Thank you QHC staff, physicians and volunteers for all that you do! The Senior Leadership Team hosted Staff Appreciation BBQs at each of the four QHC hospitals in September to thank our dedicated and caring staff, physicians and volunteers for all that they do. “We are so appreciative of the incredible work that happens in our hospitals,” said Mary Clare Egberts, President and CEO. “And thank you also to the Nutrition and Food Services staff and the North Hastings District Hospital Auxiliary for their efforts in preparing and serving the food at the BBQs!”
Improving patient safety through the best possible medication history
Wonderful results from this engaged and creative team of Best Possible Medication History kaizen participants!
The Best Possible Medication History (BPMH) is a list of all medications a patient is taking at home – including drug name, dosage, frequency and route. Medication Reconciliation (MedRec) is the process of comparing the BPMH to medications ordered in hospital to ensure there are no safety concerns. Ideally, all admitted QHC patients would receive MedRec but only about 70 per cent usually do – and when it does happen, it’s after patients are already admitted and have begun taking the new medications that the admitting physician ordered. Knowing that something had to change to improve patient safety, QHC held a four-day kaizen event where 20 engaged participants identified waste, got creative and came up with a proactive model that will allow pharmacy staff to obtain medication histories on more patients, sooner during their hospital stay. They began by identifying waste. And they found some huge ones! Pharmacy staff were spending 180 hours/ month creating a spreadsheet to track data. They realized this data could be tracked in a different, much less labour-intensive way, creating efficiencies that allow them to allocate those resources to more essential tasks. They then came up with a new model for obtaining the medication histories of patients being admitted through the Emergency Department. Instead of waiting until patients are admitted to do MedRec (and thereby always playing catch up), pharmacy technicians will be triggered of a pending admission in the Emergency Department and can create the BPMH before the patient is admitted. Physicians will now have a correct medication history before they order new admission medications for the patients.
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“In terms of patient safety, this will prevent errors,” said Dinie Engels, Pharmacy Clinical Lead. “Patient safety is at the forefront of our organization and doing this proactively will be so much better for our patients.” Another big win resulting from the kaizen is better use of staff skill sets. Pharmacy technicians will now complete the BPMH and the pharmacists will focus their efforts on resolving the discrepancies based on clinical implications. This allows technicians to perform to their full abilities and allows the pharmacists to do work that only they are qualified to do. “This kaizen has been all about finding ways to prioritize activities that most impact patient care,” said Rizwan Ahmed, Pharmacy Manager. “The acceptance of change has been amazing. I’m so proud of the team for their positive attitude and willingness to jump in. We know these changes will make a big difference for our patients, staff and physicians.”
TMH Pain Clinic gets resourceful, resulting in more patient procedures With access to only one clinic day per month, Dr. Tracy Cupido's Chronic Pain Clinic, which is run out of Trenton Memorial Hospital, had a substantial patient wait list. On clinic days, Dr. Cupido would try to pack in as many procedures, follow-ups and consults as possible. However, the demand was outpacing the resources. Thanks to some creative thinking and a willingness to think outside the box, Dr. Cupido is now doing initial consults via Ontario Telemedicine Network (OTN) from her own office. Rather than having their consult appointment at TMH, patients now go to one of the Quinte Community Health Centres where a nurse connects them to Dr. Cupido through video conference. She can see, speak to and assess the patients through the video monitor. These consult and follow-up appointments occur throughout the month, leaving her clinic days for patient procedures. This translates to patients being seen quicker, leading to a significant reduction to the wait list time. “This has been a very collaborative process that we have been refining quickly,” said Dr. Cupido. “I appreciate the work that the QHC and OTN communities have put into facilitating this process. It has given me the opportunity to expand access to chronic pain management within QHC. Additionally, seeing patients via OTN minimizes their travel. The next stage will be to provide e-consult service for chronic pain to physicians via OTN.” A big thank you to everyone involved – OR Booking staff, Pain Clinic staff, Dr. Tracy Cupido, OTN Coordinator Janet Newbatt, IS Applications Specialist Paula Molloy, Manager Anke Gilmour, and the Belleville Quinte West Community Health Centre. To learn more about how OTN can help your program, contact Janet Newbatt – email@example.com.
