2010, June - Hospital News

Hospital News, September 2007

Oncology • Medical Imaging • PaediatricsApproaches to cancer treatment, diagnosis and prevention.

A look at medical imaging techniques for diagnosis, treatment and prevention of diseases. Paediatric programs and developments in the treatment of

paediatric disorders including autism.

• Natural Path ��13

• Nursing Pulse ��17

• CEO Column ��21

• Careers ��27

More Features

• Early detection lung study gives participant a new perspective

• New imaging technology catches cancer earlier

• Reducing Tunnel Vision

• and more

Canada’s Health-Care Newspaper

June 2010 Volume 23, Issue 6

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Imaging advances in Parkinson’s disease

By avril Roberts

Imaging in Parkinson’s dis-ease diagnosis has been used primarily to rule out conditions that might mimic Parkinson’s. The traditional thinking is that the Parkinson’s brain appears normal in MRI scans.

However, scientists at the University of British Columbia (UBC) MRI Research Centre in Vancouver are challenging this

view. They are using MRI in a novel way to reveal changes in the Parkinson’s brain that are not detected in conventional scans. Research funded by

Parkinson Society Canada is pointing to the possibility of an imaging-based diagnostic tool for Parkinson’s disease, improved guidance for deep brain stimulation surgery, and new ways to measure the pro-gression of Parkinson’s disease

in the brain.Dr. Alexander Rauscher, a

physicist and research associ-ate at the UBC MRI Research Centre, has developed and vali-dated a new imaging technique that is extremely sensitive to iron, more accurate at assessing iron content, and yields better and sharper images of the brain and veins than can be obtained with conventional MRI scans. This new technique is called

susceptibility weighted imaging (SWI) with multiple echoes.

Excessive iron in the brain has been linked to the death of dopamine-producing brain cells in Parkinson’s disease. With his multi echo SWI method, Rauscher has already found a good correlation between overall iron content in the substantia nigra, which is the area of the brain affected in Parkinson’s disease, and dis-

ease severity, as measured by the Unified Parkinson’s Disease Rating Scale (UPDRS).

“Using MRI to detect elevat-ed iron content in the substantia nigra, or other brain regions, would provide a new measure-ment that could lead to earlier diagnosis of Parkinson’s,” says Rauscher. His novel MRI tech-nique has potential for wide-spread use particularly in other neurological diseases where iron accumulation plays a role.

Rauscher’s research on susceptibility weighted imag-ing with multiple echoes, was published in the Journal of Magnetic Resonance Imaging in January 2010. The study was

Dr. Alexander Rauscher, a physicist and research associate at the UBC MRI Research Centre, developed a new technique to gain better scans for Parkinson’s patients.

Continues on page 15

HRRH Paediatric Asthma Clinic

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Taking care of the children

14

Hospital News, June 2010

Newswww.hospitalnews.com

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By andrea Hanft

At The Hospital for Sick Children (SickKids), a chance meeting

between an oncologist and a geneticist produced a valuable discovery within paediatric oncology. The researchers came to the conclusion that the genome of some children genetically at risk of develop-ing cancer is strikingly abnor-mal. In 2008, evaluation of the impact of an innovative clinical surveillance protocol for early cancer detection was initiated as a result of this meeting. If a brief conversation between two researchers in a hallway can yield discoveries in paedi-atric oncology, an entire build-ing dedicated to collaborative research will hopefully generate significant breakthroughs in child health.

On May 4, SickKids cel-ebrated the groundbreaking for its new Research & Learning Tower, which is designed to facilitate these types of collabo-rations.

“Our Vision: Healthier Children. A Better World, inspires us to build on our research and education excel-lence,” said Mary Jo Haddad, SickKids President and CEO. “This Tower is about con-necting the work in the lab to caring for children being treated at bedside.”

The 21-storey, 750,000 square-foot facility to be built at Bay and Elm Streets is designed by Diamond and Schmitt Architects Inc., in partnership with HDR Inc. The building will bring together 2,000 SickKids research-ers from SickKids Research Institute who are currently spread across six different locations. Scheduled to open in 2013, the Tower will unite researchers as they work to improve child health through prevention, better cures and early detection of childhood

disease. The researchers will work in neighbourhoods designed to encourage interac-tion and collaboration. Joined by connective staircases and unique meeting rooms, the neighbourhoods will provide

new opportunities for interdisci-plinary collaboration.

The Tower will cost $400 million to construct. SickKids raised $200 million through long-term borrowing against which the Foundation has made

fundraising commitments to the Tower’s construction and operation.

“Over the years there have been many philanthropic lead-ers at the Hospital,” said Ted Garrard, President and CEO of

SickKids Foundation. “Their support and the support of tens of thousands of donors who support SickKids today remind us of the role that the commu-nity and philanthropy play to sustain and advance this great institution.”

SickKids has received a $91-million grant from the Canada Foundation for Innovation through its Research Hospital Fund’s Large-Scale Institutional Endeavours. The vast majority of the grant, $75 million, will support the con-struction of the Tower and the remaining $16 million will go towards the purchase of special-ized equipment. This invest-ment is an endorsement by the Government of Canada of the crucial research conducted at SickKids.

In an effort to provide a sus-tainable and healthy environ-ment, the Research & Learning Tower is designed to LEED® Gold Certification, the second-highest level of the rigorous qualifications developed by the Canadian and U.S. Green Building Council.

At the groundbreaking, a “Wishing Wall” was avail-able for patients, families and researchers to post their thoughts on what discovery means to them.

Brandon Gibson, who was diagnosed with cystic fibrosis at the age of four, knows the importance of research and dis-covery. At the Tower’s ground-breaking, Brandon wrote, “New discoveries in treatments have enabled me to be standing here today as a proud double-lung transplant recipient with hope that one day CF will stand for ‘cure found’.”

Andrea Hanft is a media relations intern at The Hospital for Sick Children.

SickKids breaks ground with new Research & Learning Tower

Glass walls lining the three-storey lobby and main staircase will allow those travelling along Bay and Elm Streets to sneak a peek at SickKids researchers at work.


In Briefwww.hospitalnews.com

3Caregivers can reduce pain in premature babies simply by choosing less-painful urine test

Premature babies in neonatal intensive care units (NICU) undergo many tests and pro-cedures that sometimes cause significant pain. New research led by The Hospital for Sick Children (SickKids) shows that health-care providers can reduce pain by 40 per cent, simply by selecting one type of urine test over another. The less-painful procedure also has a higher suc-cess rate. The research is pub-lished in the May 17 advance online edition of Pediatrics.

The research team, which also included scientists from Mount Sinai Hospital and the Leslie Dan Faculty of Pharmacy at the University of Toronto, studied 48 preterm infants who required microbiologic urine analysis to rule out infection.

Samples were obtained by one of two commonly per-formed techniques: suprapubic aspiration, which involves inserting a needle through the abdomen and into the bladder, and urine catheterization, which is conducted by running a plas-tic tube, or catheter, through the urethra and into the bladder. Both procedures are considered to be effective and are often used interchangeably.

The researchers found that suprapubic aspiration was sig-nificantly more painful than urine catheterization. The technique also tended to have a higher rate of procedure failure.

Suprapubic aspiration can only be performed by a physi-cian and many have considered it to be the gold standard due to a lower risk of sample contami-nation. Urine catheterization can be performed by either a doctor or a nurse.

While there have been previ-ous studies on the success and side-effects related to these two techniques, this is the first study to assess the pain responses of premature infants undergoing these procedures.

Pain management has been proven to play a vital role in the care of neonates. Other stud-ies have shown that repeated exposure to painful procedures is related to increased sensitiv-ity to pain, as well as changes in behaviour and neurodevelop-ment.

“Pain is important,” says Dr. Taddio, who is also Associate Professor of Pharmacy at the University of Toronto. “Health-care providers wouldn’t make these babies suffer unnecessar-ily. Now they have another fac-tor to consider when choosing between these two procedures.”

Millions of Canadians suffer needlessly with hearing loss

Research from the Hearing

Foundation of Canada reports that out of three million Canadians who have hearing loss, only one-in-six wear hear-ing aids. This leaves more than 80 per cent of hearing impaired Canadians straining to hear the conversation.

As the fastest growing and third most prevalent chronic health problem among elderly Canadians, hearing loss affects 10 per cent of all Canadians, of which 25 per cent are over the age of 45, and 50 per cent are over the age of 65. For most people, hearing loss progresses slowly over many years, and it often deteriorates so gradually that family members, friends and co-workers notice a hearing loss before the individual does.

According to Kate Dekok, Chief Audiologist of ListenUP! Canada, “Many Canadians affected by hearing loss are simply unaware, or they choose to downplay the impact it has on their lives.”

Numerous studies have shown that hearing loss can lead to anxiety, frustration, depres-sion and withdrawal from social activities. But at ListenUP! Canada, a hearing assessment takes just 15 to 30 minutes and there is no cost or obligation to clients.

“As hearing healthcare experts, we regularly discuss with our clients the impor-tance of regular check-ups,” says Dekok. “By ensuring they receive an annual hearing assessment, and seek treatment if necessary, it’s easy to avoid the negative effects of hearing loss, and they’re one step closer to experiencing a better quality of life.”

For more information or to schedule a no cost hear-ing test, please visit www.ListenUPcanada.com

Low brain serotonin transporter levels in ecstasy users

Levels of the serotonin transporter are low in the brains of users of ecstasy, according to a US National Institute of Drug Abuse-funded study by Toronto’s Centre for Addiction and Mental Health (CAMH) and The Hospital for Sick Children (SickKids) published recently in the journal Brain.Ecstasy (mdma) is a stimulant drug widely used recreationally that is also being tested in clini-cal trials for the treatment of post-traumatic stress disorder.

Led by Dr. Stephen Kish at CAMH, this study provides confirmation of a previous finding from Johns Hopkins University that levels of the serotonin transporter (SERT) are low in cerebral cortex of chronic ecstasy users. The subjects were “typical” ecstasy users who used about two tab-lets of the drug twice a month.

SERT is a protein respon-

sible for regulating levels of serotonin, a neurotransmitter important for mood and impulse control. Ecstasy interacts with SERT to cause the release of serotonin, an action that proba-bly explains some of the behav-ioral effects of the drug such as increased sociability.

Scientists have long sus-pected that ecstasy might harm brain cells that use serotonin, but 12 years of brain scan stud-ies have produced contradictory results, even within the same laboratory.

The CAMH study used a large subject size (49 drug users, 50 control subjects), confirmed by hair analysis that ecstasy users actually used the drug, and used an imaging probe that could measure SERT throughout the brain.

Drug hair analysis indicated that many ecstasy users, prob-ably unknowingly, also used methamphetamine, which might itself damage serotonin cells; however, low SERT was found both in ecstasy users who used and who did not use metham-phetamine. Dr. Jason Lerch at SickKids showed that those ecstasy users who also used methamphetamine had a slight-ly thinner cerebral cortex.

RNs respond to health-care cuts

Registered nurses from Peterborough Regional Health Centre, members of the Ontario Nurses’ Association (ONA), recently spoke with Peterborough residents and pro-vided fact sheets about cuts to beds and RNs.

PRHC recently underwent a peer review that recommended cutting 121 full-time registered nurses, closing 71 beds and making cuts to all areas of the hospital to balance the budget. PRHC plans to move alternate-level-of-care patients out of the hospital and into the community or nursing homes, yet there is a three-year wait list for spots in nursing homes in the com-munity and just two affordable retirement homes in the area - both of which have a two-year wait list for a bed.

Similarly, A Nursing Week event scheduled at Chatham-Kent Health Alliance was a subdued affair - 15 registered nurses were told that their posi-tions are being cut, just prior to a scheduled 11:30 barbeque lunch outside the hospital.

“Chatham-Kent’s mission statement is: Caring people, caring for people,” says Linda Haslam-Stroud, RN, President of the Ontario Nurses’ Association (ONA). “How iron-ic that Chatham-Kent decision-makers have chosen Nursing Week to deliver the news to our skilled and dedicated reg-istered nurses that they will no longer be able to care for their patients.”

Canadian Diabetes Association launches coast-to-coast movement to raise funds in support of people living with diabetes

The Canadian Diabetes Association recently launched their second annual Diabetes Summer Surge movement to help lead the fight against dia-betes across Canada.

Today, more than 3 million Canadians are living with dia-betes and a further 6 million Canadians have prediabetes. Each and every day, another 480 Canadians are diagnosed with the disease. This sum-mer alone, more than 43,000 Canadians will be diagnosed with diabetes and may see their life expectancy reduced by as much as 15 years.

The Diabetes Summer Surge is an opportunity for individu-als to take action in their com-munity by hosting a fundraising event (real or virtual), support-ing an existing event or making a personal donation all while spreading the word to friends and family.

“Last year, through the generous support of individu-als across Canada more than $600,000 was raised through the Diabetes Summer Surge,” says Anna Kennedy, Interim President & CEO, Canadian Diabetes Association.” We are excited to launch this move-ment again this year and look forward to hearing about the innovative and creative activi-ties taking place across Canada in support of those living with diabetes.”

Individuals have until August 15 to add the surge to their summer plans and the chance to win some great prizes. Get

started at diabetessummersurge.ca

The funds raised from the Diabetes Summer Surge will go towards supporting leading-edge research, services, and essential programs to help the millions of Canadians who are living with or affected by dia-betes.

5 Organizations Band Together

For the first time the Canadian Mental Health Association- Durham (CMHA – Durham), Canadian Cancer Society, Durham College - UOIT, Durham Region Health Department and the Heart and Stroke Foundation of Ontario formed a unique partnership working collaboratively to offer a whole health perspec-tive “Hope, Health and Humour Symposium ~ 2010” to the community of Durham. The first event of its kind, the event was held in the Durham Region with participants gathering at Durham College/UOIT for a mini-vacation for wellness. An exciting day for the general public consisting of a series of workshops to choose from on various health and wellness top-ics, displays, great information, refreshments, lunch, networking opportunities, generous partici-pant swag bags and prize draws. With opening Keynote Speaker Neil Crone, Canadian Actor, Writer, Comedian and Cancer Survivor providing an enthusi-astic ‘kick-off’ for the day and Closing Keynote Speaker Eli Bay, President of the Relaxation Response Institute for a won-derful ‘finishing touch’ to the Symposium sent participants off with a renewed look on their well-being and life.


Editorialwww.hospitalnews.com

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In this issue we focus on some of the many posi-tive stories in cancer care

and research. Exciting new advances in kidney cancer treatment offer hope for a criti-cal disease that is on the rise in Canada. A new imaging tech-nology currently being tested in several cancer centres may provide more accurate results for detecting breast cancer – the second leading cause of cancer death in women. Bringing can-cer care into the community, as illustrated by Scarborough Hospital’s Oncology Clinic and the Walker Family Cancer Centre in Niagara, will eliminate long commutes for patients and improve patient care. Centres of excellence, such as Sunnybrook’s Odette Cancer Centre, offer not only exceptional diagnostics and treatment, but a unified team approach that provides sup-portive care for individuals and their families – a critical part of the healing journey.

