensure their care plan is being followed.

Prior to discharge, a nurse will score the patient using the LACE index. National studies indicate that patients with a LACE score of zero only have a two per cent risk of death or readmission, while those with a score of 19 (the highest possible score) have a 44 per cent risk.

If a Quinte 4 patient scores 15 or higher, the clinical team will look at adding community services, such as a Rapid Response Nurse visit, to their care plan. The Rapid Response Nurse, provided through the Local Health Integration Network, helps patients transition from hospital to home, acting as a bridge to support patients with complex and high care needs. This, along with other community services such as Health Links or the SMILE program, can have a huge impact on patient well-being and recovery. “Before we started using the LACE tool, we probably didn’t pick up on all the times patients would benefit from these community supports,” said Kim Fletcher, Manager of the Quinte 4 ACE unit. “There are lots of things we might not have thought of and this tool allows us to consider all of the conditions that may bring them back to hospital.” If patients score 11 or higher, the Patient Care Lead (PCL) or Zone Lead, will call them at home within 24-72 hours of their discharge to check in on them (if the patient consents). She will ask if they got their prescriptions, if they made an appointment with their family doctor, if they’re eating well, if the Rapid Response Nurse came (if one was requested), and if they have any questions or concerns. “The follow-up calls help clarify for patients what they should be doing and prevent them from slipping through the cracks,” explains Joyce Brant, PCL. “There have been many times where I’ve called a patient and found out that something in their care plan didn’t happen – for example they didn’t get their medication or they turned away the Rapid Response Nurse. Catching these issues can help prevent patients from ending up right back at the hospital.”

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Upcoming Grassroots Transformation Events 

September 18-20 — Hospitalist Diagnostic Assessment

October 16-19 — ICU Transfer Out Standard Work

February 20-22 — Patient Transfer Diagnostic

New IPAC changes to help decrease pressures of bed moves and isolation Infection Prevention and Control (IPAC) and the IPAC working group have approved changes that will help reduce organizational stress surrounding bed moves and isolation. The changes take into account recent provincial recommendations for Antibiotic Resistant Organisms (AROs) and reflect feedback from key stakeholders. They will go into effect September 1st to help reduce daily antibiotic resistance-related isolation (by approximately 40%) and help relieve the stress of extra bed moves. The changes are as follows: 

Patients who are flagged as “Past Positive” for an antibiotic resistant organism (ARO) will no longer be placed on contact precautions. (Note: Patients who are past positive for an ARO will still be flagged and swabbed on all future admissions due to risk of re-colonization)

Patients who are flagged as “Exposures” for an ARO will no longer be placed on contact precautions. (Note: Patients who are exposures for an ARO will still be flagged and require 2 sets of swabs with second swab minimum of 7 days post exposure. Exposure flags will be removed 12 months after exposure. During an outbreak, the outbreak committee may require exposures to be isolated until exposure is ruled out as a control measure)

Repatriations from other non-QHC hospitals will be checked for a critical care indicator (CCI) flag. Patients without a flag will be placed on contact precautions to “isolate in place” until swabs are completed. (Note: patients without a CCI flag will be placed on contact precautions until admission swabs for AROs are received as negative. “Isolate in place” means patient will go into a room that is available without moving patients to create a private room)

Patients will not be swabbed, isolated or flagged for ESBL. (Note: Admission swabs that are taken for VRE will provide passive surveillance for carbapenem resistance) Important Note:

If there are not enough private rooms for patients requiring contact precautions then it may be necessary to place an ARO-positive patient with a non-ARO, low-risk roommate. Low risk roommates are those who are cognitively well, continent, have good personal hygiene including hand hygiene and do not have open wounds or indwelling devices. This roommate will be considered an exposure and require follow-up swabs once separated from the positive ARO patient. Infection Control realizes these are significant changes and the team is available to support you and answer your questions. The Infection Control team can be reached at ext. 2361.

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#WeAllHelpProvideCare

That extra special touch – “We recently had a long‐teerm  nurse re re from our department. We planned a tea for the  nurse and I messaged Heather Sharpe to ask that thee room  be set up in advance. Heather and her Hospitality Serrvices  team took it upon themselves and did a beau ful job b of  decora ng the room with re rement banners and other  decora ons. It was very nice!  I was so surprised and we all  so appreciated Heather and her team for making thiss  special effort on our behalf.  I have the utmost respect for  Heather and her team – they have always been theree to  support our department in educa on events, regardlless of  the ask.  They are an amazing team and we are fortunate to  have them – again it reminds me how we all help pro ovide  care – whether it is to our pa ents or each other.”  — — Terry  Holland, Prac ce Coordinator, Quality & Pa ent Safety (Picture: Inspired by Heather’s decora ve flair, her teeam  decorated Heather’s office for her birthday!) 

