Hospital News May 2014 Edition

The determination

of deathand organ donation

INSIDEEthics ..................................................13

Data Pulse ..........................................14

From the CEO's desk ..........................15

Travel ................................................... 17

Careers ...............................................23

National Nursing Week Special Pull Out Section

Integrating iDevices with rehabilitation

N1 22

FOCUS IN THIS ISSUESURGICAL PROCEDURES/TRANSPLANTS/ORTHOPEDICS/REHAB:Non-invasive surgery, plastic surgery, orthopedic surgery and new surgical techniques.Organ donation and transplantation procedures. Advances in treatment of renal disease including home peritoneal dialysis, hemodialysis and renal transplantation. Rehabilitation techniques for a variety of injuries and diseases.MAY 2014 | VOLUME 27 ISSUE 5 | www.hospitalnews.com

Canada's Health Care Newspaper

A round of applauseTHANK YOU for ensuring access to the right careAs we celebrate Nursing Week, we recognize the efforts of our 3,500 Care Coordinators – Registered Nurses, Occupational Therapists, Physiotherapists, Registered Dietitians, Social Workers and Speech-Language Pathologists – and every other member of our team in meeting our clients’ needs. You work tirelessly to ensure that people get the right care – at home, at school and in the community. On behalf of the 637,000 Ontarians we serve each year, thank you! For more details, or to apply for a Care Coordinator or clinical care delivery role, visit ccacjobs.ca.Most Community Care Access Centres of Ontario are governed by the requirements of the French Language Services Act. We provide services in French and encourage applications from bilingual candidates.

We are committed to accommodating people with disabilities as part of our hiring process. If you have any special requirements during the recruitment process, please advise Human Resources.

THANK YOU for ensuring access to the right careTHANK YOU for ensuring access to the right careTHANK YOU for ensuring access to the right careTHANK YOU for ensuring access to the right careto our Care Coordinators and Registered Nurses

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CZ2-CRI-270_FIN_REV2.indd 1 2014-04-24 9:50 AM

By Dr. Sam Shemie

Recent coverage in the media on death determination and organ dona-tion has left some Canadians with the false impression that there is an un-clear understanding of death in this country. Inferences were made that donation and transplantation procedures occur before a donor has actu-ally died, and their family members are being misled to think otherwise. This is simply not true. Continued on page 18

HOSPITAL NEWS MAY 2014 www.hospitalnews.com

2 Focus SURGICAL PROCEDURES/TRANSPLANTS/ORTHOPEDICS/REHAB

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3 In Brief

provides safety guidance for diagnostic, cosmetic, preventative, and therapeutic applications, as well as requirements for

Nurse Practitioners The aim of the Nurse Practitioner,

Practice Integration Outcomes Study is to foster a greater understanding of the nurse practitioners' practices in Ontar-io that contribute to interprofessional collaboration among nurses, doctors,

and other providers for the purpose of providing high quality, timely and safe care to hospitalized patients and long term care residents.

The study revealed a number of im-portant findings. Nurse Practitioners in

acute and long term care facilities re-ported full engagement in interprofes-sional care, and said they could increase their activities of interdependence to enhance the provision of health servic-es to patients. The study further found that Nurse Practitioners are consistent, available, peacemakers who bridge pro-fessions and focus on patient care. One additional finding was that Nurse Prac-titioners use three forms of interact-ing which include: "brief knotworking" to build and share information, "rapid knotworking" to promote collabora-tion, negotiation and delegation and they are initiators of social interactions that build trust and foster professional relationships. nH

Aspirin before surgery ineffective

Kingston General Hospital (KGH) and Queen’s University researchers are part of a groundbreaking international study that has shown that starting – or continuing – to take Aspirin before non-cardiac surgery as a way to protect the heart after surgery is ineffective and, in some cases, harmful.

Because surgery puts patients at in-creased risk of heart attack, doctors often continue to administer low doses of Aspirin before and after non-cardiac procedures. But new data from the Peri-Operative Ischemic Evaluation Study (POISE-2), published in the New Eng-land Journal of Medicine, shows that ad-ministering Aspirin provided no ben-efit in reducing the risk of heart-related complications after surgery. Quick Facts about the study:• POISE-2 is a large, international, pla-cebo-controlled factorial trial.• Half of the participating patients were either started on Aspirin or received their usual daily Aspirin before their surgery, while the other half were given a placebo.• Researchers determined that 7 per cent of those in the Aspirin group had a heart attack or died within 30 days of surgery, compared to 7.1 per cent of those who received a placebo.• Meanwhile, more patients in the Aspi-rin group experienced significant bleed-ing (4.6 per cent) compared to the pla-cebo group (3.8 per cent).• Clonidine, a drug given to control heart rate and blood pressure, was also shown to be ineffective at reducing car-diovascular complications associated with surgery. This was the subject of a second article published in the same issue of the New England Journal of Medicine with contributions from the KGH team.• Up to 200 million people undergo ma-jor non-cardiac surgery each year, and 10 million of those experience a major heart-related complication.• The most common surgeries in the study were orthopedic procedures such as joint replacements. nH

New performance data reported by Tril-lium Gift of Life Network (TGLN) shows there are opportunities for both hospitals and Ontarians to play a role when it comes to increasing the number of lives saved through organ and tissue donation in On-tario. From April 1 to December 31, 2013, 42 designated hospitals in Ontario reported an average of 93 per cent of potential organ and tissue donation cases to TGLN. During the same period, only 52 per cent of poten-tial donation cases became organ donors, referred to as conversion rate.

"TGLN is committed to working closely with our hospital partners to improve dona-tion rates by helping them implement best practices and ensure timely referral of po-tential donation cases," says Ronnie Gavsie, President and CEO of TGLN. "TGLN is also working to increase consent to organ dona-tion by ensuring well trained TGLN staff ap-proach families to discuss donation." Focus is being placed on the Greater Toronto Area (GTA) as conversion rates at the majority of hospitals in this part of the province have historically been below average. Steps are being taken to improve performance of both hospitals and TGLN. These include:•Designating a physician at each hospital

to work with TGLN to ensure integration of donation best practices with end-of-life care, starting with GTA hospitals; •Implementation of a new referral process with CritiCall Ontario and Neurosurgery Ontario to ensure potential organ do-

nors are identified and referred in a timely manner; and, •Enhanced diversity training for TGLN staff to better meet the needs of Ontario families when discussing organ and tissue donation. nH

Barely half of potential organ donors become donors

create health care team cohesion

Strengthening clinical trials The Government of Canada an-

nounced the creation of the Canadian Clinical Trials Coordinating Centre (CCTCC) – a collaborative effort of the Canadian Institutes of Health Research (CIHR), Canada's Research-Based Pharmaceutical Companies (Rx&D), and the merged organizations of the Association of Canadian Academic Healthcare Organizations and the Ca-nadian Healthcare Association (ACA-HO/CHA).

Clinical trials involve testing new therapies with patients. They are a criti-cal step toward bringing new medicines, effective vaccines, and innovative med-ical devices safely to market. They can result in better medical treatments, bet-

ter quality of life, cost savings to Cana-da's health system, new jobs, and rev-enue for the Canadian economy. Most importantly, clinical trials have the po-tential to relieve pain and suffering, and to reverse or halt the effects of disease or disability for Canadian patients.

The CCTCC will improve the co-ordination of clinical trial activities and streamline regulatory processes for companies and researchers. This will be achieved by implementing the recom-mendations produced by an extensive stakeholder consultation. Those rec-ommendations were summarized in the report To Your Health and Prosperity – An Action Plan to Help Attract More Clinical Trials to Canada. nH

•The Nurse Practitioner Practice, Integration and Outcomes Study is funded by the Ontario Ministry of Health and Long-term Care •The Study is designed to explore nurse practitioners' practices within a health care professional team setting •The study also included a nurse

practitioner self-assessment survey of 149 nurses, conducting interviews with 52 health care professionals, in 10 different health care professions •The study encompassed professional third party observations of 24 nurse practitioners in regions across Ontario in both hospital and long term care settings

Quick Facts


4 Guest Editorial

THANKS TO OUR ADVERTISERSHospital News is provided at no cost in hospitals. When you visit our advertisers, please mention you saw their ads in Hospital News.

JUNE 2014 ISSUEEDITORIAL MAY 7ADVERTISING: DISPLAY MAY 23CAREER MAY 27MONTHLY FOCUS: Oncology/Medical Imaging/Pediatrics:Approaches to cancer treatment, diagnosis and prevention. A look at medical imaging techniques for diagnosis, treatment and prevention of diseases. Pediatric programs and developments in the treatment of pediatric disorders including autism.

JULY 2014 ISSUEEDITORIAL JUNE 6ADVERTISING: DISPLAY JUNE 20 CAREER JUNE 24MONTHLY FOCUS: Cardiovascular Care/Respirology/Diabetes/Gastroenterology: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 long term management of diabetes and other endocrine disorders. Advances in diagnosis and treatment of diseases of the gastrointestinal tract.

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Hospital News is published for hospital health-care professionals, patients, visitors and students. It is available free of charge from distribution racks in hospitals in Ontario. Bulk subscriptions are available for hospitals outside Ontario.The statements, opinions and viewpoints made or expressed by the writers do not necessarily represent the opinions and views of Hospital News, or the publishers.Hospital News and Members of the Advisory Board assume no responsibility or liability for claims, statements, opinions or views, written or reported by its contributing writers, including product or service information that is adver-tised.Changes of address, notices, subscriptions orders and undeliverable address notifications. Subscription rate in Canada for single copies is $29.40 per year. Send enquiries to: [email protected] Publications mail sales product agreement number 40065412.

Jonathan E. Prousky, BPHE, B.SC., N.D., FRSHChief Naturopathic Medical OfficerThe Canadian College Of Naturopathic MedicineNorth York, ON

Cindy Woods, Senior Communications OfficerThe Scarborough Hospital, Scarborough, ON

Barb Mildon, RN, PHD, CHE , CCHN(C)VP Professional Practice & Research & CNE, Ontario Shores Centre for Mental Health SciencesWhitby, ON

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Dr. Cory Ross, B.A., MS.C., DC, CSM (OXON), MBA, CHEDean, Health Sciences and Community Services, George Brown College, Toronto, ON

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Is your life affected

by someone’s drinking?

Organ donation a rare opportunity

rgan and tissue donation is a vital part of saving and enhancing thousands of lives each year. Yet many

people – including health care profes-sionals – are not aware of the processes that enable giving the gift of life.

Just two to three per cent of hospital deaths occur in circumstances that al-low for the potential of organ donation. To be a potential donor, one must be on a ventilator at end-of-life. The opportu-nity for donation is rare.

“Our goal is to ensure that at end-of-life, all opportunities for organ and tis-sue donation are identifi ed and pursued – saving and enhancing as many lives as possible” says Ronnie Gavsie, Presi-dent and CEO of Trillium Gift of Life Network. “Every family has the right to make a decision on whether to consent to their loved one giving the gift of life. It is our obligation to ensure that right is respected.”

Trillium Gift of Life Network (TGLN) is the provincial agency responsible for planning, promoting, co-ordinating and supporting organ and tissue donation and transplantation across Ontario.

One way TGLN is ensuring every op-portunity is identifi ed is by working with hospital partners who are required to report every patient death or imminent death to TGLN. There are currently 54 hospitals across the province reporting to TGLN.

“While we depend on our hospital partners to notify us of potential do-nors, the primary responsibility of ev-ery hospital and every physician is to ensure all lifesaving treatments have

been exhausted before end-of-life con-siderations and organ donation is even considered,” says Dr. Sonny Dhanani, TGLN’s Chief Medical Offi cer, Dona-tion, and an intensivist at the Chil-dren’s Hospital of Eastern Ontario. “The patient’s care team is completely separate from the transplant team and never knows the registration status of any patient they are treating.”

For many donor families, organ and tissue donation brings a tremendous source of pride and some sense of com-fort in a time of sorrow.

Heather Higgins and her siblings were faced with that decision a few years ago after they got the call that their father, Malcolm Higgins, had been in a car crash.

They were fortunate enough to know what their father’s end-of-life wishes were, because he had spoken with each of his four children about the impor-tance of donation when they turned 16 and were able to register as organ and tissue donors themselves. After learn-ing their father’s prognosis, they were

approached by of one TGLN’s highly trained organ and tissue donation co-ordinators (OTDC) and asked to con-sider organ and tissue donation.

OTDCs are available either onsite at the hospital or by phone to support families through the donation process, as well as to help facilitate the donation process. An OTDC spoke with Heath-er and her siblings at the time of their father’s death.

“He was really sympathetic and answered all of our questions. He ex-plained the donation process to us and shared with us that three people would be receiving the gift of life from my dad,” says Higgins. “It was one of the worst days of our lives, but know-ing that others would be receiving some of the best news of theirs brought some comfort to us.”

Last year in Ontario, more than 225 deceased donors gave the gift of life to 992 people. But still every three days someone dies waiting because there are not enough organs to meet the need.

You can help by registering consent to organ and tissue donation. Evidence shows when families are presented with proof of registration they over-whelmingly consent to donation, but in the absence of registration, consent drops dramatically.

You can register at www.beadonor.ca, at a ServiceOntario centre or by mailing a Gift of Life consent form to ServiceOntario. nH

Danielle Milley is a Media Relations Advisor at Trillium Gift of Life Network.

By Danielle Milley

O

Just two to three per cent of hospital deaths occur in circumstances that allow for the potential of organ donation.


5 SURGICAL PROCEDURES/TRANSPLANTS/ORTHOPEDICS/REHAB Focus

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Vest helps rehabilitate after mild brain injuries

t is common for people with a mild traumatic brain injury (mTBI) to feel anxious and unsettled, often having trouble

judging distances. “We think this is be-cause some patients have difficulty sensing where their body is in space and they have to work hard to negotiate their environ-ment,” explains physiotherapist Shannon McGuire from the acquired brain injury (ABI) program at St. Joseph’s Parkwood Hospital. “They become overwhelmed and anxious because their brain is having trouble processing sensory information.”

Now, at Parkwood Hospital a specially-designed vest that combines weights and compression is helping patients with a mTBI know where their body is in space. It is helping them with balance, anxiety, fatigue, attention, concentration, and eas-ing overstimulation in busy environments.

Not only are therapists at Parkwood Hospital forerunners in exploring the ef-fectiveness of these vests, they are also enhancing the vests currently available in the marketplace by improving the fit and adding weights.

Linda DeGroot, a patient with a mTBI, felt an immediate transformation when she put the vest on. “It was the first time

I’d felt secure since sustaining the mTBI,” says Linda, a teacher who sustained a con-cussion when she hit her head on the ice while playing hockey.

When Linda first came to Parkwood, she was experiencing tremendous levels of anxiety. As a result of her concussion she couldn’t drive her car, go to work, attend church or do many of the things she loved. For a woman used to being independent, Linda was suddenly very dependent on others.

After brainstorming other treatments

for Linda, Shannon and her colleagues came up with the idea of using a compres-sion vest. “Once I put the vest on, it was almost an immediate transformation,” says Linda. “It was the first time I’d felt secure since sustaining the mTBI.”

“The vest fits snugly to the body–it feels like it’s giving you a big hug,” says Shan-non. “We believe the weight combined with compression helps patients feel more grounded.”

At first, Linda wore the vest whenever she left the house, but she has progressed so well that now she only wears it when she is in situations with a lot of new stimuli. After seeing Linda’s success with the com-pression vest, the ABI outpatient team be-gan introducing it to other patients with similar results.

Shannon conducted pilot research with Physiotherapy students at Western Uni-versity on the clinical impact of the com-pression vests for patients with a mTBI, and is now extending that research to gauge the impact of adding weight to the vest. nH

Anne Kay is a Communication Consultant at St. Joseph’s Health Care London.

By Anne Kay

Wearing the weighted compression vest Linda DeGroot, right, practices balancing with the help of physiotherapist Shannon McGuire.

At Parkwood Hospital a specially-designed vest that combines weights and compression is helping patients with a mTBI know where their body is in space.

I



“It’s my pleasure to say ‘thank you.’ Your knowledge and confidence guided us through all the time. You were like the light and the hope in the dark, especially in the first couple of years. I am glad it is over, success-fully. Thank you.”– A.W.

New program helps patients prepare for

new prehabilitation program at Rouge Valley Health Sys-tem (RVHS) is improving out-comes for shoulder surgery pa-

tients by strengthening them before their procedures.

The shoulder prehabilitation pro-gram, or “prehab” as it is nicknamed, is a one-hour education session for patients preparing to have shoulder surgery at the Rouge Valley Ajax and Pickering (RVAP) hospital campus.

It was introduced in March for the pa-tients of Rouge Valley shoulder specialists Dr. Stephen Gallay and Dr. Joel Lobo. The class, led by a nurse and physiotherapist, teaches patients what to expect before, during, and after their shoulder surgery.

Various topics are covered during the edu-cation sessions including: how to properly apply a shoulder sling; which exercises they can do immediately after shoulder surgery; and how to do each exercise.

By helping patients to become better prepared for their surgery, and providing physiotherapy support prior to surgery, the shoulder prehab is expected to improve the patient’s recovery. In addition, it helps bridge any delay, which might occur be-tween the day of surgery and the start of formal physiotherapy. So far, 20 patients have already gone through the program with positive results.

“Our shoulder prehab program has helped to alleviate patient anxiety, from the time they enter the operating room, to the time they see a physiotherapist,” explains Amber Curry, surgical manager, RVAP. “Due to the nature of shoulder sur-geries, many patients have to be extremely cautious after their procedure. With this program, they can become more educated on how to care for their shoulder, which can result in a safer, better and quicker recovery.”

RVHS already has a very successful pre-hab program for hip and knee replacement patients, which includes an education and

pre-conditioning component. It helps pa-tients become better educated about what to expect out of their hip or knee replace-ment surgery, and gets them in better phys-ical condition before the procedure.

The focus of prehab is on educating patients about how to best care for their shoulder after surgery, and to encourage a safe and quicker recovery.

Patient finds program “very helpful”

The majority of shoulder surgery pa-tients have a problem with their rotator cuff. These patients typically live very ac-tive lives. Learning how to care for their shoulder after surgery greatly improves their recovery.

David Leithead, 64, had surgery on his right shoulder to relieve intense pain he had for 18 months. The pain was prevent-ing him from playing baseball and pickle-ball (a combination of badminton, tennis, and Ping-Pong). “I tried to play baseball, but I couldn’t throw overhand because the pain was so bad,” he explains.

After a cortisone injection didn’t relieve David’s pain, he was referred to Dr. Gallay, who diagnosed him with rotator cuff im-pingement syndrome. David was promptly

scheduled for outpatient arthroscopic sub-acromial decompression surgery. The sur-gery was performed successfully in April at RVAP, only four weeks after his initial consultation with the surgeon.

David was fortunate to be in one of the first groups of patients to move through the shoulder prehab program. “I found that prehab was very helpful for me. It helped to prepare me for the surgery. The booklet and education session showed me what exercises to do, so that I could get started right away.”

David, who is now doing physiother-apy, has also started doing exercises he learned in prehab at home every day for 20 minutes. nH

Akilah Dressekie is a Senior Communications Specialist at Rouge Valley Health System.

By Akilah Dressekie

A

shoulder surgery

The focus of prehab is on educating patients about how to best care for their shoulder after surgery, and to encourage a safe and quicker recovery.



ights, camera, action! October 25th was a very exciting day at Halton Healthcare Services (HHS). A camera crew, set up

in the operating room at Oakville-Trafal-gar Memorial Hospital (OTMH) filmed Dr. Jack Kolenda, HHS Otolaryngologist and Surgeon performing an innovative technique to remove salivary gland stones and blockages. This cutting-edge surgi-cal procedure, called Sialendoscopy, was broadcast live across North America to an international conference on minimally invasive procedures in Colorado, USA where otolaryngologists and surgeons from around the world could watch this educa-tional session.

Dr. Kolenda explains that stones, stric-tures or stenosis (narrowing of the ducts) can form inside the salivary ducts of the glands. This in turn, can block the normal flow of saliva into the mouth and cause in-flammation of the glands resulting in pain and possible infection.

“While we do not know the exact cause of these obstructions, those who are affect-ed are generally left with recurring infec-tions and pain, which can be quite severe,” continues Dr. Kolenda. “To-date, tradi-tional surgical treatments have involved removing the entire effected salivary gland. Risk of these procedures include scarring, facial nerve paralysis, altered taste sensa-tion of the tongue and a condition known as Frey’s syndrome which is sweating of the face when eating.”

“The salivary glands play an important

role in our health. These glands produce saliva so you can chew your food,” explains Dr. Kolenda. “Without them you would have difficulty swallowing and suffer from a constant dryness and discomfort in your mouth.”

“Sialendoscopy allows us to remove the obstruction and keep the gland intact. Since there is no incision, there is no facial scarring or nerve damage and the recov-ery time is minimal,” explains Dr. Kolenda. “The procedure is done on a day surgery basis at OTMH.”

“We insert a tiny scope into the gland so we can explore the salivary ductal system, locate the stone and then, using micro in-struments, we remove the stone,” explains Dr. Kolenda. “While it may sound simple, the salivary ducts are delicate microscopic structures. The challenge of performing this procedure is reaching and opening these ducts, and then keeping them dilated while we work to extract the stones.”

Dr. Kolenda’s live demonstration also in-troduced the new instrumentation he has developed with the support of Cook Medi-cal to enhance access to these microscopic ducts. Known as “the Kolendas”, these dis-posable instruments include dilators that open the ducts as well as sheaths that help create working channels through which the surgeon can execute this microscopic procedure, using multiple instruments. Today, Dr. Kolenda’s instruments are used world-wide by surgeons who perform this surgical technique.

Sialendoscopy is still new and evolv-ing. Introduced by Dr. Francis Marchal at the University of Geneva, Switzerland it is considered as one of the most fascinating innovations in the field of Otolaryngology-Head and Neck Surgery in the last decade.

Dr. Kolenda was the first Canadian Surgeon to attend the first international Sialendoscopy hands-on course that took place in Geneva, January 2002. Subse-quent to his training, he was the first sur-geon to pioneer this innovative procedure both in North America and Canada. Even today, Dr. Kolenda is only one of three sur-geons who currently performs this proce-dure in Canada.

Dr. Kolenda continues to collaborate with Cook Medical on the development of a number of other new instruments to further enhance the Sialendoscopy pro-cedure, including a stone breaker which

is currently patent pending and awaiting FDA as well as Health Canada approval.

