exceptional care, inspired by us
August 2015
Vital Signs
Pictured left: Brian Mulvihill, Respiratory Therapist (RT) and Steph Park, Registered Nurse (RN), and pictured right: Amie Hicks, RT and Charlene Quinn, RN at the bedside performing assessments and interventions on simulation mannequins during education days at the Loyalist College Nursing Simulation Lab. According to Tena Sheridan, RN and member of the CCRT, this is what staff can expect to see when they call “5999” . - Loyalist College Photos
Critical Care Response Team (CCRT) coming to QHC Belleville General Hospital in September Starting in September, a Critical Care Response Team (CCRT) will be deployed at QHC Belleville General Hospital. The CCRT consists of specially trained staff who will work with hospital ward staff to identify, assess and respond to the needs of at-risk patients prior to the development of acute deterioration. They will bring specialist knowledge and skills from the critical care setting directly to the bedside on a 24/7 basis. During the month of July, critical care staff participated in education sessions which helped to enhance their critical thinking skills. During the sessions, they performed assessments which will prepare them to respond to requests and help them manage the care of a patient that is showing subtle to acute deterioration. The education sessions were held at the Loyalist College Nursing Simulation Lab where Respiratory Therapists and Intensive Care Unit (ICU) Registered Nurses had the opportunity to practice their assessment skills. Critical Care response scenarios were set up by the Royal College of Physicians and Surgeons of Canada and were used for the members of the team to practice on. The CCRT trial program will be in partial effect for a 12-hour day shift throughout the month of September (new consults would be for 8 hour days from 7:30 a.m. - 3:30 p.m.) and fully implemented at BGH (24 hours a day, seven days a week) for October 1.
Welcome Penny Rolinski - PECMH Foundation’s new Executive Director
As of September 8, Penny Rolinski, will hold the title of Executive Director for the Prince Edward County Memorial Hospital Foundation. Ms. Rolinski knows the County well. She was born at PECMH and attended elementary and secondary school in the County.
Penny brings to her new role years of fundraising experience and has lead successful fundraising campaigns. She also has experience in related fields such as project management, volunteer partnerships, employment law, communications and finance.
Ms. Rolinski steps into the role of Executive Director as we say goodbye and thank you to Hazel Lloyst, who has been the foundation’s Director of Development for the past year and a half.
Customizing Interprofessional Patient Care (IPC) at QHC The interprofessional approach to patient care (IPC) launches on Quinte 5 at QHC BGH and on the Inpatient Unit at QHC TMH in October. Managers Pam Melanson and Perry Simard are working hard with the implementation team, staff and physicians to define what the new team-based approach to patient care looks like on each unit.
On Quinte 5, four teams comprised of RNs, RPNs and PSWs will be formed around a defined group of patients, working collaboratively with all care providers and support services to execute the plan of care for each patient. Three of the four teams will care for 14 patients, while the fourth will care for patients in the stroke unit. On the IPU at TMH, three teams (also referred to as pods) are planned. Two pods will be assigned six acute patients each, while one pod will care for twelve Alternate Level of Care (ALC) patients.
During a recent planning day, Melanson says staff, physicians and the implementation team came together to explore the many details of interprofessional patient care and mapped out what a day on Quinte 5 would look like. Some of the processes planned include hourly rounding, the flow of charts on the unit, discharge planning, bedside shift handovers, bullet rounds and team touch points. The group mapped out roles and responsibilities as well as reviewed the staff mix on the unit.
Melanson and Simard have been engaging staff and physicians to address questions and concerns, seeking feedback as well as developing processes and identifying learning opportunities. Leading up to the implementation of IPC in October, staff from the units will attend three days of training. Continued on page 3
Health Care Tomorrow – Hospital Services Project update
Collaborative Regional Project moves on to Phase 2
The SE LHIN Board of Directors have agreed to support moving to Phase 2 of the Health Care Tomorrow – Hospital Services Project. In July, the Boards of the seven hospitals in the region all approved a motion to proceed with Phase 2. Working groups will now further explore the opportunities that were recommended as part of Phase 1 for new or expanded collaborations between the hospitals in the South East region.
