Summer 2014
Kids health a priority
at HSN
The Journey
from Cancer
Doctor to
Cancer Patient
Helping Seniors stay healthy
and at home
Research
improving
health in
Sudbury Health Sciences North/Horizon SantĂŠ-Nord
5 Years of Shaping Healthcare in the North
1964 - 2014
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Working to keep you healthy
Letter from the President and CEO of Health Sciences North / Horizon Santé-Nord
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Dr. Denis Roy
Since becoming President and CEO of Health Sciences North five years ago, I have been astounded by the stories of the people in our hospital. Everyday our doctors, nurses, scientists, and staff are working hard to provide quality health care while also looking for ways to improve that care. This culture of innovation is becoming the norm at HSN. Innovation in health care is a necessity. The hospital model we all grew up with is now outdated. Time and research has shown it is no longer the best way to deliver health care to you and your family. To ensure we are able to keep up with this evolution in care, HSN must change and adapt. That means changing how we interact with our patients by giving them and their family a greater say in their care plan. It means changing the way people receive care by becoming a hospital without walls and bringing services out into the community and into the home.
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All this change and innovation is creating a vast and interesting dynamic within and beyond our walls. That is why we decided to produce this magazine for our community. We wanted to show you what is happening in your hospital and how we are improving your care to better your health. You will discover how NEO Kids aims to tackle the big issues we have with children’s care in the North. You will learn how seniors’ health is being transformed to ensure older adults remain healthy and able to live longer in their own home. You will read an extraordinary story about a doctor who has witnessed innovations in cancer care from both sides of the gurney. You will uncover how research is benefiting patients at HSN and providing access to care never before imagined. Along the way, you will meet some extraordinary people who are working to keep you healthy.
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In the creation of this magazine, it has become obvious just how much community support has meant to HSN. Whether it has been through volunteering or your generous donations, the support from people like you is making a big difference in shaping the future of health care. This is not just a reflection of the work HSN is doing, but the success that we, as a community, are achieving. Please enjoy,
Dr. Denis Roy
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Summer 2014 Chair of the Board of Directors Mike McCann
Little Feet, Big Strides
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President and CEO Dr. Denis Roy Chief, Communications and Community Engagement Viviane Lapointe
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Exceeding Expectations
Heart of Giving
Health Editor Jesse Brady Assistant Editor Shane Gordon
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Innovations in Care
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Isabelle’s Journey
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Caring for seniors
Giving Hope
Contributors Briana Fram Sarah Grenier Dan Lessard Chris Pollesel Sarah Wendorf
Published by NORTHERN ONTARIO BUSINESS Ltd. for Health Sciences North/ Horizon Santé-Nord
PUBLISHER Patricia Mills
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Editor Vicki Gilhula
Paying it Forward
Art Director Crystal Larose
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30 Doctor-Teacher-Student
Last Words
COVER PHOTOGRAPHY Jim Gray 705.673.5667 Fax: 705.673.4352 158 Elgin St. Sudbury, Ontario, P3E 3N5 www.northernontariobusiness.com
Summer 2014
Kids health a pRioRity
at hSn
The Journey
from canceR
DocTor To canceR patient
helping senioRs stay healthy and at home
ReseaRch
impRoving
health in
Sudbury health Sciences north/horizon Santé-nord
Julie Contini and her son Peter have both witnessed the tremendous strides that have happened in children’s care in Sudbury.
Northern Ontario Business Ltd. publishes the Northern Ontario Medial Journal.
