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Patient Handbook 2018/19


FOUNDATION

After a hundred years of rebuilding lives, it’s time for a little rebuilding of our own. You’ve experienced the crucial role we play in getting people back to their homes, back to their families, and back to doing what they love most. And now we need your help. We’re raising $80 million through the Get Your Life Back Campaign to help build our new hospital so that we can continue providing the very best care for the growing number of people who need it.

Please visit westpark.org/foundation to find out how you can support West Park’s transformation into a world-class centre of rehabilitative care.

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Table of contents About West Park • Our Vision, Mission, Values.......5 • Get Your Life Back..................6 • Rehabilitation and Community Living...................6 • Complex Continuing Care.........7 • Long-Term Care......................7 • Directions..............................7 • Parking .................................8

Planning for your stay • What to bring....................... 10 • Accommodation options......... 11 • Co-payments....................... 11 • Extra support ...................... 11

Things to know for your stay • Cover your cough ................. 12 • Wash your hands ................. 12 • Emergencies........................ 12 • Privacy................................ 14 • Smoking.............................. 15 • Room assignments................ 15 • Consent forms...................... 15 • Identification........................ 15 • Ask for help......................... 16

• Falls prevention.................... 16 • Alcohol................................ 16 • Visitors............................... 16 • Special considerations when visiting the respiratory care units............................ 17

Services • Patient Experience Co-ordinator........................ 18 • Financial services.................. 18 • Resident Trust Accounts......... 19 • Funding support................... 19 • Banking/Automated Teller Machine (ATM)...................... 19 • Mobile devices and telephones........................... 19 • Computers........................... 19 • Laundry.............................. 20 • Retail food vendors............... 20 • Meals.................................. 20 • Spiritual and religious care..... 21 • Clothing Shop.......................22 • Gift Shop/Vendors................22 • Hairdressing services............22 • Library................................22 • Mail....................................23

PLEASE NOTE: We are constantly changing to meet your needs. The information presented here may be subject to change. www.westpark.org

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• Newspapers.........................23 • Items from home..................23 • Access to buildings................23 • Retail Pharmacy................... 24

Your care • Members of your healthcare team................................... 25 • Other services you may use...28 • Over-the-phone interpretation services .............................30 • Outpatient specialty clinics..... 31 • Research............................. 31

Join us • Patient/Family Advisory Committee........................... 33 • West Park Foundation............ 33 • Campus Development: A bold path of transformation.. 34 • Volunteer............................. 35 • Feedback............................. 35

Key phone numbers .... 36 Community supporters................... 37

Preparing to leave • Physicians............................ 32 • Medication........................... 32 • Support in the community...... 32 • Outpatient rehabilitation........ 32

Welcome During your time at West Park, our many dedicated professionals will work in partnership with you to help reclaim your life. On behalf of all of us it is my privilege to welcome you. At West Park, you will receive individualized care on your journey from crisis… to hope… to realizing potential. We are passionate about realizing potential. We’ve endeavoured to answer many of your questions about care at West Park in these pages. If we’ve missed something, please don’t hesitate to ask. West Park Healthcare Centre. Get your life back. Anne-Marie Malek President and Chief Executive Officer.

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About West Park Strategic Priorities: Exemplary Care; Integrated Campus of Care;

Operational Excellence;

A Great Place to Be;

Bold Partnerships.

Vision:

Exemplary care inspired by innovation and exceptional performance.

Mission:

We enhance lives, inspire hope and encourage independence through caring relationships, leading practices, specialized services and partnership.

Values:

Excellence

Respect Trust Collaboration Accountability

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Get Your Life Back Located in a park-like corner of Toronto’s cityscape, West Park Healthcare Centre is a Rehabilitation/Complex Continuing Care hospital that has been helping patients facing life-changing health challenges to reclaim their lives and realize their potential since 1904. West Park has created a nurturing campus of care where patients and their families are supported in responding to adversity and adapting to new circumstances. With deep expertise in rehabilitative medicine, we provide specialized care for patients recovering from life-altering accidents and health challenges such as lung disease, diabetes, stroke, amputation, spasticity and musculoskeletal issues. The nurturing care the Centre provides addresses all aspects of person and possibility in helping patients in their journey from crisis, to hope, to realizing their potential. The collaborative, restorative care at West Park is empowered by advanced technology and research and gives patients and their families the skills, knowledge and confidence to lead productive, independent lives. West Park Healthcare Centre provides care in these areas:

Rehabilitation and Community Living • • • • • • • • • • • • • •

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Acquired Brain Injury Adult Day Program and Respite Service Acquired Brain Injury Behaviour Service Acquired Brain Injury Behavioural Outreach Services Augmentative and Alternative Communication Clinic Amputee Rehabilitation Service Gage Transition to Independent Living Geriatric Assess and Restore Clinic Musculoskeletal Rehabilitation Service Neurological Rehabilitation Service Outpatient Rehabilitation Therapy and Wellness (West Park Rehab Plus) Outpatient Specialty Clinics Prosthetics/Orthotics Respiratory Diagnostic and Evaluation Service (including Sleep Lab) Respiratory Rehabilitation Service (including Home Ventilatory Training/ Follow-up) Seniors Mental Health Service www.westpark.org


• Spasticity Management Clinic • TB (Tuberculosis) Service

Complex Continuing Care • • • •

Chronic Assisted Ventilatory Care Geriatric Functional Enhancement Service Respiratory Continuing Care Complex Continuing Care with Multiple Sclerosis Specialty

Long-Term Care West Park’s 200-bed long-term care facility is managed by Extendicare (Canada) Inc. See www.westpark.org, for more information. The Community Care Access Centre (CCAC) is responsible for admissions to the Long-Term Care Centre and can be reached through the Toronto Central Client Service Centre at 416-506-9888.

Directions West Park Healthcare Centre is located at 82 Buttonwood Avenue, near Jane Street and Weston Road in Toronto’s West end. Driving from the North: Exit Highway 401 onto Weston Road. South on Weston Road to Dora Spencer (two streets before Jane Street). Turn right on Dora Spencer, left at Charlton Settlement and right at Buttonwood Avenue. West Park Healthcare Centre is at the end of Buttonwood. Driving from the South: Take the Queensway to the South Kingsway exit. Proceed North on South Kingsway to Bloor Street. Turn right onto Bloor and then left onto Jane Street (the first set of lights). Continue North on Jane to Emmett Avenue (watch for signs to West Park). Turn left on Emmett and then right on Verona to Buttonwood Avenue. Turn left on Buttonwood. West Park Healthcare Centre is at the end of Buttonwood, beside York Humber High School. By TTC: Via subway/bus Take the Bloor/Danforth subway to the Jane subway station (remember to obtain a transfer when you pay your fare) and transfer to bus #35A, #35B, #35C or #35D. You will get off at the Jane Street/Weston Road intersection. Buttonwood is the first street immediately west of Jane Street, running southwest off Weston Road. West Park Healthcare Centre is located at the end of Buttonwood Avenue, approximately a 15-minute walk.

