Safety is paramount at QHC A letter from Shaena Dearman, QHC Safety Specialist QHC’s safety program is exceptional right now. I’ve worked here for 17 years and I’ve never been so proud of the work being done to keep patients and staff safe from injuries. When safety is made a priority by our leadership team and the QHC Board of Directors, everyone benefits. For example, every management person – from frontline managers to our CEO – is required to perform a monthly safety inspection. They may look for unsafe storage of equipment, tripping hazards, under-utilization of provided safety equipment – anything that could compromise staff or patient safety. They then work to close the loop on these action items to ensure the issues don’t reoccur. Members of the senior leadership team regularly visit departments to discuss safety concerns or hear about great work being done. Prior to their visit, selected staff will complete mini safety culture surveys to help provide insight and get the conversation flowing. We’re also doing great work with investigating lost time/modified work cases. Instead of just the manager looking into incidents, the director and a Safety team member (like myself) will work with the staff member to help drill down to the root cause of the issue. We’re not looking for blame, but to identify failed systems – for example, ineffective training or communication. This way we can make adjustments to prevent future incidents. Continued on Page 3
Fewer number of lost time/modified work cases at QHC I’m happy to report that in the 2016/17 fiscal year, we reduced our number of lost time/modified work cases by 15 per cent. Compared to the previous year’s 67 cases, in 2016/17 we had 57 cases where staff members were unable to fulfill their full duties due to a workplace injury. I attribute this improvement to staff diligence, a renewed organizational commitment to safety, and enhancements to our safety program. While 57 is an improvement, it’s still too many. As health care providers, safety must be at the forefront of our minds. Did you know that the health care sector ranks second highest for lost time injuries among all sectors in Ontario? From falls to exposures to musculoskeletal injuries, there are many potential risks associated with working in health care and it is up to us to protect ourselves from injury. Every staff member, physician, volunteer and student at QHC has a role to play in furthering our culture of safety. I encourage everyone to be vigilant of threats to our safety and the safety of our patients. Our goal for this fiscal year is 55 or fewer cases of lost time/modified work cases. I know we can achieve that. Keep up the great work, everyone! ~ Mary Clare Egberts, President & CEO, QHC
Congratulations on a challenging but successful year A message from Board Chair Doug McGregor: As many are aware, there is an old saying “May you live in interesting times.” Looking back at QHC’s last year, it was indeed interesting because of both what was accomplished, and the degree of difficulty in doing so given both the fiscal environment and capacity challenges. As part of our oversight responsibilities, the Board of Quinte Health Care had a lot of contact this year with those who work and volunteer in our four hospitals. It is impossible not to be impressed by the staff, clinicians, auxiliaries and foundations who all do incredible work at each hospital. Of course most of the board’s interactions are with the QHC management team. These strong leaders also continue to impress us with their commitment to patient care, engagement of the front line staff in improvement efforts, and their adaptability in facing the additional capacity challenges – as faced by virtually all hospitals across Ontario, and our unique financial challenges. Here are some “Year at a Glance” statistics from 2016-17: 311, 000 people received care at our hospitals - 13, 400 were admitted as inpatients Our emergency department staff, physicians and volunteers cared for over 104, 000 patients 144, 500 diagnostic images were taken 23, 900 surgeries were conducted More than 10,000 patients received cancer care in our oncology department And happily, 1500 babies were born. All of this was done with a modest surplus to help our balance sheet. However, accomplishments simply can’t be measured by numbers alone. We acknowledge that 2016/17 was a tough year. While the quality of care continued to be high, the people of QHC had to quickly adapt to meet the challenges. Adapting while continuing to serve in a 24/7 health care environment is not easy. Extra hours, new ways of doing things, and new faces to work with were just some of the conditions faced. So, to the staff and clinicians of QHC—I want to thank you the most. You rose to a difficult set of conditions and continued to deliver excellent care. On behalf of the board of directors and the people of the Quinte Region, thank you very, very much for all that you did, and continue to do. Your motivation—to do the best for our patients — inspires us all. As the chair of the board, it is a privilege to be associated with you in your noble calling. A special #4MyTeam video was featured at the 2016/17 Annual General Meeting on June 27. Visit the QHC homepage —www.qhc.on.ca — to watch the video.
Meet Quinte Health Care’s new board members! From left: Dr. Kimberly Woodhouse, Jessica Anderson, Peggy Payne and Peter Dudding are QHC’s new board members.