“A microscopic jackhammer that can break the larger salivary stones down using kinetic energy will be invaluable in situa-tions when the stones are larger than the salivary ducts,” concludes Dr. Kolenda. “We are at the forefront of this Sialen-doscopy technology and once these new products are released OTMH will be the first hospital to offer these innovative new procedures.” nH

Zita Taksas-Raponi is a public relations officer at Halton Healthcare Services.

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At the forefront of technology:

Sialendoscopy By Zita Taksas-Raponi

Dr. Jack Kolenda has been performing a cutting edge surgical procedure called Sialendoscopy.

L

Where are your salivary glands?The salivary glands are located along the inside of the cheeks by your ear (parotid) and deep within the floor of the mouth (submandibular and sublingual glands).

What do salivary glands do?These glands produce saliva in response to smell and taste sensations so you can chew your food. The saliva helps break down starches in your diet.

What are salivary stones? Salivary stones form when chemicals from the saliva accumulate in the duct or the gland.

What causes salivary stones? While the exact cause of salivary stones is not known, factors which can contribute to the development of salivary stones include:• Dehydration• Poor nutrition• Certain medications such

as antihistamines, or those prescribed for blood pressure, psychiatric drugs or bladder control

• Trauma to salivary glands



Representing more hospital lab professionals than any other union in Ontario, OPSEU gets you RESULTS.www.joinopseu.org [email protected] 1-800-268-7376 facebook/joinopseu

“Our newest members at Sunnybrook know that OPSEU is the union for changing times, and we have the experience that gets results for hospital workers.”

Warren (Smokey) ThomasOPSEU President

From caregiver to patienthristine Jowett is used to tak-ing care of others, but her own health crisis last year turned the tables for the

mother of two. Jowett is a cardiology nurse at St.

Mary’s General Hospital and even though she was diagnosed with autoim-mune hepatitis at 13 years old, she had led an active life, including completing a 60km bike tour in June 2013.

All of that changed in an instant when an E. coli infection put her life at risk. For most, the infection would be se-rious, but for someone with a pre-exist-ing condition it became life-threatening. “I wasn’t too bad before and then I just crashed really quickly,” she says.

In less than two weeks Jowett went from working as a nurse at St. Mary's Hospital to being a patient at Toronto General Hospital – hoping a matching donor would be available in time to save her life through a liver transplant.

It was dire. Her doctor told her she might not make it a few more days with-out a transplant.

“I was just praying and praying that I would make it through the weekend,” she says.

Her prayers were answered when on her daughter’s sixth birthday and just two days after being officially listed – a match was found and Jowett received a second chance at life thanks to the gen-erosity of a donor and his/her family.

She thinks about this gift every day. “Every day I think if I didn’t have

the liver I wouldn’t have been able to celebrate my 40th birthday or celebrate Christmas with my children,” she says. “I really didn’t want my kids to grow up without a mother.”

Jowett has taken the opportunity

through Trillium Gift of Life Network (TGLN) to thank her donor’s family. “I wanted them to know something good came out of their decision,” she says. “It was a hard letter to write.”

TGLN, as the provincial agency re-sponsible for organ and tissue dona-tion, is able to facilitate communication

between recipients and donor families through anonymous letters.

For Jowett, a new liver means she has a new outlook on life. “I appreciate things more and I find I’m not in a hurry anymore,” she says. “I was always rush-ing before.”

The experience also gave her a deeper sense of empathy for her patients. “I got to see a whole new perspective from the other side of the bed,” she says. “I got to see what patients go through being poked and prodded.”

She also better understands the im-portance of approaching families to ask them to consent to their loved one be-ing a donor. As part of her job she some-times calls TGLN to report potential tissue donors; she now has a better un-derstanding of just how important that call is.

Jowett has also become involved with a local volunteer organization that raises awareness about organ and tissue dona-tion and transplantation. She is working to encourage her colleagues and those in the broader community to register their consent to organ and tissue donation, to help save the lives of the 1,500 people in Ontario waiting for an organ transplant.

Registration saves lives. You can register at www.beadonor.ca, at any ServiceOntario Centre or through the mail by completing the Gift of Life consent form. nH

Danielle Milley is Media Relations Advisor at Trillium Gift of Life Network

By Danielle Milley

Christine Jowett, a nurse at St. Mary’s General Hospital underwent a liver transplant.

C

Trillium Gift of Life Network, as the provincial agency responsible for organ and tissue donation, is able to facilitate communication between recipients and donor families through anonymous letters.



askatchewan is gaining nation-al recognition for its efforts to transform its health care sys-tem, with the goal of achieving

better health for residents, better care for patients, better teams of health care pro-viders and better value for taxpayer dollars.

On February 13, 2014, the Saskatche-wan Ministry of Health received an IPAC/Deloitte Public Sector Leadership Award Gold Medal for Putting Patients First and Transforming Health Care.

This prestigious award recognizes or-ganizations that have demonstrated out-standing leadership by taking bold steps to improve Canada through advancements in public policy and management.

Saskatchewan’s Lean Journey

Saskatchewan started its journey to transform its health system with the 2009 Patient First Review, which led to the concept that the patient comes first and needs to be actively involved in their own care. That principle drives quality, safety and service improvements throughout the system and at the frontlines where service occurs.

Saskatchewan is the first province in Canada to begin implementing a continu-ous improvement process called “Lean” across its entire health care system. Widely used in the manufacturing sector and in some high-performing health facilities, Lean is a philosophy or a mindset – a pa-tient-centred approach – to continuously improve the quality and safety of care and eliminate activities that do not add value.

Lean promotes fact-based decision-making to identify root causes of process problems and to sustain improvement. This leads to long-term cultural changes, not just short-term fixes.

In 2012, Saskatchewan’s health system was uniquely positioned to introduce this major, meaningful health care reform, with many supportive partners involved. Health regions, health care professionals and as-sociations, unions, health sector agencies and other partners committed to an ag-gressive program.

To follow through with this commit-ment, the Ministry of Health engaged con-sultant John Black and Associates (JBA) to further embed Lean practices province-wide.

Now two years into its four-year $39 million contract, the Ministry’s investment reflects the size, scale and complexity of the province’s health care system.

JBA is training 880 Saskatchewan health care executives, board members and man-agers in Lean leadership, which will allow the province to become self-sufficient and no longer reliant on outside expertise. As part of this training, more than 1,000 qual-ity improvement projects will occur across the health system to improve patient expe-riences and reduce errors.

The province’s 43,000 health-care workers are also receiving basic Lean train-ing – focusing on the patient, thinking and acting as one, and acquiring new skills to think about and do their work differently.

Key resultsTo date, Lean efforts have resulted in

a number of quality, efficiency, safety and productivity gains. For example: • Better management of blood products has achieved a 17 per cent reduction in product waste, saving $35 million since 2010 by improving inventory management and reducing inappropriate product use.• Specialist groups around the province are using pooled referrals to reduce patient wait times by as much as half.• Patients brought to Saskatoon’s St. Paul’s Hospital by EMS ambulance are now transitioned to nurse care 67 per cent faster, freeing up ambulance staff’s time for incoming calls. This reduction from 37 minutes to 18 was accomplished through standard work, improved handover pro-cesses and more efficient use of space.• Parents in labour now register directly in Labour and Delivery on the fourth floor of Saskatoon’s Royal University Hospital, rather than registering in the Emergency Department. This reduces their walking distance by 85 per cent and removes one stop in their journey to receiving care and becoming parents. • Through the creation of standard work, the Regina Qu’Appelle Health Region’s (RQHR’s) Mental Health Outpatient Clinic virtually eliminated appointment cancellations initiated by the clinic. Previ-ously, 42 per cent of all appointments with psychiatrists were cancelled – 31 per cent

were initiated by the clinic, while the re-mainder were the result of client cancella-tions and “no shows.”

Major capital projects are also Lean pri-orities, including the new Children’s Hos-pital in Saskatoon and Moose Jaw Region-al Hospital. Using Lean in facility design will improve processes, reduce waits and improve experiences of patients, families and health care providers. For example, the design and care model of Moose Jaw’s new hospital will allow health care services to come to patients in single rooms, rather than requiring patients to travel through-out the hospital. Using Lean also reduces costs: Moose Jaw’s hospital is expected to save $85 to $160 million over 20 years through operational efficiencies.

What people are sayingTrue to the province’s Patient First

focus, Lean improvement events always include patients. Their ideas and expe-riences actively shape and inform the event, ultimately improving the health services in a way that matters to pa-tients.

According to Kim Camboia, a patient advocate who has participated in a num-ber of Lean improvement events, “I be-lieve in the work that we are doing in the Lean process and I believe in everyone’s ability to pioneer change. It won’t be easy and it won’t even be hard. It will be defeating and at times even hopeless… but so rewarding and so worthwhile.”

Not only is Saskatchewan gaining national attention for its health care system transformation, attention is coming from beyond Canada’s borders: “What you are doing in Saskatchewan is globally significant. It is ambitious and creative. The eyes of the world are on you, says Helen Bevan, Chief of Service Transformation, UK’s National Health Service Institute for Innovation and Im-provement

Bonnie Brossart, CEO of the Saskatchewan Health Quality Coun-cil, sees a strong future for renewal in the province’s health care system, “Our commitment in Saskatchewan to think and act as one system, in the name of putting patients first, is the envy of pro-vincial health care systems across the country. In fact, health systems across North America and indeed around the world are watching, as this province works to achieve yet another health care first.” nH

To find out more about how Lean is being used to make health care better and safer in Saskatchewan, visit BetterHealthCare.ca

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Transforming healthcare in Saskatchewan through Lean

Patients such as Aalt Leusiuk now have quicker access to care at RQHR’s Mental Health Outpatient Clinic as a result of an improvement project. He’s pictured with Karen Muller, a registered psychiatric nurse. Photo credit: RQHR Medical Media Services

S

“This is an incredibly exciting time in health care in Saskatchewan. We are the first province in Canada to begin implementing Lean across the entire provincial health system.” - Health Minister Dustin Duncan



Nephrology clinic helps slow kidney diseasen ounce of prevention is worth a pound of cure. Just ask Dr. David Perkins, Division Head, Nephrology for Trillium Health

Partners’ Regional Chronic Kidney Disease Program. The old adage is the philosophy behind the hospital’s new Regional Ne-phrology Clinic’s mandate to help patients with kidney disease manage their illness better in order to slow its progression and delay the need for treatment such as dialysis.

“The Regional Nephrology Clinic is re-ally focused on getting our patients the best possible care at the right time,” says Dr. Per-kins. “We know that patients with chronic kidney disease benefit from being seen by a nephrologist early in the onset of their dis-ease. By making it easier for primary care providers and specialists to refer their pa-tients for renal assessment to the clinic, and for patients and their families to receive the care, education, and support they need, we are helping to improve the quality of care and treatment and slow down disease pro-gression.”

Launched this past April, the clinic is lo-cated on the main floor of the Carlo Fidani Peel Regional Cancer Centre and Ambula-tory Care building at Credit Valley Hospital and is staffed with a team of experts. Nurs-es, nephrologists and clinical educators in-corporate best practices in chronic disease management including self management and education.

The clinic features a new centralized in-

take model, which is the key to the method of prevention. Using a simple, standard-ized referral form, primary care providers and specialists now have a single point of contact for their referral, and appointments can be made within days.

In the past, there were challenges ensur-ing patients with kidney disease had quick access to the most appropriate care. Prima-ry care physicians would refer their patients with kidney disease to a nephrologist. But as with many specialist referrals, securing an appointment could take months. In the meantime, there could be visits to pharma-cists for medication to manage the symp-toms all while waiting in the community. By the time patients met with nephrolo-gists, the disease may have progressed be-yond early stages.

”It can be frustrating for patients who had to make multiple trips from primary

care to pharmacists and then back again. If they missed an appointment it could be weeks or months before they were seen again,” says Sandy Beckett, Manager, Re-gional Chronic Kidney Disease Program.

Once patients are diagnosed by a ne-phrologist, they meet with a nurse who pro-vides education on managing their disease, and helps them understand options for treatment. This enables patients to make better decisions, sooner.

This type of early intervention also brings families into the equation so they will have the information they need to as-sist with managing the disease at home.

For the patient, the convenience of go-ing to one location to meet with health care providers, receive information and pick up medication can make the task of disease management that much easier.

“It’s a much more proactive, patient-centered model of care, as opposed to a provider-centric model,” says Beckett. “Now, there is one entry-point.”

In addition, once patients enter the clinic’s system they are easily tracked. Not only does this allow for closer monitoring of the patient’s progress, but it enables Tril-lium Health Partners to compile data for research that can eventually lead to better health care outcomes.

The clinic is aligned with the Ontario Renal Network (ORN), the provincial government’s advisor on renal care in On-tario. ORN provides overall leadership and strategic direction to organize and manage

the delivery of dialysis and chronic kidney disease services in Ontario.

“At ORN, our mission is to work togeth-er with our regional partners, patients and stakeholders to improve the life of every person in Ontario with kidney disease,” says Dr. Peter Blake, ORN provincial medi-cal director. “This new clinic aligns with the Ontario Renal Plan, which lays out strategic priorities aimed at delivering high quality patient-centred care while driving improvements in the renal system. We are extremely pleased to support and help im-prove care for chronic kidney disease pa-tients in the community.”

The establishment of the Regional Ne-phrology Clinic supports Trillium Health Partners’ strategic priority to provide the right care in the right place at the right time. The clinic’s centralized intake ap-proach will bridge gaps to improve the patient’s journey, deliver better patient outcomes and respond to the most pressing needs of patients with chronic disease.

As Ontario’s population continues to grow and age, the prevalence of chronic kidney disease is expected to rise. Accord-ing to the Kidney Foundation of Canada, approximately, 1 in 10 Canadians has kid-ney disease, while an estimated 1.5 million Ontarians have or are at increased risk for developing kidney disease. nH

Priya Ramsingh is a Senior Communications Advisor at Trillium Health Partners.

By Priya Ramsingh

For the patient, the convenience of going to one location to meet with health care providers, receive information and pick up medication can make the task of disease management that much easier.

A



t Holland Bloorview Kids Re-habilitation Hospital, research-ers and clinicians collaborate and share expertise to improve

rehabilitation techniques for children and youth using prosthetic devices.

Sometimes that means Jan Andrysek, a Scientist in the Bloorview Research In-stitute, is called in by the clinical team to bring a research lens to a clinical innova-tion. Jan researches new technologies and techniques to help people with severe physical disabilities walk.

Other times, Jan enlists the help of the Prosthetics and Orthotics Department at Holland Bloorview to provide a clinical perspective for his research study. Prosthe-tists in the clinic build prosthetic devices and provide clinical rehabilitation for their clients.

WiiFit for rehab: A clinical innovation

The idea to use the WiiFit technology as a clinical tool for kids with recent amputa-tions came from Bryan Steinnagel, a Pros-thetist on the clinical team. Bryan saw the WiiFit platform demonstrated at the Elec-tronic Entertainment Expo in the US. “As soon as I saw the WiiFit, I thought ‘That’s what we need!’ I knew it would get kids up and moving.”

Bryan and the clinical team thought the WiiFit would be an excellent tool for augmenting physiotherapy for children and youth, who spend most of their therapy time practicing weight shifting on a new prosthetic device. Unfortunately, explains Bryan, “most of that work is traditionally done standing between two parallel bars with a therapist saying ‘Okay, shift your weight to the left, now to the right.’ That can get pretty dull for a kid.”

While Bryan and the rest of the clinical team were fairly sure the game, based on a pressure-sensitive pad that detects full-body movement, could help motivate their young clients, they needed a way to prove

that the WiiFit was a sound clinical tool that would produce verifiable results.

That’s where Jan Andrysek came in. Jan helped with the study design, which first involved validating the WiiFit as a reli-able clinical tool, and then sending it home with participants along with a schedule of game play.

The research study results were com-pelling – the data showed a small but sig-nificant difference in how the clients were shifting their weight, which they attribute to the feedback provided by the WiiFit sys-tem, and researchers found that the results of therapy sessions “stuck” better because the kids were practicing their weight shift-ing movements at home by playing the Wi-iFit games.

Tara-Anne D’souza, a Holland Bloor-view client, now 15, was just 10 when she participated in the WiiFit study. Tara-Anne was undergoing rehabilitation for a recent amputation. She remembers the WiiFit was fun and a great motivator to do her exercises.

Tara-Anne agreed that the WiiFit tech-nology made rehab more enjoyable. “I’ve never been great at handheld video games, but I really enjoyed this. It was very attain-able – I just had to get to level six! Hooking it to the game was so much better, because your exercises didn’t feel like work, they felt like fun.” She also said the WiiFit pro-vided additional bodily awareness, which is crucial for someone just one year after an amputation.

Tara-Anne doesn’t use the WiiFit any-more; she’s moved on to breaking Cana-dian records in the Paralympic Swimming (or Paraswimming) Nationals. But she says that the WiiFit was a helpful clinical tool when she was first adjusting to her new prosthetic, and she sees the value in con-tinued use for kids.

For Jan’s part, he’s excited that he was able to provide the research support to something that stemmed from clinical need. “It was an excellent concept that required the rigour of research to assure that it could be used in the clinic as an evidence-based tool. To me, that’s the best example of how research and clinical care can work together.”

The LC Knee: Clinical support for a research Innovation

Other times, the situation is reversed, and a research innovation requires clinical input. Jan is currently developing the LC Knee, a low-cost, light and sturdy prosthet-ic knee joint that can offer affordable help to people with amputations worldwide. For the cost of about $100, this injection-moulded plastic knee joint can withstand rough conditions like water and sand. The LC Knee is currently in testing around the world, and Jan hopes to make it widely available to people for whom a prosthetic device would not otherwise be attainable.

In developing and testing the LC Knee,

though, Jan needed a clinical perspective from professionals who fit and train clients with prosthetic devices every day. Shane Glasford, Prosthetic Team Leader, has pro-vided Jan with clinical input over the years.

“Research has been picking our brains for a long time on this project, from the development of the original idea, to us-ing the mechanism for the LC knee.” The Prosthetics department also helped with

study recruitment, tapping into their client network.

Jan says the support from Shane and his team has been crucial. “I’ve solicited their feedback on various iterations of the de-sign, and I’m glad that I had their perspec-tive at all those points along the way.” nHClaire Florentin is a Senior Communications Associate at Holland Bloorview Kids Rehabilitation Hospital.

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Albert Phan, a Holland Bloorview client, participated in a research study to assess the value of WiiFit game technology as a therapeutic rehabilitation tool.

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Scientist Jan Andrysek says clinical input was crucial to the development of the LC Knee, currently in testing around the world



Improving patients’ quality of life with at-home dialysis

emodialysis machines look complicated, but Flynn Ramirez has no trouble hook-ing one up.

With the skill that comes from constant repetition, he attaches a fresh pack of sa-line solution, along with the numerous tubes used to transfer blood through the system – a life-saving process that cleans blood for patients whose kidneys aren’t working well enough to do the job them-selves.

He adjusts the roughly four-foot-tall ma-chine’s settings and double checks all the bags and tubes to ensure they’ll properly pump blood through the dialyzer.

Then, he lifts his shirt up and gets ready to attach the tubes on the machine to the tubes coming out of his chest.

Flynn isn’t a nurse or a doctor. He’s a patient, dialyzing in the comfort of his bedroom, thanks to a program dubbed “Homeward Bound” at St. Joseph’s Health Centre.

“It’s really easy now,” the 56-year-old Etobicoke resident says of his at-home dialysis, which he started doing back in March 2013.

Ramirez dialyzes every other day, and works the 6-hour treatment around his schedule – sometimes dialyzing while he sleeps, other times while friends pop by for a visit.

This comfortable routine is a far cry from the overwhelming diagnosis Ramirez first received from his doctor: high blood pres-sure that had affected his kidneys, leaving both at a 13 per cent functioning level.

“My wife and I were devastated… I could not accept it right away,” Ramirez recalls.

The diagnosis meant he had to do he-

modialysis regularly at St. Joe’s Commu-nity Renal Centre, which provides hemo-dialysis stations and a renal management clinic for patients like Ramirez who are suffering from renal failure.

“When renal failure occurs, it means (the kidneys) aren’t performing properly – and so you end up with waste products building up in your blood,” explains Jacqui Cooper, patient care manager for the Re-nal Therapy program at St. Joe’s.

In hemodialysis, the patient’s blood is pumped through a machine, where it passes through a membrane and is then returned, in a clean state, back into their body.

It’s a rescue therapy, according to Coo-per. “Patients have to have dialysis if they want to continue living,” she says. “It is that serious.”

Serious, but inconvenient. The trek to a clinic for dialysis can take a toll on pa-

tients’ day-to-day lives, notes Renal Cen-tre nurse Janice Brown-Martin.

Some patients travel an hour to get to the Islington Avenue site, she says, then it takes them half an hour to get connected to the machine – meaning they may spend 5 to 6 hours for a three and a half hour treatment. It can be quite a cumbersome process, and sometimes makes holding down a job impossible.

With these concerns in mind, St. Joe’s began the Homeward Bound program in October 2011 to help patients dialyze at home, instead of a clinic.

“Being on a home therapy allows them to go back to work and normalizes their life again,” says Cooper. It’s also a better qual-ity of dialysis, she adds, because it can be done for longer periods of time at home, rather than the condensed variation found in a clinic setting due to shared machines and high demand.

If patients are interested in doing di-alysis at home, staff at the Renal Centre conduct an in-depth interview to figure out how to make it happen, by determin-ing the patient’s knowledge of their disease and their support network at home. Once they’ve been deemed capable of doing at-home dialysis, staff start on the training.

“On average, it takes patients six weeks to learn (at-home dialysis),” says Brown-Martin.

Patients aren’t sent home until they can do the entire process without assistance. There is also on-call support 24 hours a day, seven days a week, and a built-in alarm system on the machine that goes off if there is even a drop of blood spilled.

Ramirez takes comfort in the at-home dialysis system he’s now mastered. His wife has gotten used to the machine, he says, and he only needs to check in with his doc-tor once every two months.

“If there are no problems, you just relax at home,” he says with a laugh.

Yet many patients still choose the clinic route, rather than dialysis at home, despite what Ramirez and St. Joe’s staff see as ob-vious benefits.

“I just wish more patients would actu-ally consider it as an option,” says Brown-Martin. “A lot of people are scared.”

Ramirez was one of those scared pa-tients – at first.

But dialyzing at home “is really a lot easier,” he says, crediting St. Joe’s team with making it happen. Now, he can stay healthy without constantly trekking out to a clinic.

“Thanks to them – to the doctor, to the nurses, to this facility – I’m okay.” nH

Lauren Pelley is a Junior Associate in the communications department at St. Joseph’s Health Centre Toronto.