The Phase 1 Recommendations Report summarizes opportunities for potential changes to the regional system of hospitals. The identified options focus on improving access to patient care and making
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Continued on page 3
IPC is a change in how we provide patient care at QHC. It’s having a patient care team formed around a defined group of patients. It’s having a clear and visible plan of care for every patient. It’s now considered best practice in providing exceptional patient care! Visit the IPC page on MyQHC intranet for more information. Continued from page 2 Melanson says based on the research she’s done, the new approach to patient care will be of great benefit to patients and staff. “Taking a more interprofessional approach to patient care can result in increased patient and staff satisfaction, reduced patient falls and incident reports, and improved communication within the care team and with patients and family members,” explains Melanson. Simard credits his time working in an interprofessional care model in a previous job as the most fulfilling time he had as a bedside nurse. “It empowered me to do more things, to work to the top of my scope,” he explained. “I had a better understanding of the patients and my role in their care. I was really engaged and felt confident.” IPC is being rolled out on a unit by unit basis. The implementation team is dedicated to working with each manager and their team as well as physicians to customize IPC for each unit. Visit the Interprofessional Patient Care page on the MyQHC intranet for information, resources, videos and timelines.
Contact Project Lead Shelley Kay if you have any questions about the implementation of interprofessional care at Quinte Health Care at skay@qhc.on.ca . Continued from page 2 better use of resources across the South East in three key areas of hospital services: Clinical Services, Diagnostics and Therapeutics, and Business Functions.
The options require detailed analysis and planning before any changes to the current system will be possible. Therefore, Phase 2 of the project will consist of the next level of analysis, the design, and the potential transition planning. This detailed work will articulate the role played by each hospital within the regional model and validate the potential savings and investment costs that were estimated in Phase 1 though in-depth planning. In order to ensure that the patient voice continues to inform our process and decisions throughout, further community and patient engagement will be a key component of this second phase.
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Enhance care for seniors
Quinte Health Care is implementing a Senior Care Strategy as part of its goal to build a senior friendly hospital for the people in our region. This strategy will help provide direction for the future as working groups at Quinte Health Care introduce and incorporate initiatives to enhance care for seniors into current programs and practices. One of the projects that is being piloted on the Inpatient Medicine units at QHC Belleville General Hospital and Prince Edward County Memorial Hospital is the Acute Care for Elderly (ACE) program. Oftentimes, elderly patients on acute medicine units experience preventable functional decline and adverse events/outcomes due to impacts of hospitalization. Adrienne Bell-Smith, Project Manager for the ACE program said that the aim of the program is to address the needs of the elderly beyond the acute presenting illness to enhance (or prevent the decline of) cognitive and physical functioning so that they can return to an equivalent care setting after they have been discharged from hospital (ie. From home to home). “This new program will guide the implementation of enhanced care planning and practices for seniors to assess and address the risk factors common to elderly hospitalized patients such as decreased physical function, cognition, nutrition/hydration, polypharmacy, pain management and social support. The goal is that elderly hospitalized patients will have an individualized interprofessional care plan with interventions to address these risks – interventions such as getting out of bed for meals, normalized routines and activities, enhanced toileting routines to minimize the use of bed pans/catheters and enhanced education and support for patients and their families.” “There will also be more attention placed on engaging patients and their families in all decision making processes, to the extent they wish, and ensuring they are supported to express their wishes, including the consent and refusal to treatment and acceptance of risk,” she added. As part of QHC’s Wildly Important Goal for 2015/16 to Enhance Care for Seniors, together and though programs like Acute Care for the Elderly (ACE), the Behavioural Supports Transition Unit (BSTU) and Quinte LinkAGE, we can support the overall well-being of the hospitalized elderly patient, reduce the potential negative effects of hospitalization and support aging well at home.