Dr. Kimberly Woodhouse is a Professor of Chemical Engineering at Queen’s University. In addition, for the past 10 years, she served as Dean of the Faculty of Engineering and Applied Science at Queen’s University. Dr. Woodhouse is a professional engineer and has extensive international experience in management and educational consulting, she holds several patents, and cofounded a biotechnology company. Dr. Woodhouse currently serves on the Ontario Research Fund Advisory Board. She has received a number of awards, including the Medal for Excellence in Engineering Education from Engineers Canada. Jessica Anderson is the Executive Director of North Hastings Children’s Services (NHCS). She has a professional background in corporate, government and non-profit agencies, and a proven track-record in organizational change, program integrity, operational effectiveness, finance, legislative compliance, regulations, policies and reporting. She is also a key member of several health and family advisory boards, including: the North Hastings Family Health Team Board; Loyalist College Early Childhood Education Advisory Board; and Hastings and Prince Edward (HPE) Children and Youth Services Network Planning Table. Peggy Payne has 33 years’ experience in education, mainly with the Toronto District School Board but also in England and Australia. She has worked as a teacher, a Special Education Consultant, Vice Principal and Principal. She holds a Masters of Education from the Ontario Institute of Studies in Education. Her governance experience includes five years with the Prince Edward County Memorial Hospital Auxiliary, serving as President and Past President and two years on the Board of the PECMH Foundation. Peggy and her husband live in Picton and are involved in volunteer work in the county. Peter Dudding is a leader in health and social services who has worked across Canada and internationally. His extensive experience includes senior management, board leadership and consulting with governments and community-based organizations across Canada. Peter is a tireless rights advocate and passionately promotes the equity of opportunity in society to ensure that rights of excluded and vulnerable people are respected and upheld. He is the proud recipient of two Queen Elizabeth II Jubilee medals (2002 and 2012) for recognition of his service to children, youth and families. Peter resides in Picton with his wife. Continued from page 1—Safety is paramount at QHC
Another positive occurrence is that staff members are reporting more safety incidents. This shows an understanding of the importance of reporting, so that steps can be taken to remedy the problems. All of these components add up to an excellent safety program and an improved safety culture that I believe we can all get on board with. If you see an opportunity to improve workplace safety or if you have questions or concerns, talk to your manager or one of QHC’s safety specialists.
Quick, quality care – “I arrived at the North Has ngs Hospital emergency department feeling lightheaded, red and with low pulse and blood pressure. The triage nurse iden fied the problem immediately and within minutes I was a ended to by a doctor and team of nurses. Diagnosed with a stage 3 heart blockage, I was stabilized and transported to Peterborough. Through it all, the bedside manner of the doctor and nurses was outstanding. It was nothing short of amazing how quickly they acted and had me transported. Nurse Jenna Bierworth (pictured) held my hand, reminded me all was well and that she ‘had not lost one yet.’ She was cheerful, involved and very caring (as were all staﬀ but her face and name jump to mind through the confusion of it all). Thank you.” ‐ A grateful pa ent
#ImagineItsYou All about apprecia on – “Thank you to everyone who came out and enjoyed the 31st Annual Staﬀ and Volunteer Apprecia on BBQ, hosted by Phil Panelas and TMHF. It was a wonderful day with lots of laughs, singing, dancing, and most of all GREAT GREEK food. Special thanks to Phil for doing this every year, to the QHC kitchen staﬀ for their help, Leo Phillips for the great music and the TMH maintenance and housekeeping staﬀ for their help ge ng things set up.” – Wendy Warner, Trenton Memorial Hospital Founda on
#4MyT Team #4MyTeam
Loving learning – “During my co‐op placement at TMH, I learned numerous skills that I will use when a ending post‐secondary school and in my future career. I was able to create a good rela onship with the hospital staﬀ which made this a posi ve and happy environment to come to everyday. I par cularly enjoyed the me I spent in Diagnos c Imaging (team pictured), where I was able to observe the technicians performing X‐rays and ultrasounds. I learned things such as the structure and forma on of mul ple organs during all types of ultrasounds, how to posi on pa ents to get the clearest photo when doing an X‐ray and even how to use some of the equipment and computer to input pa ent data. I will be using all of these skills in my future career, which makes me so much more excited for what the future holds.” – Breanna Gracie, TMH co‐op student
Piano man – Medical Lab Technician student turned volunteer, Hisen Wu, has oﬀered his gi of music. Hisen will be playing piano monthly at QHC. The pa ents thoroughly enjoy his calming, therapeu c performance. Hisen also tuned the pianos at both BGH and TMH. Thanks Hisen!