While these and other sto-ries continue to offer hope and encouragement, a report just released by the Canadian Cancer Society confirms that cancer is now the leading cause of death in the country. That fact is sobering on its own, but the report’s special focus on cancer and end-of-life care is particularly poignant.

Focusing on the reality that dying cancer patients need more support is a bold but nec-

essary message. “Right now, in Canada we have a patchwork approach to providing care at the end of life. This means that some cancer patients and their families are not getting the sup-port they need during a very difficult time,” says Heather Chappell, Director, Cancer Control Policy, Canadian Cancer Society. “Uniform, high-quality support for any person dying of cancer should be available no matter where they live.”

Most terminally ill people would prefer to die at home but more than 55 per cent of deaths occur in hospitals; community-based services are just not adequate or available in some areas.

The obstacles and chal-lenges that patients and their families encounter are numer-ous. In some cases palliative care services exist, but are not used because patients and their families are not aware of what’s available to them. It’s not a surprise that families caring for dying people experience sig-nificant psychological burdens, but the financial burdens are also astounding. It is estimated that a caregiver’s financial bur-den is about $1,000 a month, not including lost income due to time off work to provide care. That burden significantly compounds the stress already being experienced by families as they struggle to cope.

Palliative care is provided

when a patient’s health-care team determines that a cancer is unlikely to be cured. But determining this is a complex issue; health-care providers are not always able to determine when cancer treatment should focus on palliative needs rather than disease treatment. As a result, patients may not receive palliative care because of late enrolment or referral to a centre that focuses on the needs of the dying.

The report also has many recommendations. “Doing more research and better surveillance on care at the end of life is vital to our future efforts in this area,” says Dr. Eva Grunfeld, co-author of the report and researcher at the Ontario Institute for Cancer Research.

More specifically they rec-ommend that:

• Surveillance about end-of-life care be improved to help define the needs of people dying from caner and to allow better planning

• Definitions and methods of reporting end-of-life care be standardized so that surveil-lance data are more compa-rable across jurisdictions – this would allow researchers, policy makers and health-care plan-ners to more easily identify gaps in care

Shedding light on this dif-ficult subject is a necessary and important part of the cancer care continuum. The more knowledge and information available to health-care provid-ers, patients and their families, the more informed the deci-sions and options will be for end-of –life care.

While we need to celebrate the numerous advances on many fronts in tackling cancer, we also need to start taking end-of-life care out of the shad-ows. This is not an easy topic but the more we talk about it the better. One caregiver even went as far as to recommend that information on patient and caregiver support should be made available upfront, right in medical offices. It’s clear that there needs to be more discus-sion, research, education and resources directed towards this very important issue.

Julie AbelsohnActing [email protected]

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July 2010 Issue

Editorial: June 4Display Advertising: June 18Career Advertising: June 23Monthly Focus Cardiovascular Care/Respirology/Diabetes:Developments in the prevention and treatment of vascular disease including cardiac surgery, diagnostic and interventional procedures. Advances in treatment for various respiratory disorders including asthma, allergies. Prevention, treatment and longterm management of diabetes and other endocrine disorders.

August 2010 Issue

Editorial: July 5Display Advertising: July 16Career Advertising: July 21Monthly Focus Emergency Services Critical Care/Trauma Emergency

Preparedness:Emergency & trauma delivery systems & emergency preparedness issues facinghospitals. Advances in critical care medicine.

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55

Tomorrow’s doctors gain insight into other health professions

By Jennifer paige

Northern Ontario’s sparse population has inspired an innovative approach

to training tomorrow’s doctors that’s helping to break down professional barriers. As a result, students of the Northern Ontario School of Medicine (NOSM) are gaining valuable insights into the practices and expertise of a diverse range of health professionals, including chiropractors.

With an aim to promote interprofessional understanding and collaboration, NOSM, a partnership between Sudbury’s Laurentian and Thunder Bay’s Lakehead Universities, has spearheaded community-based learning opportunities for its students. As a practitioner in Manitoulin Island, chiroprac-tor Dr. Harald Simon recently welcomed two NOSM students into his clinic.

“The students didn’t approach me,” says Dr. Simon, explaining that he was original-ly approached to participate in the community-based learning program by an NOSM faculty member and physician at the local hospital. “I cross refer with the physicians at the local hospital here a lot, so they all know me.”

The students, Jaimi Truchon and Aeysha Butt, both 25, are in their second year of study at NOSM and say the experiences they’ve had in the community-based learning program have been valuable.

“I didn’t know what a chi-ropractor’s scope of practice was,” says Ms. Butt of her time spent in Dr. Simon’s clinic. “We were in on every patient visit. We observed and he described what he was doing.”

Ms. Truchon agrees. “It was very interesting to see what his approach was and how we was able to work with the joints and alleviate the pain the patient was having.”

The program at NOSM requires students to spend one day a week working with practitioners in the commu-nity, supported by broadband communication information technology. In addition to their experience in Dr. Simon’s chiropractic clinic, Ms. Butt has previously spent time in diabetic clinics and working with an occupational therapist, while Ms. Truchon has worked in a rehabilitation unit in a local hospital, as well as in a phar-macy and in a hospice.

“It’s part of our program to kind of get a broader picture,” says Ms. Butt.

“We’re also getting a better understanding of what other

health care practitioners do,” Ms. Truchon adds.

For his part, as a chiroprac-tor who’s been in practice for 25 years, Dr. Simon says the experience was also extremely valuable for him.

“It’s a great stimulus to one’s own thinking to have to explain what I do as a chi-ropractor to someone who’s coming at it from a different perspective,” he says. “The students were very enthusi-astic about what I was doing. They had good questions. They weren’t just there to get their sign-in sheets validated. They were very engaged.”

Asked whether they felt their time learning in the wider community would benefit them once they are practicing physicians, Ms. Butt and Ms. Truchon felt they had gained

insights they could apply for the benefit of their future patients.

“You can’t fix everything,” says Ms. Butt. “You can’t

help your patients in all ways. Besides referring to a specialist, you have to think of other ave-nues of referral. Chiropractic is one of those areas. It can defi-

nitely help physicians. We have to work interprofessionally. We have to know people we can go to for our patients so that they can get the best care.”

“I learned a lot,” says Ms. Truchon. “I now definitely have a better understanding of what’s involved — both from talking to Dr. Simon and from chatting briefly with the patients that day, I’ve learned what a dif-ference chiropractic has made in their life. I think it’s really important as physicians in the future that we have open minds. There may not be just one solu-tion. You should have aware-ness of the resources that are out there.”

Jennifer Paige is Manager, Communications and Marketing at the Ontario Chiropractic Association.

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By Margaret Goulding

It may have been a rainy morning but spirits were not dampened during the offi-

cial groundbreaking ceremony at the Centre for Addiction and Mental Health (CAMH) for the second phase of the landmark redevelopment project of its Queen Street site.

Those who attended on April 6th were treated to a peek at the future ‘urban village’ taking shape on the site that has housed a psychiatric facil-ity since 1850. The project advances a progressive, modern approach to working with those with mental illness and addic-tion, community integration and city-building in Toronto’s Queen Street West neighbour-hood. Being part of the commu-nity is part of the treatment.

Clients spoke emotionally about how the new environment will improve recovery to a large crowd which included clients, families, staff, neighbours, donors and politicians.

Upon completion of this phase local streets will extend through the 27-acre site. Pedestrian-friendly streetscapes will be home to three new

CAMH facilities and a non-CAMH building, right on Queen Street West (to be developed by Forum Verdiroc), with ground-level retail and much-needed affordable rental housing.

In the new CAMH gateway

building, the client-run Out of this World Café and its side-walk patio will add to the street life and create a neighbourhood atmosphere, and will share a new gymnasium and green spaces with the community.

The 60-bed Intergeneration

Wellness Centre (IWC) will place services for children and youth alongside those of its Geriatric Mental Health Program to maximize integra-tion and collaboration to benefit clients.

The IWC will feature Canada’s first dedicated beds for youth aged 14-18 who are contending with both mental health and addictions issues (concurrent disorders), along with day-treatment programs to help at-risk youth before they

require a hospital bed. Think of it as breaking new

ground on very old territory. It’s also history in the making as CAMH continues transform-ing lives.

Margaret Goulding is the external communications coordinator at the Centre for Addiction and Mental Health (CAMH).

By Catherine prowd

London Health Sciences’ (LHS) Southwest Ontario Regional Base

Hospital Program (SWORBHP) was recently awarded Organizational Accreditation by the Continuing Education Coordinating Board for

Emergency Medical Services (CECBEMS).

The Base Hospital program provides medical direction and medical control, Advanced Life

Support (ALS) certification and training, quality manage-ment, leadership, guidance and advice, in the provision of ambulance based pre-hospital

emergency health care. LHSC, as the lead regional base hos-pital, also functions in an advi-sory capacity to the Ministry of Health and Long Term Care on matters relating to ambulance based pre-hospital emergency care.

The program provides train-ing and education for over 1,100 paramedics across 11 counties in southwest Ontario.

“We are proud to say that LHSC is the only organization in Ontario to have received Organizational Accreditation for Continuing Education. This is an outstanding accom-plishment which speaks to the dedication and commitment of the Base Hospital staff,” said Neil Johnson, Integrated Vice President, Medicine Services. Adds Severo Rodriguez, Regional Program Manager, “Accreditation of the Regional Base Hospital speaks volumes for a program that was started in October 2008 and has already reached such a huge milestone. This is testimony of the value placed on leadership, communication and quality that is embodied in the program.” What does this mean and how will it affect the paramedics? The Regional Base Hospital

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Breaking ground at Toronto’s most life-changing address:Next phase of CAMH’s redevelopment project begins

Base Hospital Program receives Educational Accreditation

Green is the colourA new Parking and Utilities Building considerably reduces the environmental footprint by centralizing natural-gas heating and cooling for all of CAMH’s new facilities and eliminating surface parking. In fact it’s one of several ways this redevelopment is ‘green.’ CAMH is building the first hospital buildings in Ontario to meet LEED Gold environmental certification.

• New buildings will save nearly 33% of energy costs• Reduced greenhouse gas emissions equivalent to 220 fewer cars on the road• White roofs and a partial green roof• Underground bicycle racks and showers to encourage cycling• Public transportation will come into the site• Sustainable design – building design is flexible rather than purpose-built, to ensure adaptability to future needs • Pedestrian-friendly streetscapes and attention to landscaping and green spaces

Rainy weather forced the ground breaking indoors but it was happily improvised by (l-r): Angela Foot, client; Dante Larcade, Roseland Gallery owner and Chair, West Queen West BIA; Ana Lopes, CAMH Foundation Vice-Chair; Joe Pantalone, Deputy Mayor of Toronto; Dr. Catherine Zahn, CAMH President & CEO; the Hon. Brad Duguid, Ontario Minister of Energy and Infrastructure; Nick Carveth, client; and emcee Andy Barrie.

Continues on page 7


Focus: Oncology • Medical Imaging • Paediatricswww.hospitalnews.com

7

By Kymm azzeh and Diane Belanger Gardner

The Provincial Maternal Newborn Retinopathy of Prematurity (ROP)

Remote Screening Work Group – a Work Group of the Provincial Council for Maternal and Child Health (PCMCH), recommended that a pilot proj-ect be initiated to investigate the feasibility of Registered Nurses performing remote eye exam screening for ROP via telemedi-cine. The Project was initiated in December 2008 between the Hôpital Regional Sudbury Regional Hospital (HRSRH) and Toronto’s Hospital for Sick Children (SickKids) Ophthalmology Department and is funded by the Ministry of Health and Long-term Care.

Retinopathy of Prematurity is a disease specific to prema-ture babies. Retinopathy of prematurity is disruption of normal growth of blood ves-sels in the retina and if severe may progress to retinal detach-ment and blindness. Infants with a birth weight below 1500 grams or born at 30 weeks gestational age or less (North American Guidelines) are at risk of developing ROP. ROP screening facilitates detection of the disease in its earlier stages, can be treated and can prevent blindness.

Two NICU (advanced level II nursery) nurses were trained via videoconferencing during live exams under the guid-ance of an ophthalmologist. Telemedicine platforms, Retinal

camera (RetcamTM), two NICU/Pediatric nurses, a pediat-ric ophthalmologist, a very sup-portive group of Pediatricians (two of which were trained to take Retcam images) and two incredible multidisciplinary teams from both sites come together to provide remote screening for ROP (Retinopathy of Prematurity).

Two registered nurses at Hôpital Regional Sudbury Regional Hospital in Sudbury,Ontario in a regional level II nursery (remote site) trained to obtain digital images of the retina following standard-

ized protocol and scheduling criteria, for the purpose or ROP screening began their training by learning to use a digital wide angled retinal camera (Retcam) on a “trainer eye”, making a visit to SickKids to observe and taking a basic telemedicine tuto-rial. The “hands on” training occurred during imaging with real time interaction through a secure video connection via the Telehealth network between SickKids pediatric ophthalmolo-gist, Dr. Nasrin Tehrani and the Sudbury site. Images obtained were then uploaded to a secure file transfer program (SFTP)

and forwarded to be reviewed by the ophthalmologist at the reading center. A formal report is then faxed back to the remote site. According to ROP classifi-cation and criteria some infants may require weekly exams. Follow up with Dr. Tehrani at SickKids Eye Clinic is arranged once the infant is discharged.

Remote screenings for ROP utilizing telemedicine strate-gies can bring infants closer to their family’s home, help pre-vent inter-hospital transfers for these fragile neonates as well as continue to screen for develop-ment of ROP. The infants in our

series did not develop severe ROP requiring referral to a read-ing centre. Video connection between the two sites for real-time interaction allowed person-nel without previous imaging experience to acquire images with sufficient quality for appropriate assessment. Over the last 18 months, 32 infants have undergone screening for ROP. Fifty-five separate exami-nations were performed. No infant developed severe ROP to warrant referral to the reading centre, therefore avoiding 55 separate transfers (about 370 km one way) between the two sites. Two new remote sites are join-ing the project - Royal Victoria Hospital in Barrie and Grand River Hospital in Kitchener-Waterloo as well as one new reading site at Hamilton Health Sciences Centre, Hamilton.

Parent surveys revealed posi-tive feedback. “I was able to be closer to my other children. I know how hard travelling would be on my baby.” Remote tele-medicine screening has allowed infants and their families to return or remain closer to their communities, reduced travel, saved dollars for both the health care system and the infants’ family members.