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Via bus In addition to the Jane Street route (#35A, #35B, #35C or #35D) you can also take the Eglinton West route (#32) to Jane Street where you can catch a #35 bus. #32D diverts to Emmett Avenue, where you can debus at Verona Avenue, walking up it and turning left onto Buttonwood Avenue. West Park Healthcare Centre is located at the end of Buttonwood Avenue. Otherwise check with TTC at 416-393-4636 or www.ttc.ca Via Wheel-Trans Wheel-Trans stops at the automatic doors of the Main Building, at the front door of the Ruddy Building and at the Gage B-Building. Registered Wheel-Trans users can book rides one day in advance through 416-393-4222.

Parking The visitor parking lot in front of the Main Building is reserved primarily for visitors and patients who are not staying overnight. Several parking options are available at West Park including hourly, daily, monthly and multi-use passes. Hourly and daily passes can be purchased from the parking machines in the visitor’s parking lot. These parking machines accept coins and major credit cards. A change machine is located in front of the cashier’s office. Monthly and multi-use passes are available for purchase only at the cashier’s office. Multi-use passes are known as H-Passes; and allow for 5, 10 or 30 discounted use passes over the course of a year. Information and pricing of various parking options are available at the cashier’s office. If you’ve been admitted to West Park as an in-patient, please do not leave your car in the lot, unless you have made special arrangements with a Service Manager. Please respect the “NO PARKING” signs marking designated fire routes. Emergency response teams count on these routes being clear. Fines for parking in these routes are high. Receive 1 hour of free parking with a $20 purchase or any prescription filled at the retail pharmacy on site. The retail pharmacy is located on the main floor of the Ruddy Building and is open Monday 9:00 a.m. to 7:00 p.m., Tuesday to Thursday 9:00 a.m. to 5:00 p.m., Friday 9:00 a.m. to 4:00 p.m. and Saturday 8:30 a.m. to 11:30 p.m.

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Planning For Your Stay What to bring Whether you are coming for a brief appointment or being admitted for weeks of treatment, you can help by arriving prepared with the right information and equipment. Here’s what to bring: • A valid Health Card, issued by the Ontario Ministry of Health and LongTerm Care. • Certificates or cards for extra hospital or health insurance you may have. Check with your insurer before you arrive to be sure of your coverage. • If you have respiratory equipment such as CPAP or BiPAP, please speak with your care coordinator. • Your social insurance number for making an insurance claim. • If you are a Workplace Safety and Insurance Board (WSIB) patient, bring your WSIB claim number and documents. • Any prescription or non-prescription medications you take. Bring them in their original labeled containers so there is no confusion about doses. • Comfortable clothing such as shorts, track pants, t-shirts and supportive, non-slip running shoes with good traction, even if you are staying overnight. For many treatments, you’ll need to be able to move freely. • If you are being admitted, bring a nightgown or pajamas, a robe and slippers, personal toiletries including a hairbrush or comb, toothbrush and toothpaste, soap, shampoo, shaving equipment, moisturizers and tissues. • Any aids or prosthetics you use such as a wheelchair, walker or splints. For safety reasons, wheelchairs with gel batteries must be inspected by a certified vendor. You’ll be asked for an inspection certificate when you arrive. Patients and their families are responsible for maintenance and repair. • Storage is limited. Please limit what you bring to the items listed above. • If bringing your own television, please ensure it is no larger than 24”. TIP: Put your name on everything. It’s easy to misplace items. TIP: Do not bring valuable items or large amounts of cash. The hospital cannot be responsible for the loss of or damage of personal belongings. If you are an inpatient, you may wish to have a visitor deliver and return your valuables when you need them.

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Accommodation options Three types of accommodation are available. • A standard ward includes up to four people in one room. • A semi-private room has two people sharing one room. • A private room accommodates just one person. Your government Health Card ensures no extra charge for staying in a standard ward. If beds are available, you may request a semi-private or private room to be paid for by you or through your private insurance company, if you have coverage. Review your options before you arrive. You’ll hear this option called “preferred accommodation.” In some cases, a time commitment or payment in advance is required. For full details, call West Park’s Financial Services Department at 416-243-3600 ext. 2252 or 2074.

Co-payments The Ministry of Health and Long-Term Care requires an additional daily co-payment fee for patients who are deemed to reside in either a hospital or long-term care setting. The fee is set by the ministry and is subject to change. Low-income individuals may be eligible for reductions. A 30-day notice of any increase will be provided. Patients are required to complete and sign a co-payment calculation form and to provide proof of income. For more information, contact West Park’s Financial Services Department at 416-243-3600 ext. 2252 or 2074.

Extra support Some patients or their families choose to hire a private caregiver to provide extra support. If you wish to do so, you are responsible for paying the costs and you must sign a formal agreement outlining responsibilities. Please speak to your care co-ordinator or the service manager prior to making any arrangements.

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Things To Know For Your Stay The Infection Prevention and Control Program at West Park helps provide a safe environment by following all legislation, standards, guidelines and best practices with all patients, employees, physicians and volunteers to minimize the occurrence, severity and effects of preventable infections.

Cover your cough Germs can be spread by coughing or sneezing. To stop the spread of germs always cover your mouth and nose with a tissue when you cough, sneeze or blow your nose. Cough into your sleeve if you do not have a tissue. Put used tissues in the garbage and wash your hands with soap and water or hand sanitizer.

Wash your hands Keeping our hands clean is the best thing we can all do to reduce the risk of spreading infection. This can be accomplished by using soap and water or hand sanitizers located throughout the Centre. Everyone involved in your care should clean their hands before providing care, this means family members, visitors, doctors, nurses and therapists must clean their hand before providing care. Here’s how to do it correctly. TIP: You’re in charge of your care. Feel free to remind anyone involved in your care to clean their hands. Visitors who do not feel well should not come to see you. This is another way we can keep infections from spreading in the hospital.

