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Meet Quinte Health Care’s new medical oncologist Dr. Negar Chooback has always been interested in learning about people – particularly about genetic traits and the biological process in which they are passed down through generations. This interest led her to pursue a bachelor’s degree in genetics at the University of Toronto. She enjoyed the subject matter but knew that to have a fulfilling career, something was missing. “I was always in the lab and had no contact with people,” she said. Her next decision – one she is extremely happy she made – was to attend medical school at Ross University School of Medicine in the West Indies. “It felt right the moment I started,” she said. With her background in genetics, oncology was a good fit for her. “Oncology is changing so much,” said Dr. Chooback. “Genetics play so much into how we diagnose and treat people. That particular science, and the social aspect of working closely with patients who are going through a life-changing thing like cancer, works well for me.” Dr. Chooback joins QHC’s other two medical oncologists – Dr. Roger Levesque and Dr. Janarthanan Kankesan. With the volume of new oncology consults increasing by 20 per cent for 2017, they are pleased to have the support.

Dr. Negar Chooback, QHC’s new medical oncologist.

“Negar is attentive and compassionate with a solid understanding of patients’ cancer care needs,” said Dr. Levesque. “It is delightful to be working with her.” The three oncologists have their cancer specialties – Dr. Levesque’s include breast and blood; Dr. Kankesan’s include kidney and prostate; and Dr. Chooback’s include lung and skin – but they are trained in all aspects of oncology and can treat or refer patients as required. “I feel really fortunate to get to work here,” said Dr. Chooback. “Dr. Levesque and Dr. Kankesan are great, the patients are wonderful, and I hope to make a difference in the care we are able to provide at Quinte Health Care.”


Transferring patients out of the ICU safely and efficiently

The success of our October 16-19 Kaizen event can be attributed to the participants being open and honest, identifying safety issues, learning where gaps in care lie, and gaining a better understanding of each other’s roles. Data collected for three months leading up to the Kaizen event shows that it took an average 10+ hours to transfer a patient from the ICU to another unit (from the moment a physician starts the transfer order, to the time the patient makes it to the bed on the assigned unit).

Kaizen participants discuss process changes with their peers in the ICU.

Transferring a patient from ICU involves a team of people – physicians, nurses, unit communication clerks (UCCs), patient care leads (PCLs), bed traffic controller (BTC), pharmacy, and portering/cleaning staff. “It’s a symphony that has to occur to make these transfers happen,” said James Russell, Process Improvement Manager. Kaizen participants mapped the current transfer process to identify waste and improvement opportunities. The team also determined the new transfer process and spent some time role playing, testing process changes in the ICU and creating effective (often simple) solutions. “The scope of the event was reasonable and we really got into the heart of things,” said Carol Smith-Romeril, Vice President and Chief Nursing Officer. “We recognized a lot of opportunities and created a choreography that frontline staff can do as a team.” Some solutions include:  The creation of a new transfer order set that requires pertinent information to be filled out before a patient can be transferred (so the receiving unit has all the information they need, thereby improving patient safety).  Streamlining the medication reorder process (a simple call to Pharmacy in the morning, notifying them of any potential transfers so they can prioritize those orders – preventing delays).  Setting up a new process to ensure an MRP is assigned to the patient before they leave the ICU.  Standard work for everyone involved in the patient transfer. An example of standard work for RNs is having a “break buddy” who can temporarily pick up the rest of their patient assignments so the nurse can focus on a timely transfer. “The solutions we generated have a big focus on quality,” said Sarah Corkey, ICU Manager. “We’re making sure that regardless of time of day, or who the assigned physician or nurse is, the patients are safe and informed about their care.”

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Welcome James. Welcome Change! James Russell has a family history in the automotive industry. His grandfather, father and – to a lesser extent – James himself, spent time working for Ford. As Ford’s competitor Toyota (often considered the founder of lean manufacturing) improved their processes and thereby the product they were able to offer, James recalls his father’s frustration. “I’d watch him bang his head against the wall, saying ‘we can do better!’” This experience has driven James to learn about lean philosophies and teach others how to implement change. James, who has an engineering James Russell, QHC’s new Process Improvement Manager and finance background, is QHC’s new Process Improvement Manager. Although born and raised in Oakville, he comes to us from Healthcare Excellence Institute in Phoenix, Arizona, where he spent seven years leading hospitals through lean transformations, helping the organizations improve financially, operationally and clinically. James will be helping to support our Grassroots Transformation and will work to spread the idea of continuous improvement across our entire organization. “We have the skill set, the people and the knowledge,” said James. “We just need to wrap a framework of continuous improvement around these pieces and we can do really well. We can be a leader in our province.” “We are very happy to have James working with us,” said Jeff Hohenkerk, Vice President. “He brings considerable experience and really knows his stuff. With his help, we will take our improvement journey to the next level.” You can reach James at ext. 2583 or JRussell@qhc.on.ca.