Kymm Azzeh is a Nurse

Clinician, NICU Pediatrics at Hôpital Regional Sudbury Regional Hospital. Diane Belanger Gardner is Administrative Director of the Family and Child Program

“Here’s looking at you kid”Nurses use remote screening for Retinopathy of Prematurity

via Ontario Telemedicine Network

Base Hospital Program receives Educational Accreditation

Suzanne Lacroix RN, one of the two trained nurse examiners at HRSRH, uses the retinal camera as NICU nurse Wilma Delongchamp helps to hold the premature infant.

program completed a compre-hensive self-study and peer review process to verify that the program contains the infrastruc-ture, staff, medical direction, and leadership to ensure imple-mentation of quality continuing education designed to meet the needs of paramedics and Emergency Medical Services (EMS) providers. Further, the program’s commitment to qual-ity continuing education has transcended regional and pro-vincial standards achieving an international bench mark. The Organizational Accreditation process was developed by CECBEMS to recognize entities that conduct Emergency Medical Services continuing education programs and who are committed to plan-ning and implementing activi-

ties of a consistently high quali-ty. Organizational Accreditation allows accredited organizations to review and accredit courses planned in conjunction with co-sponsoring organizations. The Base Hospital pro-gram is committed to the ongo-ing development of educational activities that will help EMS providers, educators and admin-istrators maintain the compe-tency required to deliver high quality care and enhance their professional development.

Catherine Prowd is Operations & Logistics Team Leader at the Southwest Ontario Regional Base Hospital Program.

Continued from page 6

www.hospitalnews.comHospital News, June 2010


8

By Kim sopko

David Gray was 12 years old when he lit his first cigarette. Growing up

as the middle child in a family of six wasn’t easy. Times were tough and David went to work at a young age to help his mother pay the bills. For David, hard work and responsibility defined adulthood.

It was the 1960s and a cigarette was the insignia of the cool; David chose Export A.

His habit quickly grew to a pack a day and a lifestyle that revolved around cigarettes. A trip just about anywhere was bookended by a smoke.

Like most people of that time, David didn’t associate tobacco with danger. Many years would pass before it was identi-fied as a leading cause of lung cancer, heart disease and numer-ous chronic health conditions, dubbed the ‘silent killers’.

Now at age 54 – after decades of smoking – David decided it was time to take a small but important first step towards finding out just how much his lifelong habit has impacted his health.

“I was watching the news and I saw that they were looking for people in Hamilton to participate in a lung cancer screening study. I looked at my wife who has always been concerned about my health and she already had the phone in her hand just wait-ing for me to dial,” said David. “Although I was reluctant at first, I now know that making that call was the best decision

I’ve ever made.” The Pan-Canadian Early

Lung Cancer Detection Study, which was first launched in September 2008, is jointly funded through the Terry Fox Research Institute and the Canadian Partnership Against Cancer. The first of its kind, this unique study plans to involve 2,500 current and former smok-ers across seven Canadian health care centres. Among the centres chosen to participate was Hamilton Health Sciences’ Juravinski Cancer Centre (JCC).

“Being selected speaks to the calibre of our team here. This

is also good news for Hamilton as our rate of smoking is among the highest in our LHIN,” said Dr. John Goffin, Medical Oncologist and Principal Investigator of the study at the Juravinski Cancer Centre.

The goal of the study is to gather vital information required to develop better detection meth-ods, which could ultimately ben-efit patient outcomes. Current research studies suggest that five-year survival rates for lung cancer can drastically improve from the present 16 per cent to an astounding 77 per cent with the implementation of early detection and intervention tech-niques such as pre-screening tests.

David went through a series of tests for the study including blood work, diagnostic imaging and a bronchoscopy. He was for-tunate. A 42-year smoking habit had not turned into lung cancer.

But the tests did find some-thing shocking that has forced David to rethink his habit.

They discovered Coronary Artery Disease. This form of heart disease is commonly linked to smoking and is caused by the formation of blockages in the major arteries of the heart. If left untreated, it can lead to heart attack, stroke and even death.

David’s diagnosis came as a surprise. Although, incidents of clinical trials inadvertently detecting health issues unbe-knownst to the trial subject are much more common than what one might expect.

To date, the preliminary results of this pan-Canadian lung cancer study have been success-ful in identifying 29 cases of cancer, five of which were found

at Hamilton’s JCC. The study is also creating some optimism among researchers who are now beginning to discover that the early screening tests used to identify lung cancer may also prove to be effective in detecting other smoking and non-smoking related ailments.

Dr. John Goffin considers these unexpected results or ‘incidental findings’ to be an added success of the study. “We are beginning to notice that the screening tests conducted on study subjects have not only found early signs of treatable cancer but have also identified signs of cardiovascular dis-ease and respiratory conditions such as Chronic Obstructive Pulmonary Disease (COPD), some cases of which may be very serious.”

David was referred to the Hamilton General Hospital’s renowned Heart Investigation Unit for precautionary follow-up testing. It was here that expert cardiologists discovered that David not only had three coronary blockages but he had in fact already suffered from a previous heart attack, which left a significant amount of damaged tissue and impaired heart func-tion. Doctors then delivered the news that he was a candidate for triple bypass surgery, leaving David and his wife shocked.

“I’ve always been the kind of guy who thinks: ‘what doesn’t kill you will only make you stronger’,” he said through a slightly nervous laugh. “But learning I had a heart attack without even knowing it, now that was my wake-up call.”

David’s story, like most, doesn’t offer a fairy tale ending.

Today, 42 years after his first puff, David is just now starting to realize the implications of his lifelong habit. Despite his recent diagnosis of heart disease, David, much like many other long-term smokers, still finds himself grappling with thoughts that the damage has already been done or that it’s too hard, or even worse, too late to quit.

However, despite the chal-lenges of quitting smoking and the long road ahead, David is the first to admit that being diagnosed with heart disease was the first step in acknowl-edging the seriousness of his recently discovered health con-dition. “It was then that I knew it was time to make a change,” he said. This was a realization that would never have been pos-sible if it weren’t for a simple phone call to participate in the lung cancer screening study.

And while he hasn’t quit, he has cut back. That pack a day has been halved. He can now do things without thinking there has to be a smoke before and after.

Being part of the clinical trial gave David a new perspec-tive, and chance for change, something for which his wife, children and grandchildren are all thankful.

For information on the Pan-Canadian Early Lung Cancer Detection Study, please contact: 1-866-966-LUNG (5864).

Kim Sopko is a Public Relations & Communications Assistant at Hamilton Health Sciences.

Making the call: Early detection lung study gives participant a new perspective

The Juravinski Cancer Centre’s Pan-Canadian Early Lung Cancer Detection Study team from left to right: Dr. John Goffin, medical oncologist and principal investigator of the study at the JCC, David Gray, study participant, Elaine Moore, research coordinator and Kellie Kay, research assistant.

Statistics:• Smoking causes 80 to

95 per cent of lung cancers.

• Each year, lung can-cer kills 20,000 people in Canada and 1.2 million people worldwide. That is more than colorectal, breast and prostate cancers com-bined.

• On average, 450 Canadians will be diag-nosed with lung cancer every week.

• The risk of developing Coronary Artery Disease increases with the length and intensity of exposure to cigarette smoke.

• Smokers have a 70 per cent greater chance of dying from Coronary Heart Disease than non-smokers.

• Stopping smoking reduces the risk of smok-ing-related cardiovascular disease by approximately 50 per cent within one year.

Resources:Health Canada:

www.hc-sc.gc.ca



9

By lena Ghatage

Almost 23,000 women were diagnosed with breast cancer in Canada

last year. It is the second lead-ing cause of cancer death in women. Finding cancer at the earliest possible stage is impor-tant. It means a greater chance of surviving the disease.

Mammograms are an excel-lent way of detecting small tumours that cannot be felt in an examination by a physician. However, they work best for women who don’t have dense breast tissue. Where breast tis-sue is very dense, usually in younger women, small tumours can be hidden from view.

A new imaging technol-ogy is being tested to improve detection of small tumours in dense breast tissue and pro-vide new options in addition to mammography. GE Healthcare commercialized the technology, which uses an imaging device and a molecular probe tagged with a radioactive isotope to detect tumours. The probe tar-gets and lights up the tumours and makes them visible with the use of a special camera. The procedure involves an injection of the probe and a scan with the molecular breast imaging device. There is almost no pres-sure on the breast and it offers a more comfortable experience than mammography. It takes about 30 - 40 minutes to com-plete the imaging study.

Hamilton was selected as the first site in the world to receive a new prototype of this technology following an international competition. The city rose to the top of the list thanks to its expertise in clini-cal nuclear medicine, SPECT imaging, probe development and its ability to recruit breast cancer patients into clinical trials. The clinical trials pro-gram is headed by Dr. Mark Levine. Hamilton’s McMaster University is also home to the Centre for Probe Development and Commercialization (CPDC), a world-class facility for creating new probes and bringing them to market. Dr. John Valliant leads CPDC as

Scientific Director and CEO. He is developing new molecu-lar imaging pharmaceuticals (probes) that will help increase the effectiveness of the GE device.

“CPDC’s next generation of probes can work alongside of this technology to help detect very small tumours, determine tumour aggressiveness, identify the best treatment and measure treatment effectiveness,” says Dr. Valliant. “This could help save time, money and hopefully more lives.”

The Juravinski Cancer Centre and Henderson General Hospital, at Hamilton Health Sciences, are conducting a clini-cal trial to find out how well this imaging method works. The clinical trial under way is for women who are at high risk of developing breast cancer. The trial will look at the camera’s safety and acceptability to patients as well as its ability to detect cancer. A second trial will

follow and collect information from a larger group of patients. It will take two or three years before the technology is proven to be beneficial for patients.

“We are opening the door to new opportunities,” says Dr. Karen Gulenchyn, Chief of Nuclear Medicine at Hamilton Health Sciences. “It may help reduce the number of false-positive results in breast imag-ing because it will provide a clearer picture. This will spare women anxiety and unnecessary procedures. We also hope that new probes will provide more specific information about the tumours.”

Hamilton was also chosen by GE Healthcare because of the strong partnership that exists with Hamilton Health Sciences, McMaster University’s Oncology and Nuclear Medicine Programs, the CPDC and the Ontario Institute for Cancer Research (OICR).

The CPDC is one of the Centres of Excellence for Commercialization and Research funded by Industry Canada. It also received fund-ing from OICR, whose research is focused on prevention, early detection, diagnosis and treat-ment of cancer. OICR supports imaging programs that are conducting research into better ways of finding cancer at an earlier stage.

Lena Ghatage is a Communications Intern at the Ontario Institute for Cancer Research.

New imaging technology catches cancer earlier

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Zayouna-Hospital-News-May26-5sm.pdf 5/26/2010 5:35:59 PMA new technology could improve the detection of small tumours in dense breast tissue.

“We are opening the door to new opportunities”

Dr. Karen Gulenchyn, Chief of Nuclear

Medicine at Hamilton Health Sciences



10

By Sarah Quadri Magnotta

Toruna and Tanisha Deokaran are breath-ing easier these days.

They’re also doing it closer to home.

Thanks to the new Paediatric Asthma Clinic at Toronto’s Humber River Regional Hospital (HRRH), the Deokaran sisters are receiving specialized care for their asthma conditions and understanding how to man-age their disease effectively in their own backyard.

“Step by step, they’ve shown our family how to deal with our children’s asthma issues; it’s been very helpful,” said Bhagratty Deokaran, mother of Toruna and Tanisha. “We are also grateful that the clinic is close to home. It’s a wonderful thing Humber River is doing for the community.”

Bringing care to the com-munity is a priority at Humber River; it’s also a key compon-ent as HRRH plans for its new state-of-the-art hospital, set to open in 2014. The Asthma Clinic, which opened in January, is one of many examples of how Humber River is specifically addressing the needs of patients and families in their community.

“We have a very large ethnic and African-Canadian popula-tion in our area; and people from these groups have a very high incidence of asthma,” explained Dr. Narendra Singh, Humber River’s Chief of Paediatrics. “With the on-going support from our Senior Management team, we have been able to establish a clinic that meets the needs of

our unique demographic; pro-vides families with information about asthma; and helps parents and their children to understand the treatment of the disease. Educating these families is an important part of this program.”

Helping with that educa-tion is Philomena Dos Santos-Gokul – Registered Respiratory Therapist and Asthma Educator with the Asthma Society of Ontario – who works with Clinic patients and their families to teach children and their par-

ents how to manage and cope with the everyday realities of the disease.

“With asthma medication it’s not like taking a pill,” said Dos Santos-Gokul. “There are specific techniques required for using devices such as turbuhal-ers – which dispense medica-tions – that aren’t necessarily straightforward. Spending the time to educate these families and answer their questions is our priority.”

Through education and health promotion Dr. Singh and his team are working hard to improve the health of young asthma suffers in the HRRH community.

“We’re also hoping to decrease emergency room and hospital visits for these families, and empower children and fami-lies to manage their illness more efficiently,” said Singh.

That kind of help was received with open arms by the Deokaran family last December when three year-old Tanisha arrived at Humber River’s Emergency Department in acute respiratory distress. Her condi-tion was so bad that she almost required the help of a mechani-cal ventilator.

“Based on Tanisha’s present-ing symptoms, we diagnosed her with asthma and started the acute management of her dis-ease immediately,” said Singh. “When her condition signifi-cantly improved we sent her home; but, at the same time, we also referred her to our Asthma Clinic. We wanted to ensure the

Deokaran family would receive follow up care and information about Tanisha’s disease. She was one of our first patients at the Clinic.”

“We went from a very fright-ening experience and a state of ignorance to learning a lot about asthma,” explained Bhagratty Deokaran. “We also took Toruna, our 11 year-old daugh-ter, to see Dr. Singh; she’s had severe asthma since she was two years old. Thanks to Dr. Singh and the Asthma Clinic Team we now understand how to take control of the girls’ asthma attacks before they begin. It’s also helped me to manage my asthma. It feels good to be edu-cated and have a solution.”

Along with Dr. Singh, the Clinic is comprised of a team of HRRH specialists who work with patients and their families to provide assistance throughout the treatment process. A typ-ical visit to the Clinic includes an examination by a Paediatric Respirologist and an education session with Dos-Santos Gokul.

Many patients are also seen by the Clinic’s Paediatric Allergist and undergo pulmonary func-tion testing. All patients receive education related to their spe-cific asthma condition.

“Patients are referred to the Clinic by our Emergency Department and HRRH paedia-tricians,” said Singh. “Soon, due to overwhelming demand for these services, we will also be accepting referrals from fam-ily physicians in our area. The numbers have been incredible and the expansion of the Clinic is inevitable.”

Humber River’s Paediatric Asthma Clinic isn’t the first spe-cialized clinic to open its doors to Humber River’s youngest patients; and it won’t be the last. In 2009, the Hospital opened Neonatal and Paediatric Follow-Up Clinics which focus on the continuity of quality and safe care on an outpatient basis.

As for the future of paediatric care at Humber River, “there’s more to come,” announced Singh.