Play ball! – Lisa Chesher, a clerk in the Children’s Treatm ment Centre, has been running a Challenger Baseball league in Belleville for the past 12 years. The league – for children with cogni ve or physical disabili es – gives kids the chance to play on a team and have fun. They are paired with a volunteer buddy who helps them hit, throw and develo op their skills. The kids build confidence, improve their communica on skills and learn to set and achieve goalss. “I want to make a diﬀerence in our community and get ch hildren involved in extracurricular ac vi es,” explains Lisa. “I lo ove being out there with them and seeing their smiles weekk to week. It warms my heart. They’re incredible kids.”
An excep onal experience – “I had a total knee replacement performed by Dr. Daniel Steinitz (pictured right). From admission to discharge, I cannot say enough good about the care which I received. In recovery room, nurse Pa y Grills (pictured le ), on Quinte 6, nurses ‐ Sara, Ka e, Cassandra, Ta anna , Stephan, PSW Susan, physiotherapist Miranda, her assistant Kate, were all so professional and a en ve to my needs. I am happy to say that I am doing well in my recovery, no doubt in part due to the exemplary post‐op care I received. As a semi‐re red RN myself, I know how vulnerable one is on the “other side” of the bed!” – With sincere gra tude from a grateful pa ent.
Who inspires you? Anyone can share in celebra ng our teams – staﬀ, pa ents, physicians and volunteers. Contact Carly Baaxter at ext. 2677, firstname.lastname@example.org.
Everyone can improve their civility! No one is perfect, but it’s important to keep our moods and personalities in check when working in a team environment. Consistently passing blame, not saying good morning to your team, or taking a sarcastic tone before you’ve had your morning coffee, are examples of behaviours which may seem insignificant but take a toll on the team dynamic. QHC’s Civility Booster program aims to educate team members about civility at work through a series of interactive, video-aided team sessions. “It’s about taking responsibility for ourselves and being aware of how our behaviours impact people,” said Susan Lang, Manager of Organizational Development. “It’s a chance for teams to learn together and create ‘team agreements’ that can help guide effective interpersonal behaviour, which can help dispel tensions.” After taking part in civility education sessions – either facilitated by the team’s manager or Organizational Development – the teams continue their work together to keep the conversation alive and the improved dynamic sustainable. Civility training is one piece of QHC’s Healthy Workplace puzzle and plays a role in helping QHC achieve one of our “Wildly Important Goals” of becoming an exceptional workplace. Over the next three years, all QHC teams will take part in the Civility Booster program. Some areas, including Human Resources, Diagnostic Imaging, ACTT and Surgical Services have already participated in the program and are continuing to apply what they’ve learned to improve their team climate.
Meditech upgrade coming this fall – what you need to know & how it will affect you! The IS Department will be performing a Meditech upgrade this fall. The department is already in the planning process and the Applications Team has started to review all of the updates in Meditech. The Applications Team will be working with a number of other staff members (identified by their manager or director) from various departments to build and complete the scenario testing which will start in July and be completed in October. IS has reached out to the managers and directors in each unit to identify the resources they will require. If you have not provided Jamie Kay with resource names, please call him to discuss at ext. 3023, as you will need to plan for your scheduling. There will be a “Blackout” period from November 1 – November 15, in which no changes or report work can be done in Meditech. The GO-LIVE Date is scheduled for November 15. There will be a downtime of approximately four hours that day starting at 9 a.m. Please start preparing your downtime plan and procedures for your department and communicate to your staff. Communication about the Meditech upgrade will be delivered monthly via Vital Signs and as needed via the Weekly Bulletin, so please keep your eyes open for any updates.
Human Resources was one of the first teams to complete QHC’s Civility Booster program. Look at all those happy faces!
If you have any questions or concerns about the upgrade, please contact Jamie Kay, Project Manager at ext.3023.
Effective therapy option available at BGH for mental health inpatients QHC’s mental health inpatients now have another on-site treatment option for severe depression, mania and schizophrenia. A collaborative effort from many individuals and departments including Sills 5 staff, psychiatrists, anaesthetists, Endoscopy, Professional Practice and Purchasing, has led to the re-establishment of Electroconvulsive Therapy (ECT) at Belleville General Hospital (BGH). Electroconvulsive Therapy used to be performed at BGH, but due to resourcing issues, it hasn’t been done for the past nine years. Instead, patients have been sent to Kingston for this effective treatment. “Having ECT on site is better for our patients,” said Kerry-Lynn Wilkinson, Manager, Mental Health Program. “The patients are very sick and having to travel three times a week to Kingston was draining – it makes this a more cost-effective, efficient and patient-centered approach to care.” Many people have been instrumental in reestablishing ECT at BGH. From left: Heather Lindgren, Sills 5 Patient Care Lead; Dr. Antonia Stakheiko, Psychiatrist; Dr. Karmen Krol, Anaesthetist; Anke Gilmour, Manager of Oncology, Endoscopy (BG), ECT, Bronchoscopy, OR Bookings & Pre Admission; and Kerry-Lynn Wilkinson, Manager, Mental Health Program.