By Lauren Pelley

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Patient Flynn Ramirez dialyzing in the comfort of his home.

If patients are interested in doing dialysis at home, staff at the Renal Centre conduct an in-depth interview to figure out how to make it happen

H

National Nursing WeekMay 12–18, 2014

commitment | dedication | excellence | compassion

special pull out section


N2 National Nursing Week 2014 — S A L U T E T O O U R H E R O E S

Aramark is proud to sponsor the Hospital News’ National Nursing Week contest to recognize nursing heroes.

Aramark works in collaboration with nurses in our client hospitals and residences across Canada.

Partners in Outstanding Care Delivery

ARAMARK SALUTES NATIONAL NURSING WEEK

© 2014 Aramark. All rights reserved.


N3 S A L U T E T O O U R H E R O E S — National Nursing Week 2014

ome heroes wear capes and have superhuman powers; oth-ers wear insignia-emblazoned leotards and fight against in-justice. The heroes we salute in the upcoming pages do not have superhuman powers – and are usually attired in

scrubs – but they are a breed of hero unlike any other.As you browse through the pages of this supplement celebrating

nurses, you will see that this year’s Nursing Heroes Contest was a tre-mendous success. In fact, we received a record-breaking 120 nomina-tions for 107 nurses – nearly triple the number received when this contest debuted nine years ago.

Every year I am amazed by the calibre of nominations we receive. An off-duty nurse sees a woman in distress pulled over at the side of the road and stops to help, performing life-saving CPR on her toddler as traffic whizzes by. Another nurse notices a patient in his ICU rapidly deteriorating. The nurse arranges for the patient’s wife – who is also in

hospital recovering from surgery – to be wheeled into her husband’s room so she can be by his side, in his final moments. An elderly patient in hos-pital with no family is being taking ad-vantage of financially by a neighbour, a nurse notices and steps in to protect her patient from further abuse.

These are all acts of heroism; none is greater than another. Every nurse is a hero.

Nurses are the backbone of the health care system. They do for healthcare what gasoline does for an automobile – they power it and make

it work. Without nurses, our system wouldn’t function.The Nursing Hero Contest highlights some of the many heroic acts

nurses perform every day, and gives us a chance to say thank you. So often in a busy health care environment people don’t get the chance to express their gratitude. The following pages provide an opportunity to do just that, and show nurses exactly how much they impact the lives of their patients and colleagues.

Congratulations to this year’s winners and nominees. This year it was tremendously difficult to narrow down the nomina-

tions and select only a few as “winners.” In reality, every single name on the list of nominees is a winner, because they have made a positive difference to someone. With so many nominations, it is impossible to print them all. If you are on the list and would like to read your nomi-nation, I am happy to forward it to you. You can email me at [email protected].

To all nurses, thank you for everything you do. Hospital News sa-lutes you. nH

Kristie Jones, Editor

2014 Nursing Hero Awards

SPONSORED BY

1st

prize

Linda JurincicOdette Cancer Centre, Sunnybrook Health Sciences Centre

$1000 Cash Prize

Congratulations to the winners of our

Heather ChinneryStollery Children’s Hospital, Alberta Health Services

$500 Cash Prize

2nd

prize

SPONSORED BY

Madge ReeceHumber River Hospital

$300 Cash Prize

3rd

prize

S

This year we received a record-breaking 120 nominations for 107 nursing heroes

heroesAll nurses are



OUR NURSES Knowledge professionals providing inspired care

We believe that our nurses are a true expression of our mission and values who place

compassion, respect, social responsibility and excellence at the forefront of patient care.

We recognize our nurses’ professional knowledge, experience and tireless efforts in

fulfilling our legacy of quality care and discovery.

We value the contribution our nurses make – working around the clock, changing lives everyday.

We celebrate our nurses’ many accomplishments and their dedication to nursing

excellence in patient care, education and research.

Today, and every day, we thank our 1,800 nurses for their unwavering commitment to

our culture of caring and innovation.

At Sunnybrook, over 2,900 nurses provide the highest quality of care to improve the health and well-being of patients and their families, when it matters most.

Our nurses work collaboratively within interprofessional teams to provide care when it matters most. Our nurses are committed to continually learn and lead initiatives using a person centred approach.

We are very proud and thankful of the unique contributions of our nurses at Sunnybrook. They are passionate about the care they provide.

NURSING: A LEADING FORCE FOR CHANGE

Sunnybrook.caNURSING WEEK - MAY 12 TO 18



am nominating Ms. Linda Ju-rincic at the Odette Cancer Centre at Sunnybrook Hospi-tal for the Hospital News 9th

Annual Hero Award.It is impossible to summarize in a few

words what kind of nurse Linda Jurincic is. Linda is thoughtful, kind, she has a wonderful sense of humor that can lighten any situation. She takes the time to do the little things that mean so much. Linda has a special gift of providing comfort and sup-port when needed. Linda demonstrates the “heart of nursing.” There are so many examples that I can use to describe why Linda is an amazing nurse.

In the past few years I have been through so much. A DVT in my right leg, learning how to inject lovenox into my abdomen cone biopsy with extensive hemorrhaging, an operation for a hysterectomy that didn’t happen because of the extent of the can-cer in my pelvis and paraaorta area, chemo and 4 months of radiation 5 days a week.

My fi rst HDR treatment is where I met Linda. I have to say I was pretty scared because of my previous hemorrhaging and my blood clot. The thought of having to be put under for my HDR did not sit well with me. I was scared that the blood clot would move and I would die.

Linda was at every one of my HDR ap-pointments. She was kind and very upbeat. She would insert my intravenous needle into my small veins. Inject me with my lo-venox. Linda ordered lovenox in the mil-ligrams I needed so I would not have to use my supply because of the expense. She also taught me how to inject my lovenox correctly so it wouldn’t sting and to stop me from getting huge bumps and bruises. Linda helped calm me, keeping things light by talking, joking and making me feel comfort-able. She also sang You Are My Sun-shine as we walked into the operating room and she continued until I fell asleep. When I awoke Linda would have ginger ale and a cookie from her own lunch for me.

About half way through my HDR treatments I decided that I would not fi n-ish them because of the bleeding and I was sick of being tired and run down. Linda told me to come in, sit with her and if I didn’t want to fi nish I didn’t have to. Well Linda ended up talking me into fi nishing my

treatments. She was right I needed to fi n-ish so I had no regrets later on. After that HDR treatment Linda told me they fi xed my bleeding problem. I am so grateful to Linda, for talking some sense into me so I would fi nish my treatments.

In June 2013, I had a CT Scan and MRI both suggesting my cancer was not gone and maybe the cancer had spread to my bone. A PET Scan was urgently ordered. I was a wreck and Linda helped me through a very diffi cult time. The day I got the re-sults from the PET Scan results, my family, my doctor and Linda were there holding my hand. I got the amazing news that I am cancer free. Linda leaned over and whis-pered in my ear and said “I told you that everything would be fi ne.”

I see Linda every three months for my follow up appointments. I am greeted with the biggest smile and hug. I squeeze her hand or arm because I hate my internals. She also looks after my wellbeing. I have been depressed and she talked to me about my issues and made me realize that I must enjoy life and she made an appointment for me to talk to someone.

My defi nition of a nurse: Go above and beyond the call of duty. The fi rst to work

and the last to leave. The heart and soul of caring. A unique soul who will pass through your life for a minute, but impact it for an eternity. This is Linda.Nominated by: Kimberly Fulcher

2ND NOMINATION It is my great pleasure to provide

this letter of recommendation for Ms. Linda Jurincic for the annual Nursing Hero Award. Linda was my pri-mary nurse from 2007 to 2012 and became part of the nursing team that cares for my patient popu-lation in 2012.

Linda is a senior nurse with many years of clinical experience. She started with the cancer program in 2007 after an injury precluded continued work in the ED. She tackled the new content area with the en-thusiasm and curiosity of a young learner. She continues to ask questions of me and other physicians about the care we provide in order to improve her understanding and enable her to provide better care for her patients. She is a very astute clinician. In 2013, she sought and obtained her oncol-ogy nursing credentials. Her continued dedication to lifelong learning is inspiring.

Linda is extremely devoted to the pa-tients she cares for and forges strong rela-tionships with many. She calls them "her people." I have known her to call patients well after they have fi nished treatment and are in the follow-up phase of care to see how they are doing and for example, "get that cannelloni recipe." I have known her to personally follow up lab results to call patients on the weekend (e.g. a urine C+S). It is not uncommon for me to en-ter a patient room and have the patient

greet me politely, only to be followed by Linda and hear an exuberant "HI LIN-DA!" Being able to connect with her in person is clearly the highlight of their visit. She is a huge source of encouragement to her patients.

Linda inspires me to maintain and improve the humanity in my medical practice.Nominated by: Dr. Lisa Barbera

3RD NOMINATIONWhat constitutes a hero? For me, a hero is someone who

does something without thinking of themselves,

someone who jumps at the opportunity

to help others without ques-tion, not for

the rewards or

accolades but because it is the right thing to do, someone who is a role model and makes a difference in another’s life. Ms. Linda Jurincic truly exemplifi es what a ‘Nursing Hero’ is.

I have had the pleasure of working with Linda for last 8 years at the Odette Can-

cer Centre. During this time, I have seen fi rsthand, the positive im-

pact she has on her patients. She goes the extra mile for each and every one of them, whether it is hold-ing their hand during a procedure, or listening to their fears and concerns

and addressing each one until they are comfortable,

or empowering patients to be active members of their health

care team. The patients that she touches love her which is evidenced by their inquiries when she is not around.

Linda provides holistic person-centered care rather than a disease-approach to care. One such moment occurred recently, when a patient came for her fi rst inter-nal radiation treatment. The patient was extremely nervous. Linda listened to her fears, held her hand, wiped away her tears, and provided the information and educa-tion the patient needed to get through the treatment. However, it was during the con-versation that the patient expressed what was really bothering her. The patient had recently lost her job and was dealing with this in addition to her cancer diagnosis. Linda acknowledged her loss and her fears but also provided great suggestions and support to help her get back on her pro-fessional feet. The patient was so apprecia-tive that Linda took the time to listen to her. Linda is generous of her time, gener-ous of her vast knowledge and generous of her skills to ensure that every patient she encounters receives the highest quality of care.

I have recently been appointed to an ad-vanced practice position in radiation ther-apy. Linda has been a source of support, guidance and mentorship, teaching me new skills and increasing my knowledge base in gynecological cancer treatments.

Linda has been a truly inspirational nurse to not only her patients but also for all health care professionals across the en-tire oncology program. Her passion and dedication to providing the best patient centered care has improved the care we deliver. Her commitment to her own pro-fessional development and continuous learning provides me with a positive role model to look up to. For these reasons, I believe Linda is truly deserving of this pres-tigious nursing award. nHNominated by: Laura D’Alimonte

I

Linda Jurincic RN CON (C)

Odette Cancer Centre, Sunnybrook Health Sciences Centre

It is my great pleasure to provide this letter of recommendation for Ms. Linda Jurincic for the annual Nursing Hero

Linda is a senior nurse with many years of clinical experience. She started with the cancer program in 2007 after an injury

cer Centre. During this time, I have seen fi rsthand, the positive im-

pact she has on her patients. She goes the extra mile for each and every one of them, whether it is hold-ing their hand during a procedure, or listening to their fears and concerns

and addressing each one until they are comfortable,

or empowering patients to be active members of their health

care team. The patients that she

1st

prize



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s a nursing expert in the NICU, Clinical Nurse Special-ist Heather Chinnery led the implementation of delayed

cord clamping (DCC) in pre-term babies, making the Neonatal Intensive Care Unit (NICU) at the Stollery Children’s Hospi-tal's Royal Alexandra Hospital (RAH) site in Edmonton the fi rst facility in Canada to make this a standard of practice.

A neonatologist at the Stollery ap-proached Heather with European studies showing that delayed cord clamping signifi -cantly reduced the risks of brain injury and hospital-acquired infections, and reduced the need for blood pressure support in ba-bies born between 22 and 36 weeks of ges-tational age.

At that time, the practice for pre-term babies in Edmonton was to imme-diately clamp the umbilical cord and move the newborn to a neonatal warmer.

Heather lead an interpro-fessional team charged with implementing the practice change, developing indica-tions and contraindications, and with measuring both staff adherence and patient outcomes.

This change in policy and proce-dure not only crossed departments (NICU and Obstetrics), but hospitals and required education and training of large numbers of staff and physicians.

As the fi rst site in Canada to initiate this practice, intake of new learners (staff and physicians) required on-going education to help staff adopt the new practice. As with major practice changes, uptake of the new protocol was slow and inconsistent, requir-ing close monitoring and frequent follow up and re-education.

Now, the team delays clamping the um-bilical cord by 60 seconds, allowing the baby to take his fi rst breaths and receive blood from the placenta. This extra blood stabilizes the baby’s blood pressure and is also thought to boost stem cells, which help fi ght infection and repair damaged cells.

Since this standard of practice was in-troduced at the Stollery's RAH NICU Children's Hospital in 2008, there is docu-mented evidence of improved health and outcomes for pre-term babies in the NICU. The rate of necrotizing enterocolitis – a condition where tissue in the bowel starts to die – has been reduced from 5.4 per cent to 1.5 per cent. As well, the proportion of pre-term babies whose core tempera-ture drops below normal levels has been reduced from 31 per cent to less than 20 per cent.

Over the past four years, the labour and delivery unit at the Lois Hole Women's

Hospital in the RAH has used delayed cord clamping on all pre-term babies not requir-ing other immediate interventions.

There are about 50,000 births in Al-berta annually and, of those, about 6,500 (or 13 per cent) are premature – the high-est rate of pre-term births of any Canadian province. The national pre-term rate is about 10 per cent. Nationally, delayed cord clamping is used on less than 10 per cent of all pre-term babies.

The DCC practice was expanded throughout Edmonton hospitals in 2011, and is now being shared with facilities across the province and the country, thanks in large part to Heather’s knowl-edge, expertise and passion.

I have had many opportunities to expe-rience Heather Chinnery’s dedica-

tion to the patients and families who are recipients of her ex-

pert knowledge and excep-tional care, as well as that of her colleagues and the neonatal community extending beyond the walls of the hospital.

Her involvement, hard work, and dedication

to implementing a practice that has improved outcomes

for pre-term babies is very close to my heart. As a parent of very premature and critically ill twins, I have fond memo-ries of Heather and the help that she gave us when the boys were in the hospital. One instance I remember quite clearly: After Andrew’s surgery, his stomach had a large incision and needed to heal. The regular bandages and treatments weren’t quite working for him. As the Wound Specialist, Heather came up with a new system which included a funky patch that Andrew had on his stomach. In order for this patch to work, it had to be left on and not removed like regular dressings. Heather made sure that the patch wouldn’t be removed by writing with a Sharpie pen directly on the patch “Do Not Remove” across the patch on his tummy. It proved to be very successful.

I always felt that Heather had Andrew and our best interests in mind, and she tried her very best to help Andrew. She was always kind, caring and compassionate.

I have also drawn on her expertise as I work to complete my degree in Health Ad-ministration and facilitate my own learn-ing. As part of my term paper for a Risk Management and Quality Improvement course, I was asked to review a relatively unknown clinical practice that, if widely implemented, would improve the quality and outcomes for patients. Heather’s work on Delayed Cord Clamping was inspiring and fi t the criteria perfectly. Heather took

the time to share her research with me and helped provide me with an understanding of the work involved. I wouldn’t have got-ten the A+ without her!

As a colleague, I have had the pleasure of working directly with Heather and her team on various projects focused on en-suring family centred care in the NICU. Whether it be educating new staff, intro-ducing new practices or being part of the setup of new programs (such as introduc-ing a focused approach to developmen-tal care in the NICU), she consistently demonstrates her commitment to the pa-tients, their families and her colleagues. She shows creativity in fi nding solutions.

Solutions based on facts. For example, to test the effects that ambient noise in NICU had on babies, she engaged the audiology department to test the sound levels in vari-ous conditions. These included with the incubator top up or lowered, an incubator with or without a cover, what was with the baby in the incubator (e.g. blanket, etc.), conversation levels and noises during pro-cedures. This thorough approach helped determine the best possible environment for these most fragile of babies. There are many such examples where Heather’s in-novative approach improves the experi-ence for babies and their families. nHNominated by: Marni Panas

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A

babies in Edmonton was to imme-diately clamp the umbilical cord and move the newborn to a

and with measuring both staff adherence and patient

This change in policy and proce-dure not only crossed departments (NICU

tion to the patients and families who are recipients of her ex-

pert knowledge and excep-tional care, as well as that of her colleagues and the neonatal community extending beyond the walls of the hospital.

hard work, and dedication to implementing a practice

that has improved outcomes for pre-term babies is very close

to my heart. As a parent of very premature

2nd

prize

HeatherChinnery

Clinical Nurse Specialist

Neonatal Intensive Care Unit, Stollery Children’s Hospital



adge Reece received six nominations for the Nurs-ing Hero Award. Every sin-gle nomination came from

a patient or a patient’s family member and everyone said the same thing. Madge went above and beyond as their nurse. Here are a few of the nominations:

NOMINATION 1I had met nurse Madge at a time when I

was going through a rough patch with my health in January 2014. I had been admit-ted into the hospital. I remember being so scared to be there. However, she had a calm nature that was reassuring to me. My stay at the hospital lasted over two weeks. Madge made sure that I was cared

for and that I was doing the basic neces-sities to get myself well. She encouraged me to talk to others, eat my food, cancel my health appointments that I couldn’t at-tend and always made sure I was alright. Her positive attitude gave me hope.

I had no visitors during my stay at Humber River Hospital. Madge had kind words that showed me compassion. When I started to show signs of health improvement, I could tell that Madge was sincerely happy for me. She had said things to me that uplifted my spirits. I no-ticed that on the fl oor her patients were getting the best care possible. She was thorough with her treatments. As a team leader, she had shown leadership with staff and patients. I am very grateful to have received the best care from Nurse Madge. Nominated by: Marigrace Galura

NOMINATION 2 I met Nurse Madge Reece in August

2013, when she came into my room 425 to do my stats. Right off the bat I felt at ease with her. After taking my stats she sat with me for a few minutes to get an assessment of my mental well-being. She was very sympathetic as well as em-pathetic with my condition. God must have sent her to be my guardian angel that morning (teary moment) because she was the fi rst nurse I saw besides those that admitted me throughout the night. I felt comforted by her, in speaking with her I felt like my mom was there in sprit but not in body. We sat for thirty minutes talking, with her giving me inspirational quotes to live by. I felt the weight lifted off my shoulders after speaking with her.

I developed a bond with Madge that will not be broken until death do us part. She is now my adopted mother. Through-out my stay on the unit, I constantly sought her out just to bask in her glory. I felt I needed to feed off her spirituality in order to continue my recovery. I was right, it has helped immensely. I still felt the same way on my second visit to the hos-pital. I like how she treats people with the respect and inherent dignity they deserve. She’s approachable in her manner and her

presence. These qualities are hard to fi nd in many others and so for me she is divine. I also like the fact that she does not try to impose her judgment on others but allows each individual to fi nd ways that are fa-vorable to them in solving their problems. I felt Madge went beyond the call of duty in her care for me during my stay.

My family adores her; my friend Da-vilyn felt that Madge is an inspiration to others and that she has a huge heart. The fact that Madge took us under her wings and helped to instill in us values that we never had is one of the reason my fam-ily friends are so drawn to her. I am very thankful that I met this lady when I did because she has somehow changed the course of my life. Madge not only inspired me but encouraged me and my family as well. She has opened their understand-ing to dealing with mental health issues, something that was previously not dis-cussed in our close knit family. She shows my family and friends the compassion required to deal with the touchy subject matter of what goes on in a patient with mental health and for that I am eternally grateful.

I would like to nominate this lovely lady to be a Nursing Hero because she embodies Grace, Beauty, Soul, Heart and a love for nursing like no other. Madge is the Mother Theresa of nursing.

Nominated by: Marsha Taylor

NOMINATION 3 I was a patient at Humber River Hos-

pital in February 2014. I thought all was lost in the world and needed to end my life.

I felt ashamed, lost, and alone. After my second day at the hospital, I met the most compassionate and caring nurse, Madge. She helped me believe in myself, my family love, and gave me hope to have the will to live. She put a smile back on my face, when I thought all was lost.

Madge is my hero and gave me my second chance at life. I thank her for guiding me to the right path of recov-ery. Madge, you are a blessing to all your patients and me. nH Nominated by: Charmaine

3rd

prize

Madge ReeceMental Health Unit, Humber River Hospital

M

We thank our nurses for providing quality care and serviceAs we celebrate 2014 National Nursing Week and its theme “Nursing: A Leading Force for Change”, we’d like to thank our dedicated team of nurses for the quality care they provide to our patients at Rouge Valley.

Each day our nurses deliver quality care to our diverse patient population. We value their expertise, skills, and abilities applied to a variety of clinical areas.

Our Clinical Practice Leaders, Managers, Directors, and Vice Presidents promote best practices, improve processes and systems, and shape health policies. As frontline sta�, our Registered Nurses, Registered Practical Nurses and Nurse Practitioners provide direct patient care and impact the lives of our patients in many ways:

• Providing critical and emergency care as part of our Regional Cardiac Care program, or in the Emergency department, and Critical Care units

• Helping to bring new lives into the world in our Women’s and Children’s Health program

• Providing acute and restorative care with patients in Medicine and Post-Acute Care

• Supporting patients and families in coping with the challenges they may be facing in the Mental Health program

• Holding the hand of a nervous patient while preparing for surgery

We thank and commend our nurses for the care and compassion they show to their patients, families and colleagues. Thank you for making a wonderful and profound di�erence at Rouge Valley Health System.

Rouge Valley Health System www.rougevalley.ca



n his role as a Charge Nurse in Critical Care at North York General Hospital, Edsel pro-vides admirable leadership

skills to guide new staff and colleagues for a 24 bed unit hosting critically ill patients. More importantly, Edsel is well-known for being a seasoned professional and an ad-vocate for needed changes in the critical care department as well as has mentored many new nurses and nursing students. He is described as warm and compassion-ate with a sound knowledge of nursing practices. Edsels’ career includes nursing positions at various hospitals both nation-ally and internationally, obtaining exten-sive experience in coronary and intensive care. Among colleagues, Edsel is known as one who speaks with knowledge and strives to improve the health and wellness of the people whose lives he touches. This desire for lifelong learning has effectively increased his ability to provide compas-sionate, client-centered care in a variety of settings. Edsel is recognized by his col-leagues as being passionate about his care and professional development, never satis-fi ed with the status quo and always looking for opportunities for improvement.