Emergencies From time to time, you may hear Emergency Codes announced over the public address system or fire alarms sounding. During a fire alarm, all fire doors on your unit will close automatically and staff will close all patient room doors until there is an ALL CLEAR announcement on the public address system. Staff on your unit will inform you if any action becomes necessary. If you are in the Cafeteria, please stay there until an ALL CLEAR is announced. Do not use elevators during a fire alarm. Routine fire drills are important to ensure everyone is prepared for any emergency situation and that the building’s automatic safety features are functioning properly. Emergency code procedures dictate how hospital staff and occupants are to respond in particular situations. The procedures are the same across Ontario. All West Park staff members are trained on these procedures. In addition, specific response teams are designated for each code and are trained

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Hand Washing

1. Wet hands.

2. Apply soap.

3. Lather for 15 seconds. Rub between fingers, back of hands, fingertips, under nails.

4. Rinse well under running water.

5. Dry hands well with paper towel or hot air blower.

6. Turn taps off with paper towel, if available.

Stop the Spread of Germs Always Wash Your Hands Before and after you:

• Sneeze, cough or blow your nose

• Prepare or eat food

• Use the washroom or change diapers

• Touch a cut or open sore PH0605RT037

After you:

• Handle garbage

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accordingly. A code is featured each month and mock scenarios are held on a regular basis to ensure staff readiness in case a real emergency situation occurs. In a real emergency staff will inform patients and prepare them for a potential evacuation. If you have any questions, please direct them to the nursing staff on the unit.

Privacy We are subject to the Personal Health Information Protection Act (PHIPA/the Act). The Act governs the manner in which personal health information may be collected, accessed, used and disclosed within the healthcare system. We are also subject to the Freedom of Information and Protection of Privacy Act (FIPPA/the Act). The Act provides the public with a right of access to general records held by us and also sets out our obligations with respect to the protection of personal information. To learn more about hospital privacy and access to information practices please consult the privacy protection section of West Park’s website at www.westpark.org No photography, video recording or audio recording is permitted on hospital property without express permission. This is to ensure the privacy and confidentiality rights of patients, physicians, employees, volunteers, and other members of the public, including patient visitors, are protected. Please speak with your care provider to obtain appropriate permission. If following a discussion with the care provider you have any further questions please contact the hospital’s Privacy Office.

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Smoking Through the Smoke-Free Ontario Act, the Ontario Government legislated all hospitals ban smoking on their grounds by Jan. 1, 2018. West Park’s entire grounds (including the Long-Term Care Centre) became a smoke-free environment on May 31, 2017. Smokers are directed to the closest public areas off-campus – the Buttonwood or Emmett Avenue entrances to the property. City of Toronto Tobacco and Electronic Cigarette Enforcement officers will be on the grounds of hospitals enforcing compliance with the law. An individual found to be smoking anywhere on the West Park campus could be fined $305.

Room assignments In certain circumstances, additional precautions may be needed to minimize the spread of infection or ensure patient safety. While every effort is made to minimize disruption, that could mean a change in room assignment for several people, including a move in or out of private or semi-private accommodations. If a patient is being treated with additional precautions, it could also limit participation in some activities. Any concerns or questions may be directed to the care co-ordinator or service manager, or the Infection Prevention and Control department can be contacted through your nurse or care co-ordinator.

Consent forms You, a family member, or designated decision-maker may be asked to sign consent forms. Before you sign them, the purpose will be thoroughly explained by your physician, other staff on your treatment team, or the physician responsible for the procedure. Feel free to ask questions to ensure you understand the information.

Identification During your visits or stay at West Park, you may be asked to identify yourself many times to staff providing treatment. You may also be asked to wear a wrist band that makes sure staff members know who you are. In some cases, patients may be asked to include a photograph in their records to allow for positive identification before treatment or medication is administered. Each step is part of a safety system to ensure patients receive the correct treatment designed for them. The practice follows recommendations from the Institute of Safe Medication Practices Canada.

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Ask for help Although improved mobility and independence is the goal, sometimes you may need assistance getting up, moving about or reaching for something. If in doubt, ask for help. In-patients may use the call button located by beds and in washrooms. The button will sound a tone at the nursing unit desk and activate a light above your door.

Falls prevention Your safety is assessed at admission and on an ongoing basis. We pay particular attention to preventing falls. Staff work with you to put in place approaches to prevent falls.

Alcohol Alcoholic drinks are not permitted on patient units unless prescribed by your physician. Alcoholic drinks may not be kept at your bedside. In addition, no matter how well-meaning, visitors are asked not to give beer, wine or any alcoholic drinks to patients because of the risks involved in combining them with some medications. Visitors cannot consume alcoholic drinks while visiting patients or anywhere in the building or on the grounds of the Hospital. Under Ontario Law open liquor is not permitted except in private residences or on licensed premises.

Visitors Visitors can be a welcome part of a patient’s support team. Visiting hours are between 11:00 a.m. and 9:00 p.m. daily, but many patients’ days are busy so it’s best to check on timing in advance. No more than two visitors at a time may be in a patient’s room. Visitors are welcome to join patients for concerts, worship services or special events at the hospital. Children under 14 are not allowed on the TB Service area. All visitors must clean their hands when entering the building using one of the hand sanitizer stations throughout the Centre. It is important that, if your visitors are feeling ill, to ask them to postpone their visit. A gift can be lovely but remember to avoid scented plants and products, as there are many respiratory patients here who have sensitivities or allergies. Home-cooked food is not encouraged due to food safety issues.

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Special considerations when visiting the respiratory care units Because people with respiratory diseases and allergies can be greatly affected by the environment, please note: • Cut flowers and scented flowering plants are not permitted. • The use of perfume, aftershave lotion, and other scented products is not allowed. • latex balloons are not allowed.

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Services Patient Experience Co-ordinator Patient Experience Co-ordinator (PEC) is here to support you through your experience at West Park and assist you with questions or concerns. If you have a complaint, a suggestion or a compliment, we would like to hear your feedback. If you have a concern, you can always speak to your care providers directly or the manager of the unit or program. If you don’t feel satisfied after this, please call the PEC.

When to call: • When you have general questions or would like information about services at West Park. • When you want to share your ideas or suggestions. • When you have concerns about services or interactions with West Park staff or physicians. PEC works with West Park employees, physicians, and management to engage patients and their families in resolving their concerns in a comprehensive, transparent and objective way. The issues you bring to their attention don’t get filed away – they will be documented and shared with the right people within the organization, who are committed to improving safety and quality of care at West Park.

