Way to go Quinte 5! Belleville General Hospital’s Quinte 5 has come a long way in the past 10 months! After a Kaizen improvement event in April, it took some time to establish new processes that everyone could get on board with. Hard work from all team members has led to better work flow, improved patient care and an efficient unit that runs like a well-oiled machine. And people are noticing! In January, the team was awarded 15 BGH Foundation Hospital Hero Awards! Two were for Quinte 5 as a whole, and numerous individuals were also recognized for the great care they provided. Congratulations to: Tegan Crawford, PSW, (she received four Hospital Hero awards!); Shanon Bowers, RPN; Lesley Hennessey, RPN; Bronze Guintu, RPN; David Thompson, RPN; Sarah Ryckman, RPN; Yvonne Yu, RN; Megan Dustin, RPN; Stephanie McGowan, RN; Amanda Woolley, RPN; Dr. Chad Steward and Dr. Scott Curran. “Congratulations to the whole team!” said Pamela Melanson, Manager Quinte 5. “We need to recognize all the great work and the positive impact it has on patients and each other.” #AlwaysStriveToImprove The Hospital Hero Program gives grateful patients or family members the opportunity to recognize someone at BGH who made a difference to them. By making them a Hero with a donation to the BGH Foundation, they are saying ‘thank you’ and also contributing toward the purchase of priority medical equipment. Gifts can be made in any amount. For more information, please visit www.bghf.ca.
Improving the BGH tube system — tube bad we didn’t do this sooner! Belleville General Hospital’s pneumatic tube system is meant to be a valuable tool for quickly transporting drugs, specimens or documents throughout the hospital. Problem is, it wasn’t always quick. Departments didn’t have tubes when they needed them and they’d spend a frustratingly long time calling or visiting other departments, trying to track one down. “We never had a tube when we needed one,” said Jean-Anne Hounslow, Team Leader, Endoscopy. “We would hoard them just to make sure we had one when we needed it.” Recognizing there was a problem, a group of directors and managers chose to apply their Lean learning by taking on the daunting task of fixing what ails the tube system. Bill Andrews, Sarah Corkey, Jeff Kerr and Jon Foster – with the help of Elaine Mumby from Capital Development and Paul Dawson from Facilities – audited the system. They collected data by going to gemba and asking front line staff about their needs and how often they are without tubes when they need one. With about 800 tubes going through the system daily, the initial audit revealed that about 500 times a week, someone didn’t have a tube available. The team determined a baseline number of tubes that each of the 28 tube stations should have, and then engaged with the manufacturer to optimize the operation of the system. Using programming capabilities that had not been implemented previously, they programmed the system to automatically distribute tubes where they’re needed, taking guesswork out of the equation. All staff have to do is put the tube back in the system and press “redistribute.” “With our Lean process improvements we aim to make it easy for staff to do the right thing and difficult to do the wrong thing.” - Viviane Meehan, Process Improvement Coordinator “In the first month after implementing the automated system, we reduced the number of times people don’t have a tube by 75 per cent,” said Bill Andrews, Director of Capital Development. “Now, 90 per cent of the time, people have a tube when they need one. And we’re continuously doing audits and adjusting as needed.” “The change has been wonderful,” said Michelle Carlisle, Unit Communication Clerk, Quinte 6. “It’s really rare that we’re calling units to look for tubes, whereas that was constant before. We no longer live in fear that we’re going to run out.” “The solution was always assumed that we need more tubes, but that wasn’t the problem – we just needed to organize what we have,” said Jeff Hohenkerk, Vice President. “That’s what Lean is all about – working Michelle Carlisle, UCC, Quinte 6, puts a tube back into the system to be smarter to solve problems, thereby making our jobs easier and automatically redistributed where it’s ultimately improving patient care.” needed.