One example that illustrates this in-volved a 32-year old patient with a recent

diagnosis of ALS. Edsel worked closely with the patient, connecting him with sup-ports within the community for post dis-charge, providing emotional support and positive reinforcement along with cultur-ally sensitive care to the family members involved. This patient was discharged in better spirits having hope for his condition knowing that there were support sys-tems available to help him cope effectively. Edsel was easily able to develop a supportive and culturally sensitive re-lationship with this young patient whom many others stayed away from due to the emotionally draining situation they found themselves in and they found it challenging to deal with the fam-ily. Edsel, in a very natural and respectful manner was able to intervene and advo-cate for this patient and his family. He is well known for effectively managing and caring for our most challenging patients.

A second example involves a 17-year old boy who was admitted from home with Muscular Dystrophy, whose mother had abandoned him and his father evidently was experiencing caregiver burden. Edsel frequently advocated for this young cog-nitively aware patient for age appropri-

ate interventions and support to be provided. He spent time with

this patient and got him a motor-ized wheelchair, allowed the child to

listen to music and read the news. Taking the time to provide psychosocial support in this child’s life when his own parents were unable to effectively do so demonstrates that Edsel goes above and beyond to care for his patients. When this patient was transferred to a chronic care unit, Edsel continued to visit him and provide sup-port.

Edsel is very humble about his skills. He personally mentored me when I was a new graduate and the thing I most respect about Edsel is his ability to teach and men-

tor others. He has the serenity, patience and experience to bring new nurses along in their practice, giving them the confi -dence they need to succeed. Working the nightshift for many years with minimal management, he has become an expert leader, being able to make critical deci-sions daily with very little resources at his fi ngertips. He is also well respected by his colleagues, patients and families.

Edsel has never lost his sense of empathy and caring in the many years of nursing he has provided care. It would be an honour to recognize someone of his calibre for his excellence in achievement of professional development. nHNominated by: Sharon Fernandes

Edsel Mutia RNCharge Nurse Critical Care,North York General Hospital

I

tems available to help him cope

emotionally draining situation they found themselves in and they found it challenging to deal with the fam-

ate interventions and support to be provided. He spent time with

this patient and got him a motor-ized wheelchair, allowed the child to

listen to music and read the news. Taking

HMHMHONOURABLEMENTION

Our Board of Directors, sta�, physicians and volunteers at Rouge Valley Health System wish our nurses all the best for National Nursing Week 2014. Thank you for helping us to live our vision to be the best at what we do for patients.

THANK YOU ROUGE VALLEY NURSES!



unyu is an exceptional Nurse Practitioner. She arrived at Mackenzie Health in Novem-ber 2013 and in a few short

months has established herself as a kind, caring and compassionate nurse who is passionate about providing care to pa-tients with heart failure. After working at the University Health Network for several years, Qunyu made a conscious choice to move closer to home and begin giving back to her community in Richmond Hill and the broader southwest York Region that is served by Mackenzie Health.

She was hired as the fi rst NP in Cardiol-ogy in the 50 year history of the hospital. Qunyu was selected as an exceptional can-didate for the role based on her extensive experience, knowledge and skill for a very specialized patient population. Her quiet and soft spoken demeanor, in concert with her incredible ability to give voice to the patient experience and drive quality pa-tient outcomes make her a dynamic pro-fessional.

Qunyu works collaboratively with all members of the health care team in a re-spectful and professional manner. She has quickly established credibility with her

physician partners who now seek her out to collaboratively care for patients who ben-efi t from a nurse practitioner who brings a unique approach to patients dealing with heart failure. Through her leadership and visionary think-ing and collaboration with an interprofessional team, a Heart Function Clinic was created and opened in February 2014.

Qunyu cares for the most complex heart failure patients in the inpatient cardiology unit who often have multiple visits and/or admis-sions to hospital. Through her expert and compassionate care, Qunyu has been able to provide care that is empathetic, sensi-tive and focused on the physical as well as emotional needs of the patient. She ac-tively uses a variety of teaching methods to translate complicated heart health in-formation into simple terms that are easily understood by patients and families.

Qunyu values the contributions of in-terprofessional team members and actively involves family in supporting the patient as they transition back into the commu-nity. Her leadership has been felt on the unit where nurses feel supported in seek-

ing guidance, teaching and sup-port from her as she is a role

model for practice. She creates a safe place for patients and staff to ask

questions and seek clarifi cation about the plan of care.

As a physician partner, Qunyu is an asset to the team. She collaborates and consults as appropriate and her judgment is spot on. She brings evidence-based practice to the interventions she proposes to patient care and is introducing physicians to a new way of interacting with nurses around patient care. We strongly believe that through Qu-nyu’s presence and outstanding practice, we are establishing a new model of service delivery that will make a profound impact on patient outcomes and satisfaction. This is evidenced by the fact that since her ar-rival and co-implementing a NP collabora-

tive practice model with Mackenzie Health Cardiologists, heart failure patients under that model have had zero per cent read-mission 30 days post-discharge where the national average sits around nine per cent.

We are so proud and privileged to have Qunyu as part of our team at Mackenzie Health. She brings enthusiasm, energy, and commitment to patient care that is inspiring. Patients and families have re-sponded positively to her approach and are confi dent that they are being cared for in the best way possible. We believe Qunyu Li is an extraordinary nurse who is worthy of the Nursing Hero Award. nHNominated by: Dr. Victoria Chan, Clinical Chief of Medicine; Dr. Grace Chua, Clinical Division Head, Cardiology; Tiziana Rivera, Chief Nursing Executive and Chief Practice Offi cer – Mackenzie Health.

Qunyu LiCardiac Function Clinic, Mackenzie HealthQ

with heart failure. Through her

complex heart failure patients in the inpatient cardiology unit who

ing guidance, teaching and sup-port from her as she is a role

model for practice. She creates a safe place for patients and staff to ask

questions and seek clarifi cation about the




n behalf of all staff of the Rouge Valley Health System – Centenary ER, I would like to nominate Lois Robinson for

this year’s Nursing Hero Award.Lois has been at Centenary for 39 years.

It is hard to imagine that this spring Lois will be retiring and leaving her emergency room family.

Looking at the nomination criteria for this award, I cannot imagine any nurse in our organization except Lois who meets each one above and beyond. It is diffi cult to give examples of how she meets these criteria without writing a novel so I will provide a brief summary.

“Auntie Lois” as she is affection-ately called by all is the most compassion-ate and caring person we have met. She is often seen giving her “hugs” to staff and patients when truly needed. At times of stress both patients and nursing staff can always count on Lois for her support.

Auntie Lois has a quiet and calm-ing effect on everyone. She maintains a

positive attitude no matter what. Aun-tie Lois demonstrated the organization’s Start with Heart principles before they even were invented. To watch her with a small child or even an elderly patient you can see how easily she can calm their fears with her words or even a sim-ple touch.

Auntie Lois is a great mentor when it comes to new nurses and to those of us

who have been here a long, long time. She is a true leader who not

only shows everyone respect but has our respect as well. Nursing students and new grads’ fears are often allteviated when work-ing with Lois as she puts them at

ease through her professionalism and acceptance of all.

Auntie Lois demonstrates courage, in-tegrity and strength of character through her daily practice in the way that she has overcome her own personal challenges and provides quality patient care. She maintains her professional development requirements so she can continue to pro-vide safe and current practices.

Auntie Lois has a great relationship with her colleagues here at RVC Emerg. This includes not only the nurses but doctors, auxiliary staff, support staff and the entire multidisciplinary team. She truly has our trust, respect and admiration and we can only hope to be as great a person as she is.

As mentioned earlier, Lois will be retir-

ing in April. Although we are excited for her, we are also going to miss her terribly. We think that it would be a great way to show how much she has touched our lives and her patient’s lives by presenting her with this award. nHNominated by Lynn Yantha and the emergency department staff

Lois Robinson RNEmergency department, Rouge Valley Health System

O

for this award, I cannot imagine

“Auntie Lois” as she is affection-ately called by all is the most compassion-

who have been here a long, long time. She is a true leader who not

only shows everyone respect but has our respect as well. Nursing students and new grads’ fears are often allteviated when work-ing with Lois as she puts them at

ease through her professionalism and acceptance of all.

Auntie Lois demonstrates courage, in-

HMHONOURABLEMENTION

Celebrating world-class nursing care and caring

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N75-NUR-071_FIN_REV.indd 1 2014-04-30 9:52 AM



Heather AndersonAlberta Health Services Lac La Biche Mental Health

Kathrine AndersonThunder Bay Regional Health Sciences Centre

Ervin AngHaro Park Centre, Vancouver

Sarah BairdPeterborough Regional Health Centre

Monica BallOrillia Soldiers’ Memorial Hospital

Dell BascusUniversity Health Network

Jared BaxterOrillia Soldiers’ Memorial Hospital

Kris BayleyUxbridge Cottage Hospital

Paulina BleahUniversity Health Network

Tami BrantSunnybrook Veterans Centre

Susan BreckenridgeAlmonte General Hospital

Elizabeth BrownHotel Dieu Hospital

Marcia BryantHotel Dieu Hospital

Cheryl Byrns (2)Humber River Hospital

Lindsay CarlssonUniversity Health Network Princess Margaret Hospital

Cara CarneyRunnymede Healthcare Centre

Dolores (Lolly) Castro (2)Runnymede Healthcare Centre

Sylvie CharetteBruyère Continuing Care, St. Vincent Hospital

Heather ChinneryStollery Children’s Hospital, Alberta

Christine ChoatePeterborough Regional Health Centre

Delia CianoMackenzie Health

Linda ClarkPeterborough Regional Health Centre

Angie ColuccioTrillium Health Partners

Alfredo Cootauco (2)Runnymede Healthcare Centre

Veleta DouglasUniversity Health Network Toronto Rehab

Angela DwyerNorth Bay Regional Health Centre

Helen DwyerTrillium Health Partners

Lauren EdwardsTrillium Health Partners

Carla ErumRunnymede Healthcare Centre

Aimee EsmejardaRunnymede Healthcare Centre

Nafeesa FatimaMarkham Stouffville Hospital

Cherise FernandoHaro Park Centre, Vancouver

Kelly FreemanSt. Mary’s General Hospital

Joseph GajasanUniversity Health Network, Toronto General

Margeret (Maggie) GallagherOrillia Soldiers’ Memorial Hospital

Anne GarlandSunnybrook Health Sciences Centre

Nicole GlaubitzAlberta Health Services, Lac La Biche Mental Health

Sandra GosineTrillium Health Partners

Whitney GowanlockOrillia Soldiers’ Memorial Hospital

Leona GrahamTrillium Health Partners

Sheila HallowayAlmonte General Hospital

Kathy Hardill360 Degrees VON Clinic Peterborough

Marvia HarveyTrillium Health Partners

Tammy HirkalaAlmonte General Hospital

Arden HamiltonNorth Bay Regional Health Centre

Susan HamiltonSaint Elizabeth Health Care

Deb Hanna-BullPeterborough Regional Health Centre

Janice HolmesTrillium Health Partners

Lauren HullNorth Bay Regional Health Centre

Janice JonesSunnybrook Health Sciences Centre

Julie JosephRunnymede Healthcare Centre

Camelia JurchescuRunnymede Healthcare Centre

Linda Jurincic (3)Sunnybrook Health Sciences Centre

Jeanette KennelSt. Mary’s General Hospital

List of Nominees 2014 Nursing Hero Awards

Colette Parker, – McKenny Creek Hospice Residence BC

Colette has been a nurse for over 44 years and is currently working at McKen-ney Creek Hospice in Maple Ridge, BC. I have been a volunteer at the Hospice for 2 years and I have had the honour of watch-ing Colette be a hero to countless people and families. Her care and compassion far exceeds the daily requirement of doing her job well. We have an altar where the names of people who passed are written and there is a book where families can write some-thing if they choose to. I have seen and heard Colette's name come up again and again for being the greatest of support dur-ing such a difficult time. She truly cares about each and every person she takes care of in the Hospice. Losing someone you love is one of the hardest things to deal with so those that have had the support of such a wonderful nurse have been truly blessed.

Kris Bayley – Uxbridge Cottage Hospital

Kris embodies all the qualities of a pro-fessional and caring nurse that we all as-pire to reach. We work in a small rural ER dept. One night we received a call – teen-age VSA. We had about 2 minutes to get ready for this patient. He had been in a terrible car accident not far from our ER doors. Our small ER team worked on him for over an hour using every resource avail-able to us including a couple of ORNGE paramedics that were there to transport yet another acute patient.

It wasn’t until well into this code when I was given his wallet to ID him that I found his next of kin was listed as one of our staff members, someone well known to us all. When the deceased patient’s mother ar-rived, Kris was incredible.

This is where you see what the true meaning of being a nurse really is. She demonstrated the perfect combination of caring, compassion and support during this unthinkable time.

I was in complete awe of her empathy and professionalism in what was also a very distressful time for her as well. Despite the emotional upheaval of the deceased young man, we still had a full department of patients and no break in sight on our 12 hour night shift. Kris continued the shift providing the care each individual patient deserved. Kris obviously has found her

calling because she is one of those special people that see more than just the patient.

When you work in a small commu-nity, often you are working with limited resources and frequently on patients that you know. They are your family, friends and coworkers. It takes a very special nurse to thrive under these extenuating circum-stances and Kris is one of those rare nurses.

Pernille Pedersen – Princess Margaret Hospital

Pernille is an extremely dedicated and reliable nurse. Stays after hours to take care of patients and sort urgent problems. Always attentive, kind and polite. Has ex-cellent clinical skills and will never “turf” solvable problems. I vote for her with my hands and feet.

Monica Ball – Orillia Soldiers’ Memorial Hospital

Monica goes out of her way to get to know patients and their families, and pro-vides them with clarification of informa-tion related to their medical conditions. She welcomes telephone inquiries at any time, and provides answers quickly and ef-ficiently. No interruption is ever a bother to her, no matter how busy her day. She is readily accessible and approachable to GDH patients, whether via telephone or drop-in visits. Monica’s pleasant, friendly, down to earth manner successfully allevi-ates the anxieties of patients and their fam-ily members. She ensures that each con-cern presented is treated with respect and humanity. She also successfully pre-empts problems; she has often provided families with knowledge and guidance which has resulted in avoidance of crises, emergency department visits or hospitalizations.

Alfredo Cootauco – Runnymede Healthcare Centre

Alfredo is a nurse with a big heart. He understands not only the patient but the patient’s family as well. He never rushes when taking care of my dad. Everything he does is methodical and well-thought out. He is the one who helped my dad during an attempt at toilet training. Alfredo showed respect for my father’s dignity and the situ-ation went well. My dad feels comfortable and at ease with Alfredo as his nurse which means the world to me and my family.

Lauren Hull – North Bay Regional Health Centre

Lauren demonstrates commitment, dedication, compassion and leadership, whether it comes to her patients, col-leagues or the public, and she has done this despite the use of only one function-ing lung! Identified as “Mother” by staff, she embodies that role in the care that she provides in all her work. She has been a driving force for the Healthy Living Pro-gram, which combines the benefits of physical and mental health, through a col-laboration of nursing skills with those of a recreation therapist as well as a dietician and general practitioner to epitomize cli-ent-centred care. Beyond this, Laurie pos-sesses a wealth of knowledge on Clozap-ine, which is why nurses and doctors alike approach her for clinical consultation. She also reaches out to external partners to ac-quire additional resources, which are espe-cially necessary in a healthcare context of increasingly limited funding. Additionally, she participates on a number of projects for the benefit of patients and staff alike, including the Diabetic Education and Support Committee, Health and Safety Committee, while serving as the Ontario Nurses’ Association representative for the Mental Health Clinic.

Ray Lam – The Hospital for Sick Children

As a graduate student in the MSc Global Health program at McMaster University, students were presented with an opportu-nity to complete an internship in an area of their choice. I had always been passionate about infectious diseases but being new to Toronto I was feeling a bit lost as to where to turn to gain experience.

I came across Ray's name when search-ing for connections and after a few phone conversations he agreed to take me on as his intern for the summer. Ray went above and beyond making me feel a part of his team and a part of my new city. He never treated me as a student but rather would introduce me as a colleague. He constantly challenged me to think outside of the box, push beyond my limits and leap out of my comfort zone.

He went above and beyond putting me in touch with several people in an effort to expand my network, offered me hours

Hospital News salutes all nominees of the 2014 Nursing Hero Awards



Ailie KerrInterior Health, Ponderosa Lodge

Olga KoveshnikovUniversity Health Network, Toronto Rehab

Gabriela KudiaborRunnymede Healthcare Centre

Daniel KwiatkowskiTrillium Health Partners

Brian LalibanTrillium Health Partners

Ray LamThe Hospital for Sick Children

Marcia Langhorn South West Regional Cancer Program

Catarina Ann LemosSunnybrook Health Sciences Centre

Dan Li (2)Runnymede Healthcare Centre

Qunyu LiMackenzie Health

Yu (Kathy) MaSunnybrook Veterans Residence

Vanessa MadridAlberta Health Services, Carewest Glenmore Park

Dorothy Martin Chatham Kent Health Alliance

James MastinToronto Central Community Care Access Centre

Wendy McElroyTrillium Health Partners

Melody McGregorThunder Bay Regional Health

Sciences Centre

Maureen McLeod FrazerAlmonte General Hospital

Connie MorrisonSouthwest Regional Cancer Program

Edsel MutiaNorth York General Hospital

Marge NapBluewater Health

Bonnie NicholasThunder Bay Regional Health Sciences Centre

Colette ParkerMcKenney Creek Hospice Residence, BC

Pernille PedersenUniversity Health Network, Princess Margaret Hospital

Franca PellegrinoThunder Bay Regional Health Sciences Centre

Leon PlukhovskiSunnybrook Health Sciences Centre

Cathy PorteusAlmonte General Hospital

Lorna QuailHaro Park Centre

Madge Reece (6)Humber River Hospital

Pam ReeseKelowna Mental Health and Substance Use

Eleanor ReyesSunnybrook Health Sciences Centre

Estrella ReyesRunnymede Healthcare Centre

Lois RobinsonRouge Valley Health System

Marilena RutkaUniversity Health Network Toronto General

Natalie SakinMount Sinai Hospital

Rich SchregardusMarkham Stouffville Hospital

Kathy ShauleTrillium Health Partners

Iceval (Icy) Simpson-WeirRunnymede Healthcare Centre

Elizabeth Angela SmithTrillium Health Partners

Lee-Anne StaynerUniversity Health Network Princess Margaret Hospital

Anne StephensToronto Central Community Care Access Centre

Gina StokesSunnybrook Health Sciences Centre

Nancy TimanProvidence Care, Kingston

Donna TomlinsonRunnymede Healthcare Centre

Gurjit ToorUniversity Health Network,Toronto Rehab

Nicholas TsergasSunnybrook Health Sciences Centre

Mary Tulk (2)Interior Health Penticton Health Centre

Kate Uchendu (2)University Health Network, Toronto General

Dragica VelimirovicTrillium Health Partners

Mary Wadsworth Trillium Health Partners

Millicent WaltersRunnymede Healthcare Centre

Lijuan YangRunnymede Healthcare Centre

Landy ZhangHaro Park Centre, Vancouver

Barb ZitaMount Sinai Hospital

of insight on my scholarly paper, and of-fered me amazing opportunities to get involved with projects I could have only dreamed to be involved with. It is not too often you enter into an organization as an intern and have a chance to work WITH and be a part of such a cutting edge and well respected team. Ray has brought the infectious disease team together in ways I have never seen before. The usual hierar-chy of health care workers is simply not there. Ray has put everyone on an equal playing field (which is huge for the nurs-ing profession). He is so well respected. In fact, countless times I have overheard doc-tors state that Ray is the most important person on their team. Pretty incredible. Not only is he an amazing, compassion-ate, dedicated, committed nurse, mentor and person, he is making huge strides to help the nursing profession become more respected. Every day working with Ray I was touched by the care he demonstrated for his patients. He has inspired me to be better – in my career, in delivering patient-centred care, and as a human being.

Vanessa Madrid – Alberta Health Services

When I think about what makes a nurse a hero it is not, in my mind, solely related to providing care and services to the cli-ent. While that is indeed a vital and im-portant nursing role, the support of oth-ers, whether new nurses, students, other health care professionals is what makes a nurse a hero. As her manager, I am daily honoured to have her not only as an em-ployee but as a colleague. Her judgement and commitment to nursing as a profes-sion coupled with her thoughtful and em-pathetic approach to all her interactions continue to motivate me and make me truly glad to work alongside her.

Wendy McElroy – Trillium Health Partners

Wendy works in the spirit of team col-laboration and cares for her patients be-yond what is required from our profession-al duties. Working nights can be physically and mentally draining, but she still man-ages to assist her colleagues. One example is providing peri-care on her partner's patient while she was on break (and then bathing him) instead of waiting until her partner returned and waking up the pa-tient again to bathe early in the morning.

Kelly Freeman – St. Mary’s General Hospital

Kelly truly gives 150% percent of her-self. One night shift we received a patient, sadly close to end of life. After medical assessment, the family wanted to take the patient home. A ride was not possible due to patient’s condition. Kelly being the kind person she is, allowed the patient’s family to bring their car into the ambulance bay and she physically helped lift the patient into the back seat for transfer to home. She called the family to ensure they ar-rived safely.

Dorothy Martin – Chatham Kent Health Alliance

Dorothy approaches each day, with en-thusiasm and compassion. She is a leader amongst her peers and colleagues. On the Thanksgiving weekend, we had a new type 1 child diagnosed, and admitted to hospi-tal on the Friday afternoon. The patient's family had not received the diagnoses, by the time our regular work day had com-pleted, so Dorothy, – very willingly offered to come back on the Saturday – to meet the family, and do an initial teach of in-sulin etc. Dorothy has always maintained that our initial contact with the Type 1’s is so important from the get go… Dorothy – was also serving Thanksgiving to her fam-ily of 17 people that same day!

A second example of her going above and beyond, is when she starts a patient on the insulin pump, she gives out her per-sonal phone number and pager number, so the patients can contact her ANYTIME within the first 48 hours of starting on the pump – just for support and re-assurance. She has talked to MANY patients/family members well into the wee hours of the night, just to provide them with a listen-ing ear, and to help support them on their initial journey with improving the quality of their life on the pump.

Nancy Timan – Providence Care, Kingston

I have had privilege of being mentored by Nancy entering into a field of nursing that was new to me, Geriatric Psychiatry. Nancy provided the softest landing for me with her compassion, understanding, attention to detail, excitement in teach-ing, love for the nursing profession and

joy in mentoring in me. Nancy’s warm, enthusiastic, empathetic and personable presence creates a space to learn from her great wealth of knowledge. She motivates her colleagues to learn more and resolves conflicts and other difficult situations with remarkable patience and admirable tact.