Extraordinary people working to keep you healthy
Dr.Amanda Fortin Plastic Surgeon Despite having studied and trained all over Canada and the world, Dr. Amanda Fortin decided that home is where the heart is when she came to HSN. Born in Sudbury and raised in Timmins, Dr. Fortin is a plastic surgeon and one of HSN’s most recent recruits. 6
Health Sciences North/Horizon Santé-Nord
I started with a bachelor’s and master’s in pharmacology at Western University before going to medical school in Calgary and plastic surgery in Manitoba. I also did two fellowships, the first at MD Anderson Cancer Center in Texas for cancer reconstruction, and another in Australia focusing on hand reconstruction. After all of that, I returned to Western for five years, doing education, research and surgery with my focus being breast reconstruction. In 2011, I came back to the city I was born in to be with my husband, son and daughter. HSN was a natural next step. Plastic surgery is a great specialty and there’s a huge variety of treatments. Every day is different. Plastic surgeons operate on nearly every part of the body which allows for collaboration with other expert surgeons. There’s also opportunity to be creative. No two patients are the same. Even if two patients come in with a similar condition, everyone’s body is different and a plastic surgeon has to be comfortable thinking outside of the box. Unfortunately, many people have a negative impression of plastic surgery. Yes, plastic surgeons do “tummy tucks” and other changes to a person’s body that might impact how they live, but that same impact can be made from reconstructing a finger that has been injured. Sometimes the small things we can do can have a huge impact on our patient’s livelihood. A lot of plastic surgery is not as much life and death as it is quality of life. Seeing our patients happy after their treatment is hugely rewarding for me and really for all plastic surgeons.”
Research is Health
Care Our doctors and scientists are conducting cutting edge research and bringing it directly to patients. Whether it is finding better cancer treatments, fighting infectious diseases, creating a smoking vaccine, or keeping seniors healthy, AMRIC is finding ways to improve your everyday life.
AMRIC is the affiliated research institute of Health Sciences North. Headquartered in Sudbury, AMRIC aims to improve the health of people in Northern Ontario and beyond.
Dr. Colin Germond went from cancer doctor to cancer patient
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Health Sciences North/Horizon SantĂŠ-Nord
Exceeding All
Expectations Dr. Colin Germond’s story mirrors the history of the Northeast Cancer Centre By Dan Lessard
Dr. Colin Germond appreciates life a lot more these days. It’s a quiet but open gratitude from a reserved and dignified man. It’s an appreciation cultivated during a 20-year career as a medical oncologist at the Northeast Cancer Centre. But it’s a gratitude also forged by his own experience with cancer. He was diagnosed with a form of lymphoma in 2008. Dr. Germond’s story mirrors that of the Northeast Cancer Centre. Both involve breaking new ground, working through challenges, and exceeding expectations. To appreciate the parallel journeys of Dr. Colin Germond and the Northeast Cancer Centre, you have to go back to 1989. Dr. Germond had just settled in Sudbury, having moved to Canada three years earlier from South Africa. Back then, limited cancer care services were being offered on the site of what is now the Ramsey Lake Health Centre. The Northeast
Cancer Centre would not be officially opened for at least another year. “When I arrived, patients in Greater Sudbury went to Toronto for treatment,” Dr. Germond reflects over a cup of coffee at a downtown café. “There was no radiation service yet, and only some chemotherapy was being administered to patients. Princess Margaret Hospital was still sending specialists up to Sudbury to provide follow-up care. But soon we were providing all medical oncology services.”
What this taught me is that treatment is tougher than I ever imagined. When you have to go through it, you appreciate how devastating the impact of cancer is.”
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Dr. Andrew Pearce with a new linear accelerator, an advanced machine used for radiation therapy.
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Health Sciences North/Horizon SantĂŠ-Nord
It took extensive lobbying by the community to convince the government that northeastern Ontario warranted its own cancer centre. The equally challenging argument to make was that the care provided at the fledgling Northeast Cancer Centre could be as good as what was offered at the more established centres. “At first there was some concern. It takes a while to build a reputation. But it was a very exciting place to work with lots of room to try new things. With the recruitment of Dr. Anthony Ho in 1989 as head of research, we moved several rungs up the ladder.” Dr. Ho began the centre’s stem cell program. It became the first in Canada to collect and transplant peripheral blood stem cells to help regenerate the bone marrow of patients so they can tolerate higher doses of chemotherapy. It remains one of the centre’s proudest accomplishments. Ironically, this breakthrough in cancer care was the same treatment Colin Germond would undergo during his own battle with cancer. “I had a curable type of lymphoma. That’s the good news. The bad news is I had an unusual subset of that type of lymphoma, which usually kills most patients within six months, and standard treatment options are not good.” It was recommended that Dr. Germond undergo an experimental kind of treatment in Ottawa, involving high doses of chemotherapy and total body irradiation, followed by stem cell reinfusion. Despite the treatment, Dr. Germond’s cancer recurred within six months, requiring further radiation and chemotherapy. Subsequent courses of chemotherapy have kept the disease under control. “I thought I only had a couple of months. The median survival for this form of cancer is four months. I’ve been living six years. It’s very unusual. I have the excellent care at our centre to thank for that.” His own experience with cancer has had an impact on his views on life and health care.