The PEC can be contacted in the following ways: • Phone: 416-243-3600 x 2337 or x 2526 • Email: patientexperience@westpark.org • Mail: 82 Buttonwood Avenue Toronto, ON M6M 2J5 Attention: Patient Experience Co-ordinator • “Tell Us What You Think” pamphlets located near most elevators throughout West Park.

Financial services During your time at West Park you may use services that have fees attached, such as TV rentals, parking, or preferred accommodations. Payment can be arranged through West Park’s Financial Services Department. The cashier for the Financial Services Department can be found at the Communications Desk Monday-Friday (excluding statutory holidays) 8:30 a.m. to 4:00 p.m. and can be contacted at 416-243-3600, ext. 2077. No financial transactions can be done after these hours. The Communications Desk is located on the main floor of the Main Building.

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Resident Trust Accounts If you are staying for a longer time period, you may need cash from time to time to purchase personal items. To avoid keeping large amounts of money at your bedside, you may wish to set up a trust account through Financial Services. You will be able to withdraw small amounts of money from your trust account with a signed form. There are no administration fees and no interest paid on the accounts. Your account can also be arranged and accessed through the cashier at the Communications Desk Monday to Friday from 8:30 a.m. to 4:00 p.m. Requests for patient trust withdrawals $100 and under will be provided during regular working hours. Requests for patient trust withdrawals over $100 require 2 days’ notice. Phone, Television, Cable, and Laundry Service You may arrange to rent a phone, television or cable service (provided you bring your own TV) for your stay by visiting the cashier at the Communications Desk. Laundry service is also available for a monthly fee. For more information, contact the cashier at 416-243-3600, ext. 2077

Funding support Assistance is provided to arrange funding sources for income maintenance or equipment such as wheelchairs and walking aids. The service can be arranged through your care co-ordinator.

Banking/Automated Teller Machine (ATM) An automated teller machine (ATM) is available in the Main Building, behind the Gift Shop on the main floor. A portion of the ATM transaction fee is donated to patient care at the hospital.

Mobile devices and telephones Mobile devices may be used throughout the hospital. Telephones can be rented by visiting the cashier at the Communications Desk.

Computers Several computers with Internet access are available for patient use throughout the Centre, including one in the Patient Library. In addition, you are welcome to use your own wireless device with your own Internet access. West Park also offers free WIFI access.

Username: wphWiFi Encryption: WEP Password: abcde12345

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Laundry Personal laundry (not hospital bedding and towels) is your responsibility. It’s best to have family or friends take it home to be washed. If that can’t be done, you may use West Park’s Laundry Services. The service is basic. It does not include dry cleaning, hand washing or hang drying. Our machines can’t accommodate heavy blankets, comforters or pillows. The service is provided for a modest charge. You will be asked to pay for one month of service when you sign up. Payment can be arranged through Financial Services at the Communications Desk on the main floor of the Main Building. Inform your caregiver that you have paid for the service and you’ll be given a laundry bag and further directions.

Retail food vendors You’ll find Presse Café on the ground floor of the Main Building. They serve a wide variety of hot and cold breakfast options, soups, daily hot meals, and sandwiches and salads. On select days in the summer, Presse Café also offers a barbecue menu. Presse Café is open Monday to Friday from 7:00 a.m. to 4:00 p.m. If you are looking for food options outside of the café hours, there are vending machines located throughout the hospital and are accessible 24 hours per day. Machines are located in the cafeteria and off the main lobbies. These vending machines provide cold drinks, hot coffee and tea, snacks, and sandwiches.

Meals Your meals will be provided in accordance with the diet ordered by your physician. Food Services will only serve you foods that are compliant with this order. If you do not understand why you are on a special diet, please ask your physician/nurse for clarification or ask to speak with a registered dietitian. Your nurse can connect you. Be sure to tell your nurse about any true food allergies you may have and the related symptoms. If a food allergy is noted in your electronic medical record, any form of that food cannot be served to you to keep you safe. This is why it is important that you do not confuse an intolerance with a food allergy. Each patient is visited shortly after admission by our Diet Technician to discuss dietary preferences, likes and dislikes, etc. We offer our patients a three week cycle menu for lunch and dinner that includes a lot of variety and popular offerings. We feed a very ethnically diverse population that makes it challenging to suit everyone’s preferences. Our breakfast menu cycle stays the same every week and features our most popular menu selections. We serve delicious fresh brewed coffee because our patients look forward to this.

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Our Complex Continuing Care patients are sent printed menus to make their meal selections. It’s wonderful if family can assist the patient with menu marking on weekends. We cannot guarantee that special extra items written onto the menus can be accommodated as we feed so many in a short period and the food might not be available. A registered dietitian can guide you with meal selections or our Diet Technician if we know you need assistance. Many rehabilitation patients are visited by our Spoken Menu clerk from Monday to Friday to obtain food selections for all three meals. Meals are served to inpatients with breakfast arriving between 7:20 a.m. and 8:30 a.m., lunch from 11:20 a.m. to 12:10 p.m., and dinner from 4:20 p.m. to 5:10 p.m. The cut off times for when we stop serving a meal is 10:00 a.m. for breakfast, 1:00 p.m. for lunch, and 5:30 p.m. for dinner. Your nurse can arrange for an early tray or bagged meal if you have an outside appointment during a meal time. We know that holidays are important special occasions for our patients. For those that stay over during these times, we offer festive theme meals to celebrate. If you need to speak with Food Services about your dietary needs, please do not hesitate to tell your nurse. We will gladly visit you as soon as possible. Our goal is to provide you with the best meals possible to make your stay a pleasant one! A nutritious diet made up of healthy foods is just as important as medicine to get your life back … healthy food heals.

Spiritual and religious care West Park offers Spiritual and religious Care offers a wide range of services including: • • • • • •

Spiritual and emotional support Religious Services End-of-life support Crisis intervention Spiritual counseling Collaboration with local clergy and local faith healers

The Meditation room is open as a quiet and restful place for prayer and reflection located near the main lobby. Muslim WUDU (washing facilities) are available in the washrooms near the patient Library, off the main lobby. Protestant and Catholic services are held in the Enbridge Auditorium Sunday mornings. A Roman Catholic Mass is held at 10:45 a.m. The Protestant worship service is held at 9:30 a.m. following a monthly schedule:

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First Sunday Second Sunday Third Sunday Fourth Sunday Fifth Sunday

– Anglican – Baptist – Presbyterian – United/Pentecostal (alternating) – Interfaith service

Spiritual and religious programs are posted on the Centre-wide calendar.