Hard-working and dedicated, she car-ries out her work at a high standard and is always striving to find ways to improve patient care. She deserves recognition for all her extra efforts and strong char-acteristics that are not listed on her job description.

Aimee Esmejarda – Runnymede Healthcare Centre

In all our interactions with Aimee, she demonstrates exemplary performance that goes above and beyond her outlined nursing duties. Aimee has embraced and utilizes a rehabilitation philosophy with all her patient interactions, helping each individual to achieve their discharge goals.

On numerous occasions, she takes the time to conduct and encourage therapy with patients. She is especially diligent with those who are historically difficult to engage. She is compassionate and has an excellent bedside manner which builds rapport and encourages patients to partici-pate and interact with her.

Natalie Sakin – Mount Sinai Hospital

Natalie’s patients usually come from re-mote places in Ontario. The patients are often very sick and diagnosed with cancer malignancies. She always does best to pro-vide patients and families with the utmost comfort in their most overwhelmed and anxious state. Her knowledge and exper-tise in the field of peritoneal malignancies identifies her leadership abilities.

Marcia Bryant – Hotel Dieu Hospital

Marcia is an outstanding nurse and co-worker every day. She is always happy, compassionate and friendly. Always goes the extra mile to make life easier for every-one she comes in contact with. Her smile and sense of humour can melt even the most unwilling and uncooperative.

Hospital News salutes all nominees of the 2014 Nursing Hero Awards

Continued on page 14



Yue (Kathy) Ma – Sunnybrook Veterans Residence

My husband has been a resident in L Wing(LGSW) for 2 years and 5 months. Kathy has been Bruce's primary nurse for most of this time. An outstanding, true professional who cares deeply for the vet-erans in her care. She keeps me posted by phone when needed and we chat when I visit. She shows great compassion for my husband as his behavior is a challenge due to Alzheimers.

Lauren Edwards – Trillium Health Partners

I have been fortunate to work with Lauren and have seen her demonstrate a breadth of nursing skills and knowledge that is quite impressive. Her competence as a great leader and her willingness and enthusiasm to participate in building a stronger emergency nurse team through information sharing and the skills devel-opment of less experienced and begin-ning nurses is well respected amongst her peers.

Delia Ciano – McKenzie Health

My wife was rushed to Mackenzie Health with high fever. After necessary tests and medications, she was transferred to floor 4- East. The Nurse who looked after her was Ms. Delia Ciano. Her mind-ful listening, support and care towards my wife was commendable. Delia provided excellent clinical and emotional support. Above all, she is a knowledgeable nurse and my wife got appropriate care that was courteous, timely and respectful.

Joseph Gajasan – University Health Network

Transformational Leadership is what Joseph does on a day-to-day basis. For ex-ample, he helped a Partner in Care project that I’ve been working on for the past two years to become something much bigger and a lot more patients benefited. It be-came something much more innovative and creative than I anticipated. Joseph is a true Leader and I aspire to be like him one day and I’m encouraged to continue with my leadership development.

Kate Uchendu – University Health Network, Toronto General (2)

I have Sickle Cell Disease. I’d like to honor Kate Uchendu as a Hero because she is a good nurse.

Since I met Kate 2 years ago, she makes me feel very secure. She is very concerned about my well-being. Kate has a big heart and she loves her work very much. She is doing everything to get more informa-tion for Sickle Cell and she finds what she needs to help patients be better in life.

2nd nomination: She is having a global impact through

her work as she recently submitted an ab-stract that got selected for a conference abroad. Kate embraces academic excel-lence and seeks ways to embark on quality improvement for our clinic. She is leading other projects in the hospital such as the novel pilot project to enable Red Blood Cell Disorders patients have their cross-match specimens drawn at centres close to home. This project, if successful (and I have no doubt with Kate on the project

it will succeed), will change transfusion practice as it will reduce patient wait times significantly.

Anne Stephens – Toronto Central CCAC

Watching Anne Stephens work with a client with aphasia, who is unable to speak, in order to perform a ‘capacity assessment’ to determine their ability to make and communicate decisions for themselves, is a remarkable experience.

Her care, respect, patience, determina-tion and creativity are all on display as she searches for the person ‘masked’ by illness and the inability to speak. Anne’s ency-clopaedic knowledge, perfectionist drive and respect for clients and colleagues alike make her a very special member of the nursing profession.

Mary Tulk – Interior Health, British Columbia (2)

She works tirelessly to meet all of her client’s needs, going above and beyond on a daily basis for each and every one of them. She works with adults, children and pregnant women, helping them to manage their diabetes. On any given day you will find Mary in her office making telephone calls, or visiting one-on-one with clients, quite often during her lunch break or after hours. To top this off, after an extremely busy day she heads off to see clients in their homes for foot care. It is exhausting watching Mary as she never stops!! She is also a certified insulin pump trainer for the South Okanagan. All pump training is done on her own time.

2nd nomination:Mary is one of the hardest working peo-

ple I know, and is extremely deserving of this award. She spends many hours coun-selling people with diabetes and helping them live healthy, happy lives.

Mary is an integral member of the pe-diatric diabetes team. She is incredibly knowledgeable regarding this pediatric population and is always able to help the families work through the many issues that arise. She is often a voice of reason when dealing with the many teenagers in the program and a supportive listening ear for the parents.

Melody McGregor – Thunder Bay Regional Health Sciences Centre

Melody McGregor is a sexual assault and domestic violence outreach nurse here at Thunder Bay Regional Health Sciences Centre which means she not only a famil-iar face here at the hospital but also within the Thunder Bay community.

While I am only an intern here at the Thunder Bay Regional Health Sciences Foundation she made time in her day to talk with me after I had missed a presenta-tion she had given in the community that I wanted to attend. She took the time to ex-plain what her role was within the hospital and the community, how her patients are affected and she still now always has time to chat quickly when I pass her office in the hallway in the morning.

She works tirelessly with the most vul-nerable of patients with grace and care and still remains passionate to her values and personal investment in the community to educate those about sexual assault, domes-tic violence and how to get help.

If Melody was unable to do this our re-gion would be less informed, less safe and less reassuring.

Sarah Baird – Peterborough Regional Health Centre

Sarah has worked in the ICU for six years. She meets all of the aspects of a Nurs-ing Hero as she is committed, dedicated, compassionate, and a nursing leader. Sarah demonstrates her commitment to nursing by actively participating in the operation of the ICU. She is a member of the Criti-cal Care Operations Committee where she has advocated for the implementation of strategies to promote patient safety and the implementation of evidence-informed nursing practices. An example of this was the development of the Oral Care Policy. Sarah conducted a literature review, re-searched current guidelines and wrote the Oral Care Policy that has been adopted in the ICU. Sarah demonstrates her compas-sion outside of her ICU job. She has trav-elled to Honduras for three consecutive years, at her own expense, with “Friends of Honduran Children” to provide nursing care for those who lack access to funda-mental health services. Her comment to me was that “these people give [her] far more than [she] could ever give them” – this statement reflects Sarah’s humble attitude about the contributions that she makes on a daily basis.

Paulina Bleah – University Health Network

Within just 6 months of joining Uni-versity Health Network as a nurse at To-ronto General Hospital, 22 year old recent Ryerson U grad Paulina Bleah knew she wanted to do more. So Paulina set out to solve recurring practice issues. The num-ber one problem she identified on her ward was incontinence amongst the geriatric population, so she set about determining how to arrest the issue. With the support of her colleagues and her manager Pau-lina researched and wrote a proposal to be considered for a research scholarship un-der UHN’s Collaborative Academic Prac-tice Fellowship Program. The Fellowship Awards provide funding to worthy projects allowing health care professionals to devel-op solutions to practice issues and advance practice. Paulina’s proposal was accepted, and she set about looking for solutions by reaching out to patients, and her entire health care team. Paulina’s intelligence gathering allowed her to zero in on the issue of geriatric incontinence on her floor – and that led to a sustained change in practice.

Susan Hamilton – Saint Elizabeth Health Care

As the new leader of client experience, I like to travel with front line staff while they deliver care to patients, in order to better understand the work and needs of the staff and the clients. I spent the better part of the day with Susan and was amazed by her compassion, creativity, and humil-ity. In one trip, I saw (and heard) of three separate stories where she went well above and beyond the call of duty. One story: Su-san’s patient, living in a low income area, had bedbugs, and could not find anyone to help get a new mattress or rid of the old one. Susan brought her own air mattress to give to the patient, while helping her to locate a new one that she could afford and get assistance in removing the old mattress. I am constantly surprised by the hardwork, compassion, empathy and cre-ativity of our visiting nurses and staff, but Susan really stands out for me as someone who gives more. nH

Recognizing Nurses For Providing Leadership At �e Point Of CareOn behalf of the team at RPNAO, we’d like to take this opportunity to wish all our nursing colleagues throughout Canada a very happy Nursing Week.

Nursing Week is a time when all the countries around the world pause to celebrate nurses and the important work they do. �ere are more than 35,000 Registered Practical Nurses (RPNs) working in Ontario today. And more than ever, these nurses are being asked to play key roles in diverse health care teams along their Registered Nurse and Nurse Practitioner colleagues and a wide range of allied health professionals.

RPNAO’s theme for Nursing Week 2014 is “Leadership at the point of care. Ontario’s RPNs.” It’s a theme that celebrates the skill, expertise and dedication of Ontario’s RPNs, who, working alongside their peers in health care, demonstrate true leadership as they work to make positive differences in the lives of their patients, clients, residents and their family members. �ey demonstrate this leadership at the point of care in long-term care facilities, palliative care units, operating rooms, community care settings, emergency rooms and every other health care setting in which you will find a nurse.

During this special week, it is our honour to recognize and thank all nurses and other health care practitioners for the important and selfless work they do.

Sincerely,

�e Staff And Board Of Directors Of RPNAO

Registered Practical Nurses Association of Ontario



arcia has worked at the Lon-don Regional Cancer Program (and South West Regional Cancer Program) for over 25

years. Marcia began her career as a che-motherapy unit nurse and worked her way up to clinical manager for the chemo-therapy suite. She is now a regional educa-tor providing support to six satellite sites within the South West. Marcia has been instrumental in creating and promoting programs that allow patients to undergo chemotherapy treatment close to home. Care close to home allows patients to be supported by family and friends while re-ceiving cancer treatment in a comfortable, familiar setting.

Marcia was an integral member of the core project team that worked tirelessly to ensure the successful launch of the ex-panded chemotherapy unit at Woodstock Hospital. With her extensive nursing back-ground and intimate knowledge of the cancer system in the South West, Marcia helped to mentor the nurses in the new unit to ensure patients would be receiving safe, high quality care at the facility.

Those of us who are lacking a clini-cal background always look to Marcia for guidance and support. She never hesitates

to explain medical terminology and wel-comes the opportunity to share the learn-ings she has acquired with colleagues and staff. Marcia has a special way of helping colleagues to understand without making them feel inadequate or inferior. She is an incredible teacher and mentor.

Marcia Exemplifi es Leadership

In her roles as charge nurse and clinical manager in the chemotherapy unit, Marcia was highly respected and appreciated. She took an active role in orienting new nurses and training or updating others that re-quired recertifi cation. Marcia has an end-less amount of patience and skill in teach-ing nurses and recognizing their individual learning needs. Marcia was always the go�to nurse in the clinic when it came to questions about a particular treatment or clinical trial. She had an excellent rapport with all physicians in the clinic and would strive to accommodate urgent requests to get patients started on cancer treatment. Marcia often arranges her schedule to ac-commodate educational sessions across the region. She leads annual spill review sessions for providers and travels across the LHIN to ensure staff safety is a prior-

ity. Marcia’s cheerful attitude when faced with a challenge is an example to others and exemplifi es the leadership competen-cies championed at the London Health Sciences Centre. When Marcia is involved in a project or team, there is never any question that issues and challenges will be resolved.

Marcia Supports Patients, Families and Caregivers

Earlier this year, Marcia was recognized by Cancer Care Ontario (CCO) for her commitment and contributions to the Evi-dence based Care Program. The program completed seven new guidelines, three recommendation reports and updated and endorsed 10 additional guidelines. The documents are making a difference in cancer control in Ontario by providing guidance for clinical care, improving ac-cess to new effective drug treatments, and informing administrative and policy deci-sions aimed at improving the quality and safety of patient care. Marcia’s role on this committee helped ensure physicians and patients in Ontario have the high�quality tools they need to facilitate and access the best in cancer care practice.

Marcia Mentors & CoachesMarcia provides timely support, orien-

tation and education to new and experi-enced nurses when new regimens or pro-grams are introduced. She always makes herself available for consultation and as-sistance and is skilled in determining the unique learning needs of patients and/or nurses. Marcia continues to organize nursing mentorships for CON(C) certifi -cation, regional CCO community of prac-tice workshops for symptom management, and regional South West workshops aimed at improving patient and provider safety. She has worked to incorporate the CCAC program into community of practice meet-ings. Marcia has also been instrumental in organizing and coordinating many CME courses for nurses, pharmacists, commu-nity oncologists, internists and GPOs over the last several years.

Marcia Respondsto Patient Needs

Marcia was involved in the expansion of satellite clinics in the South West re-gion. She possesses a leading, supportive

and caring personality that translates into her interaction with patients. Marcia works closely with stakeholders and part-ners in the region to ensure the models of care that are being implemented support the dynamic of the community and the culture of the hospital. Cancer patients who are receiving treatment in Wood-stock (among other hospital sites) have commented about how care close to home has eased the cancer burden in insur-mountable ways. Marcia is the conductor working behind the scenes to ensure these services are tailored to support patients and their individual needs.

Marcia has visited every emergency department in our LHIN to provide education about the Fever Card that is given to patients receiving chemother-apy. This important patient�centered initiative, championed and promoted by Marcia, has resulted in more rapid and appropriate care for cancer patients presenting at emergency departments across the region.

Marcia believes that the interest and safety of the patient is a priority and goes out of her way to ensure regional sites have the educational tools required to meet es-tablished targets.

When Marcia worked in the chemo-therapy unit, colleagues commented about her compassion for patients. She has a particular fondness for the elderly and would ensure they were comfortable and safe while in her care. Although there was often pressure to work at a faster pace, Marcia never rushed through the process of administering chemotherapy. She made sure that each patient understood their treatment plans, and addressed questions and concerns with empathy and kindness. Marcia always exhibits great professional-ism as a nurse and great care as a caring person to those she serves.

Support for Marcia Langhorn:

“It is not exaggerated to say that over the years Marcia has been the glue that keeps our regional systemic therapy pro-viders together and keeps the lines of com-munication open.” Dr. Ted Vandenberg, Medical Oncologist, London Regional Cancer Program

“Marcia is an amazing nurse, woman, and friend.” Connie Morrison, RN, Lon-don Regional Cancer Program

“People are drawn to Marcia from all walks of life for exactly one reason � she truly cares and gives a “human touch” to every situation she encounters.” Lynn Wa-reing, RN, Woodstock Hospital

“All of our nurses that have trained with Marcia agree that her wealth of experience and compassion is refl ected in her teach-ing methods. She is a great mentor.” Barb Pletch, RN, Listowel Wingham Hospitals Alliance

As outlined in this letter, I feel that Mar-cia Langhorn is a deserving candidate for a Nursing Hero Award. nH

Nominated by: Shari Beaton, South West Regional Cancer Program

D’Youville offers choice for Canadian students seeking nursing degree

Bu�alo, N.Y. - D’Youville College, a small private four-year institution near the PeaceBridge in Bu�alo, has become the school of choice for thousands of Canadian studentsseeking an education in health care and education.

D’Youville created western New York State’s �rst four-year nursing program in the1940s and today o�ers a complete array of nursing programs as well as other health careo�erings. From Bachelor of Science in Nursing (BSN), Registered Nurse to a Bachelorof Science degree in nursing (RN to BSN), Master of Science in Nursing, Family NursePractitioner and a Doctor of Nursing Practice program, the college o�ers it all.

D’Youville, named a�er a well-known Canadian Saint, makes it easy for Canadians toattend. Students enrolled in the RN to BSN program receive 50 percent o� tuition; allother Nursing programs receive a 20 percent discount for Canadians and undergraduatescholarships go up to $69,000.

In addition, there are Friday only classes to meet the needs of students who are workingand clustered nursing courses on �ursdays and Fridays for graduate nursing programs.

Over the past �ve years, D’Youville has invested approximately $70 million in newand upgraded campus facilities including new state of the art nursing simulation labsthat opened last year featuring the full body high tech patient simulator mannequinsthat bring amazing realism to the nursing students today. �ese are the most advancedpatient simulators available today.

Recently unveiled this year was another state of the art Simulation Lab to help teach students collaboration with a variety of health care disciplines. �ese include pharmacy,physician assistant, physical and occupational therapy, dietetics, chiropractic andnursing, all taught at D’Youville.

�e students work together to treat a “patient” with speci�c symptoms.

�is lab features a simulated hospital room and another representing an outpatient clinic.

D’Youville has been an excellent alternative for Canadian students for over 20 years.It’s within easy travel distance, a�ordable, with an accommodating atmosphere withclasses taught by professors with clinical experience.

Visit us on the web at ww.dyc.edu

Educating for life

Marcia Langhorn RNSouthwest Regional Cancer ProgramM

HMHONOURABLEMENTION

Marcia is the conductor working behind the scenes to ensure these services are tailored to support patients and their individual needs.



s a nurse working in a busy emergency department, James was devastated to see people brought to emergency, only

to die in a hallway, when they could have stayed at home if they and their families had been better prepared and had the right supports in place.

James’ conviction that things could be better led him to us, and his current role at the Toronto Central Community Care Ac-cess Centre (TC CCAC), where he has been a nurse practitioner with the palliative care team since January 2012.

For the period of time consid-ered for this award, I can tell you James has made an incredible difference in caring for palliative care clients and their families, and demonstrated the qualities that make him a truly extraordinary nurse. His wholistic view and training mean that he cares for the whole person: not just the illness.

James’ nursing care combines a high level of professional and clinical knowl-edge and practice with a compassion that is remarkable to witness. He says he thinks about the care he would want for his fam-ily, and lets that guide him.

I really notice James’ remarkable com-mitment to his clients when he cares for some of our city’s most vulnerable people. A number of his clients are homeless, or dealing with addictions or mental health issues. His respectful and wholehearted treatment of these clients, who many of us might see as outcasts, is humbling. As he does with all his clients, he makes sure these clients understand their diagnosis, its prognosis and their options, and he en-

sures he understands what’s most important to them. His dedica-

tion is remarkable – he will tru-ly do whatever is needed and displays incredible creativity in fi nding solutions, connecting with new people when needed.

In the past year, James has also done pioneering work as the

fi rst nurse practitioner on the Pallia-tive Care team and as a member of the TC CCAC’s Interprofessional Specialty Team. James’ exceptional interpersonal skills have allowed him to be an ambassador for the role, which is not yet widely under-stood, even among health care profession-als. He has established very effective work-ing relationships with external partners. His knowledge and skill as a clinician has

established not only credibility for himself, but for the profession.

James has been a generous colleague and encouraging mentor to new nurse practitioners on his team; there are now five, based on the success of his pio-neering work. He has also supervised a number of students in the nurse practi-tioner program at a local university and has been asked to speak at a number of recent conferences.

I can tell you James is passionate about nursing, and fi nds it a privilege to work

with clients facing the end–of–life. In-credibly, on his vacation time, he goes to northern Canada to communities without permanent primary care providers, to give them invaluable service for a few weeks at a time.

In his skill, compassion, holistic ap-proach and innovative determination, James truly exemplifi es the best of the nursing profession. nH

Nominated by Josie Barbita, Director of Client Services, Professional Practice, Toronto Central CCAC

cess Centre (TC CCAC), where he has been a nurse practitioner with

care clients and their families, and demonstrated the qualities that make him

sures he understands what’s most important to them. His dedica-

tion is remarkable – he will tru-ly do whatever is needed and displays incredible creativity in fi nding solutions, connecting with new people when needed.

also done pioneering work as the fi rst nurse practitioner on the Pallia-

HMHONOURABLEMENTION

A

James MastinPalliative Care Team, Toronto Central Community Care Access Centre

716.829.8400 www.dyc.edu

UNDERGRADUATE PROGRAMSNursing (2-yr. RN to BSN)Nursing (4-yr. BSN)

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hen most of us think of a nurse going above and beyond, we imagine them in the middle of a chaotic emergency depart-

ment, or in a stressful operating room, or maybe even sitting next to a patient’s bed comforting them.

I had the opportunity to witness some-one going above and beyond at the side of the road as I stood by and watched a nurse save my son’s life.

Last summer, I was driving home with my toddler Jack, who was one and a half years old. We were just around the corner from our house when I looked in the mirror and noticed he was having a seizure.

I frantically moved through traffi c, looking for a safe place to pull over. In-stinctually, I pulled Jack out of his seat and tried to get him to a safe place to lay down. Panic was starting to set in for me.

A motorist in the car directly behind me had pulled over to see if I needed any assis-tance. Rich Schregardus is an emergency room nurse at Markham Stouffville Hospi-tal who I think was on his way home from his shift at the hospital.

Taking one look at me and one look at my son, Rich clearly knew the situation was very serious and told me to call 911 as he assessed Jack. Within minutes, Jack

had stopped breathing and Rich began performing CPR on my baby.

I watched in absolute terror as Rich me-thodically breathed into Jack’s mouth and performed chest compressions. In that mo-ment, all of his training and thinking was going towards saving my son.

Although it felt like an eternity, Rich was able to quickly resuscitate Jack and

very shortly after that police, fi re and ambulance arrived.

Rich interacted with the other medical personnel and relayed critical information about the situation and Jack’s vitals. It was like he was in the

middle of his familiar environ-ment in the emergency depart-

ment caring for a patient, except we were at the side of the road as traffi c whizzed by.

Jack was taken to the hospital by am-bulance and Rich continued on his way home.

It was an extraordinary few moments when our lives intersected.

On what should have been a very ordi-nary day, I was blessed that someone like Rich crossed paths with me and my son and that he was a nurse. And more impor-tantly, he was a nurse who cared enough to stop and save my son’s life. nHNominated by: Karen Matthews

Rich Schregardus RNEmergency Department, Markham Stouffville Hospital

I frantically moved through traffi c,

ambulance arrived.

other medical personnel and relayed critical information about the situation and Jack’s vitals. It was like he was in the

middle of his familiar environ-ment in the emergency depart-

ment caring for a patient, except

HMHONOURABLEMENTION

W

would like to nominate Eliza-beth Angela Smith for the Nursing Hero Award. I am a patient at the Addictions & Concurrent Disorders Centre

at Trillium Health Partners, Credit Valley Hospital site for the past 3.5 years. This is where I fi rst met Angela Smith.