What are YOU doing about workplace violence and harassment? Did you know that more than one-third of Canadian nurses reported physical assault from a patient in the past year? And 808 Canadian health care workers missed work last year due to workplace violence? Workplace violence in health care is a problem. Acts of aggression and violence can be committed by anyone – including staff, physicians, patients, families of patients and visitors. “Our staff and physicians need to be familiar with our The Sills 5 Mental Health team does an exemplary job with violence and Workplace Violence and harassment prevention/response. Harassment Prevention policy,” said Bree Gaber, Director, Human Resources & Occupational Health & Safety. “They should be doing all they personally can to prevent violence, and also know how to respond if violence occurs.” The Sills 5 Mental Health team is a great example. While most of their patients aren’t violent, the team is prepared for violence if it occurs. The unit itself is outfitted with video cameras in its Intensive Treatment Area (ITA) as well as convex mirrors to see around corners. The interview room has two points of exit, in case a patient gets aggressive, and all of the patient room doors have big windows so staff know what they’re walking into. The team also takes action to protect themselves and each other. Patients with a higher potential for violence are flagged with a purple triangle sticker on their chart/whiteboard, so staff are aware. Staff wear their personal duress button and carry a portable phone, and they’re all trained in de-escalation techniques in case things get heated. They also ensure that those visiting the unit are safe by requiring all guests to report to the front desk. If a staff member from Lab or Pharmacy has to meet with a patient, someone from Sills 5 always accompanies them to the patient’s room to provide familiarity to the patient – preventing distress. “It makes me proud to know that we take all of these precautions each day,” said Ted Lavigne, Interim Manager, Sills 5. “It’s important to remind ourselves why we do these things and look at if we should keep doing them this way or change them. We want to recognize any gaps we may have.” Heather Lindgren, Patient Care Lead, agrees. “I think we’ve spotted some issues that we have to be more cautious of, but management is well aware and they’re being looked at. I’ve been working in psychiatry since 1994 and I’ve never felt alone on any of my shifts. The team is there, security responds to codes, social workers and clerks are trained in nonviolent crisis Continued on page 7 Intervention techniques. We are supported within the hospital.”
Point of pride — “While listening to CBC radio (O awa sta on) a caller was discussing her father with Alzheimer’s. The caller said her father was sent to the Behavioural Supports Transi on Unit (BSTU) at Belleville General Hospital. She sang the praises of all the staﬀ and spoke about how the focus of staﬀ in iden fying strategies to manage behaviour worked well. She said her dad’s behaviour improved significantly while in the BSTU. It made me very proud to listen to her and know that staﬀ’s good work is appreciated! Congratula ons!” – Paule e Jamieson, re red Director of Medicine and Cri cal Care at QHC
Support in safety — Mary Clare Egberts, QHC President & CEO, took a Safety Walk through Nuclear Medicine last month, where she spent me talking to staﬀ about safety concerns. They discussed the need for a Hoyer pa ent li , their troubles with a damaged pa ent privacy screen, and steps to take in the event that a pa ent is aggressive or violent. The small Nuclear Medicine team agreed that they all have each other’s support and can address issues quickly as they come up. “We want you to feel like you all can have input in the workplace and that you can do your jobs safely. Your safety is a top priority,” said Mary Clare.
Friendly face — If you’re walking through Trenton Memorial Hospital, you may take no ce of Kim Baillargeon. As a Facility/Hospitality Services Representa ve (FSR/HSR), she may be working a broom or wiping down a surface – but that’s not what makes her no ceable. It’s her big smile and her willingness to help anyone who looks like they may need help finding their way. “Having Kim on our team makes a huge diﬀerence and adds to a posi ve environment,” said Tammy MacDonald, Hospitality/Facili es Team Leader.
We’ll miss you Doc! — Thank you to Doc Hudson for his 12 years of service at Belleville General Hospital. He and Leona Gosson, Convenor of the Therapy Dog Program, have been visi ng various areas of BGH and bringing smiles to people’s faces since Doc was just one year old. With Doc Hudson experiencing some health issues, it’s me for him to re re. Leona, who has been running the Therapy Dog Program for 24 years, will con nue in her role.