Clothing Shop Renewed and new clothing for men and women is sold at reasonable prices at the Clothing Shop on the ground floor of the Main Building (beside Occupational Health). The shop is open Thursdays only from 9:30 a.m. to 1:30 p.m. If you have an urgent clothing need, call Volunteer Resources at 416-243-3600, ext. 2097 or 2108 and special arrangements will be made.

Gift Shop/Vendors The Gift Shop on the main floor of the Main Building is operated by Pharmasave and stocks a variety of toiletries, healthcare products, cards, confectioneries and gifts. Stamps, phone cards, Nevada break-open tickets and TTC tickets are also available. The Gift Shop is open Monday to Thursday from 10:00 a.m. to 3:30 p.m. and on Fridays from 10:00 a.m. to 3:00 p.m. Outside vendors are often invited to sell a variety of clothing, giftware and personal items in our main lobby. A schedule of sales is posted each month.

Hairdressing services The Hair Salon is in the Main Building, beside the Martin Family Lounge & Garden View. Services are available Monday to Friday from 12:30 p.m. to 4:00 p.m. Bedside services are also offered. To make an appointment, call 416-243-3600 ext. 2120. Please pay in advance at the Communications Desk and bring the receipt to your appointment.

Library The Patient Library on the main floor of the Main Building offers a quiet space for reading and browsing or accessing the Internet. Patients may borrow print or audio books, magazines and music. Some large-print publications and a video magnifier are also available. Deliveries can be arranged, if needed, through Volunteer Resources at 243-3600, ext. 2097 or 2108. The Library computers are restricted for the use of West Park patients. When other patients are waiting, we ask that you limit your use to 30 minutes.

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Donations of soft cover and audio books, current magazines and music are welcome. The Library is open from 9:00 a.m. to 9:00 p.m.

Mail Mail addressed to you will be delivered to your room. Your address here is:

Your Name, Nursing Unit, Suite Letter and Room Number West Park Healthcare Centre 82 Buttonwood Avenue Toronto, Ontario M6M 2J5

Stamps are available at the Gift Shop and a mail box is located outside the automatic doors at the entrance to the Main Building near the visitor parking lot.

Newspapers If you wish, your unit clerk can make arrangements for delivery of one of the major daily newspapers (the Globe & Mail, National Post, the Toronto Star and the Toronto Sun) are available in boxes outside the automatic doors at the entrance to the Main Building.

Items from home Some long-term patients may wish to bring a limited number of items to the Centre. To ensure a safe living and treatment environment for you and a safe working environment for staff in accordance with the Occupational Health and Safety Act, some guidelines must be followed. Your care co-ordinator will review the guidelines with you. Placement of personal items must not interfere with staff safety, heating and ventilation, cleaning, infection control or fire prevention. All electrical equipment is required to be safety checked by West Park staff prior to using.

Access to buildings All front entrances to the main building are locked after visiting hours each day. The two front entrances to the Main Building are locked at 9:30 p.m. and unlocked at 6:00 a.m. The main entrance to the Ruddy Building is locked at 7:00 p.m. and unlocked at 6:00 a.m. On weekends and statutory holidays, the main doors remain locked until 8:30 a.m. The Ruddy building remains locked until normal business hours resume. An identity card reader has been installed outside the wooden doors of the Main Building to allow staff and/or physicians access to the building. Family members coming to the hospital in emergency situations may enter the hospital by pressing the Security buzzer at the wooden doors and waiting for Security who will escort them to the unit. www.westpark.org

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Retail Pharmacy The retail pharmacy on the main floor of the Ruddy Building is operated by Pharmasave and stocks all prescription medication, home health care items, vitamins, over-the-counter medications, personal care items and snacks. TTC tickets are also available at the retail pharmacy. Pharmasave is an authorized ADP vendor and can assist with the purchase of any medically required mobility aids and wheelchairs. The pharmacy is open Monday 9:00 a.m. to 7:00 p.m., Tuesday to Thursday 9:00 a.m. to 5:00 p.m., Friday 9:00 a.m. to 4:00 p.m. and Saturday 8:30 a.m. to 11:30 p.m.. Seniors receive a 10% discount (some restrictions apply). For inpatients, West Park Retail Pharmasave will work with your clinical team to ensure the prescription medications you need for your recovery at home are ready upon your discharge. Call West Park Retail Pharmasave at 416-243-2700.

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Your Care Your care while staying at West Park as an inpatient will be managed by a team of professionals trained in a wide range of areas that relate specifically to your needs. You are part of that team. Feel free to ask questions and stay informed on your condition and treatment.

Members of your healthcare team Your Care Co-ordinator In the Rehabilitation Program, your care co-ordinator is part of the team developing a care plan with you. He or she is the consistent contact for you, your family, your physician and outside agencies dealing with West Park. You may take any questions or concerns you might have to your co-ordinator. In the Complex Continuing Care Program, your care co-ordinator helps with the transition after you’ve been admitted. That includes developing a care plan and providing orientation to the Centre for you and your family. Once that’s complete, any concerns about care plans or treatment should go to the registered nurse on duty.

Physicians While you are a patient at West Park Healthcare Centre, your family doctor is no longer responsible for your care. One of our medical staff physicians will be assigned to you and he or she may call on other specialists to assist in your treatment. When you leave West Park, responsibility for your care moves back to your family doctor who will receive discharge information.

Nurses Nurses are part of a team assisting you with activities of daily living and provide nursing care to support or restore your health and well-being. They focus on assessing your care needs each shift and providing care for you to attain or maintain optimal health.

Dietitians Registered dietitians provide nutrition assessment, counseling and individual diet plans for Complex Continuing Care and Rehabilitation patients who need special diets. Understanding your nutritional needs is important to your overall health and well-being. A dietitian can be contacted through your nurse or care co-ordinator.