Hats off to Trenton – “I just wanted to give a big SHOUT OUT to Trenton  Memorial Hospital Emergency Department and all support staff, including  great registra on and very hard‐working cleaning staff too. I was in and out  within an hour with a friendly and knowledgeable triage nurse, very helpful  and a en ve nursing staff and Dr. Aleykina, who treated me and put my  mind at ease. As always at TMH, efficient and effec ve service from some  very competent and dedicated people focused on pa ent care! Thank you  all!” – A grateful pa ent 

#4MyyTeam

A friendly face – Anne Morrison is co‐ convenor and one of the nine wonderful  volunteers currently providing comfort  to pa ents and families in the BGH  Oncology Clinic. The volunteers provide  coffee, snacks and a friendly face to  those coming for treatment. “We see  people from Madoc, S rling and all over  who all have a story to tell,” said Anne.  “We provide an ear to listen and comfort  and encouragement. I’m amazed by the  courage I see here from pa ents and  their loved ones. Despite what people  may believe, this is a happy place to  volunteer. People are so grateful – we  get called angels.”  

#RespectEveryone

Savvy surgeon – “Just wanted to take a  minute and recognize Dr. Ma  MacEwan,  and say how thankful I am for his incredible  work. He was so nice and most importantly  did an amazing job repairing my sha ered  radius bone! He even took the  me to avoid  cu ng into my ta oo. I am beyond grateful.  He is wonderful at what he does and  deserves recogni on!” – A grateful pa ent 

#ImagineItsYou Team‐building in the county – The Prince Edward County Health Care  Team par cipated in another Par cipACTION 150 challenge. This  me,  horseback riding at Diamond J Ranch!  “Eight par cipants enjoyed the  serenity of the forest while the horses made their way around the twisty  trails,” said Lawrie Ackerman, Administra ve Assistant, PECMH. “It was  an experience of trust and bonding with these incredible creatures on  the final evening of July. We're very grateful for the opportunity.”  

#4MyTea am #AlwaysStriveToImprove

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Who inspires you? Anyone can share in celebra ng our teams – staff, pa entss, physicians and volunteers. Contact Carly Baxter at ext. 2677, cbaxter@qhc.on.ca.

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Preparations for the March 2018 roll out of eCTAS Patients arriving to an Emergency Department (ED) with an ailment deserve peace of mind, knowing that no matter which ED they go to they will be triaged the same way and end up with the same CTAS (Canadian Triage Acuity Scale) score. “Right now, patient acuity scores are subjective based on the nurse’s experience, education and assessment,” explained Perry Simard, Manager of the Trenton Emergency Department. Emergency Departments all across the province are in the process of implementing eCTAS – an intelligent decision support system to standardize how CTAS guidelines are applied. The tool was created by nurses for nurses and is meant to be user-friendly and intuitive. “Implementing eCTAS at each of our ED’s will ensure patients are getting consistent, safe, quality care,” said Perry. Although Quinte Health Care isn’t fully implementing eCTAS until March 2018, work is already being done to get ready. The Emergency Departments have narrowed down their chief complaint lists from more than 400 options to 167 options. That means they have fewer complaint options to pick from when a patient presents in the ED, reducing the potential for variability in the CTAS score. “Going to a smaller list is a big change for staff, so we’re getting them familiar with what they’ll have to work with once eCTAS is in use and we’re addressing any concerns with the smaller list now,” said Perry. The IS department is also in the process of setting up dual screens in the triage areas – one screen will be used for eCTAS and the other will be used for Meditech. Furthermore, a small group of QHC managers and staff travelled to Ross Memorial Hospital in Lindsay for a site visit. Ross Memorial was one of the first hospitals in Ontario to execute eCTAS, so the QHC group went to see it in operation and ask questions about any challenges they have experienced. “Ross Memorial has had a very successful rollout of eCTAS,” said Perry. “Some staff were hesitant to get on board, but they’re now finding it easy to use and really see how it benefits patient care.” Look for more updates about the eCTAS roll out over the coming months. In his three years volunteering with the Belleville General Hospital Auxiliary, Kevin Kang has logged many hours working in the gift shop, doing meal time assistance on Sills 3, and helping to recruit other student volunteers. This month, Kevin was honoured with the BGH Auxiliary Student Volunteer Bursary. The $1,000 award will help Kevin pay for his education at McGill University where he will be studying anatomy and cell biology.

BGH Auxiliary members Judy Hurst, Mary Jo Fortin and Sharon Ostman present a $1,000 bursary to student volunteer Kevin Kang.