#RespectEveryone Teamwork exemplified— “We had a very sick pa ent in the ICU and I was so proud to watch the whole team come to ogether to care not only for this pa ent but to also ensure that all the other pa ents in the ICU at the me were cared for as well. The response to this pa ent involved nursing staﬀ (and a nursing student) in ICU, RTs, X‐ray tech, Echo tech, bloodbank, laab, porters, HSR staﬀ, QHC physicians as well as an external team of paramedics and surgeons. “We all Help Provide Caree” is a value that is always lived in ICU however this day was an impressive demonstra on of eﬀec ve team work both in the care of this pa ent as well as the other pa ents in the ICU. “Always Strive to Improve” was also alive and well in the ICU as tthe team worked to understand and support the implementa on of a necessary interven on that we simply don’t see here at Q QHC. The ICU team “Took Ownership” of the ICU to ensure that all the needs of each pa ent were met during a flurry of ac vity and to ensure that all pa ents remained safe during a me when the usual level of observa on in ICU could not be maintain ned. The team embodied the value of “Respect Everyone” as they interacted with each other during this high stress and intensse me and, most importantly, demonstrated a high level of respect for the needs of the family of our sickest pa ent at the me as well as the families of all our ICU pa ents. “Imagine It’s You” has always been the value that I connected most closelyy with and I must say that if I were to imagine it was my family or I in a similar situa on, I would want this qualified, dedicated, aand compassionate group of people at the bedside.” – Sarah Corkey, Manager ICU & Respiratory Therapy
Who inspires you? Anyone can share in celebra ng our teams – staﬀ, pa ents, phyysicians and volunteers. Contact Carly Baxter at ext. 2677, email@example.com.
Staff at BGH make the 2017 “I’m In” Campaign another huge success
eCTAS goes live March 6!
Every day, the staff at QHC positively impact patient care. From oncology to the ER, diagnostic imaging to the medical device reprocessing department, patient records to the pharmacy, maternity to housekeeping, and every department in-between, the wonderful and caring staff all help provide care that improves the patient experience.
With the Meditech upgrade successfully completed, we can now focus our attention on the next big technology change – eCTAS! eCTAS will standardize how Canadian Triage Acuity Scale (CTAS) guidelines are applied to patients visiting Emergency Departments across the province. So far, 19 hospitals – spanning six LHINs – have implemented eCTAS and the rest, including QHC, are preparing for roll out. On January 31, eCTAS champions will be trained by Diane Smith, Emergency Department Clinician. Those champions will then help Diane train other Emergency Department RNs throughout our four hospitals, February 20-23. If you’re a triage-trained RN working in a QHC ED and haven’t been scheduled for eCTAS training, contact your manager to ensure you’re booked to attend. Work is underway to have ED staff signed up for their eHealth Ontario ONE ID so they are able to log on to eCTAS.
You might not know that the same dedicated staff also helped provide care by becoming donors through the annual, ‘I’m In’ Staff Campaign. In 2017, 348 staff made financial contributions to the campaign totaling an amazing $70,278! When asked to explain why they wanted to donate to the staff campaign, a few of the answers really stood out:
“To provide equipment that supports quality patient care and make my job more efficient.” – Kim “To help care for patients/families and staff.” – Sarah “So everyone gets great healthcare and the best treatment possible.” – Nicole “I want everyone to have access to the best possible care.” - Barb
If you or a loved one has in the past or is currently receiving care at BGH, be sure to thank a staff member for their contributions, both monetary and nonmonetary. The government doesn’t pay for priority medical equipment, donations do. Every gift counts, every gift matters and will help make care better at BGH. For more information on enrolling in the Staff Campaign, please visit www.bghf.ca, call 613-969-7400 ext. 2601, or drop by the Foundation Office, Main Floor, Sills Wing.