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Occupational Therapists and Physiotherapists Occupational therapists (OTs) are professionals who empower people to overcome barriers in their lives. OTs help you to improve your independence in everyday activities so that you can return safely to work, home, or school. OTs work with you to regain physical and cognitive abilities, learn new skills and/or modify your environment. They also prescribe equipment, such as seating, mobility and/or communication aids. OTs focus on improving quality of life, even if functional challenges remain following recovery. Physiotherapists work with you to achieve the highest possible level of independence through therapeutic exercise, manual therapy, pain management, hydrotherapy, or the prescription of mobility aids. Education is an important part of physiotherapy and questions from you and your family are welcomed.

Rehabilitation Assistants Rehabilitation Assistants, under the direction of occupational therapists and physiotherapists, help patients practise new skills.

Pharmacists While you are in hospital, your medications will be provided by the pharmacy and administered by your nurse. Do not use your own medications in hospital without first checking with your doctor, nurse or pharmacist. Pharmacists are part of your healthcare team and work with your doctors and nurses to provide the best care for you. Pharmacists review all medications ordered for you in the hospital and check for allergies and drug interactions. Pharmacists continually monitor and review your medication needs during your hospital stay. If you have any questions about your medications, please ask the unit clinical pharmacist.

Psychologists Our psychologists are here to help you cope with the challenges of daily living. They provide assessments and treat difficulties in thought processes, emotional adjustment or coping with changes to your health. These services, which include counseling and education, are available to you and your family through referral by your healthcare team.

Recreation Therapists Recreation Therapists and Assistants assess your leisure needs and plan services to meet them. A broad range of social, entertainment and special interest groups are offered and outings to community events and facilities are scheduled regularly. In addition, you and your family and friends may make arrangements to use on-site recreational equipment, resources and space (such as the recreation room, patio and garden area) for individual or group use.

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For current information, check the Centre-wide calendar of events posted on your unit, drop into the Recreation Therapy room on the main floor near the Martin Family Lounge & Garden View or speak with your care co-ordinator.

Religious and Spiritual Care Spiritual care is offered by clinically trained professionals who ensure that the spiritual and religious dimensions of health and wellbeing are provided in the context of holistic patient-focused model of care. To contact the Spiritual and Religious Care Provider, please call ext. 2168 to request a visit or arrange contact with a community religious leader of your choice (where possible).

Respiratory Therapists Your healthcare team may include a Registered Respiratory Therapist (RRT), committed to working with the physician and other members of the team in the assessment, treatment, management and education of patients with respiratory and related disorders. The RRT emphasizes patient and family involvement through training and education in Home Mechanical Ventilation from pre-admission through discharge and in follow-up in the hospital and community.

Social Work Our social workers are available to provide individual or family counseling and group meetings to help you cope with your illness and the changes and adjustments it has brought to your life. Social workers also provide community resource information, connections to financial assistance, referral for ongoing support throughout your stay, and assistance with your transition back into the community.

Speech-Language Pathology and Communicative Disorders Speech-Language Pathologists and Communicative Disorders Assistants help you manage communication and/or swallowing disorders. They work with you to recover and maintain abilities, and compensate for problems, related to speaking, understanding, reading and writing, as well as safe eating and drinking.

Healthcare Students You may be cared for from time to time by a healthcare student working under the direction of a qualified member of West Park’s staff. West Park Healthcare Centre participates in the education of healthcare professionals of many disciplines. All of the students are associated with accredited or recognized centres of healthcare education. If you have any questions or concerns, please speak to the supervising staff member.

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Volunteers In addition to running the clothing shop, patient library and enquiry desk, volunteers help with rehabilitation programs, therapeutic recreation groups, outings, mealtime and more. West Park volunteers are recruited, screened and trained to help with a variety of activities at the hospital. You can recognize them by their photo identification tag labeled “volunteer” on a West Park lanyard. If you need help from a volunteer, or if you are interested in becoming a volunteer, contact Volunteer Resources at 243-3600, ext. 2097 or 2108.

Other services you may use Pharmacy Services - Your Medication Bedside Medications Unless you are a participant in the self-medication program, you should not store medication at your bedside without a physician’s order. This rule is to prevent accidental overdose, adverse effects from drug interactions or other patients mistakenly taking your medications. Weekend Leave Medications The Pharmacy will supply medications you need for absences from West Park. If you are planning a day or weekend pass, notify your nurse (preferably several weekdays in advance). Please bring back the medication containers when you return to West Park. A self-medication program is available for some as an educational component of rehabilitation prior to discharge.

Dental Services Dental services can be arranged through your West Park unit clerk. Although there is no charge for the first consultation, further services are not covered by OHIP. You will be responsible for payment.

Prosthetics/Orthotics Our certified prosthetists and orthotists support West Park’s Amputee Rehabilitation Service by designing, manufacturing and fitting custom-made prosthetic limbs and braces. The Ontario Ministry of Health and Long-Term Care’s Assistive Devices Program (ADP) covers a significant portion of the cost of most manufactured limbs and orthopaedic braces. You are responsible for payment of any costs not covered by the ADP.

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This service includes a lab where pulmonary function studies, or breathing tests, are performed, as well as an exercise testing laboratory and a four-bed sleep laboratory. These labs are staffed with professionals who assess lung function and exercise capacity and assist in the diagnosis and management of people with sleep-related disorders.

Augmentative and Alternative Communication Clinic The Augmentative and Alternative Communication (AAC) Clinic helps individuals who have difficulty communicating face-to-face with others using their speech, and/or through writing or using a keyboard. The clinic provides recommendations for AAC devices or techniques so that individuals with communication difficulties can participate more actively in their important life activities. There Get to know the is no charge for assessment or treatment for residents of Ontario who have a valid Health Card. Funding assistance for communication aids is available for eligible clients through the Ministry of Health’s Assistive Devices Program. The AAC team is made up of a variety of health care professionals, including Speech• Physiotherapy Language Pathologists, Occupational • Occupational Therapy Therapists, Communicative Disorders • Massage Assistant, Client Computer specialists, • Acupuncture Equipment Control Assistant, • Chiropody & Orthotics Biomedical Engineering Technologists • Hydrotherapy & and Administrative Support. The AAC Aquafit Clinic is located in the Ruddy Building, • Speech & Language Pathology 6th floor. Contact 416-243-3600 ext. • Psychology 4687.