A stellar team — “Please thankk the nurses on Quinte 6 for the outstanding care they all provided me during my stay. They are all true professionals and a credit to their chosen profession.” ‐ Ted Baker
Making a bad daay good — “I just want to tell you how awesome Angela Dall, Ultrasound Technician, was today. I had an ultrasound booked for kidney stones. She is not only professional and friendly, shee is eﬃcient in her role at Belleville General Hospital. Someone like her deserves the recogni on of o doing more than just a job. She is excep onal as a person and a technician… Thank you again n for such a pleasant experience, and I thank her for making my horrible day so much be er. Shee completely turned it around.” ‐ Heather Smith
Great work recognized — Joseph Mancuso, Director of Support Services (pictured in white shirt), received the na onal ABC (Above and Beyond the Call of Duty) award from his employer Compass Canada. He was chosen over 400 other Compass Canada Healthcare Division leaders for his role in the response to and remedia on of the Quinte 5 fire in May. “I’m very proud to have Joseph as part of our QHC leadership team,” said Jeﬀ Hohenkerk, QHC Vice President and Chief Transforma on Oﬃcer. “He’s easy to work with and very reliable and, although Joseph’s employer – Compass Canada – is an external partner, Joseph has always ensured he’s part of the QHC family. Congratula ons to Joseph on his na onal award!” #TakeOwnership
ICU to the rescue! — When a man and his service dog named Boots were transferred via ambulance from North Has ngs Hospital to Belleville General Hospital’s ICU, the ICU staﬀ embodied QHC’s “Imagine It’s You” value. The pa ent was unable to care for his dog, so staﬀ took care of, fed, watered and walked Boots. The pa ent’s family, who live four hours away, were unable to make the journey to Belleville to pick up Boots so he caught a ride back to Bancro with a nurse heading that way. The family then picked Boots up in Bancro . The pa ent was very grateful and con nued to recover in the ICU knowing that his li le pal was safe and sound. Thanks to everyone involved!
A job well done — “My recent visit to PECMH Emergency was a textbook example of what a hospital experience should be. From the triage nurse on, everybody was helpful and the wait me was reasonable. The examina on was thorough and the staﬀ was very friendly. Dr. LeBlanc explained every detail to us and the follow up treatment by Dr. Beach was superb. It le us with a warm feeling that these professionals care about you and that's what counts. Thank you for a job well done.” ‐ A grateful paƟent Pictured from leŌ: Dr. Sarah Leblanc, Dr. David Beach, and Registered Nurses Amy Weir, Jessica Mossey, and Kim Leonard.
Who inspires you? Anyone can share in celebra ng our teams – staﬀ, pa ents, physicians and volunteers. Contact C Carly Baxter at ext. 2677, firstname.lastname@example.org.
Hospitals teaming up for better patient and health care provider experiences Regional Hospital Information System to help standardize clinical care processes across southeastern Ontario It is not uncommon to hear stories about patients who are happy with the care they receive from individual providers, but are frustrated with their experiences with the health care system as a whole. Health care doesn’t always come from one provider or from only one part of the health care system. When patients travel between hospitals, they often have to answer the same basic questions about their health care, and are frequently expected to track and share their own complex medical information. Sometimes their tests are duplicated because health care providers do not have easy access to information about the care patients have received in other settings. This can add up to an uncoordinated and challenging experience for all. “Currently across our region, the information we have about a patient’s care exists in many different systems that don’t connect to each other,” said Nick Vlacholias, Regional HIS CEO Lead and CEO at Brockville General Hospital. “This makes it difficult to provide coordinated care for the tens of thousands of patients who rely on us every year.” In order to provide patients with smooth transitions between care settings and providers, and better support them in managing their health issues, staff at the six hospitals within the South East Local Health Integrated Network (LHIN) will be working together to implement a regional Hospital Information System (HIS). The regional HIS will help us move from isolated systems to a single, standardized information system that allows for ‘one patient, one system, one experience.’ “We are going to need a significant amount of involvement from health care professionals across our region in order for this regional HIS project to have a visible, positive impact on patient care,” said Troy Jones, Regional Executive Lead for the HIS project, and Executive Vice-President, Chief Information Officer for Kingston Health Sciences Centre. A primary goal for this project is to provide patients with a well-coordinated experience throughout their health care journeys. “We want to give health care providers the tools they need to help guide patients through a single health care system, so that people receive the care they need, without unnecessary delay or duplication, wherever they are in our region,” explained Jones. The Regional HIS Advisory Committee has been formed to oversee the project and includes two representatives from each of the six hospitals involved: Brockville General Hospital, Kingston Health Sciences Centre, Lennox and Addington County General Hospital, Perth & Smiths Falls District Hospital, Providence Care, and Quinte Health Care. Over the next several months, the Regional Core Project Team that will manage key project milestones, along with the local and regional working groups, will review the functions of the HIS to make sure workflows provide patients with seamless and coordinated experiences – regardless from which hospital in our region they receive care. This review will also support the publication of a request for proposal (RFP) and lead the process to secure an HIS vendor for the project.
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“Not only will patients’ experiences improve, but care teams will have more sophisticated clinical tools, and there will be opportunities to improve the overall health of the region by collecting, analyzing and responding to regional health data,” said Jones. Organizations across the southeastern region have worked diligently to meet the needs of patients by improving internal processes and implementing regional programs. Building on this work, the regional HIS will further improve patients’ experiences, as a single information system will link patients and health care providers throughout the region, and help with medication management, diagnostic orders, scheduling, registration and more. “We are preparing to work closely with our partner hospitals in the LHIN to move forward with this significant project,” said Brad Harrington, HIS advisory committee member and Vice President and CFO, Quinte Health Care. “As a result, we will be closely examining our clinical processes and procedures, and will be trying to find innovative ways to standardize our practices across every department and each health care organization, to ensure we are supporting the safest and highest quality care.”