“Back in 2008, I wondered if I’d see my daughter Caitlin, graduate from high school. Now I’m expecting to go to her university graduation in June.” Caitlin Germond is graduating from the Radiation Therapy program at Laurentian University. Colin’s son, Richard, is studying engineering at Queen’s University in Kingston. “What this taught me is that treatment is tougher than I ever imagined. When you have to go through it, you appreciate how devastating the impact of cancer is.” Dr. Germond believes the treatment offered by the Northeast Cancer Centre is as good as one will find anywhere. He’s also confident the creation of the Advanced Medical Research Institute of Canada (AMRIC) will further enhance care. “Research is so entrenched at the cancer centre, and AMRIC will build on what’s already here.” This view is shared by another longtime employee of the Northeast Cancer Centre. Like Dr. Colin Germond, Mark Hartman’s journey to Sudbury began halfway around the world. Mark Hartman arrived in Sudbury in 1992, as a radiation therapist from Australia. He rose through the ranks to become Vice-President of Cancer Services in 2012. During this time, Hartman has watched the Northeast Cancer Centre evolve. “We’ve adopted a regional model of care for patients, plus we have branched into more aspects of the patient journey such as prevention, screening, palliative care, and survivorship. We’ve also done a lot of work to create partnerships with other communities in the northeast. In fact, we have the highest volume of chemotherapy treatments in satellite sites in Ontario and, for oncology, we have the highest use of telemedicine in the province.” Hartman credits the success of the centre to those strong partnerships, along with generous support from patients, families and the community, led by the Northern Cancer Foundation. That community input still drives the centre’s ongoing progression. www.hsnsudbury.ca
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A new frontier being explored at the centre is personalized medicine, which tailors a patient’s diagnosis, treatment and follow-up care on their individual genetic makeup. Research on this front will be done at AMRIC, through Dr. Rebecca McClure, a pathologist and leader in the field of next-generation DNA sequencing. But cancer care is not just about the body. It’s also about the mind and heart. Dr. Carole Mayer believes this holistic approach is indispensable to effective cancer care. Mayer is the Director of Research and Regional Clinical Lead for the Supportive Care Oncology Department. She joined the centre in 1989 as its first-ever social worker, eventually earning her Ph. D. in the field. “If you don’t support the patient and their families and address their psycho-social well-being, it can deter patients from following treatment,” says Dr. Mayer. “They can lose motivation. The potential for ‘cancer fatigue’ is very real, which is why all patients at the Northeast Cancer Centre are screened to determine their psycho-social needs.” Supportive care services include oneon-one counselling, support groups and classes led by professionals, dietary advice, a specialized nurse who works with children receiving cancer care, and a support worker to help patients navigate the cancer care system. Another unique feature of the Northeast Cancer Centre is its Dental Oncology Clinic. There are only two such clinics in Ontario. An estimated 40 per cent of cancer patients will experience oral side effects during treatment, which can lead to a disruption or discontinuation of their care. To prevent or minimize this, the clinic provides oral care for patients before, during, and after treatment. They also provide rehabilitation for head and neck cancer patients who require special prosthetics after oral reconstruction. It also offers a clinical tobacco intervention program and oral cancer screening. “The mouth is a window to your overall health,” states Dr. Deborah Saunders, a dentist and the clinic’s Medical Director.