West Park

Rehab Plus Outpatient Rehabilitation and Wellness Clinic

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have access to any of the Rehab Plus wellness services during your inpatient stay. West Park Rehab Plus is located in the James Grand Rehabilitation Therapy Centre on the main floor in the main building. The clinic provides globally funded and fee-based services. Many services offered under a fee-for-service basis may be covered by Workplace Safety and Insurance Board (WSIB), Motor Vehicle Accident insurance or private insurance extended health benefits packages. Rehabilitation services include: • Physiotherapy • Occupational Therapy • Speech Language Pathology • Chiropody and Orthotics (Foot/Nail Care) • Recreation Therapy • Wellness services • Massage Therapy • Acupuncture • Back Care Education • Kinesiology • Hydrotherapy and Aquafit (warm-water pool) • Motor Vehicle Accident Treatment Program • Work Related Injuries (WSIB) Program • Return to Work Program • Wheelchair, Walker and Seating Assessments For information and appointments, call 416-243-3778.

Over-the-phone interpretation services If you prefer to speak in a language other than English, our over-the-phone interpretation services are available in over 180 different languages and dialects to help you communicate with your care providers. This service is offered at no cost to you during your stay and is available 24 hours, 7 days a week. Please let your health care provider know if you would like to communicate in your preferred language using our professionally trained interpreters. Ensuring that all patients have access to quality care no matter who they are and what language they may speak is a priority at West Park. Some examples of languages offered are: Punjabi, Mandarin, Cantonese, Portuguese, Italian, Korean, French, and Arabic.

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Outpatient specialty clinics Following your discharge, you could be seen at outpatient clinics. You may also be referred by your physician to a West Park specialty clinic during your stay. Arrangements are made by staff from your healthcare team. Fees apply for dentistry and optometry services. The clinic area is located on the main floor across from the Gift Shop, near the main entrance. • • • • • • • • • •

Amputee Clinic ABI Assessment and Follow-up Clinic Optometry Otolaryngology (ear, nose and throat) Respirology Spasticity Management Clinic Surgical assessment and follow-up TB Clinic Urology MSK Assessment and Follow-up Clinic

Seniors Mental Health Service When an older adult, 60 years of age and older, shows signs of memory loss, seems depressed, or begins to behave in a way that is out of character, he or she may be experiencing deteriorating mental health. The professionals of West Park’s Seniors Mental Health Service provide free in-home assessments and practical advice to help individuals and families deal with issues like difficult behaviour, stress, depression, confusion and dementia. For further information on this service, please call 416-243-3600, ext. 4536.

Research West Park Healthcare Centre is an academic hospital which undertakes important research and education. As a patient of West Park you may be invited to participate in a research activity designed to improve the quality of care provided at West Park. You have no obligation to take part and will only be included in the research if you have signed a “Informed Consent” form outlining details of the program. If you do agree, you are welcome to withdraw from the research activity at any time. West Park’s research activity is approved and monitored by the Joint Bridgepoint/West Park/Toronto Central CCAC/Toronto Grace Research Ethics Board. The Board reviews all applications to ensure the research meets with underlying principles of respect for human dignity, free and informed consent, and privacy and confidentiality, among others.

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Preparing to leave in-patient care Your care doesn’t end here. Before you leave West Park, you and your family or caregivers will have been offered training and information to help you stay healthy, strong and as independent as possible. In addition, you may join the many people who visit West Park as out-patients, continuing with support and treatment without having to stay overnight.

Physicians Your family doctor will receive discharge information when you leave West Park. If you do not have a family doctor, please notify your care coordinator as soon as possible so you can be connected with one.

Medication Once you leave, you will be responsible for keeping track of your own medication – when to take it, how much to take and with what. Be sure to ask questions to ensure you have a good understanding of how to manage your medication. Before you leave, you may fill your prescriptions at the retail pharmacy located on the main floor of the Ruddy Building. The pharmacy is open Monday 9:00 a.m. to 7:00 p.m., Tuesday to Thursday 9:00 a.m. to 5:00 p.m., Friday 9:00 a.m. to 4:00 p.m. and Saturday 8:30 a.m. to 11:30 p.m. The pharmacy accepts all insurance plans and is also able to prepare your medications in blister packs at no extra charge.

Support in the community Your illness or injury may have changed your ability to get around, carry out personal or household chores and your relationships. Your care co-ordinator and social worker will help with discharge planning, providing community resource information, connection to other supports you may need to regain your independence.

Outpatient rehabilitation Outpatient rehabilitation may be recommended to build on the progress you made as an inpatient. You may continue your outpatient rehabilitation at West Park Rehab Plus. Please refer to the Other services You May Use section for more information on the rehabilitation and wellness programs offered. Unless it is an emergency, if you must cancel an appointment, you must give 24 hours notice. Call the reception desk at 416-243-3778.

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Join us Patient/Family Advisory Committee West Park’s Patient/Family Advisory Committee provides a group forum for discussion of new programs, issues, ideas and policies, concerns and issues that affect inpatients. The Committee acts as a consulting body to the senior management team and other departments. Its members also act as advisors on committees, seminars and presentations on Centre activities. The Committee meets the last Monday of each month at 2:00 p.m. in the Enbridge Auditorium, Main Building. All patients are encouraged to attend and family members are welcome.

West Park Foundation Community support and the generosity of individuals has been part of West Park’s more than 100 years of service. In fact, the hospital was founded with the support of a philanthropic legacy. In 1904, Sir William Gage purchased the Buttonwood Farm to offer as the site of a new hospital, beginning a legacy of care that has helped thousands of patients to reclaim their lives. Today, West Park Healthcare Centre Foundation serves as the official fundraising vehicle of the hospital, supporting innovative methods of treatment, leading-edge research and patient care technology. The support of our community is now more important than ever, as West Park develops its campus into a world-class centre of rehabilitative care. West Park Foundation has embarked on the ambitious Get Your Life Back Campaign to raise $80 million towards the capital costs of the new hospital building that is at the centre of West Park’s stunning transformation. There are several ways you can contribute to West Park’s future and help more people get their lives back:

Personal Giving to the Campaign Whatever the size of your gift, it will help accelerate our bold transformation and help the many people who depend on West Park. You can make a cash gift today, a pledge to give monthly or annually, or a gift of securities. www.westpark.org

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Monthly Giving Donating monthly is an easy, convenient and effective way to support the new hospital. Knowing that you’re giving every month helps West Park plan for the future.

Legacy Giving You can make a gift to West Park that will support patients and their families after your lifetime. By making a charitable bequest in your Will, you will be creating a legacy that will help people reclaim their lives for many years to come.

Tribute & Memorial Giving Making a donation to West Park in the name of someone special is a meaningful way to honour those close to you.