Meditech Downtime – November 13 The IS Department will be performing a Meditech upgrade on November 13, starting at 9 a.m. Meditech will be down and unavailable during the upgrade (up to 4 hours long). Please review and understand your department’s downtime procedures. Ask your manager or Professional Practice if you are not aware of and/ or want more information on your department’s downtime procedures. You are expected to use these downtime procedures during the time of the upgrade.

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Moving towards safety – During his September Healthy Workplace visit, Brad Harrington, CFO and Vice President, had the opportunity to talk to TMH Health Records staff about their new file storage room. The old room was down two sets of stairs in the damp basement, making retrieving records hazardous for the file clerk. A er seeing the condi ons, Director Peter Papadakos put the wheels in mo on to get the room moved to a closer, dryer, safer loca on. “I’m very happy with the new room,” said Sherry Mifsud, Manager. (In photo, from le : CFO Brad Harrington; Health Records Manager, Sherry Mifsud; and Health Records staff members Tory St. Hilaire, Bri any Meeks, and Sarah Clunas.)

Ray of sunshine – “I would like to give a shout out to my friend and colleague Ben Leung from Respiratory Therapy. Ben is a ray of sunsshine in our li le department. He has gone out of his way on countless occasions to lend a helping hand, offer technical support, or create "cheat sheets" to help us learn new skills or processes. He is literally always happy and joyful and a true joy to work with. Thank you y Ben for all you do!” – Amie Hicks, Respiratory Therapist

Paintball pals – Some staff members on the Quinte 7 Maternal Child/ Labour & Delivery unit at BGH recently par cipated in a fun team ac vity at PRZ Paintball in Picton! “It was a really fun day and a great way to get to know each other outside of work,” said Heather Hendrick, RN.

#RespectE Everyone

#4MyyTeam #TakeOwnership

Courteous care – “I had an excellent experience at the Belleville General Hospital Emergency Department – star ng with the Triage nurse, through to Registra on and on to being assessed by Physician Assistant Nathalie Dyer and Dr. Michelle Miron. I found them all professional and courteous. I felt able to talk to them and felt they had listened. Thank you.” – Linda J. Dooley (Pictured from le : Nathalie Dyer and Dr. Michelle Miron)

#ImagineItsYou

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#4MyTeam Celebra ng team members – “In honour of Ultrasound Sonographers Apprecia on Week, we had cake to celebrate Dane e Rushnell here at North Has ngs Hospital. Dane e has worked for QHC for 25 years. Her work ethic and skill set, in addi on to her bright smile and calm demeanor, make her a vital and valuable member of our team.” – Tammy Davis, Manager of Pa ent Services, NHH

#WeAllHelpProvideCare

#We WeAllHelpProvideCare

Sharing supplies – Under the leadership of Shari Fish, Clinical Risk Specialist, dona ons of QHC’s expired pandemic supplies were donated to Fire Fighters Without Borders. This has come at a most opportune me, as supplies are much needed in the recently devastated areas of the Caribbean. Thanks go out to our own QHC staff at TMH ‐ Beth Ann Dick and Shawna Kinlin, as well as Caroline Suchard and Laurie Ackerman at PECMH, who assisted in the coordina on of this dona on. (Pictured: volunteers from Fire Fighters Without Borders load pandemic supplies onto a truck at TMH. )

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

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New medical leadership at QHC A new medical leadership model has been established at Quinte Health Care. This new model was developed with input from QHC’s medical and administrative leads and is congruent with best practices at other Ontario hospitals. Twenty-six divisions and 10 departments were collapsed into 11 departments, which included the creation of the new Department of Primary Care. This new department was created to provide greater support for our three primary care hospitals in Trenton, Picton and Bancroft.

From left: Dr. Florian Braig, Dr. Rans Perera, Dr. Norma Charriere, Dr. Shalea Piteau, Dr. Emma Robinson, Dr. Cathy Goetz, Dr. Julie Bryson, Dr. Melanie Chanda, Dr. Iris Noland, Dr. Colin MacPherson, Dr. Dick Zoutman.

Each of the 11 departments’ Chief positions were also made Medical Directors of their respective programs. Additionally, four Medical Leads were recruited – two Hospital Medical Leads for PECMH and NHH, and a Critical Care Medical Lead and BGH Emergency Medical Lead.