A few words about myself, I am male, 59 years old, married 35 years. I have 2 sons and 1 daughter. My middle son passed away 3 years ago of cancer.

My disease is addiction. Af-ter my son passed away I start-ed drinking quite heavily and hit rock bottom. It was so bad that I would black out, fall and could not remember any-thing. I was out of control, felt helpless and was desperate. I suf-fered and my family suffered because of me.

This is when I met Angela Smith for the fi rst time. She is a therapist who helps people with the disease of addiction in a compassionate and non-judgmental way. She saved my life! She has a way of making everyone feel comfortable and special. Ad-diction affects everyone in the family and

she helped us understand that. Angie gives 110 per cent of herself and is very mindful and attentive to other people’s needs.

Angie is a very empathetic and caring person with a very big heart. She is a very good listener who lets you talk and vent if you need to, she is the kind of person that you can talk to.

Angela Smith RN

I

Addictions & Concurrent Disorders Centre, Trillium Health Partners

thing. I was out of control, felt helpless and was desperate. I suf-fered and my family suffered because of me. she helped us understand that. Angie gives



Vocal. Visible. Respected.

Since 1973, NPAO has been working to help achieve the full integration of Nurse Practitioners across the healthcare system to ensure that Ontarians receive the best possible care by the most appropriate team player.If you are an NP or student, join NPAO to:• Influence health system change through involvement in advocacy

and sector negotiations. NPAO is recognized by stakeholders and government as the professional voice of NPs.

• Get support from colleagues. Join a professional community for networking and mentorship at local, regional and provincial meetings.

• Be the first to know through our members-only website and message board as well as e-bulletins and social media (follow us on twitter!)

• Polish your practice with conferences, webinars, OTN sessions, best practice guidelines, and clinical updates.

• Be recognized as a shining star through awards, bursaries and media spotlights.

• Build public awareness and increase the profile of NPs through media coverage and print materials. Offer your expert NP opinion on common health-related questions on our Ask the NP section.

• Re-orient our system to a health-care system!

Join the largest professional association of Nurse Practitioners in Canada.

www.npao.orgemail [email protected]

call 416-593-9779


N19S A L U T E T O O U R H E R O E S — National Nursing Week 2014

Are you new to Canada? / Nouveau au Canada? Do you want to improve your workplace communication skills?

Participate in free Occupation-Specific Language Training courses Workplace Communication Skills for Health Care • dental hygienist • medical radiation technologist • nurse • personal support worker • sleep technologist

Workplace Communication Skills for Interprofessional Health Care Providers • dietitian • nurse • occupational therapist • physiotherapist • social worker

Visit http://www.co-oslt.org for more information

Pour de plus amples renseignements sur les formations francophones consultez : http://www.lacitedesaffaires.com/service-immigrants/flap.htm

To qualify, you must have training or experience in the fields listed under each course above. Also, you must be a permanent resident of Canada or protected person and your English/French must be at an intermediate level (Canadian Language Benchmark 6 – 8 for courses delivered In English or Niveaux de compétence linguistique canadiens 6 – 8 for courses delivered in French).

The Nurse Practitioners’ Association of Ontario Celebrates

National Nursing Week 2014

Congratulations to all Award Winners and Nominees! You Inspire Us!

We applaud our nursing colleagues as Expert Clinicians!

Go to the “Ask the NP” section of our website where

experienced NPs provide answers to your common health-related questions

Congratulations to all Award Winners and Nominees! You Inspire Us!

We salute nurses as change agents creating a better future!

Better Care. Better Value.

See how you can support a plan from the

Province’s Nurse Practitioners for a Healthy Ontario

We commend our nursing colleagues as researchers,

educators and life-long learners!

Hold the date for the NPAO Annual Conference Nov 6 to Nov 8, 2014 at the

Hamilton Convention Centre.

This year’s conference features 12 pre-conference workshops including

workshops on casting, joint injections and MSK assessment. Sessions also include:

liability and risk management, research on the cost-effectiveness of NPs and an

update on regulatory issues.

www.npao.orgor email [email protected]

or call 416-593-9779

At NPAO, we believe that all RPNs, RNs and NPs are heroes



n behalf of the entire Endos-copy Department we heartily submit our tribute to Barb Zita for consideration of your Nurs-

ing Hero award.Judith, one of our nurses explains, “I’ve

seen her change people, I’ve seen people leave here for the better.”

We could not agree more- so this is our thank you to an exceptional nurse, one so deserving of this generous award.

Confession I sit silently when I know I should speak,

overwhelmed by intimidation… Our endoscopy unit has a host of visitors

today. They are the brass, a compilation of representatives that run the gamut from department heads to the hospital CEO. They come to seek quality assurance, in-vestigators of the attributes that earn the hospital its high standard.

Upon hearing the stories of our units’ cohesiveness, superior performance and reputation, their fi nal question is: “What do you think it is that makes endoscopy such a special place?” their query is met with smiles and unarticulated ponder-ings… My mind automatically calculates, for amid the myriad of possibilities, there is one consistent…. one who sets the bar….

one who brightens each day, one like no other. Barb Zita is a nurse who radiates warmth. Barb is a nurse who soothes the nerves of the anxious, reassures the in-trepid, and leads the inexperienced. Barb is a teacher to students and peers alike, a nurse who takes pride in her work, a vet-eran, guided by principles honed by experi-ence, respect and integrity.

If you were to meet her, you would smile, for her energy could light up a room. I smile to myself when I see her with patients. I see her transform tense situations with an ef-fortless sense of calm and expertise gilded with humor, which could tame the most skittish of beasts.

Barb is our teacher. Barb is our compass. Barb is our mentor.

This day I will not remain silent, this day, I will make public the efforts of a nurse who has dedicated her life to the service of others. So here it is brass, Mount Sinai hospital is a better place because of the ef-forts of nurses like Barb Zita. A true nurs-ing hero…. decorated by countless unspo-ken medals of Honor.

The TeacherI fi nd her sitting in the lounge. She

seems frightened of her own shadow, a pal-pably awkward girl. The tell tale badge of a

nursing student adorning her uniform is an unnecessary billboard of her junior status.

She confi des that she is worried about the placement ahead, disillusioned by past nursing preceptors that have been less than kind. She is contemplating giving up, contemplating leaving the profession rather than face another harsh encounter.

Unbeknownst to her, a saviour of sorts was awaiting, a teacher who had guid-ed and supported so many before her, a teacher who can be credited with molding so many young nurses. That teacher was Barb. While other nurses recoil at the add-ed work and stress of overseeing the edu-cation of student nurses, Barb continually assumes the role.

I see her throughout her placement with Barb. She is engaged, encouraged, and supported. I see her observing her mentors amazing style with each patient. I see her emulating Barb as she executes skills with compassion and respect. I see her gaining confi dence with each passing day. I see her empowered… I see her change.

I fi nd her sitting in the lounge. This day, she wears the attire of another hospital, the nursing student badge now replaced with a staff badge. She is a confi dent, com-posed, young woman. She has come after a night shift at a trauma unit. She has gone on to do great things, gone on to be an as-set to this world.

She confi des that she is here to see Barb, here to thank Barb. To honor a nurse, who showed her warmth, showed her patience. Showed her she had what it took to be-come a great nurse.

“I will never forget her,” she said… I agreed- for no one ever could.

The Gift“Jane” comes to us again.She comes to us many times, with many

faces. Sometimes, she is a shivering child, at others she is brash and spiteful. She is trying, demanding, and has worn many nurses down. Many would avoid her, busy themselves elsewhere. Most would be pushed to treat her fi rmly, deal with only

the medical matters at hand and in turn, fuel the fear that lurks beneath the surface.

Barb welcomes her again.She smiles and speaks to her kindly re-

gardless of the face before her. She maintains control, expertly diffusing any outbursts.

Barb touches her hand, calms her, speaks to her like she is real, speaks to her like she is special.

That is Barb. A lion tamer of sorts… nurturing the

shivering child, diverting the brash and spiteful. Barb has a gift that comes only to those who have an insight into the experi-ences of others – the gift of empathy – a gift that she’s happy to give to all those around her.

The Acts There was escalating drama in Room 1.

A patient was in trouble. A sea of green and white coats instantly descended upon the room.

The drama had a happy ending, but the tumultuous events in the room have unknowingly become a source of fear for nearby pre and post procedure patients, and, terror for the family of the patient in-volved.

I brace for the onslaught of reassurance and explanations that will surely be due to those who wait… as I enter the patient area of the clinic, there is not fear or ter-ror, but rather, there is a sense of peace and calm.

All I have to see is Barb attending to them, and I understand why. While oth-ers rushed blindly to fulfi ll a role, Barb calmly took hers. Hers was one that was without the accolades of “saving” a patient – she knew those roles were taken care of. Rather, hers was a role of unfaltering reassurance and encouragement to those vulnerable to the insecurities of being in a hospital.

She kept the home fi res burning, a most genuine and noble of acts.

Barb is a hero. Our hero. nHNominated by Cindy Campbell and the entire Endoscopy Team.

Barb Zita RNEndoscopy, Mount Sinai Hospital

O

HMHONOURABLEMENTION

When you speak to Angie her expertise steps forward, she will explain why I am feeling this way and how to work out my problems without using substances. It’s not just problems you can speak to her about but also everyday life experiences that come up and you have a problem resolv-ing – and she listens without judging my feelings.

Angie is a wonderful advocator; if a pa-tient needs letters or help with legal docu-mentation for work, she will help you and fi ght for your rights. It is diffi cult when you have an addiction and have no control of your life. Angie has helped me get control of my life and made me dig deep into my feelings of why I had my addiction, besides the passing of my son. I am now clean and sober for 3 years 5 months thanks to

Angie’s help and guidance. She is very dedicated and compassionate in helping patients at the Addictions & Concurrent Disorders Centre. I still see her at least once a week for guidance and counseling. Angie has a way of restoring faith, self-dignity and respect in everyone she sees. And because of her work, I am a better husband, father, and a friend. She inspired me to be the agent of hope to others who suffer with addiction and now I am a vol-unteer at The Addictions and Concurrent Disorders Centre because this work can-not be done alone.

By nominating Angie I want to help break down the stigma of Addiction & Mental Health and recognize a nursing hero. nHNominated by Carmen Prezio

Elizabeth Angela SmithContinued from page 18

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would like to nominate Mau-reen McLeod Frazer as a Nurs-ing Hero.

Maureen joined Almonte General Hospital not long ago. She chose our facility after being an inpatient here and explains that she was so impressed by the hospital she decided to take on the challenge of a community hospital setting. We have been amazed by her commit-ment to the nursing profession and her pa-tients. She openly shares and teaches her speciality in neonatal care and children's medicine.

We continue to be amazed by her ability to accept new challenges with ease, a calm nature and how she has the ability to en-gage others without them feel-ing intimidated. Maureen ac-cepts situations as they present themselves with eagerness and fl exibility.Maureen accepts these challenges willingly and engages the team to work together in a collaborative approach. Maureen is refl ective of the care she provides and takes on any situation with a problem solving attitude. She en-gages others in a unique fashion as to illicit cooperation and camaraderie to fi nding a solution. Maureen is a master in multitask-ing and is in constant motion when she is on shift. Her energy and cheerful, teach-ing manner is appreciated by all who are in her circle of care. Maureen describes her desire to care for maternity patients and in

particular she aspires to be an expert lacta-tion consultant.

Maureen and I have shared many tours on our fi ve bed Obstetrical unit. I recall one night shift when we were experiencing torrential storms and every expected baby decided to be born that day/night. Mau-reen and I came on shift with a patient load of 11 postpartum moms and babies. We were over capacity which necessitated us completing care of our postpartums on the Medical/Surgical inpatient unit. I was the junior nurse to obstetrics and initially felt overwhelmed with the workload.

Maureen displayed such control and organization of our workload

that I was compelled to equally meet the challenges of that shift. When I returned from the medical fl oor where we had put four moms and babes, I saw

Maureen setting up for a deliv-ery. I did not believe her when

she told me that she had received a call from an expecting mother who called while on route to a tertiary centre stat-ing that she didn't feel she would make the drive and was coming to our hospital because she felt she was going to deliv-ery right away. Maureen expediently and skilfully prepared for the patient and she prepared me. We readied for a preterm de-livery, secured a physician and awaited our patient. The patient arrived soaking wet and afraid. Maureen easily calmed the pa-tient and assured her that all was well and

that we were prepared for everything. I was most grateful that Maureen was on shift that night to care for this distressed wom-an and to receive the preterm baby that arrived. Her knowledge, skill and calming nature made it seem so easy. I as well as my team have commented numerous times how reassured we all are that Maureen is on duty when a sick baby arrives.

Maureen attributes her skill to her in-satiable appetite for new knowledge and a commitment to ongoing learning and teaching. She recalls a mentor and friend who exampled for her the ease and skill of a nurse managing a choking child. This event inspired Maureen to choose a nurs-ing profession in neonatal care.

Maureen's ability to teach and instruct other nurses comes from a desire to over-come her fears as a public speaker. She recalls how she challenged herself to over-come that fear by involving herself in a nursing education program in Hamilton. Maureen overcame her fear of speaking in public by continually challenging herself to complete education, in-services and public speaking events. Maureen's commitment to the nursing profession, her ability to ef-fectively teach and her gift of being able to identify challenges and enlist cooperation in determining solutions to those challeng-es with a calming nature facilitating learn-ing and are valued and unique qualities. Maureen has saved the lives of many sick babies and children and she has effectively assisted team members to care for our sick

babies. Maureen is now a certifi ed Neona-tal Resuscitation Program (NRP) instruc-tor, providing course instruction for nurses and physicians.

Maureen is a valued professional who in-spires change, motivates us to have a con-tinuum of learning, a safe environment for patients and enlists the cooperation of the interdisciplinary team. She goes the extra mile, invests volunteered hours of service to the betterment of her colleagues learn-ing needs and strives for excellence in care. There is no challenge too big for Maureen to tackle. I am grateful that I have been afforded an opportunity to thank Maureen in this written format to acknowledge her contribution to our nursing profession and let her know that she is a Nurse Hero. I want the world to know how honoured we are to have her share her gifts with us. nH Nominated by Susan Breckenridge

ability to accept new challenges

fl exibility.Maureen accepts these challenges willingly and engages the

and organization of our workload that I was compelled to equally meet the challenges of that shift. When I returned from the medical fl oor where we had put four moms and babes,

Maureen setting up for a deliv-ery. I did not believe her when

she told me that she had received a

HMHONOURABLEMENTION

Maureen McLeod Frazer RNObstetrics Program, Almonte General Hospital

I

OUR NURSESSTAND OUT!Thank you for putting patients first.Thank you for putting patients first.Thank you for putting patients first.Thank you for putting patients first.

At North York General Hospital, our teams are making a world of difference. Caring, skilled and dedicated, our nurses play an amazing role in achieving a new standard of excellence in integrated patient-centred care. On behalf of the people we serve in one of Canada’s most diverse communities, we recognize and appreciate everything you do each day to exceed the expectations of patients and their families.

TAKE A BOW. YOU’RE AMAZING.

To find out more about our outstanding nursing team, visit us online.

www.nygh.on.ca/careers

N29-ADV-091_v3_FIN_REV.indd 1 2014-04-29 9:42 AMDay_North_york_Gen_HALF_2014.indd 1 2014-04-29 12:50 PM



entered the AIPU for treat-ment and intervention to manage my depression in Oc-tober 2013. That is when I met

Arden. Over the next few days I was able to explain an issue I was having regarding my children. Arden took it upon herself to contact the person needed to resolve the issue. Arden was not required to do that because she wasn't my direct nurse. She had her own case load of patients. That right there touched my heart. I had to thank her for being so kind and helpful. It was selfl ess.

At the time I was admit-ted, I was worthless, nothing, alone, and dreadfully sad. She gave me this hope and a glim-mer of positivity that had been clouded by my depression and past abuse. Further along during my stay I suffered a setback due to the loss of an integral key player on my health team. Seeing how distraught I was, Arden insured my safety by following protocol. Since I was to be under constant supervision the next day she became my nurse. During that time she spent over four direct hours with me, listening, relating, helping, and educating me on the steps my new doctor wanted me to take. She had this ability to get me to open up about the deepest things in my life. Her calmness and knowledge of dif-ferent situations made it that much easier.

She played a key role in helping me ac-

cess certain treatment options as well as accessing certain privileges. She continu-ously rallied for so many things that would improve the quality of my life. Feeling like I matter has been eye awakening. Arden would constantly push me forward, help-ing me to exist without fear. She saved my life. Being without a voice for 32 years to meeting this lady and her allowing me to have such a simple thing, like an opinion,

helped this change in me.During my 90-plus day stay I had

many nice nurses, but it was Ar-den that constantly went that extra mile. Not only did she do that but she was extremely hum-ble about it always. All the while,

she dismissed this truly amazing and kind behaviour as just part of

her job. If every nurse put forth half the effort Arden does, healthcare would be forever changed.

Because of Arden, I know I matter. I know I have worth. I know that there are amazing people in this world who are will-ing to do whatever it takes to change a life – my life. That is why she is my nurs-ing hero. I cannot ever thank her enough for what she has given me, which in turn extends further to my children. They have a mother because of her. I am forever grateful.

Thank you for reading my story and I hope she gets the recognition she de-serves. nHNominated by Laura Albert

That right there touched my

gave me this hope and a glim-mer of positivity that had been

During my 90-plus day stay I had many nice nurses, but it was Ar-

den that constantly went that extra mile. Not only did she do that but she was extremely hum-ble about it always. All the while,

she dismissed this truly amazing and kind behaviour as just part of

her job. If every nurse put forth half

HMHONOURABLEMENTION

Arden Hamilton RNNorth Bay Health Sciences Centre

I

The NurseFlorence Nightingale, the lady with the lamp,Mother Theresa in the refugee camp,Caring, compassionate, gentle and kind,A more noble profession, one could not fi nd.

The nurse is the doctor's eyes and ears,Records any changes, allays patient fears,Monitors rhythms, takes vital signsAdministers drugs, sets up IV lines.

The nurse is highly trained in her skills,To assist in the healing of wounds and ills,In the OR, wards or critical care,Her presence unnoticed because she is always there.

With devotion and pride, she nobly serves,Though pressures, demands, may fray her nervesThe nurse lowly paid, in gold is her worth,For she's truly god's angel sent down to earth by.

By Roopdai Mohotoo and Nita Marcus


13 Ethics

Leaps of faith are not some-thing that ethicists tend to take very often…being more inclined to rely on thoroughly

thinking through things. But a leap of faith might well have been what was taken as the Canadian Bioethics Society, in col-laboration with the Nova Scotia Health Ethics Network, launched the inaugural National Health Ethics Week. How could anyone really know what it might end up looking like?

I have heard the idea suggested for a few years now, but it had never actually been ‘declared’ until 2014. That old ad-age ‘build it and they will come’ may have manifest this time as ‘declare it and it will happen’!

It was declared and it happened. Or rather, it was made to happen, and suc-cessfully. With the week landing in the calendar from 2-8 March, and adopting the theme ‘Health ethics in Canada – from coast to coast to coast’, the website lists al-most 30 organizations large and small that participated. The organizers described it as ‘organized to raise awareness of health ethics issues that are important to Ca-nadians and to provide a time for health regions and facilities, educational institu-tions, health care professionals and com-munity organizations to host and take part in events that explore these issues.’

The registrants did range from across most of the country – from Nova Scotia and Newfoundland and Labrador on the east coast, to many sites up and down Al-berta and to the shores of Lake Ontario. Saskatchewan and Manitoba were also represented, and there was national rep-resentation in the form of the Canadian Institutes of Health Research. Among the nearly 50 sessions listed on the events page, topics ranged from allocating scarce resources, end of life issues and moral dis-tress among health care providers to re-search ethics and governance of the health professions to straightforward opportu-nities for folks to meet their local ethics team. Check the varied events for yourself at http://www.bioethics.ca/ethicsweek.

While the week might not have literally achieved the coast to coast to coast theme (though that may well have happened – I don’t have access to those details), what is probably most useful about such coordinat-ed events is that teleconferencing technol-ogy enables many to join the sessions from small and remote settings – where such ethics content may be less easily sourced. Various provincial telehealth services did plenty of coordinating to make simultane-ous webcasting happen for many sessions. And a further possibility for any individual or groups was to join some events by toll-

free telephone line. With the presentation materials offered in advance, there was no need to have access to telehealth services to join in – just a phone.

And that willingness to share presen-tation materials means there are ongoing benefi ts as well – the open exchange of the materials either in advance, or after the fact upon request, shares the chance for deeper pondering of the issues with more people. In addition, some of the events will be archived for future viewing on the various telehealth websites.

It’s not likely possible to calculate the

full impact of the week across the country. Even the posters in the elevators advertis-ing the week and local sessions got people talking and thinking in the places I work. Our efforts to pull it together locally were rewarded by both the presence of new faces I’ve not seen before and the telecon-ference connections to groups and places I have not heard of before.

So do take the time to look at the list of events, and don’t hesitate to contact the participating organizations if you might like to have further information. And keep your eyes open for next year’s Na-

tional Health Ethics Week – it’s likely to build on the success of the fi rst year and of-fer plenty of thoughtful explorations of the ever more complex fi eld of health care eth-ics. You don’t have to organize a presenta-tion to be a participant – only connect! nH

Kevin Reel is a Clinical and Organizational Ethicist at Southlake Regional Health Centre and Mackenzie Health and an Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto.

416-868-3100 | 1-888-223-0448www.thomsonrogers.com

YOUR ADVANTAGE, in and out of the courtroom

Danny McCoy was rendered a paraplegic in a terrible car accident at the age of 43. Before the accident he was an avid sailor. After the accident, Danny became one of the top ranked competitive disabled sailors in the world. He’s also the founder of the Disabled Sailing Association of Ontario and one of the sport’s foremost international ambassadors.

Thomson, Rogers is a proud supporter of The Disabled Sailing Association of Ontario. We are honoured to have represented Danny McCoy in his lawsuit and to count Danny as a friend and one of the many everyday heroes we have been able to help.

Focus on the things you can do, notwhat you can’t, and you will find,just like I did, that life is fantastic.”

– Danny McCoy

“

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ood news: More Canadians are making living or deceased or-gan donations, helping to meet Canada’s need for organ trans-

plants and improving the quality of life for patients.