“As an organization that takes pride in delivering qual-ity and safe care to our patients, their families and our commun-ity, we will continue to develop programs to the best of our ability that reflect the illnesses of our catchment area and bring care closer to home for every-one.”

Sarah Quadri Magnotta is Senior Writer/Communications Specialist at Humber River Regional Hospital.

HRRH Paediatric Asthma Clinic: A wonderful thing for the community

Dr. Tania Samanta (right), HRRH Paediatric Respirologist, is happy to be helping young asthma suffers in the Humber River community.

That kind of help was received with open arms by the Deokaran family

last December when three year-old Tanisha

arrived at Humber River’s Emergency

Department in acute respiratory distress



11

Reducing Tunnel VisionBy Brittany Hughes

For Kim Barnes, the idea of getting inside a mag-netic resonance imaging

(MRI) machine was terrifying, something she thought she could never do. But when the computed tomography (CT) scan for her fibromyalgia came back inconclusive, her health-care team told her an MRI was necessary to confirm her diag-nosis.

“When I heard ‘MRI’ I thought, there’s no way,” says Barnes. “I was panic-stricken. I just kept thinking, they’ll never get me in there.”

Because Barnes suffers from severe claustrophobia, the thought of having to lie motion-less for over half an hour inside a tube smaller than a children’s play tunnel was unbearable. But when she was told by her rheumatologist that Women’s College Hospital had a machine that was not only wider, but also shorter (meaning her head would not be inside), getting the MRI scan suddenly did not seem like such an impossibility.

With the widest diameter opening, or bore, of any MRI machine in the Greater Toronto Area, and one of only a small number across Canada, the machine has enabled Women’s College Hospital to provide MRI scans to claustrophobic or obese patients who cannot fit in a traditional machine. With a diameter of 70 centimetres, the bore is approximately 15 per cent wider than traditional models. And the length is about half that of a standard machine. This means that if your legs need scanning, your head will be outside of the machine.

“We’ve had patients come from all over the province to be scanned in our MRI machine,” says Dr. Heidi Roberts, site director for medical imaging at Women’s College Hospital. “Some even from other prov-inces, because they could not fit or endure being in a traditional machine.”

Don’t be fooled by its size – the large bore does not compromise the quality of the scan. “The quality is identi-cal to that of a smaller-bore machine,” says Holly Tutin, MRI technologist at Women’s College Hospital. What’s more, other large-bore machines have a stronger magnet than the 1.5 tesla machine at Women’s College, which Tutin explains can be a problem for some. “It poses safety concerns for patients with certain types of implants. These patients wouldn’t be able to go through an MRI machine with a stronger magnetic field, whereas they are safe to use ours.”

What really sold the expe-

rience for Barnes, however, were the personal touches she received. “The time, atten-tion and privacy the technolo-gists were able to provide at Women’s College because it’s a smaller hospital, made all the difference in the world,” she says. “They talked me through every single noise, detail and step along the way.”

For those needing an MRI but who have severe claus-trophobia like Barnes, or are

unable to fit in a traditional machine, Women’s College Hospital offers an alternative. “We hear a lot of people say they couldn’t have tolerated the scan anywhere else,” says Tutin. “With our large-bore machine, we are able to offer these patients some relief.”

Brittany Hughes is a member of the Strategic Communications team at Women’s College Hospital.Dr. Heidi Roberts with Women’s College Hospital’s

large-bore MRI machine.

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12

By Ron Foster

The National Center on Shaken Baby Syndrome indicates that thousands

of children are injured or killed each year as a result of child abuse. One of the most com-mon causes for injury to an infant in the first two years of life is Shaken Baby Syndrome. Shaken Baby Syndrome is a term used to describe the con-stellation of signs and symp-toms resulting from violent shaking or shaking and impact-ing of the head of an infant or small child. The degree of brain damage depends on the degree and duration of the shaking and the forces involved in impact of the head.

In North America, as many as 1,200 to 2,000 children are shaken. Of these tiny victims, 25 per cent die as a result of their injuries and over 80% are left with some form of brain injury. Over 60 per cent of all child abuse occurs in infants under one year of age.

Windsor Regional Hospital and its Family Birthing Centre experience over 4,000 births annually. It introduced The Period of Purple Crying pro-gram in March of this year, described as a new way to understand a newborn’s crying. Through resources provided by the National Center on Shaken Baby Syndrome, an organiza-tion with 25 years of research experience, the program is now fully implemented where information is shared with new parents before they leave the

hospital with their newborn.As new parents will experi-

ence, it may seem that their baby cries more than other babies. However, at about two weeks of age, babies may start to cry more each week which is a normal, natural expression of life. During the second month, babies usually cry more than any other time and after two to three months, they begin to cry less; sometimes crying by the infant can last up to five months. It is a fact that babies can still be healthy and normal even if they cry five hours a day.

Dealing with constant cry-ing from an infant can be very

difficult and parents often do not realize just how frustrating it is until they are in a stressful situation. No one thinks they will shake their infant however research shows crying by an infant as the number one trigger leading parents or caregivers to violently shake or injure babies.

The American Academy of Paediatrics describes Shaken Baby Syndrome as “The act of shaking leading to shaken baby syndrome being so violent that the individuals observing it would recognize it as danger-ous and likely to kill the child. Shaken baby syndrome injuries are the result of violent trauma. The constellation of these inju-ries does not occur with short falls, seizures or as a conse-quence of vaccination. Shaking by itself may cause serious or fatal injuries.”

The most common injuries of Shaken Baby Syndrome are subdural hematoma (bleeding on the brain), celebral edema (massive brain swelling) or retinal hemorrhages (bleeding inside the eye). Most shaken baby cases include one or more of these injuries. In some cases, victims may also suf-fer skull fractures from head impact, rib fractures from intense squeezing pressure and/or long bone fractures in the arms and legs due to violent shaking. It should be noted that activities involving an infant or child such as tossing in the air, bouncing on the knee, place-ment in a swing or jogging with them does not cause the brain or eye injuries characteristic of Shaken Baby Syndrome.

Staff at Windsor Regional Hospital, now trained about the program share their experience by teaching new parents/care-

givers ways to comfort their crying newborn and important action steps when the crying is persistent and frustrating. The program also focuses on why shaking a baby is harm-ful through use of a simulated baby model along with shar-ing a video produced by the National Center on Shaken Baby Syndrome.

“Through funding, each family of a newborn is given a copy of the video and infor-mation package before they leave the hospital.” states Alissa Howe-Poisson, Clinical Practice Manager at Windsor Regional Hospital. “The pro-gram encourages parents to speak to other new parents about how important it is to understand consistent crying and why it is alright.”

The development of The Period of Purple Crying pro-

gram at Windsor Regional Hospital was supported by community partners such as Hotel Dieu Grace Hospital; Leamington District Memorial Hospital; London Health Science Centre; Windsor Essex Health Unit, Victoria Order of Nurses; University of Windsor School of Nursing; Midwives of Windsor and the Windsor Essex Children’s Aid Society.

For more information on The Period of Purple Crying and Shaken Baby Syndrome, go to www.purplecrying.info or www.dontshake.org.

Ron Foster is Vice President, Public Affairs, Communications and Philanthropy at Windsor Regional Hospital.

Windsor Regional Hospital Staff Shannon Woolcock, Cecile Cook, Alissa Howe-Poisson, and Debra Charron were part of a team who put together the Period of Purple Crying initiative.

Windsor Regional Hospital focuses on the issue of Shaken Baby Syndrome

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R - Resists soothing (Your baby may not stop crying

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L - Long Lasting (Crying can last as much as five hours

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13

By sana abdullah

Cancer is the number one cause of death in Canada. Its causes

and treatments are still being understood and examined by scientists and researchers, both conventional and naturopathic. But while there is much work to be done, substantial advances in medical care, combined with the holistic benefits of naturopathic medicine, have succeeded in improving the quality of life for many people diagnosed with cancer.

The adjunctive cancer care shift at the Robert Schad Naturopathic Clinic (RSNC) takes a whole-person, comple-mentary approach to adjunctive cancer care by using gentle, non-invasive naturopathic rem-edies to strengthen the body’s immune system and its innate ability to heal itself. These treat-ments work alongside the use of other cancer care medica-tions and pharmaceuticals to dramatically increase the overall health and wellbeing of cancer patients.

“The adjunctive cancer care shift offers physical, mental and emotional support for patients while they are undergoing conventional therapies such as surgery, chemotherapy and radiation,” says Jill Shainhouse, a naturopathic doctor (ND) and a board-certified naturopathic oncologist by the Oncology Association of Naturopathic Physicians.

Jill, a supervisor on the adjunctive cancer care shift, became an ND after witness-ing firsthand how complemen-tary medicine and adjunctive therapies can ease the suffering of patients with cancer and chronic disease. “In a perfect world, naturopathic oncologists would work alongside main-stream oncologists to ensure that patients get the best overall care,” she states.

The first adjunctive cancer care shift appointment involves reviewing one’s medical history and creating a treatment plan with an ND and a student intern. “At RSNC, we only use evi-dence-based therapies that have scientific research to support their use,” Jill explains. Types of therapies and supportive care can include:

• Diet and nutrient prescrip-tion, which are individualized for each patient

• Acupuncture to treat and decrease many common side effects of chemotherapy and radiation such as peripheral neu-ropathy, pain and nausea

• Intravenous (IV) nutrient therapies such as high doses of vitamin C

• Herbal medicine and nutra-ceuticals to treat adverse effects of conventional therapies or to

instill renewed balance within the body

• Psychological medicine, stress management techniques and individualized counseling

Naturopathic oncology dif-fers from conventional oncol-ogy, in that NDs apply the modalities of naturopathic medicine (such as lifestyle modifications, dietary changes and physical medicine) to man-age and help prevent cancer. Treatment at the adjunctive cancer care shift can result in

improved energy levels, a bal-anced immune system and better strategies for cancer prevention and health maintenance; in addi-tion, NDs are trained in modern medical therapies so they are able to assess a patient’s com-plete health profile – physical and emotional – before devising a treatment plan.

NDs also analyze and moni-tor any possible implications arising from herb/drug interac-tions. Because one appointment with an ND at RSNC typically

lasts from one hour to 90 min-utes, more time is dedicated to discussing the disease and treat-ment options with patients and their families. “A naturopathic oncologist sees a wide range of patients and concerns, from those preventing recurrence to palliative cases. A large part of what we do is to help treat the person as a whole and reduce any bothersome symptoms they might have.”

Ultimately, NDs strive to improve a patient’s overall qual-

ity of life by complementing the treatment of conventional cancer drugs, supporting physical and emotional wellbeing and creat-ing a healthy internal and exter-nal environment.

Visit www.rsnc.ca or call RSNC at (416) 498–9763 to learn more about the adjunctive cancer care shift.

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By Donna Danyluk

There is nothing more frightening than watch-ing helplessly while your

small child struggles to breathe. That’s exactly what happened to Sandy and Paul Iacobelli and they will never forget the expe-rience.

It was Christmas day when the two, both health-care profes-sionals, had to put their skills to the test. Their one-year-old son, Aiden, began to gasp for air in what was later diagnosed to be an asthma attack. “It was very scary. You almost forget what to do because all you know is that your baby is sick and can’t breathe,” says Sandy, a regis-tered nurse.

Aiden had been prescribed a puffer at a previous trip to Royal Victoria Hospital, so Sandy immediately adminis-tered it to him. “He was scared and too little to verbalize it, but I could see he was just look-ing at us as if to say, ‘help me I can’t breathe.’ It was terrify-ing.”

Sandy and Paul promptly jumped in the car and headed to RVH where the toddler’s condi-tion was brought under control. Once diagnosed with childhood asthma and armed with the correct medication, the couple then went in search of educa-tion and that’s when they were introduced to the staff of the Paediatric Asthma Clinic, one of RVH’s Paediatric Ambulatory Clinics. “The staff was fantastic and gave us lots of education which helped immensely,” says Sandy. “When it’s your

child you want as much infor-mation as possible to avoid any more trips to Emerg.”

Aiden, now three, has had only one more emergency visit to the hospital. Sandy believes that without the support of the Asthma Clinic the number of ER visits could have been much higher. Every three months Aiden has a checkup at the clin-ic where his oxygen levels are monitored and his parents meet with a respiratory therapist to go through his asthma manage-ment plan. “Having this clinic just alleviates my worries. It is a reassurance to parents, because the education component is so excellent that parents are more confident when their child does have an attack,” says Sandy.

That’s the kind of statement

Janice Woychyshyn loves to hear. “We are fortunate at RVH to be able to provide excellent care for children with asthma in our community. Effective childhood asthma management is hindered by several factors, most notably, lack of asthma education. These barriers increase hospitalizations, emer-gency department visits and impose a great burden on fami-lies caring for these children,” says Woychyshyn, respiratory therapist/respiratory educa-tor and coordinator for RVH’s Asthma Clinic. “Our goal is to reduce emergency room visits and hospitalizations for these children and increase quality of life. We want these children to be able to live an active life without symptoms, and their parents to be able to sleep at night.”

The Asthma Clinic is just one RVH program specifically created to meet the health-care needs of the children of Simcoe Muskoka. “Barrie has the fast-est-growing youth population in the county and RVH is com-mitted to providing exceptional care to this growing popula-tion,” says Karen Fleming, director, Women and Children’s Programs at RVH.

RVH’s current children’s services are continuously evolv-ing to meet the region’s unprec-edented demand through its Paediatric Ambulatory Clinics, the inpatient care unit, and the Children’s Development Services division. “We are renovating and improving our Paediatric Ambulatory Clinic space, thanks in large part to a financial gift from The Kiwanis Club of Barrie. Our new space will include several exam rooms with a spacious waiting room for families,” says Fleming.

Once the renovations are complete, the existing Paediatric Ambulatory Clinics will relo-cate from the fourth floor of the hospital down to the first floor; this relocation groups all the clinics together providing easier access for families who require the services. While the renova-tions will bring all the clinics together on one floor, Sandy Iacobelli is just glad the Asthma Clinic was already there for her family when they needed it.

“It’s nice to know they are monitoring our progress,” says Sandy. “The staff at the clinic has really helped us get our heads around all of this. Now that we know what to do and how to treat Aiden it’s not so scary anymore.”

Donna Danyluk is in the Corporate Communications department at Royal Victoria Hospital in Barrie.

Taking care of the children

Children’s Services at RVHA referral to the clinic can be obtained by a physician at a walk in clinic, Emergency Department or your family physician.