“All in all, 15 medical leadership positions were successfully filled,” said Dr. Dick Zoutman, Chief of Staff. “During the interviews we learned that we have extraordinary talent in our medical ranks at QHC, with diverse backgrounds in business, entrepreneurship, computer science, engineering, remote health care administration, and even an Olympian!” This new model is expected to provide tighter integration of operational management with clinical leadership, as well as strategic leadership that is focused on the needs of QHC as a whole. “We have established a ‘Community of Leadership’ at QHC where our new exceptional medical leaders can meet, learn together and support one another,” said Dr. Zoutman. “We will be providing them with the career development and support they need to be successful in their new roles at QHC.” The new medical leads are: Chief / Medical Director of Emergency – Dr. Rans Perera Chief / Medical Director of Anaesthesia and Interim Medical Director of Surgery – Dr. Chris Perkes Chief of Surgery – Dr. Florian Braig (interim) Chief / Medical Director of Paediatrics – Dr. Shalea Piteau Chief / Medical Director of Primary Care – Dr. Iris Noland Chief / Medical Director of Family Medicine – Dr. Julie Bryson Chief / Medical Director of Diagnostic Imaging / Radiology – Dr. Emma Robinson Chief / Medical Director of Laboratory Medicine – Dr. Cathy Goetz Chief / Medical Director of Obstetrics and Gynaecology – Dr. Melanie Chanda Chief / Medical Directory of Psychiatry – Dr. Colin MacPherson Chief / Medical Director of Internal Medicine & Critical Care – Dr. Leandra Grieve-Eglin NHH Medical Lead – Dr. Parambir Keila PECMH Medical Lead – Dr. Norma Charriere Critical Care Lead – Dr. Carolyn Tram BGH Emergency Lead – Dr. Craig Bolton

Let us celebrate and support our new medical leaders at QHC! And let us also acknowledge and thank those medical leaders who have served in a wide variety of roles over the years at QHC. Thank you all!

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Patient Experience Partners (PEPs) Q&A with Taralynn Richmond, Patient Experience Specialist

Holiday cheer with the TMH and BGH Auxiliaries!

QHC will be recruiting six Patient Experience Partners (PEPs) who will act as champions and advocates for enhancing the patient and family experience at our hospitals. These volunteers will have had a recent experience at a QHC hospital – either as a patient or loved one – and will work in partnership with staff, physicians and leaders to create a truly patient- and family-centred experience at QHC.

“Adding Patient Experience Partners to our teams will ensure that the voices of patients and loved ones are heard, considered and included in all that we do at QHC,” said Mary Clare Egberts, President & CEO. “They will truly help us live our ‘Imagine It’s You’ value.” Q: What role will the PEPs have? A: PEPs will help with education, committee work, short-term projects, and will provide input to improve hospital facilities and processes. Q: Which areas will PEPs be involved with? A: While the end goal is to have Patient Experience Partners embedded into every program at QHC, we want to ensure the successful implementation by starting with just six PEPs. The first PEPs will be in: oncology, medicine, emergency, primary care and maternal child. Q: Who will the PEPs report to? A: They will report to the leadership of the program they are assigned to and will be further supported by a member of the Senior Leadership Team. Q: Do other health care organizations have PEPs? A: Over the past 10 years, patient advisors have become a standard in health care. Most other hospitals in our LHIN have them, and welcoming PEPs to QHC is an accreditation expectation for 2019. Q: What if I know someone who is interested in becoming a PEP? A: Contact Taralynn Richmond at trichmond@qhc.on.ca or ext. 2769. Q: How soon will we see PEPs at QHC? A: They will be recruited, oriented and joining their teams by January.

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Collaboration leads to incredible stroke care Quinte Health Care’s stroke team is doing incredible work! Collaboration between EMS, Kingston General Hospital, and many departments throughout QHC, is allowing stroke patients to receive quicker treatment. In one case, a patient was rushed to Belleville General Hospital by EMS, quickly assessed and given tPA clotQHC stroke team members work quickly to diagnose and treat a patient. busting medicine within 33 minutes (the target is less than 60 minutes). The patient was assessed again by tele- Neurology, and then, because of the type of stroke, whisked away to Kingston General Hospital by EMS to receive endovascular treatment (clot removal). Endovascular treatment (EVT) can only be performed within six hours after a stroke has occurred but because of the quick work and incredible collaboration of all involved, the patient underwent EVT in only 89 minutes! When every minute means more brain cells lost, that’s incredible patient care. “This is an amazing accomplishment for everyone involved,” said Dr. Leandra Grieve-Eglin, Chief/Medical Director of Internal Medicine & Critical Care at QHC. “There is so much work going into this and we’re surpassing our targets. It just shows how collaboration and effort can bring great success.”

A thoughtful donation to TMH’s Diabetes Clinic Marilyn Terry was diagnosed with diabetes when she was 15 years old. Now, she is celebrating the life she has been able to live, having been on insulin for 56 years. “Diabetes care has changed a lot over time,” said Marilyn. “I remember having to sharpen reusable insulin needles with a stone.”

Standing in front of the donated picture, from left: Louanne Melburn, Team Lead Diabetes & Clinical Nutrition; Michelle Wilcox, Registered Dietitian; Debbie Donahue, RN (diabetes nurse educator); Marilyn Terry; Ruthann Hubbs, Manager Diabetes & Clinical Nutrition.

A few years back, Marilyn received a NovoNordisk Half Century Award – a beautiful print of London’s Banting House. Marilyn no longer has a place to hang the picture, having recently moved, so she decided to donate it to the Trenton Memorial Hospital Diabetes Clinic. “I thought it might be something people would be interested to look at,” said Marilyn. “I’m so delighted it’s here.”

QHC Vital Signs Newsletter, October 2017: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400 ext. 2677, cbaxter@qhc.on.ca

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October 2017 vital signs web