Less encouraging news: A big gap re-mains between donations and need, and compared with other countries, Canada still has a long way to go.

CIHI’s recent report Treatment of End-Stage Organ Failure in Canada, 2003 to 2012 rounds up the data on organ trans-plants for the past 10 years. The report offers a hopeful picture for Canadians and important insights for health care leaders and policy-makers.

Worth mentioningCIHI’s report refl ects a shift in living

donor generosity—most notably, a 114 per cent increase in non-related living donors in Canada since 2003. Also worth noting is that young Canadians, from birth to age 39, comprise Canada’s largest group of liv-ing organ donors, followed closely by those age 40 to 49.

Perhaps the most signifi cant fi nding is that the rate of deceased donors has ris-en steadily over the past decade. For the

fi rst time in recent years, the number of deceased organ donors in Canada has ex-ceeded the number of living donors.

This is important because deceased do-nors can provide up to eight organs for transplant to Canadians in need.

Waiting for organsThe positive numbers in CIHI’s report

may be explained partly by a rise in the number of government advocacy initia-tives, like easier online registration for or-gan donation. Added to that is heightened public awareness due to greater media cov-erage and social media campaigns.

However, even with the increases in or-gan donation numbers in Canada, particu-larly over the past four years, there has still been a shortfall: for each organ group—heart, lung, liver and kidney—there is an equal or larger number of Canadians on a waiting list for organs.

The human cost is refl ected in the num-ber of Canadians who die while waiting: 230 people in 2012.

Susan’s story Susan McKenzie is the senior director

of development for the national offi ce of The Kidney Foundation of Canada. She’s

also a transplant recipient.Susan explains that her

health care team originally aimed to do a pre-emptive kidney transplant to circum-vent the effects of her famil-ial kidney disease. However, in 2009, after 10 years of relatively little change to her health, Susan’s disease suddenly progressed—too rapidly to fi nd a compatible organ donor and get a kidney trans-plant. Before she knew it, she was on di-alysis.

“Almost overnight, I went from enjoy-ing good health to going for dialysis three times a week,” she explains. “It was a dif-fi cult adjustment.”

A new perspective on lifeSusan began her search for a donor. Be-

cause of the nature of Susan’s disease, her blood relatives could not donate a kidney. Instead, she asked friends and other fam-ily members. Being her own advocate, she claims, was a crucial component to the success of her search. Six people came forward and the testing process for organ compatibility began. “Just knowing that

people were there and being tested helped get me through,” Susan says. “It was like a light at the end of the tunnel.”

Just over a year later, Susan had a new kidney—and a new lease on life. And she’s been healthy now for four years.

“The whole experience has changed me and given me a new perspective,” she says. “Getting a transplant changes the way you look at the world.” nH

Brent Diverty is Vice President, Programs, Canadian Institute for Health Information.

By: Brent Diverty

G

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organ donor and get a kidney trans-plant. Before she knew it, she was on di- Canada’s deceased donor rate still lags

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15

ontending with severe allergies and asthma for decades now, Pat Schmidt is a regular at St. Joseph’s Hospital in London,

visiting outpatient clinics as often as every two weeks. Here, she receives specialized care to control her symptoms, but, if you ask her, that’s not what impresses Pat most about the clinics.

“I am treated like family. They all know my name and whenever anyone sees me, they always have a smile and say hi and ask how I am. When I call in for an unsched-uled appointment, they accommodate me. If I ever have questions, they make sure they get the answers for me and they take the time to talk to me about my concern.”

Pat’s experience – the personal touch and education she receives, the focus on supporting self-care, and integrated care that meets her varied needs – are the goals for chronic disease management at St. Joseph’s Hospital.

On October 10, 2013, the hospital of-ficially opened a new, 42,000 square-foot central outpatient area purpose built for the treatment of complex medical and chronic disease. This opening represents an important juncture and a new era for St. Joseph’s Hospital brought about by a 15 year-odyssey of hospital restructuring and renewal in London. The hospital, one of five sites that make up St. Joseph’s Health Care London, has made the transition from acute inpatient care to specializing in minimally invasive short stay and day sur-gery, and outpatient treatment of complex medical and chronic disease. With this new role, and an innovative philosophy and ap-proach to providing care, St. Joseph’s is re-defining what it means to be a hospital.

Chronic disease management is a critical area of focus whose time has come. One in five Canadians is living with chronic dis-ease and the numbers are growing. So too is the burden of chronic illness – on peo-ple’s lives, the economy, and on the health care system. Chronic illness financially ac-counts for 87 per cent of disability costs and consumes 67 per cent of direct health care costs.

St. Joseph’s Hospital is home to a broad range of ambulatory medicine programs for chronic disease with a common goal – to provide and coordinate care in new ways focused on each person’s multiple, complex continuing needs and individual priorities. This means recognizing that patients are coming to us with more than one chronic

disease that requires team work across pro-grams, across sites, and with our commu-nity partners. It means multiple appoint-ments on the same day during the same visit and finding new ways to deliver care that improves access, outcomes and qual-ity of life for patients. It means truly under-standing the patient experience.

This takes a fundamental shift in health care delivery for chronic disease and we are taking those steps. Our commitment is en-trenched in our strategic plan – integrated chronic disease management is one of three areas of clinical focus for our organization. This means teams are provided the capac-ity to do this important work. A Medicine Services Chronic Disease Management Planning Team has developed a model of care based on the Chronic Care Model (CCM). This conceptual model has been adopted as the basis for planning chronic disease management services worldwide. It addresses issues such as adherence to prac-tice guidelines; care coordination; follow-up to improve outcomes; and patient edu-cation to help individuals self-manage their illnesses.

A survey of our ambulatory medicine clinics was conducted to assess our adher-ence to the CCM model from the patient perspective. The Patient Assessment of Chronic Illness Care (PACIC), a standard-ized measure of care delivery, was used. While our programs rated well against comparators, there is work to be done. These results now serve as a baseline to ad-dress and evaluate improvements to care as our new model of care is implemented.

It’s a significant undertaking. The am-bulatory medicine programs at St. Joseph’s Hospital, which serve a vast region of Southwestern Ontario, see a combined to-tal of about 84,000 patient visits each year. In addition to new models of care delivery, other components of our focus on chronic disease management include teaching, re-search to improve outcomes, and region-wide collaboration to improve the health care system.

There have been some exciting, early accomplishments. A new, robust referral process has been implemented in our Pain Management Program to improve our re-sponse time. This includes a single, stan-dardized referral form and consistent triage process. Also implemented were reminder calls for patients and a protocol for uncon-firmed appointments to be filled with pa-tients on a call list. As a result, we have seen a 10 per cent increase in the number of new patients over the same period last year. The reminder calls are a major con-tributing factor, reducing the ‘no show’ rate for new referrals by a staggering 60 per cent and allowing access to more new patients.

For patients with pituitary disease, St. Joseph’s created the One-Stop Pituitary Clinic in collaboration with specialists across the city. Through a central refer-ral process, initial lab testing, endocrinol-ogy consult, visual field testing and neuro-ophthalmology consult are arranged on the

same day. In the past, patients with pitu-itary disease from across the region made on average 2.4 trips to London travelling a total distance of about 300 km. The total number of visits has since dropped to one and the average distance to 116 km.

In November 2013, St. Joseph’s and about 80 regional health care stakehold-ers from a wide variety of sectors gath-ered for the London Partnering in Health Care Transformation/Health Links event to discuss ways to better serve high-needs patients at this time of rising health care costs. Since then, the province’s Health Link model launched in London of which St. Joseph’s is a committed partner. Health Links encourage greater collaboration between family care providers, special-ists, hospitals, long-term care, home care and other community supports. The goal is for patients to spend less time waiting for services, improve patient transitions within the health care system, and have care providers working together to develop solutions that address each patient’s specific needs.

The approach is a good fit with our own

goals of integrated, interprofessional care, not only at St. Joseph’s Hospital but across the organization at Parkwood Hospital, Re-gional Mental Health Care, Mount Hope Centre for Long Term Care and the South-west Centre for Forensic Mental Health Care. We are creating synergies between experts from various fields and bringing them together to collectively focus on pa-tient needs. Through our new Centre for Cognitive Vitality and Brain Health, for example, geriatricians, psychiatrists, phys-iatrists, psychologists, scientists and others are working collaboratively to provide care and improve outcomes for those with men-tal illness, dementia, brain injury, and other neurological conditions.

With an enduring commitment to rise to new challenges and a willingness to go in new directions, the ultimate goal is to earn complete confidence in the care we pro-vide and make a lasting difference in the quest to live fully. It’s to create experiences like that of Pat Schmidt. nH

Dr. Gillian Kernaghan is President and CEO, St. Joseph’s Health Care London.

By Dr. Gillian Kernaghan

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he Change Foundation’s lat-est report (April 2014) inves-tigates the evolving function and best practices of Ontar-

io’s hospital-based Patient/Family Advi-sory Councils (PFACs): one mechanism some hospitals are using – among other approaches – to advance patient/fam-ily engagement and patient-centred care. Despite the increasing number of councils being created across Ontario, little was known about them prior to this review. The Foundation is an independent, On-tario health care think tank which uses research, policy analysis, and public en-gagement to improve people’s health care experience as they move in, out of, and across the health care system over time.

The review is well-timed. Ontario is shifting toward patient-centred care un-der the Excellent Care for All Act – ex-cellent news for all – and the report pro-vides guideposts on the road ahead. The tangible lessons and leading examples it presents are useful for hospitals setting up a council, for hospitals further along in the process who want to empower their councils even more, and for potential ad-aptation in other sectors.

“This preliminary review builds on The Foundation’s strategic work to help advance a patient-centred system in On-tario, by focusing in on the important cultural shifts underway within hospitals. It’s clear that while still evolving, hospital PFACs are engaging Ontarians to become active partners in their own care, to shape how care is organized, delivered and ex-

perienced. Leading PFACs also said that when hospital leaders embed patient and family centred care into their strategic plans, they create an enabling environ-ment for patient/family councils to truly succeed by moving policy into practice,” says Cathy Fooks, CEO ,The Change Foundation.

The 3-part report aims to guide, con-nect and inspire by presenting thematic findings with examples of challenges and successes; quantitative data; and listings of PFAC initiatives, with contact infor-mation. The Foundation interviewed 64 patients, family and staff from 29 On-tario hospitals about the functioning and impact of their PFACs. There were two interview guides, one for patient and family members, and the other for staff members. The Foundation asked ques-tions like “What were the council’s roles in relation to the hospitals? How are they structured? What is their impact to date? Is the PFAC an effective model for pa-tient/family engagement?” The resulting snapshot provides valuable insights into emerging themes, challenges/successes,

and best practices associated with various aspects of PFACs.

Part 1: Emerging Themes presents thematic findings from the Ontario-wide telephone interviews. The report notes that councils range in terms of years of experience – some have been operat-ing only for a few months while others have been around for 20 years. Seasoned PFACS (10+ years) tend to exist in spe-cialty centres such as children’s hospitals and mental health institutions.

Part 2: What the Data Tells Us fea-tures data graphs from key close-ended questions about PFAC operation, struc-ture, purpose, governance and overall impact. Some top findings: (96%) of pa-tients/families said they participated as equals with staff, and lauded the ensuing collaboration; and (89%) reported inter-action with senior hospital management about the council’s work indicating orga-nizational support.

Part 3: Examples: What the Coun-cils Changed is especially useful for those leading or participating in a hospital PFAC. This part lists specific PFAC ini-

tiatives with key contacts to facilitate dia-logue/collaboration across the sector. The five key types of initiatives spearheaded by councils (with examples) include:1) Changes to hospital policy and pro-grams: e.g., CAMH’s – Right to Daily Access to the Outdoors for mental health clients.2) Support infrastructure planning, re-design, signage and wayfinding: e.g., St. Joseph’s Healthcare Hamilton’s tracking board for patients undergoing surgery/recovery.3) Food/nutrition: eg., Bluewater Health's collaboratively developed policy allowing families to bring safe/nutritious food for patients from home.4) Staff orientation/public education: e.g., Kingston General Hospital’s patient advisors integrated throughout every committee dealing with major decisions, including staff hiring.5) Creation/updates to hospital informa-tional materials: e.g., Holland Bloorview’s collaboration with families to make all educational information accessible/user- friendly.

The Change Foundation plans future partnerships to learn more about similar advisory bodies in other health care sec-tors. The Change Foundation recognizes that this review touches only the surface of this fast evolving area, so we welcome your input on this report. Tell us if we missed anything, or share your PFAC ex-perience with us. Please email: [email protected] nH

Anila Sunnak is a Communications Specialist at The Change Foundation.

By Anila Sunnak

New report on patient advisory councils “Patients and families bring a unique perspective. It’s a perspective that no one else can have… you see the inner workings of the hospital from the inside out. You might have these really great policies and procedures on paper, but how does that actually roll out and what is the impact?” Julie Drury, a Family member from Children’s Hospital of Eastern Ontario.

T


17

here is a great variety to be found in Europe: from moun-tainous sceneries to stunning beaches, from bustling cities to

picturesque villages. The fact that there is something for every budget makes it a great continent to travel to; however, there are destinations in Europe that mostly cater to those who seek luxury and opulence. Lavish hotels, fi ne dining restaurants and high-end shopping, combined with white, sandy beaches, make these destinations the ultimate place to go to in summer. Let’s take a look at some of Europe’s best luxury destinations.

MonacoIf you have the desire to be surrounded

by the jet set along the French Rivièra, Mo-naco might be the place for you. Multi-mil-lionaires show off their fast sports cars and luxury yachts in the harbor, while tourists splurge on fi ne dining and high-end shop-ping. Thankfully, there is also a plethora of sightseeing to do. Monaco-Ville still feels like a medieval village in many ways, as it mostly has pedestrian streets, and a guided tour through the Prince’s Palace and the Prince’s car collection will leave many astonished. Is this too much culture and history for you? Those who want to sun-bathe can head for the beach and opt for a cocktail or two at one of the trendy lounge clubs afterwards.

IbizaWhen it comes to traveling to Ibiza, you

can make it as expensive as you would like. While there are many options to make a holiday to Ibiza affordable, spending a lot of cash is not diffi cult either. Ibiza has countless luxury boutique hotels with stun-ning views, as well as trendy restaurants and clubs where Ibiza’s jet set is seen after sunset. It is a popular hotspot for those in the movie, music and fashion industry and people come here to fl aunt. Even though Ibiza’s jet set scene is prominent, the island also attracts a wide variety of people who enjoy things like water sports, music festi-vals, great food and relaxation.

Saint-TropezBefore the 1950s, Saint-Tropez was a

serene fi shing town that no one found worth visiting, but when Brigitte Bardot came here for her movie And God Cre-ated Woman, this instantly changed. Since then, the town has attracted many million-aires and large numbers of tourists, who gasp at the wealth that this town showcas-es with its luxury yachts in the harbor, chic boutiques and fi ne dining restaurants. For a small town like Saint-Tropez, the possi-bilities are endless. On warm summer days, the beaches with crystal clear waters are an easy occupation, but the cobblestone streets of Saint-Tropez and its neighboring towns are a charming variation of scenery. History lovers adore this jet set fi shing town because of its historical and religious sights.

CapriAlthough tourism to the Italian island

of Capri has grown tremendously over the past decades, it has remained charming. In the 1950s, the island transformed into a jet set destination after Jackie Kennedy and Sofi a Loren visited, but compared to other luxury destinations in Europe, Capri is modest.

Luxury yachts and expensive sports cars are seen sporadically; however, luxury is certainly present. Capri is home to high-end shopping, and the excellent dining scene makes the island a favorite for food-ies. For the young and sophisticated, there is a lively night scene in Capri Town, and the mountainous heart of the island is a way to incorporate some activity into a re-laxing holiday.

MykonosOver the past years, the Greek island

of Mykonos has gained a reputation of a party island, but it is in fact a holiday d estination for the international jet set. In the 1960s, Jackie Kennedy Onassis and Aristotle Onassis frequented here and since then, Mykonos has become a favorite destination for high-end fash-ion designers and celebrities. With stun-

ning beaches, a trendy night scene and some of the finest restaurants of Greece, Mykonos is a hotspot in summer, but even in winter it attracts plenty of tour-ists. Cooler seasons on Mykonos are generally sunny and warm, compared to other parts of Europe, and it is a great

way to benefit from Mykonos’ glamour at a lower price. nH

Diana Herst is a freelance writer. This column appeared on www.aluxurytravelblog.com. It is reprinted with permission.

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rgan donation saves lives. The majority of life-saving and life-preserving organ trans-plants occur through a process

known as deceased donation, whereby organs are removed after death has been determined. Deceased organ donation can therefore occur when a person has been declared dead because either their heart or brain has completely and permanently stopped working.

Guidelines for both forms of deceased donation are in place and have been for many years in Canada. These guidelines include full disclosure and informed con-sent, the separation of duties of medical teams who are caring for critically ill pa-tients from medical teams who perform organ transplantation, and rigorous stan-dards for determining death, which must be performed by two physicians who are independent of transplant teams. As well, the guidelines stipulate that no transplant surgical procedures may start before a pa-tient has died.

It is important to understand that after death is determined and life has ended, the brain is no longer able to function. Despite how recent death is, donors are not able to experience any pain or suffering during the donation process.

Of course any discussion about death should never minimize the profound, emo-tional, psychological and spiritual impact that the loss of a loved one has on family and friends. Discussions about death are

diffi cult given the emotional and sensitive subject matter. There are philosophical, religious, and cultural differences when it comes to defi ning death and a lack of understanding and awareness, not just amongst the public, but health profession-als as well. Despite these challenges and various dimensions, it is important to un-derstand how death remains fi rst and fore-most, a biological process.

Over the last 50 years, the advances in medicine, biology, and technology have been remarkable and have helped us in

two major ways: by saving patients and by helping us understand the biology of life and death. The specialties that have led to improving our understanding of this domain include: cardiopulmonary resus-citation and physiology; cardiac surgery and cardiopulmonary bypass; ICU-based life support; extracorporeal support and extracorporeal membrane oxygenation (ECMO); cell biology and organ donation, preservation and transplantation. These advances have been truly astonishing in the collective effort to save lives. They

have also informed, and complicated, how medicine and modern society understands what it means to be alive or dead.

In the ICU, during the treatment of life-threatening illnesses, sustaining life is based on delivering oxygen and nutrients to cells, specifi cally, to the mitochondria of the cells. This process provides energy for metabolic processes required for life. Trillions of cells are grouped together and make up our organs – all distinct structures with very distinct functions. Vital organs have basic functions; the lungs provide oxygen to the blood, the heart is the pump that circulates the blood containing oxy-gen, the liver metabolizes and the kidney fi lters. The role of acute care and ICU pro-fessionals is to treat organ failure by rec-ognizing life-threatening conditions and to intervene with life-sustaining treatments to prevent death.

Technologies that support vital or-gans can sustain life in order for time or treatment to reverse the life-threatening condition.

These complex, resource intensive and arduous treatments are extraordinarily suc-cessful, with survival rates around 98 per cent in children and 85 per cent in adults. These treatments are fundamentally di-rected to provide oxygen delivery to the body. Without oxygen delivery, cells and organs stop working.

The dying process, which can be inter-rupted by life-saving intervention, is se-quential and predictable.

In general, death occurs by one of three mechanisms: 1) A primary respiratory illness/event causes breathing to stop, resulting in a fall in oxygen levels in the blood, which fi nally causes the heart to stop pumping; 2) Primary heart disease such as a heart attack – the heart arrests and cannot pump; and

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Dr. Sam Shemie in the PICU at Montreal Children’s Hospital.

O


Continued from Cover



3) Catastrophic brain injury – the brain stops working, the brain’s control of breathing is lost, breathing stops, oxygen drops and the heart stops beating.

Remarkable advancements in technolo-gies and transplantation permit the inter-ruption of this dying process by supporting or replacing failing organs, with the as-sumption that time and/or treatment will reverse the disease. Organs can now be supported by machines such as artificial hearts (ventricular assist devices), artificial kidneys (dialysis machines or blood filtra-tion systems), breathing machines that ef-fectively push oxygen into the blood stream or artificial lungs that completely replace lung function. These treatments and tech-nologies can be used inside the body or deployed outside the body. Examples of ex-tracorporeal, or outside of the body tech-nologies, include ECMO (extracorporeal membrane oxygenation) for respiratory failure or cardiac arrest and heart-lung by-pass machines used for open heart surgery. It is an incredible achievement to be able to provide patients access to these complex heart/lung/kidney machines that can pump and circulate, oxygenate and filter blood. They can completely replace the total ar-rest of heart/lung/kidney function. If that is the case, then how does one die?

These technologies serve as so called ‘bridges.’ If the underlying life-threatening organ failure can improve with time or treatment, these technologies are ‘bridg-es to recovery.’ If the failing organ can-not recover, they may become ‘bridges to transplant,’ but only if an organ transplant becomes available in time. In many un-fortunate cases, when recovery is not pos-sible and transplant is not an option or is unavailable, these technologies effectively become onerous ‘bridges to death.’ In this case, the technologies allow us to keep or-gans of the body working artificially, even when all effective treatment options are exhausted. Unfortunately, this is a circum-stance many families find themselves in when a loved one has a non-recoverable illness and, based on the expert opinions of the health care team, must choose whether it’s time to stop life-sustaining treatment.

In ICU’s‘ across Canada and worldwide, a decision to withhold and withdraw life-support is the most common event preced-ing death. The goals of care change from life saving to comfort measures. In Canada, it is a decision that can only be made by the family, consistent with the wishes and values of the patient. The vast majority of these deaths are not eligible for organ donation and in all cases, it is a decision made independent of consideration of organ donation.

The one organ that cannot be replaced or supported is the most complicated and important – defining who we are and what we are – the brain. The brain is responsible for our ability to breathe independently. It controls consciousness, awareness, sen-sation, movement, thinking, feeling and acting as well as brainstem reflexes and interaction/exchange of information with our environment. Most treatments, in supporting or replacing failing organs, are dedicated to preserving or restoring brain function. Regardless of the severity of the brain injury or the degree of the coma, the body and the organs can be kept alive indefinitely by replacing breathing with a machine (one that provides oxygen to the blood in order to keep the heart beating) and attentive ICU care. There are many diseases that cause catastrophic brain in-

juries such as stroke, trauma, oxygen de-privation, and brain hemorrhage. If there is any degree of residual brain function, no matter how minimal, the patient is still alive and decisions to start, stop, or con-tinue life-sustaining treatments are made by the family based on the advice provided by the medical team.