Paediatric Asthma ClinicPaediatric Weight Management ClinicPaediatric Diabetes ClinicRespiratory Syncytial Virus (RSV) Immunization ClinicPaediatric Mental Health ClinicPaediatric Conscious Sedation ClinicPaediatric Feeding and Swallowing ClinicNeonatal Follow-up ClinicDown Syndrome ClinicThe Simcoe County Preschool Speech and Language ProgramSimcoe Muskoka Parry Sound Infant Hearing ProgramSimcoe Muskoka Parry Sound Blind Low Vision Early Interven-tion ProgramOccupational Therapy – PreschoolPhysiotherapy – Infant OrthopedicAudiologyHearing Instrument Dispensing

Aiden Iacobelli, 3, goes over the use of his puffer with Janice Woychyshyn, respira-tory therapist/respiratory educator and coordinator for RVH’s Paediatric Asthma Clinic.

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By Deb Maskens

Five years ago, kidney cancer was in the shad-ows. A diagnosis of the

disease left few options for patients and the average surviv-al time was just 12 months. But through exciting new develop-ments in treating the disease, there is now a brighter outlook for people living with ki dney cancer in Canada. This is criti-cal for a disease that is on the rise in Canada.

These developments can be summed up in five words: sur-vival, support, understanding, research, and hope.

SurvivalOn average, patients with

kidney cancer are living years longer today than ever before. Kidney cancer has few signs and symptoms and is often diagnosed in the late and much more serious stages. Unfortunately, kidney cancer does not respond to convention-

al therapies such as chemother-apy or radiation, which makes the need for newer targeted treatments critically important. After 10 years of waiting, the introduction of four new tar-geted therapies in Canada in the past five years has significantly changed the lives of people with kidney cancer.

SupportLiving with cancer is not just

about the medication. Disease management often includes support, education and an inclu-sive community. Kidney Cancer Canada (KCC) was formed in 2007 to provide that level of support to Canadian kidney cancer patients. KCC (www.kidneycancercanada.ca) is now a registered charity with a strong presence across Canada.

UnderstandingIn 2009, KCC established

a Medical Advisory Board, comprised of cross-Canada experts from specialties includ-ing urology, medical oncology,

radiation oncology and nurs-ing. Their mission is to provide KCC with a dedicated group of medical practitioners focused on kidney cancer research, col-laboration, and best practices in patient care, creating a strong connection to build awareness for the disease among health-care professionals and patients alike.

ResearchKidney cancer research has

come a long way in a short period of time but there is still a long way to go. Increased research funding allows for the development of superior treatments, and more treatment options allow physicians to tai-lor their care more effectively, ultimately giving patients more time with loved ones.

However, a recent report from the Canadian Cancer Research Alliance shows kid-ney cancer is proportionally and significantly underfunded. Kidney cancer receives less

than 1.2 per cent of the $402.4 million invested in cancer research in Canada, even though it accounts for up to three per cent of new cancer cases. To continue on the path of achievement, more dedicated research funding is urgently needed.

HopeResearch advances have

already translated into longer survival, deeper understand-ing and greater support. Researchers and patients share a greater sense of hope than

ever before. Hope that research will continue to deliver break-throughs in treatment and hope that more Canadians with this rare cancer will have access to this new era of treatments and the hope they bring.

To learn more about kidney cancer or find out how you can help make a difference, visit www.kidneycancercanada.ca.

Deb Maskens is a writer for Kidney Cancer Canada.

Brighter future expected with new advances

in kidney cancer

Imaging advances in Parkinson’s disease

funded by Parkinson Society Canada.

As a direct result of this study, Rauscher and his col-leagues have found that the high resolution and high con-trast of SWI enables clear visualization of the subtha-lamic nucleus in MRI. “The subthalamic nucleus is a small structure in the brain and it is a target for deep brain stimulation which alleviates Parkinson’s disease symptoms in some people,” says Rauscher, “but it is difficult to identify in conventional MRI scans.” Reliable, direct targeting of the subthalamic nucleus with clear identification of shape and loca-tion could eliminate one step in DBS surgery and dramatically shorten the procedure which typically takes six to eight hours. A research paper on this was published in the Journal of Neuroradiology in 2009.

Rauscher presented his findings on iron and UPDRS rating at the joint annual meet-ing of the International Society for Magnetic Resonance in Medicine in Stockholm, Sweden, in May 2010.

In complementary research, Dr. Martin McKeown, a professor of medicine at the University of British Columbia and clinical direc-tor of the Pacific Parkinson’s

Research Centre, is working with Rauscher to see if iron is deposited in specific patterns in Parkinson’s disease, making the technique even more sensitive.

McKeown and colleagues are also using conventional MRI (collected at the same time as the SWI) and novel analysis methods to look for changes in the shape of brain structures in people with Parkinson’s disease. They are then exam-ining whether those shape changes correlate with specific Parkinson’s symptoms and dis-ease severity.

“If we can tell, from the change in shape of a part of the brain, whether a person will have more severe tremor, be more rigid, have worsen-ing memory and so on, this may allow us to predict how a person’s Parkinson’s disease will progress,” says McKeown. “One of the challenging things about Parkinson’s disease is that it varies tremendously from person to person. If we could target individuals who are at risk for specific symptoms, we could become more efficient and effective at offering them treatment.”

Avril Roberts is a Toronto-based health writer. reveraliving.com

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16

By Natalie Chung-sayers

“I still remember when I was first diagnosed. I knew immediately it was

going to impact my life,” says Ginny Merringer. “What if I died? Who would help my hus-band raise three, then school-aged boys? I wanted desper-ately to live, see my sons grow up and generally enjoy the life I was living. Although I had tremendous support from fam-ily and friends, at the time, all I wanted to do was talk to some-one who had been where I was going, that is, into treatment and a very uncertain future.”

“Cancer and cancer treat-ment impacts all aspects of the whole person –“one’s human-ness – one’s family, one’s emo-tions and psyche, one’s physical self”, says Dr. Margaret Fitch. “More individuals are living longer through cancer. We want to help them live better too.”

Dr. Margaret Fitch and Dr. Jeff Myers co-lead the newly established Patient and Family Support Program at Sunnybrook’s Odette Cancer Centre which aims to improve quality of life for patients and their loved ones by addressing their informational, emotional, psychological, physical, social and spiritual needs.

Dr. Fitch has the addi-tional role of head of Oncology Nursing and together with Dr. Myers, a palliative care physi-cian, they partner to provide leadership to this interprofes-sional group which includes social workers, registered dietitians, occupational thera-pists, physiotherapists, speech language pathologists, psy-chologists, a psychiatrist, a drug reimbursement specialist and administrative support staff.

“The professionals within our Program work alongside the oncology teams and focus on the needs of patients and care-givers that extend beyond treat-ing the cancer itself” says Jeff. “Given the academic mandate

of the Odette Cancer Centre, the Program’s research and education activities endeavor to inform our practice and serve to contribute to the educational experience of many health care professions’ trainees.”

“It is about having the right support available at the right time when the individual is ready,” says Margaret.

“When I was going through treatments,” says Nora Doran,”I had to learn to focus on ‘me’. I had always focused on work, my marriage, and other stuff, but I got to the point where I asked myself: what do I need to get through this? What kind of support would best fit me?”

Nora’s nurse, Anne, told her about the expertise of the professionals in the Program. “Though it felt a bit strange at first to ask for help about the how and why I was feeling a certain way, you realize these professionals have a different

perspective,” says Nora. “They can offer you ways to cope. No question was trivial and there wasn’t a question they couldn’t help you find an answer to.”

After being diagnosed with colorectal cancer and having been treated, Peter Duffy devel-oped liver cancer. His situation was serious and his medical and surgical oncologists felt he could benefit from a more unique but more risky treatment approach. “I was distraught. I didn’t understand -- and I need-ed help,” recalls Rita, Peter’s wife. Working closely with the nurses, Alva, a social worker within the Program, facilitated more meetings to help Peter and Rita better understand what would happen. “She also offered us help on how to deal with our families’ questions,” says Rita, “and how to deliver the information. She and the care team helped steer our way.”

During surgery Peter’s gall

bladder was removed to reduce the chance of cancer returning. It also meant he had to modify his diet. “Pauline [a registered dietitian within the Program], spoke to us about what I could and couldn’t eat and about substitutes, for example, for ice cream. It’s as if she knew I might be overwhelmed by the talk. She gave us brochures to take away so we could pick out things later.”

Clinicians within the Program also provide special-ized emotional support and expertise in pain and symptom management to help manage the physical experiences related to cancer and the side effects of treatment. “Our goal is to help individuals and their loved ones in a sensitive and compassion-ate way, to help maintain their quality of life,” says Jeff.

“In the case of Ginny and the need to talk to those who have been through the cancer jour-

ney,” says Margaret, “individu-als may choose to share with others getting treatment, or talk with our volunteers – many who are also cancer survivors. They ‘lend’ an ear to offer encourage-ment and support.” To ensure access to a range of community resources the Program part-ners with organizations such as Wellspring Cancer Support Centres.

For information about the Patient and Family Support Program at Sunnybrook’s Odette Cancer Centre, visit http://www.sunnybrook.ca/content/?page=Focus_OCC_Prog_PsycOnc.

Natalie Chung-Sayers is a Communications Advisor at Sunnybrook Health Sciences Centre.

The right support at the right time: The Patient and Family Support Program at Sunnybrook’s Odette Cancer Centre

offers a unified approach to meeting the needs of individuals and their families

The Neuroscience and Trauma Program of Hamilton Health Sciences will be presenting the 7th Annual 'Focus on Neuro Trauma' Conference on Thursday Sept. 16th 2010 at Winona Vine Estates.

This will be a dynamic program including a talk by Dr. Alison Fox-Robichaud on sepsis and the trauma patient, a back to basics look at the brain and spine, and a session on the relationship between risky behaviors and trauma.

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From left to right: Patient and Family Support Program co-leads, Dr. Jeff Myers and Dr. Margaret Fitch, Dr. Karen Fergus, a psychologist within the Program, Nora Doran, a cancer survivor, Holly Bradley of Wellspring Cancer Support Centres and Dr. Linda Rabeneck, chief, Sunnybrook’s Odette Cancer Centre.

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Nursing Pulsewww.hospitalnews.com

17www.hospitalnews.com

By stacey Hale

After 16 years as an emergency room nurse and six years

doing endoscopies, Tracey Corner found herself back in the classroom two years ago. This time, the registered nurse was learning to steer a 60 centimetre-long flexible tube with a small camera and light at the tip through a virtual reality simulator shaped like a person’s buttocks. Today, she’s using the camera on real people as an RN who’s qualified to per-form flexible sigmoidoscopy, a test that uses a soft, flexible tube inserted into the rectum to examine the lower third of the colon for polyps or cancer. The procedure takes 20 minutes and detects 60 per cent of cancers. It’s also considered safer than a colonoscopy.

Since Corner finished her education, she’s completed 500 procedures and has helped catch cancer in people who otherwise would have found the disease much later, when it’s harder to treat. The Hamilton Health Sciences RN spends a few days a week travelling to

local family doctors’ offices to educate people (those between the ages of 50 and 74) about the risk of contracting colorectal cancer and the benefits of pre-screening. The rest of her time is spent performing flexible sigmoidoscopy at McMaster University Medical Centre.

Corner is one of 11 nurses in Ontario to take on this cut-ting edge role that’s allowing RNs to use their knowledge and skills to open the door to care that can save lives. Her work is especially important because colorectal cancer is the second leading cause of death from cancer for both men and women. According to the Canadian Cancer Society, an estimated 8,100 people in Ontario were diagnosed with the disease last year, and about 3,300 will die from it, despite the fact that there is a 90 per cent chance colorectal cancer can be cured.

That’s why RN-preformed flexible sigmoidoscopy is one of many roles the Registered Nurses’ Association of Ontario (RNAO) is calling on politi-cians to provide more funding for. Ontario is the only prov-

ince using nurses to do flexible sigmoidoscopies alongside a province-wide program called Colon Cancer Check, which aims to raise awareness about the illness. Esther Green, Provincial Head, Nursing and Psychosocial Oncology at Cancer Care Ontario (CCO) says saving lives was in mind when the Ontario government and CCO introduced the role as a pilot project in 2006.

“When you look at the num-bers, the death rate was fairly high,” Green says. “Ontario needed to address some sig-nificant issues, one of which is around screening, to try and manage patients earlier and identify them earlier… and to improve the outcomes so that people are not dying, so that they are actually surviving their illness.”

Green says nurses are a good fit to do the procedure because the job is far more than a tech-nical function.

“(The role) requires the knowledge, skill and clinical judgment that an RN has in terms of patient assessment, clinical assessment, counsel-ling, and teaching,” she says.

Today, six Ontario hospitals are participating in the pilot. Nurses selected from each hospital receive advanced train-ing at the Michener Institute for Applied Health Sciences in Toronto. They study gastro-enterology nursing, pathology and the anatomy, physiology and anatomical markers of the bowel. Ingrid LeClaire, Program Manager at CCO for the flexible sigmoidoscopy pilot project, says much of the education also focuses on improving dexterity and hand-eye coordination, so RNs prac-tise guiding the camera through tiny holes in a box, and passing the tool from their right to left hand. She says manual agility and an ability to multi-task is important because the scope is inside the person and the nurse has to rely on a two dimension-al image that is being projected on a computer monitor. After completing the course, nurses complete clinical training with real patients before being evalu-ated by an independent physi-cian assessor.

Robin Wheeler says the training is intense. The RN at Hotel Dieu Hospital in

Kingston joined the program last fall when the Ministry of Health funded an expansion of the pilot. She hopes the project – along with the government’s public awareness campaign – will encourage people to be proactive about colon health. And she says she’s excited to be part of a program that taps into RNs’ skills to save lives.

“This (pilot) specifically rec-ognizes the skill level and the knowledge of RNs. It’s going to open a lot of doors,” she says.

Stacey Hale is edito-rial assistant at the Registered Nurses’ Association of Ontario (RNAO), the professional asso-ciation representing registered nurses wherever they practise in Ontario. Since 1925, RNAO has lobbied for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shap-ing the health-care system, and influenced decisions that affect nurses and the public they serve.

Navigating colon healthCutting edge role allows RNs to increase patient access to cancer screening



18

By Mary Jo Haddad and Dr. Charlotte Moore

In 2008, the mandate of Ontario’s Provincial Council for Children’s

Health (PCCH) (formed in 2006) was expanded by the Ontario Government to rec-ognize the continuum of care within the maternal, newborn, child and youth health-care sys-tem. With the expanded man-date, the PCCH transitioned to become the Provincial Council for Maternal and Child Health (PCMCH).

As part of the Ministry’s Health System Strategy, the Council’s overall goal is to support the development of a system of care that provides timely, equitable, accessible, high quality, evidence-based, family-centred care in an effi-cient and effective manner.

The scope of the PCMCH is secondary, tertiary and quater-nary services, delivered in both community and hospital set-tings and includes responding to the needs of disadvantaged communities across Ontario.

The Council has two distinct and formal roles:

• an expert advisory body responding to the needs of the Ministry of Health and Long-term Care (MoHLTC) and other Ministries on issues, priorities, and strategies for the mater-nal, newborn, child and youth health care system in Ontario.