QHC meets annual provincial improvement targets
The Cancer Performance Steering Committee has recognized Quinte Health Care staff for their exceptional work in meeting the annual provincial improvement targets for the following four performance indicators from the 2014/15 fiscal year: • • • •
Cancer Surgery Wait Times - Decision to Treat to Treatment at QHC Pathology Post-Surgical Report Turnaround Time for All Disease Sites at QHC OBSP – Diagnosed within seven weeks with biopsy at QHC BGH OBSP – Diagnosed within seven weeks with biopsy at QHC TMH
Janet Baragar, Director of Surgical Services at QHC, said that these great accomplishments reflect a “stellar model” of clinical collaboration across many areas involved in cancer screening, diagnosis, surgery and oncology therapies and that clinical and support staff who work in various associated departments are to be commended. “We truly have an effective and efficient system of cancer care here at Quinte Health Care. Our ability to meet these targets and provide such exemplary service is in large part due to the generosity of our community and the hard work of our Foundations in acquiring state of the art equipment to support technology needs in diagnosis and treatment,” she said. Thank you for your continued work to improve the quality of Cancer services for Ontarians.
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Vicki Fulcher, Spiritual Care Coordinator for Quinte Health Care
Spiritual Care at QHC In times of illness, trauma and loss, people often require more than physical care to help them manage and adjust. According to Spiritual Care Coordinator Vicki Fulcher, for patients and family members spiritual care “can provide peace in the midst of chaos”.
The spiritual care practitioners at QHC are professionally trained to work with people in the hospital and patients do not need to be religious to benefit from their care. The department is diverse in the support it provides to respect and support the core values of patients and family members. Spiritual care practitioners, often identified as chaplains, are part of the health care team providing care to patients and families at QHC, as well as to staff. Spiritual Care Services includes: • Visitation by referral or request • An opportunity to explore the spiritual significance and meaning of illness, suffering and life transitions • An opportunity to express feelings and concerns • Encouragement and solace • Support for end of life issues • Grief and loss care • Opportunities for prayer, meditation, reflection and rituals • Multi-faith availability - to assist patients in making contact with their own faith background
Spiritual Care resources are available at each QHC hospital. Each hospital has a designated chaplain who provides and/or coordinates requests for spiritual care in partnership with several community spiritual care practitioners and volunteers. Spiritual Care is available 24 hours a day. Patients and/or staff may ask a nurse in any of our patient care areas to request Spiritual Care. Staff members may also contact switchboard and ask them to page the spiritual care practitioner on duty. To learn more, visit QHC’s website at www.qhc.on.ca (Beyond the Headlines) to listen to a six-minute podcast with Vicki.
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Meet QHC’s Decision Support Team
Pictured, L-R: Peter Papadakos, Director Decision Support and Analytics, Health Records, Privacy; Dwayne Quenneville, Senior Business Analyst; Chris Gould, Business Intelligence Analyst; Joanne Pipe, Wait Times Coordinator and Julia Aubrey, Case Costing and Performance Improvement Coordinator
A peak into the work of QHC’s Decision Support team A Decision Support department is an information resource that assists staff who require data to support their initiatives when performing research. QHC’s Decision Support department consists of five staff who have access to multiple years of electronic health record data at their fingertips, which includes information pertaining to the Operating Room, Outpatient Clinics, Emergency Department, Diagnostic Imaging, Pharmacy and more. With this information, they can search a large variety of common themes such as wait times, Length of Stay (LOS) and the number of hospital acquired infections.
What do QHC’s Decision Support department do?
Business Intelligence • Answer questions such as: what happened, how many, where is the problem, and what actions are needed? • Also provide self-service data, reporting, drill downs, and alerts. Business Analytics • Answer questions such as: why is this happening, what if these trends continue, what will happen next, and what is the best that can happen? • Predictive and explanatory modeling, statistical and quantitative analysis. Performance Management • Scorecard and indicator development. • Strategy mapping
Data Development The chart provided on page • Data modeling, extract/transform/load services, and automation. 7, for example, gives us a reading of how Quinte Health Care compares to other hospitals in the SE LHIN, and all hospitals in Ontario for the Length of Stay in our Emergency Departments within a specific time frame. With the ability to gather information in an efficient and easily comparable format, the team can provide a detailed analysis to help facilitate strategic, tactical and operational decision making.