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“Kevin has volunteered far above and beyond the 100 hours required to receive this bursary,” said Leah Johnson, President of the BGH Auxiliary. “He’s been an outstanding volunteer who has shown dedication and professionalism. We’re going to miss him.”


Grand Opening of the “Quinte Children’s Treatment Centre Medigas Celebrity Classic Therapy Playground”

A celebration attended by children and staff from the Quinte Children’s Treatment Centre (QCTC), donors and representatives of QHC and the BGH Foundation, was held August 2 to mark the official opening of the new therapy playground at the Belleville General Hospital. The ceremony capped more than a year of planning, fundraising, and construction. The playground has been a dream of the Quinte Children’s Treatment Centre (QCTC) since its relocation to the Sills Wing in 2012. Thanks to the many generous donors who contributed to the “Help Them Play” Campaign and to the generosity of community partners like Medigas, the new therapy playground has become a reality. The Quinte Children’s Treatment Centre provides close to 10,000 habilitation and rehabilitation sessions each year, including physiotherapy, occupational therapy, speech and language therapy, social work and medical services to children and youth with special needs. They support almost 1,000 children per year from birth to 18 years of age. Other Community partners and organizations who stepped forward to make the therapy playground a reality were the Frederick J. Hennessey Foundation, Rotary Club of Belleville, 100+ Women Who Care Quinte, McDougall Insurance Brokers, Giant Tiger Belleville, Alarm Systems, Royal LePage ProAlliance Realty and hundreds of other donors throughout the Quinte area. Thank you for “Helping Them Play!” Continued from page 2 — Quinte 4 ACE unit better supporting discharged patients

While it’s still too early to officially track whether the LACE tool is helping to prevent readmissions, Kim and Joyce are confident that the interventions the Quinte 4 ACE unit is providing to patients upon discharge are helping to improve patient care. “I’m really proud,” said Kim. “This extra step adds huge value for our patients.”

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My experience shadowing in the Belleville General Hospital Emergency Department: Ever since my early childhood, I’ve aspired to become a physician within Ontario. As a recent Queen’s University graduate (class of 2017), I’ve obtained my Bachelor of Science in Kinesiology and seek acceptance into medical school. While many are content applying to medical school with minimal knowledge of physician routine, I sought to gain firsthand experience that could further strengthen my passion toward medicine. After all, studying medicine is a lifelong Kurt Lukas feels privileged to be shadowing some of BGH’s excellent process that requires continuous physicians. From left: Dr. Mark Froats, Kurt Lucas and Dr. Andrew Samis. education and ongoing commitment. I was astonished to be granted the opportunity to shadow Dr. Mark Froats in the Belleville Emergency Department. While, admittedly, I was anxious to begin this journey, the Quinte Health Care staff welcomed me with open arms. Dr. Froats has undoubtedly been the best mentor any pre-med student could imagine. I’m particularly impressed not only by his medical knowledge, but bedside manner. A rather memorable experience was the first time I observed Dr. Froats interacting with a patient struggling through mental health issues. I was amazed by his professional, yet compassionate approach when handling the situation. It gave me an appreciation of how to combat difficult circumstances to ensure patient safety. Likewise, his willingness to teach is second-to-none. During my visits, we’ve discussed numerous topics that have ranged from congestive heart failure to the “golden hour” in emergency medicine. Despite my lack of a medical background, Dr. Froats would still explain each case, along with the corresponding treatment and prognosis. There was nothing more beneficial than to experience what a future as an ER physician entails. This positive experience with Dr. Froats has further kindled my medical aspirations and motivation to achieve acceptance into a Canadian medical school. While shadowing in the ER, I’ve also had the pleasure of being introduced to numerous other staff members, including Dr. Andrew Samis. Another of my many hallmark experiences thus far has been to observe a laparoscopic appendectomy. Although a task that required focus, dexterity and precision, Dr. Samis did not refrain from providing invaluable education throughout the entire process. The ability to observe and step foot into an operating room demonstrated a novel perspective of medicine that I thoroughly enjoyed and appreciated. I would like to extend a tremendous thank you to Dr. Froats, Dr. Samis and all of Quinte Health Care team who have made this experience possible. I understand that such opportunity is seldom for pre-med students and am grateful for every moment spent within the hospital. QHC Bellville General Hospital is filled with phenomenal staff whose attitudes, hard work and dedication go the extra mile to ensure top quality patient care. It would be an honour to work at such an exemplary facility in the future. ~ Submitted by Kurt Lukas, student QHC Vital Signs Newsletter, August 2017: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400, ext. 2677, cbaxter@qhc.on.ca

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August 2017 Vital Signs  
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