• a resource to maternal, newborn, child and youth

health care in this province to support system improvement.

The Council fulfills this role by:

• Generating strategic advice for the MoHLTC and other Ministries through research and analysis, including input from expert panels, work groups, forums, and consultations with stakeholders as appropriate;

• Identifying and advising on evidence-based best practices in maternal, newborn, child and youth health care services;

• Addressing provincial alignment and coordination of planning for maternal, newborn, child and youth health care ser-vices in Ontario;

• Serving as a provincial

resource to support planning for health human resources in the maternal, newborn, child and youth health care system;

• Promoting innovations in the delivery of care across the health care continuum to improve the health and health care of mothers, newborns, children, youth and families;

• Supporting knowledge transfer to current and future maternal, newborn, child and youth health care professionals; and

• Interfacing with the region-al child health networks and other stakeholders as appropri-ate to facilitate the implementa-tion and adoption of approved initiatives.

The strength of the PCMCH rests in its collaborative work-ing model. By bringing togeth-er multi-disciplinary providers and working with existing networks, the Council’s work is grounded in frontline experi-ence and expertise, well tested best practices and consistent and credible evaluation. In effect, the PCMCH has been established not to “fix” a part of the system that isn’t working, but to strengthen one that is.

The Council is supported by a secretariat led by Marilyn Booth, Executive Director. The Council and its Maternal-Newborn and Child and Youth Advisory Committees, as well as numerous working groups, are comprised of frontline clini-cians, planners and executives from health-care organizations across the province.

Over the past 12 months the PCMCH has made remark-able progress in a number of areas including developing reports and recommendations on issues related to Access and Transportation and is currently working on issues related to Breastfeeding, Mother-Baby Dyad Care, Late Preterm Birth, as well as introducing a pilot project focusing on Retinopathy of Prematurity (ROP), a poten-tially devastating eye disorder affecting premature infants.

Another success is the devel-opment and implementation of Fetal Fibronectin guidelines which are now being used across the province. Use of the

guidelines has improved the uti-lization of and access to, high risk maternal beds, while help-ing to keep new moms-to-be as close to home as possible.

Fetal Fibronectin is a pro-tein that acts as a “glue” dur-ing pregnancy, attaching the amniotic sac to the lining of the uterus. The fetal fibronectin test is used to rule out preterm labour. If the Fetal Fibronectin test is positive, a health care provider may take steps to address premature labour. If the Fetal Fibronectin test is negative, mom can be assured that her pregnancy is likely to continue for at least another week or two, thereby avoiding the immediate need for a higher level of care which might have involved a transfer to another facility, often farther from home.

In the fall of 2009, the Council played a key role in assisting the Ministry of Health and Long-term Care with determining the appropriate allocation of 43 new neonatal bassinets across the province. These new neonatal beds will help to ensure that more moms and babies have access to this essential health care service, closer to home.

According to Andrew Williams, CEO of the Huron Perth Healthcare Alliance – a four hospital alliance in rural Southwestern Ontario which was allocated three of the bassi-nets, “the addition of three new neonatal bassinets at the Huron Perth Healthcare Alliance’s Stratford Site means we can provide more care, closer to home for new moms and their babies. It also allows us to strengthen the coordination of the overall maternal-newborn health system and enhances our specific role as a regional resource.”

The PCMCH looks for-ward to continuing to support Ontario’s vision for maternal-newborn, child and youth care through evidence-based policy development, the sharing of best practices and ongoing col-laboration with frontline pro-viders.

For more information visit us at www.pcmch.on.ca.

Mary Jo Haddad is Chair, Provincial Council for Maternal and Child Health and President and CEO of The Hospital for Sick Children. Dr. Charlotte Moore is Lead, Maternal, Child and Youth Strategy (Health System Strategy Division) for the Ontario Ministry of Health and Long-term Care.

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By Natalie Chung-sayers

“You are there as a con-stant,” says Sheila Williams who is in her

nineteenth year as an oncology nurse at Sunnybrook. “You develop a very close relation-ship with the family and the patient. For every individual who survives and is doing well, it is a triumph for all of us, and for the family. For every individual who passes away, theirs is a life lived – a life and a presence that forever holds meaning. For all of us on the units and in the clinics, these are lasting connections with the patient’s family.”

Oncology nurses support patients and their families at every step of the cancer jour-ney. They are professionals with specialized knowledge in oncology, delivering care with steadfast compassion and offer-ing solace and hope at challeng-ing times. When asked about their roles, oncology nurses of Sunnybrook’s Odette Cancer

Centre reflect on how patients and families continue to touch their lives. They reflect on the relationships they develop with them over the years or over a compressed period of months - often as members of an extend-ed family.

“Sometimes family mem-bers don’t return because of the memories, but they generally

call around the anniversary of the patient’s death. They always remember and appreciate the care and support their loved one received here,” says Sheila.

Other patients revisit the ward from time to time or send cards of appreciation. One individual writes: “To the staff: On this day – my one year anniversary – my heart is

overflowing…I am so thankful to have been able to receive my treatment among those profes-sionals who face such daunting circumstances daily with con-viction and balance it with love, laughter and grace.”

Oncology nurses are also educators and leaders provid-ing mentorship to early career nurses.

“I have only been on the unit for seven months but I have learned so much from my colleagues. Some days are very challenging,” says Safin Tharani, “but what sustains me is my goal to continue to have a positive impact on patients and their families.”

Tracyann Machado describes the journey of an oncology nurse as one of joy and sad-ness. Adds Sharon Greene, “Oncology nursing has given me and many of my colleagues the strength to accept the things that cannot be changed and the continuous courageous chal-lenge to change what we can, in the lives of our patients and

their families.”It is these connections and

meaning in their work that is reaffirmed by the appreciative words of patients and family members. A member of the community whose spouse was cared for on one of the Odette Cancer Centre’s three oncology in-patient wards, writes: “Most particularly, we would like to thank the many nurses who looked after [my spouse]. They are really the front lines of care who have to perform not only the daily medical management but the most demanding per-sonal tasks. Not enough words of appreciation can be made to all of you. Every specialized field of medicine has its own unique challenges, but the field of oncology must be one of the most professionally – and per-sonally – challenging of all.”

Natalie Chung-Sayers is a Communications Advisor at Sunnybrook Health Sciences Centre.

By william tyler tran

Approximately half of all cancer patients will likely receive radia-

tion as part of their treatment regimen. At the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto, radiation therapists are integral members of the health-care team and are responsible for

many aspects of patient care, treatment planning and radia-tion treatment administration.

Radiation therapists are university trained professionals who are members of a regula-tory college that governs their conduct and practice. They work closely with radiation oncologists who are physi-cian specialists in radiation medicine. These health-care

providers are at the forefront of emerging technologies that are being used to fight the battle against cancer. As the second largest com-prehensive cancer centre in Canada, Sunnybrook’s Odette Cancer Centre sees approximately 400 patients per day just for radiation treatments. The radiation program is one of the largest of its kind in North America and houses 13 treatment units (Linear Accelerators) to deliver radiation treatments to cancer patients.

More recently, image guided radiation therapy (IGRT) has been an exciting treatment approach in order for radiation therapists to pinpoint exactly where the treatment should be delivered according to the phy-sician’s prescription. This new technology is being used to guide treatment for many types of cancers including prostate, lung and cancers of the head and neck.

“Image guided radiation therapy is the next step to enhancing treatment efficacy through high-precision radio-therapy delivery,” says Lori Holden, Clinical Specialist Radiation Therapist at the Odette Cancer Centre. The on-board system allows the treat-ment machine to effectively take images around the patient and reconstruct these images into a three dimensional scan,

similar to what you would find in a CT scan. “Radiation Therapists can use these images and target the radia-tion dose precisely as intended by the radiation oncologist,” says Holden. These three dimensional images allow the Radiation Therapist to look at many different viewpoints on the patient. “This is a huge advantage over traditional two dimensional x-rays because we can visualize the internal anatomy more precisely.” In essence, this technology is allowing Radiation Therapists to capture the target volume within millimeters through enhanced imaging techniques. Studies continually pres-ent promising evidence that patients actually receive less radiation dose to the healthy surrounding tissue and more to the tumour bed. The great-est advantage to the patient is that the long-term and short-term side effects may be reduced because less healthy tissue is affected. As radia-tion side effects are a common occurrence with treatment, image guided radiation ther-apy can be quite a powerful approach in minimizing these effects. Patients don’t notice any difference to their treatment experience and the process take only approximately five addi-tional minutes.

Image guided radiation ther-apy is allowing practitioners to

define the treatment with great-er precision and reduce side effects. “The benefits to our patients are enormous,” says Sheila Robson, Manager and Head of the Radiation Therapy program at Odette Cancer Centre. Depending on the type of cancer, patients will likely receive image guided radiation therapy on a daily basis and it is slowly growing in popularity as an effective partnering tool to radiation therapy treatment delivery. A common question that patients ask about this technol-ogy is whether it can give diag-nostic results from the images acquired. Unfortunately, image guided radiation therapy pro-duces images only suitable for determining where the radiation will go in the body and is not meant for diagnostic workup or determining treatment prog-ress. These post treatment results are performed at the end of treatment through the patient’s physician specialist. Odette Cancer Centre at Sunnybrook Health Sciences Centre continues to expand its image guided radiation therapy program as it acquires more treatment machines with image guidance capabilities.

William Tyler Tran is a Radiation Therapist at Sunnybrook Health Sciences Centre.

A day in the life of an oncology nurse: Sunnybrook’s Odette Cancer Centre oncology nurses celebrate

the triumphs and rise to the challenges

Radiation therapists integral part of the team at the Odette Cancer Centre

A group of Sunnybrook’s oncology nurses at 7th Annual Oncology Nursing Day celebrations held in conjunction with the Canadian Association of Nurses in Oncology.


From the CEO’s Deskwww.hospitalnews.com

21

By Mary Jo Haddad

We hear a lot about quality – as a per-sonal trait, as a

distinguishing characteristic, as a degree of excellence. In health care when we talk about quality, we’re talking about safe, timely, effective, efficient, equitable, and patient-centred care. Quality encompasses the availability of care, the patient’s experience when receiving care and perhaps most impor-tantly, the outcome of the care received. In paediatric health care, quality is about enabling children to achieve their great-est potential, about communi-ties effectively promoting chil-dren’s health and well-being, and our society achieving these results with equality and with-out waste.

Across the country we’re developing a deeper under-standing of the nature of qual-ity in health care. We’ve seen evidence of the gap between what science demonstrates is effective and what the usual practice has been. We’re asking the question: How often does something happen, when, and how is it supposed to happen?

We know from experience in our own and other sectors that complex systems can perform better than they do. We can apply management strategies to improve processes and reduce harm. Hospitals are learning from high-reliability organiza-tions in other industries and adopting strategies such as pre-procedure checklists, which are similar to the pre-flight check-lists that are used in aviation.

We understand that errors in health care can be catastrophic, just as errors in sectors such as energy can have enormous consequences. The explosion resulting in the oil spill in the Gulf of Mexico has surpassed the damage done by the Exxon Valdez tragedy, posing a seri-ous threat to the livelihoods of those along the Gulf coast, to marine habitats, to beaches, wildlife and to human health. Among the lessons of SARS, which took the lives of 800 people around the world includ-ing 44 in Toronto, was that local officials who are the first to observe an infectious out-break and best poised to contain it, had the least resources avail-able to do it. The importance of clear communication and cooperation among all levels of government and among health-care providers was also a key learning.

Our policies on communica-tion are changing. Critical care response teams out of our CCU are always on call to respond to early hints that there may be

a problem. The teams can be called by any caregiver who senses that the patient may be deteriorating.

Quality data has never been more important; measurement plays a crucial role in identify-ing gaps and variations in care, in tracking success and commu-nicating to the public and each other how well (or how poorly) we’re doing.

Good data drives good decisions, and along with measurement comes transpar-ency. Openly sharing data with stakeholders and comparing our performance with others is key to future quality progress.

At SickKids we’re enhanc-ing our measurement tools and methods for taking action to strengthen our performance. We can point to dramatic success-

es—to programs that are mak-ing significant improvements. While it’s important to reflect on what contributed to these successes, we must also keep our eye on the goal: Healthier Children. A Better World.

We know that the overall performance of the health-care system for all citizens must continue to make dramatic strides forward. We must be able to confidently assure par-ents that their child will receive evidence-based care in a way that is consistent with family preferences and cultural val-ues. We want to deliver on our promise to families that their child will not be exposed to harm from medication errors or hospital-acquired infections, and that all of the important aspects of their care will be communicated across the insti-tutional boundaries of home, hospital, and school, accu-rately and on a timely basis. A valuable result of improved quality is that it can increase efficiency. Reducing the inci-dence of infection, for example, can shorten a patient’s stay and open up a bed for the next child.

What will it take to get us from here to there? Two criti-cal steps. The first is greater focus on the design of an ideal health-care system for all, including children and families, one that contributes to a larger system that better promotes and maintains health. We also need to look at transformational approaches such as integrated planning of health, education, social support and other ser-vices, and shared accountability across these systems. Such

designs to provide better care and better systems will reap a return on investment through societal gains.

We have made tremendous advances. We are minimizing error and improving quality. Despite improvements there is still more work to do. We haven’t solved medication safety or interpersonal commu-nications issues. We still have organizational structures that can inhibit those at the front line from speaking up when things don’t look right.

We need to see quality and patient safety as a science, gaining access to research fund-ing and ultimately to a deeper understanding of effective safety solutions. We must build on the foundation of data col-lected, shared, and compared to make necessary change hap-pen. As we continue to refine both measurement and quality improvement approaches, we must also define broader sys-tem changes that will lead to dramatically better outcomes, identify policies that promote the adoption of these changes, build coalitions, and seize opportunities that move these policies into practice.

High-quality health care matters for all children and all citizens. And because the foun-dation of health in adulthood and old age is laid during child-hood and adolescence, high-quality paediatric health care is important to us all.

Mary Jo Haddad is President and CEO of The Hospital for Sick Children (SickKids).

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22

By Cindy woods

It was only for a CT scan, but by the time 67-year old Nelda Lozinski got

home to Scarborough from her appointment at a downtown hospital, she was exhausted.“I had nothing to eat or drink since midnight, and the test was at 2 p.m. And I’m a diabetic on top of that,” Nelda explains as she waits to start her chemotherapy treatment at The Scarborough Hospital’s Oncology Clinic. “I was overly tired, and couldn’t unwind for hours.“But here at the Oncology Clinic, I’m only ten minutes away. If I can’t drive myself, my brother can take me. I’m so happy to get my treatment here. It’s convenient and the care is excellent.”