However, the most extreme form of brain injury is brain death. It is better understood as ‘brain arrest,’ which is the complete and permanent cessation of all clinical func-tions of the brain. All functions of the brain have been lost and they will never resume – no ability to breathe independently, no capacity for consciousness, no awareness, no sensation, no thinking, no feeling, no acting, no brainstem reflexes and no inter-action/exchange of information with the environment – the person has died.

It is important to note that the majority of these cases are associated with complete arrest of blood flow to the brain. Organs that do not have oxygen delivery cannot function. In accordance with deceased donation guidelines, in the presence of a clear cause of the brain injury, after revers-ible or confounding conditions are care-fully excluded, and a detailed neurological examination is performed by two physi-cians separate from the transplant team, the person is declared dead by neurological determination.

However, as long as the body remains on a breathing machine, the remaining organs can retain function. Once the determina-tion is made, the person is medically and legally dead, the breathing machine will be stopped and the option for organ donation is offered to the family.

Confusion has arisen with recent media cases of brain death in pregnancy. After brain death it is possible to sustain organ function with mechanical breathing, infec-tion control, hormone replacement and diligent ICU care for long periods of time to allow for fetal development to mature birth. Effectively, these pregnant but brain dead mothers serve as life support systems for the baby, similar to extracorporeal life support systems such as ECMO, until the fetus is viable. It does not change the medi-cal and legal fact that the mother remains a dead person with an artificially sustained body to allow the baby to be delivered, after which organ support systems are terminated.

Death that is correctly diagnosed by neu-rological criteria is not reversible – there is no chance of recovery of brain function. Rare reports of ‘miraculous recovery’ of such patients are misleading – these cases are patients who did not have the full di-agnostic criteria for the neurological deter-mination of death applied by experienced physicians. In Canada, the requirements across the country are uniform and include diagnostic requirements, clinical checklists and a minimum of two physicians with ex-perience and expertise to prevent the pos-sibility of error.

In public surveys, more than 90 per cent of Canadians support organ donation and transplantation. There are over 4,000 Ca-nadians waiting for an organ transplant and in 2012, 230 Canadians died waiting for an organ transplant while more than 2,200 transplants were performed. In Canada, if you require a life saving organ transplant, you have a 30-40 per cent chance of never receiving one.

While brain death is a principal source for organ donation, donation after circula-tory death (DCD, cardiac death) has re-emerged as an option in Canada. DCD has

been a well-established form of donation in many countries for many years – like the US and the UK – and accounts for 20 -50 per cent of deceased donation in well-established regions. This form of donation is still relatively new in Canada, as we have taken a prudent and planned approach.

In response to the Canadian Transplant Community asking ‘why is Canada not doing DCD’, the Canadian Council for Donation and Transplantation (now Ca-nadian Blood Services) sponsored a forum in 2005, hosting 120 national and interna-tional experts. During the forum, rigorous discussions were had about whether or not Canada should perform DCD. The answer was yes and, together, they created the rec-ommended guidelines that are now avail-able to hospitals across the country. That was nine years ago. As part of this expert consensus, public and professional surveys showed strong support for DCD and trust in the system. Since 2006, there have been more than 360 Canadians who donated organs after circulatory (cardiac) death, and more than 1,000 transplants would not have occurred if this donation option was not available to Canadian families. Ontario has been a DCD leader, account-ing for 75 per cent of donors in Canada. DCD programs have been implemented in British Columbia, Edmonton, Ontario, Quebec and Nova Scotia. Manitoba and Saskatchewan are in the process of devel-oping DCD policies.

The goal of every ICU team is to save lives. They work closely with the family of critically ill patients, making consensual decisions about starting, continuing and–only when a life cannot be saved – with-drawing life-sustaining treatments. The dying patients who are candidates for DCD are generally patients with catastrophic brain injury, not brain dead but with some residual brain function and a very poor prognosis for meaningful recovery. Their families have made the decision to stop life sustaining treatments. In these cases, the ICU teams manage end-of-life care, ensur-ing relief of suffering, comfort and dignity. For patients who are candidates for organ donation and whose families have given their consent for donation, it is also the

sole responsibility of the ICU team to de-termine death according to national organ donation guidelines. In the case of dona-tion after cardiac death, it is required that two physicians must be present to moni-tor and document the absence of a pulse, breathing and blood pressure for a period of no less than five minutes. The transplant team has no role in any of these duties.

The brain stops working prior to or within 20 seconds after a cardiac arrest so it is impossible for donors to experience suffering.

In medicine, death is defined as the complete and permanent cessation of heart function or brain function. Canada is a world leader in establishing the ethical and medical practices on the determina-tion of death and donation. In May 2012, in collaboration with the World Health Organization (WHO) and international experts who care for critically ill patients who may die, Canadian Blood Services or-ganized and hosted a meeting as part of the first phase in the process for the develop-ment of International Guidelines for the Determination of Death. The report from this meeting has been published recently in the journal Intensive Care Medicine. The re-port supports current practices in Canada and reaffirms Canada’s leadership in ethi-cal and medical conduct and procedures regarding death determination.

The loss of a loved one is tragic. Organ donation is wonderful act at the worst time – the juxtaposition of an unavoidable death in a willing donor to a preventable death in a transplant recipient. This gift, this be-nevolence, is predicated on the public trust of the health care system, based on the first and foremost priority to save the life of the ill and injured whenever possible. If not possible, then we care for patients at the end of their life and when possible, provide the option of organ donation. nH

Dr. Sam D. Shemie, MD works in the Division of Critical Care, Montreal Children’s Hospital, McGill University Health Centre where he is Medical Director of the Extracorporeal Life Support Program and is a Professor of Pediatrics, McGill University; Loeb Chair and Research Consortium in Organ and Tissue Donation, Faculty of Arts, University of Ottawa and Medical Advisor, Donation, Canadian Blood Services. The views expressed are those of the author alone and do not necessarily represent the decisions, policy or views of the Montreal Children’s Hospital, McGill University, University of Ottawa or Canadian Blood Services.

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In ICU’s‘ across Canada and worldwide, a decision to withhold and withdraw life-support is the most common event preceding death.

Continued from page 18Death and organ donation

Canada is a world leader in establishing the ethical and medical practices on the determination of death and donation.



Rehab program gets patients home sooner

unnymede’s Low Tolerance Long Duration (LTLD) Re-habilitation program is play-ing an increasingly important

role in the health care system. Since the program’s inception in April 2012, it has helped over 400 patients – who were oc-cupying a bed as an alternate-level-of-care (ALC) patient in an acute care facility – regain the functional skills necessary for day-to-day living, mobility and indepen-dence to return home.

ALC is a classification given to patients who are ready to be discharged but re-main in hospital as they await transfer to a more appropriate setting to receive the next phase of treatment. Patients would be designated ALC, for instance, if they are staying in acute care but are actually wait-ing for – and in need of – a bed in rehabili-tation that is not yet available.

According to the Ontario Hospital Association, approximately 2,300 ALC patients occupied acute care beds in the province as of March 2013. Of these, 25 per cent were waiting for a regular reha-bilitation bed or a complex continuing care bed. In addition to freeing up beds that may be needed by more acute patients, reducing the prevalence of ALC stays ben-efits patient safety and wellbeing. Patients who stay in acute care longer than medi-cally necessary may be at risk of declines in physical and mental health due to de-creased mobility.

Sometimes known as slow stream rehab, LTLD rehab serves patients who, because of their level of disability, need slower-paced rehabilitation therapy to maximize their abilities after surgery, illness or injury. For example, a senior who has suffered a hip fracture and has a weakened tolerance for physical activity might benefit from this less intensive approach to rehabilitation.

Runnymede’s LTLD Rehab program was formed in collaboration with St. Joseph’s Health Centre and has been successful in transitioning ALC patients waiting at St. Joseph’s for LTLD rehab to a more appro-priate care setting at Runnymede.

To date, the results have been extraor-dinary. As of September 2013, St. Joseph’s has seen a 3.4 day decline in the average length of stay of an ALC patient waiting for LTLD rehab. Further, in the last quar-ter Runnymede has reduced the average length of stay of an LTLD rehab patient to 55 days, which is significantly lower than the provincial average of 90 to 120 days. This means that the LTLD Rehab program has been instrumental in easing healthcare system pressures by freeing up acute care beds and efficiently transitioning patients to an environment that is more congruent with their clinical needs.

A patient can be classified as ALC at any point in their journey through the health care system. If a patient in the LTLD Rehab program has reached their rehabilitation goals at Runnymede and is ready to return to the community but can-

not do so, that patient would also be des-ignated as ALC. A patient might not be able to return home, for instance, if they are on a waiting list for a long-term care facility or if their home is being renovated to accommodate their needs during their hospital stay.

To mitigate factors that may prevent patients from returning home or to the community sooner, as well as minimize the number of ALC patients at the hospi-tal, Runnymede recently implemented an ALC Avoidance Strategy.

Formed in partnership with the Toronto Central Community Care Access Centre (CCAC), the ALC Avoidance Strategy includes policies, education and increased reporting and accountability to support the discharge planning process. In addition, a team consisting of Runnymede and CCAC staff participate in biweekly rounds to discuss each current ALC patient. These consultations enable the team to identify barriers to discharge, assess the patient’s community support needs and develop action plans to facilitate the patient’s safe and smooth transition to the community.

“Our ALC Avoidance Strategy takes a proactive, preventative approach,” says executive lead of the strategy and Vice President, Clinical Programs, Lisa Dess. “Through early identification of patients who may potentially become ALC and taking necessary steps to address factors that might prevent their anticipated dis-charge, we are able to ensure each patient receives the most appropriate care in the most appropriate setting.”

The Ontario Hospital Association pre-dicts that as the population ages, the need for rehabilitation services will likely in-crease. A report by the Canadian Orthope-dic Care Strategy Group revealed that the number of Canadians with musculoskeletal disease is expected to rise with the aging baby boomer population, from 11 million in 2007 to 15 million in 2031. Since or-thopedic conditions such as knee and hip fractures are the most common reason for inpatient rehabilitation, it will be increas-ingly important to ensure patients are able to access this type of specialized care and rehabilitation therapy that we provide at Runnymede. nH

Debbie Kwan is a Communications Associate at Runnymede Healthcare Centre.

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The LTLD Rehab program has reduced the average length of stay of a patient to 55 days.

The ALC Avoidance Strategy includes policies, education and increased reporting and accountability to support the discharge planning process

R


21 Healthcare Technology

magine a world where ev-ery physician will be able to compare, in a keystroke, their diagnosis with the data of

thousands of other patients with the same symptoms and demographic and lifestyle makeup. Our access to information today is unprecedented. We have smartphones with us everywhere we go and we can search anything online in a second. In the health care industry however, a compara-ble access to information doesn’t exist. The fact that we can’t search any medical infor-mation immediately, the same way we use Google in our daily lives, means doctors and physicians are being held back from providing the highest level of care.

The health care industry is evolving, however. The changes are not sudden and spectacular, but steady and evolution-ary in nature. We’re seeing a slow transi-tion take place towards a more connected health care system. Most recently, the British Columbia Centre for Excellence in HIV/AIDs announced that it is pioneer-ing new technology to treat patients with immediate and personalized care. This is the first initiative of its kind in Canada. Once the technology is installed, the Centre will be able to quickly identify a patient’s unique strain of the virus by rapidly analyzing massive amounts of data, and provide a treatment that is personalized to the patient. This means that patient care is greatly improved as treatment is provided quickly, which in turn can help lower health care costs.

What is personalized medicine?

We are able to provide personalized medicine when medical decisions, prac-tices, and products are being tailored to the individual patient. A classic example of how personalized treatment has been hugely successful is the discovery of Trastu-zumab (Herceptin), history’s most success-fully targeted cancer drug. It is prescribed to treat breast cancer induced by over ex-pression of a specific gene (HER2) and is a major pharmacogenetics success story. The drug can shrink tumors, slow disease pro-gression, and increase survival. And unlike most chemotherapy drugs, trastuzumab is a

targeted therapy that kills only cancer cells while leaving healthy cells intact.

We now know through genomics and testing for this mutation that this drug is only effective in roughly 25 per cent of breast tumors. Knowing this and using it only in the right patients generates a tre-mendous savings of health care dollars. The treatment of broad populations with regimens that do not benefit most patients is not economically sustainable and is in-creasingly less necessary.

The use of genetic information has played a major role in the journey towards personalized medicine. Decoding genomes will increase our understanding of the genetic makeup of diseases, which could speed up the development of new drugs as well as determining more targeted treat-ment therapies.

Using personalized medicine to treat HIV/AIDs in Canada

The British Columbia Centre for Excel-lence in HIV/AIDS at St. Paul’s Hospital, British Columbia, has teamed up with a local technology startup company, PHEMI Health Systems, and SAP, to deliver per-sonalized medicine to HIV/AIDs patients based on the genetic signature of the virus that infects each patient.

Dr. Paul Terry, CEO of PHEMI Health Systems, offers a simplified view on what this means for health care professionals: “Over 70 per cent of health care informa-tion is unstructured and difficult to mine for relevant insight using traditional meth-ods. What we intend to offer health care professionals, essentially, is the ability to turn physician letters and lab results into searchable information, thereby helping to unlock vast amounts of new information for clinicians, analysts and researchers.”

“We’re changing the face of treatment for HIV and AIDS,” explains Dr. Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS. “This technology will be invaluable to the lives of our patients. We will be able to quickly treat patients by delivering personalized medicine based on their unique strain of the virus. This will help us save time and money while also significantly decreasing the number of new HIV and AIDS cases. For the first time, we shall have access to vast amounts of information and get an-swers immediately thanks to technology from PHEMI and SAP.”

The future of medicineAdvances in genomics are improving

our ability to predict and prevent ad-verse drug reactions, and mitigate dis-ease conditions. Personalized approaches to health care will help eliminate the trial-and-error inefficiencies that inflate health care costs and undermine patient care. The hope is that genomic insights will reduce the time it takes to find a treatment down from weeks to minutes, bringing the most effective therapies to patients faster, and improving the lives of people surviving with chronic disease. The bold action taken by the BC Centre for Excellence is a great proof point that forward-thinking Canadian healthcare companies can lead the world in this in-dustry. Doctors and researchers are now envisioned to have a much faster way of treating patients. Working together, we plan on lowering healthcare costs by speeding up treatment plans, improving patient care and addressing chronic dis-ease as a whole. nH

Bob Elliott is Managing Director for SAP Canada.

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I

nlargement of the prostate, or benign prostatic hyperpla-sia (BPH), is a condition that affects nearly half of all men

over 50 and close to 90 per cent of men over 80 worldwide. It’s a condition that causes urinary complications that can in-clude a weak flow, the sudden feeling of urgency to urinate (often in the middle of the night), inability to fully empty the bladder and incontinence, among other symptoms. Prolonged BPH without treat-ment can lead to urinary tract infections, inability to pass urine and even bladder or kidney damage.

Recent technological advancements have led to the introduction of a therapy that is both improving treatment and sav-ing health care costs. This procedure – called photoselective vaporization of the prostate (PVP) involves the use of a la-ser to quickly vaporize and safely remove prostate tissue. PVP is a minimally inva-sive procedure that offers many benefits including virtually no blood loss, a fast recovery time and the fact that it can be performed in an outpatient setting.

In addition to patient benefits, a 2013 study by Health Quality Ontario, an On-

tario government agency that evaluates the effectiveness of new health care tech-nologies, examined the PVP procedure. The study found PVP to be cost-effective, providing clinical benefits to patients at a lower cost to the health system. The results also indicated that patients re-covered faster with fewer side effects and complications following surgery. Were it to be deployed across Ontario, the HQO study estimates an annual cost saving of $14M and 28,213 days saved in hospital bed occupancy.

The PVP procedure “has a lower in-cidence of post-operative complications and requires less hospitalization” says Dr. Paul Whelan, a urologist at St. Joseph's Hospital, Hamilton and contributor to the HQO study. “And with an aging de-mographic, it's also good for the future of Ontario's healthcare system” he adds.

PVP is currently in use in over 60 hospi-tals across Canada, but there are many op-portunities for its expansion. It’s just one example of a minimally invasive procedure enabled by medical technology that can help deliver better treatment to patients, while contributing to the sustainability of our health care system. nH

Innovative laser procedure improving patient experience

E


22 Healthcare Technology

rovidence Healthcare’s iPad project began when Occupa-tional Therapists identified an opportunity to advance thera-

peutic approaches in stroke and neuro rehabilitation by incorporating the use of technology in patient care. In review-ing current literature, they found that iDevices are becoming integrated more into the rehabilitation process thanks to both their versatility as well as the greater use of technology by patients and their families.

A team of Providence Occupational Therapists and Speech-Language Pa-thologists researched mobile apps for use with stroke and neuro patients, later de-veloping a process for incorporating the use of mobile tablets into patient care. Three iPads donated at the Providence Healthcare Foundation’s 2012 Silver Ball were implemented within Providence Hospital’s Stroke and Neuro Rehabilita-tion program for both inpatients and out-patients.

The iPads have since been used regu-larly in speech and occupational therapy sessions to help patients with their think-ing, perception, speaking, understanding, reading and writing, and to help them learn more about stroke and its effects.

The devices have also helped other team members, including physiothera-pists and nurses, provide visual feedback to patients through photos and videos.

Over a four-month trial, 98 per cent of patients using the technology reported

finding the iPad helpful and 100 per cent reported they would try it again. Patients identified that the iPad could help them with practicing for return to driving, keeping the mind sharp, making the left hand better, having better awareness of what is happening with swallowing, prac-ticing spelling, preparing for going home and continuing to work on speech thera-py independently.

Therapists appreciate the iPad’s po-tential for augmenting current therapeu-tic practices with engaging apps and for providing education in a visual way that is easily understood. For example, a dys-phagia app shows patients with swallow-ing problems what it looks like when they

aspirate (have food or liquid go into their airway) using slow-motion video.

Next steps for the project include enabling patients to use the devices in-dependently between sessions in order to practice what they have learned in therapy, and continuing to explore new apps and creative ways to use the devices to help our patients work toward their rehab goals. nH

Jennifer Joachimides is an Occupational Therapist Practice Consultant and Marcia Curry is a Speech Language Pathologist with Providence Healthcare’s Stroke and Neuro Rehabilitation program.

By Jennifer Joachimides and Marcia Curry

Providence Healthcare Speech-Language Pathologist Kristin Hayes uses an iPad dysphagia app to help a patient learn more about the effects of a stroke on swallowing.

P

ovidien, a global provider of health care products and in-novator in patient monitoring and respiratory care devices,

announced Health Canada approval of its Puritan Bennett™ 980 ventilator.

The new acute care ventilator from Co-vidien – designed to be simple, safe and smart – helps enable patients to breathe more naturally through some of the most innovative breath technology available.

“We are excited to introduce our next-generation acute ventilation platform, the Puritan Bennett 980 ventilator,” says Tere-sa Mattarelli, Vice President and General Manager, Canada, Covidien. “We believe this ventilator will provide health econom-ic solutions by naturally helping to reduce patient dependency on ventilation.”

The Puritan Bennett 980 ventilator fea-tures a range of software capabilities, in-cluding Proportional Assist™* Ventilation Plus (PAV™*+) and Leak Sync software, which can help clinicians achieve the most critical goal: reducing time on the ventila-tor versus traditional volume control me-chanical ventilation.

Patients on mechanical ventilation are often sedated to ease agitation and help them tolerate breath support and other medical interventions. The Puritan Ben-nett 980 ventilator features advanced synchrony tools that help clinicians set the ventilator to adapt to their patients’ unique needs and help provide the ap-propriate level of support throughout the breath. Reducing patient-ventilator mis-match may reduce the need for sedation and stop the vicious cycle between seda-tion, asynchrony and muscle weakness.

The new ventilator features a custom-izable display and intuitive screen navi-gation, and software to enhance patient safety and clinical workflow, including:• NeoMode 2.0 software – Helps clinicians provide ventilatory support to neonates weighing as little as 300 grams by deliver-ing tidal volumes as small as 2 ml.

New acute care ventilator helps patients to breathe more naturallyBy Korinne Jew

C


Integrating iDevices with rehabilitation

Puritan Bennett™ 980 ventilator


23 Careers

At the Toronto Central Community Care Access Centre (CCAC), we are committed to the relentless pursuit of every option to deliver what is most important to each of our clients, and to supporting them to live the fullest and healthiest lives possible. In the same way, we work tirelessly to unleash the potential of our people.

We are looking for Client Services Managers with a passion for health care, expert communication skills and a commitment to quality improvement and employee engagement, to lead teams of hospital-based, office-based and community-based staff, and help clients and their families get the health care services and support they need. With 3 to 5 years of experience managing in a multidisciplinary, culturally diverse health care environment, you have the operational and people management skills needed to oversee the management, planning and evaluation of community health care coordination in your area. A graduate degree (or equivalent) in a relevant field or regulated health profession is expected. English/French bilingualism is an asset.

Full position details are available online at www.ccacjobs.ca. If you are seeking a chance to truly make a difference in the lives of others as well as your own, please apply online or send your résumé directly to [email protected] Community Care Access Centres of Ontario are governed by the requirements of the French Language Services Act. We provide services in French and encourage applications from bilingual candidates.

Toronto Central CCAC is committed to accommodating people with disabilities as part of our hiring process. If you have special requirements, please advise Human Resources during the recruitment process.

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• Leak Sync software – Detects and automatically compensates for leaks in the breathing circuit and patient in-terface, giving clinicians the reassur-ance that their patients are receiving the level of ventilatory support they need.• PAV™*+ software – Helps manage work of breathing and supports the patient’s breathing efforts, allowing

the patient to drive the start, duration and end of each breath. • Noninvasive ventilation – Allows versatile options including noninvasive SIMV and CPAP. • Bi-Level software – Permits spontane-ous breathing at all times and supports biphasic or airway pressure release venti-lation for extra fl exibility. • Proximal Flow Sensor – Measures lower

fl ows, pressures, and tidal volumes right at the patient wye in neonate applications. • Volume Control Plus – Enables the patient to take spontaneous breaths to achieve a targeted tidal volume, and pres-sure is automatically adjusted. •Respiratory Mechanics software – En-ables monitoring of key respiratory pa-rameters for easy assessment of patient status.

• Tube Compensation software – Accu-rately overcomes the work of breathing imposed by the artifi cial airway.

The Puritan Bennett 980 ventilator system is for patients ranging from neo-natal to adult, and became available in Canada earlier this year. nH Korinne Jew, PhD, BSN, is the Respiratory and Monitoring Solutions Medical Affairs Manager for Covidien.

Continued from page 22



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