2017 Infection Prevention and Control (IPAC) a year in review Area
Hand Hygiene April 2017 Gowns June 2017
Automated Speedy Audit hand hygiene surveillance tool was launched. Improved efficiencies for both data collection and dispersion. Visitors wear a gown when providing direct care or entering a room of a patient with Clostridium Difficile infection or Carbapenemaseproducing Enterobacteriaceae. Health care worker to wear a gown: Consistent with routine practices When having direct contact with a patient on contact precautions or his or her environment Carbapenemase-producing Enterobacteriaceae identified at QHC in 2017 for the first time. CPE are gram-negative bacteria resistant to most antibiotics. The World Health Organization named CPE priority 1 pathogens. Incidence of CPE in Canada is increasing. 40% reduction in isolation related to antibiotic resistance due to: Patients who are flagged as “Past Positive” for an antibiotic resistant organism (ARO) no longer be placed on contact precautions. Patients who are flagged as “Exposures” for an antibiotic resistant organism (ARO) no longer be placed on contact precautions. 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. Patients will not be swabbed, isolated or flagged for ESBL. QHC reviewed practice concerning VRE. We are consistent with recommendations from both Public Health Ontario and Provincial Infectious Disease Advisory Committee. Surveillance indicates a significant increase in our VRE Bacteremia and outbreaks.
CPE August 2017
Reduction in bed moves and Isolation September 1 2017
VRE Dec 2017
Continued from page 3—Workplace violence
Over the past year, QHC’s Workplace Violence Prevention Working Group has been focusing its work in a few key areas, including staff education/training, creating a standard violence assessment tool, and increasing violence prevention signage throughout QHC, to name a few. “These are some of the things the group is working on, but teams and individual staff members need to be their own safety champion,” said Bree. “If there are things you see that need to be done, speak up. Your ideas are always welcome. If you have questions about how to stay safe, talk to your manager or Occupational Health &Safety.”
Decision Support makes a good thing even better! When about half of Ontario’s health care budget is spent on just one per cent of the population (people with very complex medical needs), coordinating care in a more efficient way is essential. The LHIN’s Health Links program, introduced in 2013, is helping to improve care for chronically-ill patients while also lowering health care costs – and QHC’s Decision Support team is providing the patient data needed to support this program. For the past four years, Decision Support has been providing Health Links with details like the number of Emergency visits and Dwayne Quenneville, Decision Support types of diagnoses at our hospitals. This information has helped the LHIN understand patient care needs and identify the hurdles faced by patients with chronic health problems. QHC’s data has informed decisions that have contributed to more coordinated care, care being provided in a more appropriate setting, decreased Emergency Department visits, and decreased admissions/readmissions. A couple of months ago, QHC’s Decision Support team switched to a new platform called DS Analytics, allowing them to provide more comprehensive data to Health Links. “With this new tool, we can provide faster, more inclusive information that can be used in a number of ways to deliver a more complete picture,” explained Dwayne Quenneville, Decision Support. “We added new, previously-unattainable data fields, which were on a wish list from Health Links. And we can also search through the data in new ways and look for correlations.” “We’re proud to be supporting the LHIN in this way, and contributing to improvements in our health care system,” said Peter Papadakos, Director of Decision Support & Analytics. “Thanks to our great team for their hard work.”
Festival of Trees raises $40,000…no wait, $50,000 for PECMH! Thank you to the people who bid on the beautifully decorated trees, or purchased baked goods, bucket draw tickets and items from the Second Time Around Shop Boutique at the 2017 Festival of Trees. The participation from patrons helped the Prince Edward County Memorial Hospital Auxiliary raise $40,000 for Prince Edward County Memorial Hospital (PECMH). When time came to present the cheque to the PECMH Foundation, the PECMH Auxiliary added another $10,000 to the total! The $50,000 gift will help offset a $101,890 purchase of an Endo Works picture archive system for the Endoscopy department. Thank you also to all of the incredible Auxiliary volunteers who put many hours into making this event fantastic! QHC Vital Signs Newsletter, January 2018: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400 ext. 2677, firstname.lastname@example.org