Nelda has been undergoing chemotherapy on and off at the Oncology Clinic at the General campus since November of 2006, when a colonoscopy at the Birchmount campus diagnosed she had cancer. “They found out I had stage 4 cancer on my colon, and it had spread to my liver,” Nelda says. “Dr. Patrick Yau performed the surgery on my colon, but couldn’t operate on my liver. I was treated very quickly; it was unbelievable. I didn’t have time to think or worry about it.”

Dr. Yau referred Nelda to the Oncology Clinic where an RN explained everything in detail about the chemotherapy treat-ments she was about to under-take to shrink the tumours. “Oh, there’s just no name for these people; they’re so great,” Nelda says of the staff at the Oncology Clinic. “They treat every person as if you’re the only one in the clinic – they give you that kind of attention. It’s just wonderful.”

Dr. Henry Krieger, Nelda’s oncologist, has practiced oncology since 1975 at The Scarborough Hospital. He referred her to The Toronto General for surgery on her liver once the chemo treatments had shrunk the tumours down to a size where they were operable.

“The surgeon downtown said a lot of the credit goes to Dr. Krieger that I’m still alive, that I responded so well to the chemo formula I receive at the Oncology Clinic,” says Nelda. “The care here is one-on-one, but at the bigger hospitals down-town, I don’t know if the word is ‘commercial,’ but I feel like I’m more of a number than a patient.”

That kind of personalized care that Nelda raves about is at the heart of what makes the Oncology Clinic such a vital service to the Scarborough com-munity. “Our oncology program

strives to ensure that wait times from time of diagnosis to time of treatment are well within acceptable targets,” explains Sari Greenwood, Patient Care Manager, Oncology and Palliative Care Services. “Urgent cases, like Nelda’s, are seen without delay.”

The Oncology Clinic com-prises a superb team of medical oncologists, specially trained oncology nurses, pharmacists, social workers, dieticians and volunteers. “The addition of two new medical oncologists (bring-ing the total number to five), and a soon-to-be on-site consultation clinic specifically for patients to be seen by a radiation oncolo-gist, provides greater capacity to serve our community,” Sari adds. Aside from Dr. Krieger, the other medical oncologists are: Drs. Richard Colwill, Afshan Rana, Jeff Rothenstein and Orit Freedman.

For Dr. Krieger, patients receiving cancer treatment close to home is a key to positive out-comes. “Generally, people with cancer who are getting treatment feel unwell, and the closer they are and the less travel they do, the easier it is for them,” Dr. Krieger explains. “We have a group of physicians who prac-tice evidence-based medicine, who are anxious to deliver the best quality of care, and who are caring about their patients.”

Dr. Krieger also points out the challenges of providing care in a culturally diverse communi-ty like Scarborough. “We serve a tremendous diversity of popula-tion where English is a second language to a large number of our patients,” he says. “It’s more challenging, but it also makes our Oncology Clinic unique.”

For Nelda, getting her cancer treatment at the Oncology Clinic is common sense. “I tell family

and friends that this is a wonder-ful hospital. I don’t understand why other people feel they have to leave town or the country to get treatment when we’ve got it all right here in Scarborough,” she says. “Thanks to the Oncology Clinic, I’m feeling on top of the world!”

Cindy Woods is a Communications Specialist at the Scarborough Hospital.

Scarborough Hospital’s Oncology Clinic improves patient care

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Charge Nurse Laura Lamkie prepares Nelda Lozinski for her chemotherapy treatment under the watchful eye of Medical Oncologist Dr. Henry Krieger.

Services provided by TSH’s Oncology Clinic

1. Medical consultations for new patients where the phy-sician reviews the case, and discusses treatment plan with the patient.

2. New patient assessment where a Registered Nurse provides chemo teaching, gen-eral information about what to expect.

3. Pharmacy counselling where all patients on chemo receive teaching and counsel-ling.

4. Social work assessment where patients may require assistance with adjustment counselling, and counselling around any issue related to coping with cancer, practical assistance with activities of daily living, referrals for home assistance, financial assistance.

5. Dietitian provides infor-mation for all new patients, such as tips to maintain opti-mal nutrition while on chemo.

6. Literature is provided to all patients on the disease, the treatment, the side effects, what their role is in safety and infection prevention.

7. Administering chemo treatments.

While colon cancer is highly treatable if caught early, it is

still currently the second lead-ing cause of cancer deaths in Canada. We can help change

that by encouraging our friends and family over age 50 to speak to their doctors about getting checked for colon cancer. Talk to your doctor, your family, your children, your partner and your

friends. Spread the word about getting checked.

The Canadian Partnership Against Cancer’s National Colorectal Cancer Screening Network recently launched a new awareness campaign devoted entirely to getting peo-ple talking about colon cancer screening. The first of its kind, the “colonversation” campaign includes an important new national web site – www.colon-versation.ca.

“Like going to the dentist or checking blood pressure, com-pleting a colon screening test at least every two years should be part of a regular health routine for Canadians over 50,” says Heather Bryant, vice-president of cancer control for the

Canadian Partnership Against Cancer. “We want Canadians to have ‘colonversations’ with their loved ones over 50, encouraging them to ask their doctors for a simple screening test that they can do at home. It may save a life.”

There are a number of tests – such as a stool test – that can check for signs of colon cancer before you have any symptoms. The stool test is a simple at-home test, which should take place every two years for people over 50. Studies show that screening with this test every two years reduced death from colorectal cancer by 16 per cent over a decade.

Visit colonversation.ca to learn how to start a life-saving

conversation about colon cancer screening with friends and loved ones. Learn why, where and how to get screened; make use of educational videos; and share the news through social media outlets like Twitter, YouTube and Facebook.

For more information on getting checked for colon can-cer go to www.colonversation.ca. Additional resources are available through the Canadian Cancer Society (accessed toll-free at 1-888-939-3333 or online at www.cancer.ca) or through the Colorectal Cancer Association of Canada (1-877-502-6566 or online at www.colorectal-cancer.ca.

This article was provided by News Canada (NC).



23

By liisa Morley

When it opens in 2013, the Walker Family Cancer Centre will

become the hub of a coordinated regional cancer treatment net-work for Niagara, meaning that 95 per cent of Niagara cancer patients will be able to receive their chemotherapy and radia-tion treatment in Niagara.

The Outpatient Oncology Clinic – established by Hotel Dieu Hospital and now oper-ated by Niagara Health System (NHS) – has provided chemo-therapy treatment, diagnostic procedures, education and follow-up care in Niagara for 25 years. However, cancer patients must travel to Hamilton or beyond for radiation treat-ment each year. The number of patients currently leaving the region for radiation treatment is estimated at 1,200.

In planning for the new cancer centre, which will have the capacity for four radiation treatment rooms, the NHS is working in partnership with the Juravinski Cancer Centre in Hamilton and Cancer Care Ontario, the provincial agency responsible for overseeing can-cer services.

Radiation therapy is often used to treat or cure cancer or it can be used to provide relief from symptoms in cancers that have spread to other parts of the body. Treatment is provided by linear accelerators (LINAC), powerful X-ray machines that produce ionizing radiation to direct radiation beams to the patient’s tumour from differ-ent angles in order to destroy tumour cells in its path.

“Essentially these are fancy X-ray machines such as the ones you might find in an X-ray department,” says Alan Rawlinson, Project Manager of Medical Physics for Cancer Care Ontario. “However, these are more powerful and capable of penetrating the body by using high-energy, or ionizing radia-tion beams in a finely-focused way. These beams are strong enough to damage or kill cancer cells and stop them from divid-ing and spreading.”

In a typical radiation session, the patient lies on the couch positioned under the LINAC which is capable of rotating in circles to allow the beam to be directed to the patient’s tumour region. The beam works by destroying tumour cells in its path.

“Because X-rays can do harm to healthy cells by destroying the cell’s ability to divide, we need to ensure the amount and direction of radiation is correct and minimized to the surround-

ing healthy tissue,” explains Rawlinson.

To do this, the NHS must comply with stringent national and international standards set by Canadian Nuclear Safety Commission (CNSC) to ensure staff and public safety.

“We must be careful that staff and visitors are not exposed to radiation as a consequence of using these machines. This is done by paying attention to design of the facility and by putting ongoing safe radiation safety measures in place.”

For example, the walls of the treatment rooms housing the LINACs are constructed out of concrete with thickness of up to five feet to contain the radiation.

“Our design also employs a doorless entrance maze system that interlocks allowing staff to get in and out of the room with-

out radiation escaping while the machine is on, without need for using heavy shielding. There are also safety systems built into the design of the room to prevent accidental radiation.”

The combined planning team has followed a rigorous process submitting the design of the shielded radiation facilities to the CNSC. This has resulted in the NHS receiving formal

approval this past December to construct the cancer centre as designed.

“Even though this step has been achieved we will still have to get final approval to test the machines, and then obtain a license to run the machines which means we’re able to guarantee that we use this facil-ity in complete safety,” assures Rawlinson.

The concrete forming the ground floor of the cancer cen-tre was complete by the end of March, with the specialized con-struction of the radiation treat-ment suites on schedule to start mid-April.

For more information on Niagara Health System’s new Health-Care Complex and Walker Family Cancer Centre please visit www.nhs.plenary-projects.com.

Liisa Morley is the commu-nications coordinator for the NHS Health-Care Complex and Walker Family Cancer Centre project.

Comprehensive cancer care coming to Niagara

The NHS recently recognized the legacy of the first 25 years of quality cancer care in Niagara at a Touched by Cancer open house. From left to right oncologists Dr. Michael Levesque; Dr. Martin Samosh; Dr. Brian Findlay; Dr. Philip Hughes and Dr. Janice Giesbrecht.

At approximately 67,000 square feet, the Walker Family Cancer Centre will occupy the fi rst and

second levels of a four-storey ambulatory care

building component of the health-care

complex.

Level one: Main entrance and public facilities, four radiation

therapy rooms, conference/education centre and

supportive care

Level two: Outpatient clinic, systemic oncology/chemotherapy, satellite pharmacy, clinical

trials and medical staff facilities



24

By Cindy woods

Losing a baby through miscarriage or stillbirth is a heart-wrenching

time for a mother and family. The Scarborough Hospital’s Perinatal Loss Program at the Birchmount campus helps ease the pain by honouring the baby’s existence with lasting mementos, grief counselling and even cremation/burial.

For 25 years, Chaplains and nursing staff at the Birchmount campus have worked with families who have experienced a loss. It’s a team effort where the Chaplains and nurses pro-vide emotional support as well as look after the post-mortem care of the baby, including preparations for cremation and burial.

(One in five pregnancies end in miscarriage – under 20 weeks gestation; and one in 100 pregnancies end in stillbirth – over 20 weeks gestation.)

In addition to offering emo-tional, spiritual and religious support pre-, during and post-delivery, the Chaplain will explain – when the time is right – the Perinatal Loss Program. If the parents opt for the program, once the baby is delivered, the Chaplain or nurse take the baby to be washed and then dressed in a gown, hat and blanket knitted by hospital volunteers. The baby is measured using a paper tape, and photographed. Handprints and footprints are

also taken. All of these materi-als are placed in a small box and presented to the parents.

The program helped Mehrnaz Eshaghi-Azad, who not only had two miscarriages at TSH, but is also a midwife here part-time. “As a midwife, I knew what I was going through physically. But emotionally, it was so difficult,” Mehrnaz says. “When they came and took my baby, dressed him and brought him to me, it made it real for me. It wasn’t like a shadow dream and it’s gone; I was able to touch and kiss my baby. I don’t think I would have been able to overcome the pressure without this program.

It was important to me that my baby be recognized as an indi-vidual.”

That sentiment is echoed by Deris Fillier, one of TSH’s Chaplains with the Salvation Army. “First and foremost, we treat the fetus as a baby – with dignity as you would in pro-viding post-mortem care for an adult,” Deris explains. “We have a lot of parents who have been neglected in their grief because, by and large, society doesn’t recognize a miscarriage as a loss or a grief process. This program is fantastic and, for

the most part, parents are very appreciative.”

The nurses’ role in the pro-gram is integral. RN Marlice Clarke, who has spent 32 years as a nurse in obstetrics, 22 of those at the Birchmount cam-pus, considers the Perinatal Loss Program a part of nursing. “It’s difficult to do; it’s always a sad situation, but you do your best to help the patient cope with her loss,” Marlice says. “You feel good knowing you have done your best to care for them.”

Over the years, Marlice has helped many parents cope with their loss, and understands why some nurses would be uncom-fortable participating in the program. “We recognize how important it is for the parents,” she says, recalling how her own mother never forgot the baby she lost 45 years ago at another hospital. “She had a full term stillborn, and the nurses just whisked the baby away; she wasn’t allowed to see the baby. About 30 years later, she wrote to the hospital for information because she was still thinking of her baby, wondering what happened. I think of how her life might have been different had she been given the opportu-nity to see her baby.”

After having the oppor-tunity to say goodbye to the baby along with receiving the mementos and grief counsel-ling, the parents are given three choices: they can take the baby to a funeral home; if miscar-ried, they can leave the baby at the hospital for disposal; or they can sign a release form allowing for cremation, burial and a graveside service at Highland Memorial Gardens. (Highland donates the plot and monument, but there is a charge for an engraved plaque.)

As for Mehrnaz, she opted for burial. Now a mother of one daughter, she’s a great sup-porter of the program. “I think it’s necessary, and I encourage parents who are going through this situation to take advantage of the program,” she adds.

The current Perinatal Loss Program at the General cam-pus, which has been in practice for 15 years and is limited to stillbirths, will be expanded to include miscarriages as well as establish a partnership between the nurses and the Chaplains.

Cindy Woods is a Communications Specialist at The Scarborough Hospital.

Perinatal Loss Program eases the pain of loss

Mehrnaz Eshaghi-Azad took advantage of The Scarborough Hospital’s Perinatal Loss Program when she miscarried twice. She says it was important that her babies be recog-nized as individuals.

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25

By Jessica Bouchard

Between large family gath-erings and maintaining flower and vegetable gardens at home, Mrs. Francesca Tancredi has always been independent and on the go.

However, her active lifestyle came to an abrupt stop when doctors discovered a tumour on the left side of her brain. In March 2010, Mrs. Tancredi had surgery at Sunnybrook Health Sciences Centre.

Although the tumour was successfully removed, the sur-gery left Mrs. Tancredi severely weak. Everyday tasks that used to come easily to her were dif-ficult. She realized that her biggest challenge had only just begun.

“I couldn’t move the right side of my body. I thought I would never walk again,” she says.

Despite her condition, Mrs. Tancredi was determined to be independent again. A few weeks after surgery, she was transferred to the unique oncology rehabilitation pro-gram at St. John’s Rehab Hospital in Toronto. Developed through a partnership between Sunnybrook Health Sciences Centre and St. John’s Rehab, the program involves intensive, inpatient rehab treatment that ensures patients can transition smoothly from acute care to rehabilitation.