ECT was introduced in the 1930s after it was discovered that some people with depression and schizophrenia, who also had epilepsy, reported an improved mood after suffering a seizure. During ECT, electrodes are placed on a patient’s temples or forehead and an electric current causes a brief (20-50 second) controlled seizure. ECT causes chemical changes and increased blood flow and metabolism in the brain, leading to restored chemical balance and improved mood.
From start to finish, the procedure takes about 30 minutes. The patient is given anaesthetic and muscle relaxants in advance, providing comfort and decreased muscle spasms. The procedure is very safe and effective – relieving the everyday, unbearable symptoms many patients with severe mental health issues experience. “The sickest people at highest risk respond better and faster to ECT than medication. And ECT is considered to be lower-risk than medication for many patients,” said Dr. Antonina Stakheiko, Psychiatrist. With the reintroduction of ECT at Belleville General Hospital, QHC psychiatrists (with whom the patients are familiar) work together with QHC anaesthetists to create a care plan, resulting in more streamlined, continuous care within the same hospital. “It’s easier for the patients to wake up and see familiar faces,” said Dr. Stakheiko. To perform ECT, Dr. Stakheiko and the other psychiatrists received special training and hands-on experience at other hospitals. The Sills 5 nurses who are involved with ECT patients also did some extra training and changed their work schedules to accommodate the early morning time slots available in the Endoscopy suite for ECT. “Everyone involved has just been so dedicated,” said Kerry-Lynn. “It’s really been a team effort.”
FAQs About QHC’s New Gown Guidelines
In April, the Infection Prevention and Control (IPAC) Committee made changes to how we use gowns at QHC. Here, the IPAC team answers some Frequently Asked Questions: Why did we change our gown type and practice?
Review of staff exposure events revealed that former gowns were not fluid resistant and thus increased the potential for staff exposure. To meet guidelines and CSA requirements that at least an AAMI level 1 gown be used. Change in gown practice supports greater focus on hand hygiene. An organizational risk assessment was done indicating that an AAMI level 2 gown was required in the majority of cases. Blue gowns for use by visitors were not well accepted (too hot, poor fit over coats). Blue gowns are still available for staff to use if dealing with large amounts of blood, body fluid, secretions or excretions. Promotion of adherence to gown usage needed to be reasonable, evidence-based and clear. Why can I not just use a glove and perform hand hygiene when I go into the room of a patient on contact precautions? (E.g. to reset an IV, shut off a call bell, or hand the patient their magazine) ? Provincial Infectious Disease Advisory Committee (PIDAC) guidelines indicate for contact precautions in an acute care setting to “wear a long sleeved gown when entering the patient’s room or bed space if skin or clothing will come into direct contact with the patient or the patient’s environment.” Resetting an IV, shutting off a call bell and touching a patient’s magazine are all considered coming into contact with the patient environment. If you enter a patient’s room and then find out that you need to have contact with the patient/ patient environment, you must leave the room, perform hand hygiene and don gown and gloves. Why may visitors go into a room, have contact with a patient/environment without a gown, yet staff members are to use a gown if they are having contact with the patient/environment? Visitors who are not providing direct care do not need a gown because they are not going to another patient room and are not likely to be transmitting pathogens from patient to patient. Direct Care: Providing hands-on care (e.g., bathing, washing, turning patient, changing clothes, continence care, dressing changes, care of open wounds/lesions or toileting) What about visitors who come in and visit several patients? It is recommended that visitors only visit one patient. If they plan on visiting several patients, it is recommended to visit patients on additional precautions last. If they are visiting more than one patient on additional precautions, then personal protective equipment (PPE) that staff members use should be worn. Hand hygiene between patients and entering/leaving room should be emphasized. Why must visitors and staff always gown when going into a room with a patient that has C. difficile? C. difficile has the potential to cause life-threatening disease. C. difficile produces spores that are particularly challenging to manage in the environment. Greater care is needed to ensure C. difficile does not spread. If you have questions about QHC’s new gown guidelines, contact Infection Prevention & Control at ext. 2361. QHC Vital Signs Newsletter, July 2017: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400, ext. 2677, email@example.com