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Decision Support launching new software that will enhance graphs and improve user experience The Decision Support department at QHC is launching the next iteration of their Business Intelligence software platform branded Compass. Over the next two months, Decision Support will be transitioning the existing Compass platform to a more advanced version with; • enhanced graphs and visualizations; • powerful functionality and user control; • dramatically improved user experience with customization capabilities; and • self-serve data and analytics. Chart referenced in article on page 6
Keep patient information private
How do I know if I can access a patient’s personal health information?
Imagine it’s you!
In the coming weeks, a poster will be sent out which will help staff determine when they are and are not permitted to look into a patient file. The posters will be sent to Managers via interdepartmental mail in early September and managers are asked to review the information with staff during an upcoming huddle and to post on their huddle board.
Ask yourself these important questions FIRST: Am I in the patient’s immediate Circle of Care? Do I NEED to access the record to provide or support PATIENT CARE? DO I NEED to access the record to perform my JOB DUTIES successfully? Am I ACCESSING THE RECORD IN THE patient’s best interest? Yes
• • • • •
You ARE permitted to access the patient file Acceptable reasons to access patient information: I am a member of the patient’s immediate circle of care I need to administer care to the patient Accessing the chart is necessary to successfully perform my job duties I am consulting with a professional colleague to facilitate patient care The patient is on my unit and I need to access the chart to assist in providing care
No
You are NOT permitted to access the patient file
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Thank you! “I had to write in to express my gratitude for the fabulous care I received at the Bancroft Hospital. I broke my leg waterskiing and right from the paramedics to all of the emergency room staff that Saturday evening into Sunday morning when I was transferred to Belleville hospital, were outstanding. Very caring, attentive and made my experience a less painful one. Well done Bancroft Hospital! I would also like to share my positive experience about the care I received while at Belleville hospital. I had a fractured tibia and needed surgery with Dr. Copithorne. Between Dr. Copithorne and all the nurses, I felt so well looked after. I am healing well and am now under the post care with Dr. Steinitz who is also fabulous. Well done Belleville hospital!”
We all help provide care
Mark Your Calendar Prince Edward County Memorial Hospital Auxiliary is once again
sponsoring the County Festival of Trees Friday, Nov. 27: 10 a.m. - 9 p.m. Saturday, Nov. 28: 10 a.m. - 9 p.m. Sunday, Nov. 29: 10 a.m. - 2 p.m. Event will be hosted at the Isaiah Tubbs Resort Among the activities at the Festival are a silent auction of decorated Christmas trees, bucket draw, Second Time Around Shop Boutique, bake & preserves sale, musical entertainment and more. Admission is FREE All proceeds will support health care needs in the community
Get your raffle tickets for a chance to win! The Trenton Memorial Hospital Foundation is selling raffle tickets.
First prize is a Caribbean cruise, second prize is a ladies diamond pendant and men’s cuff links and the third prize is a BBQ! During a recent night shift, Steve Brohm, Kelsey Sharland, and Francine Maurice from Nutrition and Food Services were on their way back from a break when they witnessed a Patient Transfer Attending having a seizure in a hallway of the Sills building. Steve ran to his aid and put him in the recovery position while Kelsey and Francine called Emergency for assistance. Staff arrived quickly, the attendant was stabilized and rushed to the Emergency Department for further care. Thank you to Steve, Kelsey, Francine and to everyone involved!
Tickets are $50 each. Only 1000 tickets available Draw date: October 23 To purchase tickets, call: 613-392-2540 x 5401
QHC VITAL SIGNS NEWSLETTER August, 2015 Published by QHC Communications Department Editor: Susanne Anderson (613) 969-7400, ext. 2677 sanderson@qhc.on.ca
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