Historically, cancer survivors were sent home immediately after their acute care. This left them with little support to cope with the physical and emotional issues resulting from cancer treatment, including the chang-es to their bodies, and feelings of fear, despair or anxiety. At St. John’s Rehab, patients who have undergone or are planning

for cancer surgery or cancer treatment work with a team of expert rehabilitation profes-sionals to develop a customized treatment plan. Active, spe-cialized rehab care is a key to rebuilding strength, endurance and hope to maximize people’s independence so that they can start rebuilding their lives.

“In the past, cancer care only involved chemotherapy, radia-tion and surgery,” says Barb Daly, RN, Team Coordinator of the oncology program at St. John’s Rehab. “Now, we can build up patients’ endurance so

they can get back to doing the things they want to do with an enhanced quality of life.”

For patients like Mrs. Tancredi, St. John’s Rehab focuses on the whole person – body, mind and spirit - to ensure maximum recovery. Individually customized treat-ment includes physiotherapy, occupational therapy, physia-try, social work, nursing care, speech-language pathology, nutrition, psychology, pharmacy and pastoral care.

Although Mrs. Tancredi’s mobility was extremely low

when she began her rehab, with the help of her highly skilled clinical team she was soon able to stand using a walker and a cane. In only three weeks, she took her first unassisted step. The determined 78-year-old grandmother of four never lost hope, but was surprised by her quick recovery.

“I can’t believe I’m already walking again,” she says.

Cancer Care Ontario (CCO) reports that there were an esti-mated 62,700 new cancer cases in 2007 - 1,600 more than the previous year. It is expected that the number of new cases will increase by two-thirds by 2020.

“The need for oncology sup-port is growing in our commu-nity,” says Mila Bishev, Patient Services Manager for oncology and neurology rehab. “And the program at St. John’s Rehab is growing in response to this need.”

Since the commencement of its pilot phase in late 2005, the number of patients admitted to the oncology rehabilitation pro-gram at St. John’s Rehab has steadily increased. In its first year, approximately 20 patients went through the program. As of March 2010, nearly 300 patients have successfully com-

pleted their oncology rehabilita-tion at St. John’s Rehab.

Often when patients arrive for rehabilitation, they focus on their illness. However, staff at St. John’s Rehab encour-age patients to concentrate on rebuilding their lives by direct-ing them to resources including the Canadian Cancer Society and Wellspring, a network of cancer support centres provid-ing education and coping skills. In addition, St. John’s Rehab is currently working on estab-lishing a support group to help patients, families and staff deal with the effects of cancer.

Due to the dedicated care she received at St. John’s Rehab and her strong faith, Mrs. Tancredi has maintained a positive outlook throughout her rehabilitation process. At one time, she wondered if she would ever regain her indepen-dence. Now, she looks forward to getting back to family visits, gardening and her parish.

On the day Mrs. Tancredi left Sunnybrook Health Sciences Centre for St. John’s Rehab, her surgeon presented her with a unique challenge: “He told me that he wanted to see me walking the next time we met,” she says.

Soon, she will be able to do just that.

Jessica Bouchard is a Communications Intern at St. John’s Rehab Hospital. To find out how we’re rebuilding people’s lives, visit www.stjohn-srehab.com.

The AsthmaToday Widget, a new, interactive virtual tool downloadable at no

charge from the Asthma Society of Canada’s website, will help people stay up-to-date on issues surrounding asthma and associated allergies and make informed decisions about their daily activities. The software is easy to download, easy to access and even easier to use.

The AsthmaToday Widget gives instant access from a computer or laptop, to the Air Quality Health Index (AQHI), available for a number of Canadian cities, local weather

forecast and relative humidity, as well as important updates from the Society on new pro-grams, educational materials, research and advocacy initia-tives.

Access to timely environ-mental and weather information can make a significant differ-ence for people with asthma, since high humidity levels and certain weather conditions can trigger an asthma attack or allergies.

“The potential for this kind of ‘app’ to reach people with asthma and associated allergies is promising” says Christine

Hampson, President and CEO of the Asthma Society of Canada. “Conveying infor-mation to people through a medium which is highly access-ible and delivered directly to them, will empower people to be actively informed on import-ant issues, and adjust their asthma management plans to better control their asthma or allergies.”

It only takes two simple steps to download the AsthmaToday Widget, plus the relevant postal code, to access local weather and relative humidity. The widget page is

well laid-out, clean and easy to read, even on small screens, and when it is minimized, the Society’s trade-mark blue butterfly logo appears.

“The AsthmaToday Widget is an easy way to stay in touch with the Society on pressing issues,” says Debbie Valentini, NAPA Executive Committee member, who has endured asthma all her life. “Because it is updated automatically whenever I access it on my computer, I always have the latest news. It also gives me the information I need to plan my outdoor activities appropriately.

This is going to help me live well with my asthma.”

Download the AsthmaToday Widget at www.asthma.ca/widg-et/ to determine factors and forecasts for increased asthma and allergy severity.

Submitted by Sabrina Panetta, project coordinator for the Asthma Society of Canada. For more information contact: [email protected]

Brain tumour survivor returns to life and the things that matter most

Simple desktop tool provides real time, local information for people with asthma

Francesca Tancredi learns to walk again at St. John’s Rehab Hospital. She’s recovering after a brain tumour that left her partially immobilized.

At St. John’s Rehab, patients who have undergone or are

planning for cancer surgery or cancer

treatment work with a team of expert

rehabilitation professionals to develop

a customized treatment plan.



26

By elizabeth McCarthy

Five Ontarians whose kind-ness, compassion and professionalism has made

life better for cancer survivors were honoured at Cancer Care Ontario’s fourth annual Human Touch Awards in Toronto in April.

“These are exemplary indi-viduals, whose caring nature and commitment to patients have surpassed expectations in their provision of exceptional care,” said Terrence Sullivan, President and CEO, Cancer Care Ontario. “While compas-sion is not easily measured, it is clear that our winners recognize the importance of caring for a patient’s emotional needs.”

The Human Touch Awards recognize those who have made a difference in patient lives through exceptional compas-sionate care. The Awards are open to all part-time or full-time health care providers, professionals, and volunteers in Ontario who provide direct patient care at either a regional cancer centre or as part of a

Regional Cancer Program.This year the Human Touch

Awards added a new, volunteer category for individuals who have demonstrated a commit-ment to cancer care through exceptional volunteer work that enhances the quality of life of

cancer patients. Strachan Bongard, a

Volunteer at Princess Margaret Hospital in Toronto, is the first winner in this category.

“The Human Touch Awards reflect our shared mission to enhance the quality of life of

people living with cancer,” said Rick Perciante, Acting CEO, Canadian Cancer Society, Ontario Division. “We are for-tunate that every day, dedicated health-care professionals and volunteers become partners in the cancer journey with patients,

going beyond the expected.”This year’s other Human

Touch Awards winners were: Linda Johnson, RN, CON(C), CINA, of Winchester District Memorial Hospital, Julie Garrett, RN, of the London Regional Cancer Program, Karen Simpson, RN, NP Extended Class, of Grand River Hospital, and Dr. Chris Lund, Palliative Care Physician, Wellington County, Waterloo Wellington.

The Human Touch Awards are jointly sponsored by Cancer Care Ontario – the provincial agency responsible for continu-ally improving cancer services and the Ontario government’s cancer advisor – and the Ontario Division of the Canadian Cancer Society. The awards are made possible in part by a donation from the RBC Foundation.

Information on the 2011 Human Touch Awards can be found at www.cancercare.on.ca.

Elizabeth McCarthy is Senior Advisor in Public Affairs at Cancer Care Ontario.

By Jennifer Knarr

An updated symptom management tool at Grand River Hospital’s

Grand River Regional Cancer Centre (GRRCC) is helping to improve patients’ quality of life and in some cases, provide faster

referrals to specialized services.GRRCC is celebrating the

successful launch of a symptom management tool called the Edmonton Symptom Assessment System (ESAS). Using touch-screen computer kiosks in the GRRCC, the ESAS asks ques-tions on nine cancer symptoms

that patients experience. Patients rate (on a scale of zero to 10) the severity of pain, fatigue, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath.

“Cancer treatment at GRRCC is about more than just medica-tion, surgery and radiation ther-apy, but focusing on the patient experience by taking symptom management very seriously and addressing not only physical symptoms, but a patient’s emo-tional and psychosocial well-being throughout their cancer journey,” Dr. Craig McFadyen, vice president of cancer servi-ces.

GRRCC volunteers help patients at their first visit to learn how to use the tool. 80 per cent of patients at GRRCC use the service, in part thanks to the efforts of front-line staff and volunteers to help patients feel comfortable with it.

“Through the ESAS process, my husband and my family were able to lovingly focus on and be held in acute awareness of his daily health during the final days of his time with us. Completing ESAS seemed to give Mark independence and a sense of autonomy, while navigating with his physical, emotional, intellec-tual, spiritual and social health

symptoms during his cancer journey. The ESAS process kept him in a vital and close partner-ship with his health-care team, which included our family,” said Alannah Bell, wife of patient Mark Bell.

“It’s wonderful to walk down the halls and see our volunteers talking with our patients to help them use the kiosks, and reduce some of the anxiety of their clinic visits. Our volunteers and staff exemplify team work and commitment to excellent patient care,” said Jane Hatton-Bauer, regional coordinator of support-ive care.

GRRCC is one of Ontario’s leading cancer centres, with among the fastest access to chemotherapy and radia-tion therapy, along with other advanced services. In the past seven years, GRRCC has pro-vided care to patients in over 170,000 visits. GRRCC works closely with hospitals and care providers across the Waterloo Region and Wellington County to provide a network of care ser-vices including prevention, early detection, treatment and pallia-tive care.

Jennifer Knarr is Marketing Coordinator at the Grand River Regional Cancer Centre.

Human Touch Awards honour Ontarians for making life better for cancer patients

Updated tool for cancer patients identifies symptoms earlier; helps clinicians provide customized care

left to right: Dr. Chris Lund, Karen Simpson, Julie Garrett and Strachan Bongard, (missing Linda Johnson)

Hospital volunteer Doris Johnston (left) helps patient Lois Manser navigate the touch-screen computer at the Grand River Regional Cancer Centre.

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www.hospitalnews.com Hospital News, June 2010

Careers 27DeaDline for July 2010 issue: June 23, 2010View career ads at www.hospitalnews.com

Committed to providing first-class clinical care,research, and prevention, the Centre for Addiction andMental Health (CAMH) is Canada's leading addiction and mental healthteaching hospital. A recognized Pan American Health Organization and WorldHealth Organization Collaborating Centre with an affiliation to the Universityof Toronto, we succeed in transforming the lives of people affected byaddiction and mental illness.

TransformingLives

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Manager, Inpatient &Day Treatment Programs

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You will manage a 10-bed inpatient unit (including three acute care beds), daytreatment program with 20 spaces, and consultation/liaison services for otherCAMH units. With a strong administrative focus, you will coordinate clinicalprogramming, schedule staff, supervise the interprofessional team, managehuman resources, and monitor and analyze budgetary and statistical data. As amember of the program leadership team, you will participate in the strategicplanning, growth, and development of a clinical teaching program, oversee theplanning and implementation of new approaches to community-basedassessment and treatment for people with complex needs, and, in collaborationwith the outpatient manager, act as an ambassador for the program. Within aprogram where clinical research and education are closely integrated withservice, you will benefit from a strong continuous learning mandate and besupported in your development with access to a certificate program in dualdiagnosis and leadership development programs.

An emerging leader seeking not just a management role but a career step that isa foundation to further opportunities in the field of administration, you have aminimum of five years’ management and/or supervisory experience, clinicalexpertise, and a commitment to diversity and client-centred care. A baccalaureatedegree in nursing is preferred. Candidates with other health care professionqualifications will be considered. You must be registered in good standing withthe appropriate regulatory college.

For a dynamic career applying the latest in scientific advances through integratedcompassionate clinical practice, health promotion, education, and research,please apply in writing, outlining your interest and qualifications and the namesand contact information of three references to:

Human Resources, Centre for Addiction and Mental Health1001 Queen Street West, Toronto, ON M6J 1H4

e-mail: [email protected] fax: (416) 583-4316

CAMH and the University of Toronto are strongly committed to diversity within their communities and especially welcome applications from visible minority group members, women, Aboriginal persons,

persons with disabilities, members of sexual minority groups, and others who may contribute to the furtherdiversification of ideas. All qualified persons are encouraged to apply; however, Canadian

and permanent residents of Canada will be given priority. Applications will be reviewed on a continuing basis until the position is filled.

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Program Chair

The Michener Institute provides innovative health care education in a variety of health science programs. Reporting to the Vice President Academic, the Program Chair is responsible for providing leadership to the program speci�c faculty, sta� and students, ensuring an e�ective learning environment for students, enhancement and development of programs in alignment with Michener’s strategic directions.

Quali�cations: management/ supervisory experience in an unionized educational/health care environment. Experience in Medical Laboratory Science would be an asset.

Quali�ed applicants should submit a detailed resume and cover letter noting posting #10-14FT by June 14, 2010 to:

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For more information, visit www.michener.ca

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To AdverTise in HospiTAl news ConTACT Denise HoDgson

Tel.: (416) [email protected]

Hospital News, June 2010www.hospitalnews.com

Bayshore Home Health is a Canadian-owned company that is a leader in home and community health services. We promote a culture based on respect, continuous learning and improvement, and valuing our employees’ individuality and contributions.

We are o�ering registered nurses the opportunity to experience the unique setting and culture of rural/northern communities across Canada. Short- and long-term nursing assignments are available to �t your lifestyle. We o�er excellent wages and bene�ts, bonuses, 24-hour administrative/clinical support and thorough orientation programs. Requirements include:

• Valid registration with the College of Nurses of Ontario (CNO)• Baccalaureate in Nursing (BScN) from a recognized university• Certification in Basic Trauma Life Support (BTLS/ITLS)• Minimum 2 years experience in acute care (ER, ICU, pediatrics)• Valid certification in CPR Level 2• Valid membership with the Registered Nurses’ Association of Ontario (RNAO)• Skills in venipuncture/phlebotomy and trauma stabilization• Strong assessment skills• Knowledge of Ontario Immunization Schedules

If you are interested in this opportunity or would like further information, please contact: Human Resources, Email: [email protected] (emails must state “RESUME” in Subject line). Bayshore is an equal opportunity employer and welcomes all applicants.

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Develop,provide &

support

We are currently accepting resumes for nursing positions in all Paediatric specialty units. For a complete listing, visit www.sickkids.ca.

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will receive full training and the opportunity to work with our experienced nursing staff while

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To apply: www.sykesassistance.comFor more information: Phone 1-877-671-8356

Sykes Assistance Services Corporation provides the very latest and most advanced customer communication, healthcare and employee wellness programs to over 100 private sector, public sector, and Fortune 500 companies.

2010, June - Hospital News

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