New Fetal Alcohol Spectrum Disorder (FASD) program in QHC’s Children’s Treatment Centre There is now more local support for young people with Fetal Alcohol Spectrum Disorder (FASD) and their families. Quinte Health Care’s Children’s Treatment Centre is the host organization of a new program – in partnership with community agencies in Hastings, Prince Edward and Northumberland Counties – that will focus on raising awareness, coordinating FASD services, educating and advocating for those dealing with FASD. FASD is caused by prenatal alcohol exposure and is present across all socioeconomic backgrounds. Occupational Therapist Lauren MacAlpine was hired to be the key
Lauren MacAlpine, the new Occupational worker for the program. She is excited to join the program at its Therapist for the Fetal Alcohol Spectrum inception and is prepared to develop the program in a way that meets Disorder (FASD) program.
the needs of the community. The program will serve children birth to 18 years (or until they finish school).
“Research is telling us between one and three per cent of the population could be affected by FASD,” said Margo Russell-Bird, Manager, Children’s Treatment Centre. “A lot of people go undiagnosed. It’s often seen as a behavioural or mental health disorder when, in fact, it’s a brain injury. The brain is injured because of alcohol exposure prior to birth.” People with the disorder may give the impression that they understand what you are asking them to do, but in reality, they may be having difficulty understanding. This lack of comprehension can result in the impression that they are being defiant, or may result in poor behaviours due to frustration. One of the program’s goals is to increase education so people understand that FASD is a brain injury and if you accommodate and adapt to the brain deficit, you can prevent escalation of behaviour. For example, don’t overload someone with FASD with multi-step instructions when they are only capable of processing one or two steps at a time. “Unless other people understand how their brains have been impacted by prenatal alcohol exposure, accommodate for the deficits and recognize and use their strengths, these individuals can struggle in every environment,” said Margo. To learn more, call: 613-969-7400, ext. 2247.
TMH Inpatient Unit drastically reduces workplace violence incidents The Trenton Memorial Hospital Inpatient Unit exemplifies QHC’s Being A Healthy Workplace strategic priority. Manager Ruthann Hubbs and her team have done incredible work to reduce workplace violence incidents on the unit. With 25 reported incidents in 2016/17, down to just four in 2017/18, the extra effort from the team is going a long way to create a culture of safety. The TMH Inpatient Unit made it a Wildly Important Goal for 2017/18 to reduce staff injury related to patient behaviours. The TMH Inpatient Unit was recognized by the QHC Board of Directors at In an effort to achieve their goal, the the September 25th Board Meeting for the fantastic work they’ve done to team created new processes all built around one concept – looking out for reduce workplace violence incidents on the unit! Pictured from left: Heather Campbell, Program Director, Emergency and Primary Care; one another. That means, if a patient Michelle Ryan, TMH Inpatient Unit Patient Care Lead; Ruthann Hubbs, has a tendency toward more aggressive TMH Inpatient Unit Manager; Karen Baker, QHC Board of Directors responsive behaviours, care providers Treasurer. Congratulations to the entire TMH Inpatient Unit team! will alert each other and will provide #4MyTeam #AlwaysStriveToImprove care in tandem. Communication is key on the unit. Through daily rounding and patient documentation, the care providers are never left in the dark about which patients could be at risk for aggressive behaviours. Staff education has been another important component. Many staff have received Gentle Persuasive Approaches (GPA) and/or Nonviolent Crisis Intervention (NVCI) training to better understand how to deal with patient behaviours. “Before, we were more likely to have a bigger reaction to patient behaviours, including using restraints when needed,” said Ruthann. “But now, we’ll back off and let the patient be in their room to calm down. This approach decreases stimuli for patients and makes them feel more at ease.” The team also involves patient families in determining the best approach to take with their loved ones. Recognizing that each patient is unique with their own particular triggers and responses to situations has been very important in reducing staff injuries. Ruthann stressed that the unit takes pride in being team-oriented and she recognized Patient Care Lead Michelle Ryan as a key part of the success to date, by reinforcing the importance of completing assessments and patient identification processes. “Kudos to Ruthann and her team for their commitment to ensuring workplace safety on the TMH Inpatient Unit,” said Heather Campbell, Program Director, Emergency and Primary Care. “Ruthann and the team took on the challenge, championed it and worked with Occupational Health and Safety to drastically improve the working conditions for staff.”
QHC Vital Signs Newsletter, September 2018: Published by QHC Communications Department Editor: Carly Baxter (613) 969-7400 ext. 2677, email@example.com.