West Park Heroes Program Honour your “West Park Hero” – an employee, physician or volunteer who went above and beyond to help you. When you make a gift to West Park Foundation in the name of your hero, he or she will receive a pin to wear proudly and, if you wish, a special message from you. For more information on giving opportunities, contact the Foundation office at foundation@westpark.org or 416-243-3698, or visit westpark.org/foundation

Campus Development: A bold path of transformation Our unique campus has a rich history that stretches back more than a century, but it’s the future that holds the most promise for us. West Park’s Campus Development will transform its 27-acre site into an integrated campus of care that truly models the way of the future for patient care delivery, education and research. To achieve this, West Park has embarked on two exciting capital projects that will open the door to a new era in healthcare delivery.

New Hospital Development West Park is building a new, world-class hospital facility that will incorporate the best and latest in architectural design, advanced technologies and stunning therapeutic landscapes. The contemporary facility will create an accessible, senior-friendly and green environment that is flexible and technologically sound to meet the healthcare needs of the next generation.

Features of the new hospital include: • 314 beds (20% increase) • 80% single and 20% double occupancy rooms • Three-piece washroom for every patient

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• Communal dining areas and therapy gyms on every floor • Geriatric day hospital and clinics, and satellite hemodialysis • Thirteen outdoor destinations including therapeutic gardens, walking paths and courtyards

Non-Hospital Development We have also embarked on a non-hospital development project to develop community-based service buildings. West Park will convert five acres of its current staff parking area into a vibrant community hub offering a spectrum of services — which may include supportive housing and doctors’ offices — for seniors and persons with disabilities. The project will generate revenue to help cover the cost of our share for the new hospital.

Current Status We are in the planning phases for both capital projects and anticipate construction in the next few years. If you have any questions, please contact 416-243-3600 ext. 2111 or development@westpark.org, or visit www.westpark.org/CampusDevelopment

Volunteer West Park welcomes volunteer support. Volunteers are recruited, screened and trained to help with a variety of activities at the hospital. They are involved directly with patients, serving on the Board of Directors and everywhere in between. In addition to running the clothing shop, patient library and enquiry desk, volunteers help with rehabilitation programs, therapeutic recreation groups, outings, mealtime and more. If you are interested in the rewards of volunteering, contact Volunteer Resources at 416-243-3600, ext. 2097 or 2108 or go to www.westpark.org

Feedback We’ve based this handbook on the most frequently asked questions we receive. Let us know if we’ve missed anything. Jot down your thoughts and ask your care-co-ordinator or nurse to pass it on to Public Relations, or contact Public Relations directly at feedback@westpark.org or at ext. 4510. Thanks for your help.

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Key phone numbers Augmentative and Alternative...........................416-243-3600 ext. 4614 Communication (AAC) Clinic Spiritual and Religious Care Provider .................416-243-3600 ext. 2168 Emergency (from inside the Centre)...................5555 Financial Services Department..........................416-243-3600 ext. 2252 or 2074 Hair Salon......................................................416-243-3600 ext. 2120 Infection Prevention and Control Program...........416-243-3600 ext. 2005 Outpatient Rehabilitation and Wellness Clinic.......416-243-3778 (West Park Rehab Plus) www.westparkrehabplus.com Outpatient Specialty Clinics...............................416-243-3721 Prosthetics and Orthotics..................................416-243-3614 or 1-800-350-8706 Recreation Therapy..........................................416-243-3600 ext. 2153 Retail Pharmacy..............................................416 243 2700 Sleep Laboratory.............................................416-243-3600 ext. 2188 Security (from inside the Centre).......................4444 Volunteer Resources........................................416-243-3600 ext. 2097 or 2108 West Park Foundation......................................416-243-3698 Wheel-Trans....................................................416-393-4222 To contact security from inside the centre 24 hours a day, seven days a week, call extension 4444. In case of emergency, call 5555.

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Community supporters West Park Healthcare Centre would like to thank the following local businesses/sponsors who made this Patient Handbook possible for our patients and their families. Please note, placement of an advertisement in this booklet does not imply endorsement by West Park Healthcare Centre.

Lynett Funeral Home by Arbor Memorial

Diane Moniz-Alves Managing Director

3299 Dundas Street W. Toronto, ON M6P 2A5

t: 416.767.1176 | www.lynettfuneralhome.ca | f: 416.760.0973

Stay home. Stay mobile. Your one-stop solution for virtually every type of mobility product. Our team of accessibility specialists will work with you and your caregivers to meet all of your mobility needs. Call us for a free in-home assessment, or visit our showroom and discover ways to improve your independence. Locations to serve you throughout the GTA

844.352.7677

silvercrossstores.com

stairlifts • porch lifts • accessible vans • walkers • daily living aids • ceiling lifts • medical beds

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INJURED? ONE CLIENT ONE TEAM ONE GOAL

GETTING RESULTS

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WORKING TOGETHER TO ADVANCE HEALTH CARE As Ontario’s leading provider of client centred health care solutions, we are committed to providing clients with integrated services that seamlessly adapt to their current and future health care needs. Our diverse health care solutions include: Home Health Care Services Our home health care division, Spectrum Health Care, can provide you or your loved one with: • Nursing

• Physiotherapy

• Personal and Home Support

• Foot Care

• Palliative and Advanced Illness Care

• Family Caregiver Support • Immunization Clinics

• Wound and Ostomy Care

spectrumhealthcare.com • TORONTO 416.964.0322 • PEEL 905.272.2271 • YORK 905.771.2766 Patient Transfer Services Our non-urgent patient transfer division, Spectrum Patient Services, can provide you or your loved one with: • Stretcher Transfer Services

• Dialysis Transfer Services

• Pediatric Transfer Services

• Bariatric Transfer Services

• Wheelchair Transfer Services

• Hospital and Patient Shuttle Services

spectrumpatientservices.com • 1.866.527.9191 Companion Services Our non-medical seniors home care division, Seniors for Seniors, can provide you or your loved one with: • Driver Companions • Live-In/Drop-In Companions • Overnight Companions

• Hospital Bedside Companions • Handypersons • House Cleaners

seniorsforseniors.ca • 1.844.422.7399

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Profile for Willow Publishing

West Park Healthcare Centre Patient Handbook  

West Park Healthcare Centre Patient Handbook, Toronto, Ontario

West Park Healthcare Centre Patient Handbook  

West Park Healthcare Centre Patient Handbook, Toronto, Ontario