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“Head and neck cancer patients have some of the highest morbidities and side effects after treatment. When I started here there was no oral cancer screening, no clinical tobacco cessation program, no prosthetic rehab program. We’ve been building more services to provide access to care not offered elsewhere in this part of the province. We’re on the map nationally and internationally for the unique service we provide here.”
When I came here five years ago, a patient needing radiation treatment for head and neck cancer could get advanced treatment, but it would take 45 minutes. Now, that same procedure can be done in five minutes thanks to new linear accelerators purchased for us by the Northern Cancer Foundation. Treatment is faster, there are fewer side effects, and we can target more radiation to the tumour and less to surrounding healthy tissue.” Dr. Andrew Pearce is spending a rare moment in his office, as he prefers to be on the treatment floor, closer to his patients. Dr. Pearce is a radiation oncologist and the Chief of the Department of Oncology at the Northeast Cancer Centre. Dr. Pearce joined the centre in 2009.
Raised in Sudbury, he completed his university undergraduate and master’s studies at Laurentian University, before completing medical school and residency training in Toronto and Calgary. “It was an easy decision for me to move back here,” says Dr. Pearce. “It’s great to work and live here.” Since his return to Sudbury, he has noticed some significant changes at the centre. “When I came here five years ago, a patient needing radiation treatment for head and neck cancer could get advanced treatment, but it would take 45 minutes. Now, that same procedure can be done in five minutes thanks to new linear accelerators purchased for us by the Northern Cancer Foundation. Treatment is faster, there are fewer side effects, and we can target more radiation to the tumour and less to surrounding healthy tissue.” Dr. Pearce has also noted improvements to the way chemotherapy is delivered. He says new drugs are leading to increased survivability, decreased toxicity, and better quality of life. Given all the changes he’s witnessed in a relatively short time, what is he most proud of? “All of us are very aware that we are seeing people at their sickest, and everyone here puts the patient first. The most important thing to me is to know you are making a difference in the lives of people.” Dr. Colin Germond would agree. Due to his cancer, he stopped practicing as an oncologist in 2009. He misses his work. “I loved it. People would say to me: working in cancer must be depressing. How can they think that? People’s lives are saved and improved, and I was a part of that.” He still is, in his quiet, dignified way. These days, he’s not improving lives with the power of pharmaceuticals or beams of radiation, but with the power of his story. Dr. Germond and those who continue to work at the Northeast Cancer Centre are dispensing an equally powerful prescription for their patients’ health and well-being: hope.
Extraordinary people working to keep you healthy
Susie Perry Patient Advisor Susie Perry is a member of the CEO Patient and Family Advisory Council. Made up of patients, family members and HSN leaders, the Council provides advice on how HSN can deliver care that is first and foremost patient-centred.
One of my favourite things about being a part of this council is we get to see the change coming, both in the institution and in the community. The big changes that HSN made over the past few years are finally coming to be accepted in the community. That’s not to say we’re perfect, but HSN is taking steps in the right direction to becoming completely patient-centred in its care. The reason I joined the CEO Patient and Family Advisory Council was because my husband had a long hospital stay that was good, but there were many little things about it that could be improved. After my husband’s discharge, I had decided to write a letter to Dr. Roy but then I saw advertisements for the council in the newspaper. I was one of many who applied but one of few who were selected to be on the council. It’s an interesting position to be in and definitely not one to be taken lightly. Everyone who is on the council comes with a story and those patient stories help us identify areas of HSN that allow us to say, “Hey, we can improve this!” My background as a nurse lets me look at different things from that perspective of direct patient care at the front line and it’s coming along very well. Before HSN’s focus on patient and family-centred care, the focus was on disease-centred care where you would be treated according to your condition rather than as a person. If someone came in with pneumonia, they became a “pneumonia patient” rather than “Mr. Smith.” Being patient-centred doesn’t mean we’ve stopped treating the disease, rather we treat the disease and Mr. Smith based on who he is and what his individual needs are. That’s been a big change in the provision of health care since I started nursing and it is definitely a positive one.” www.hsnsudbury.ca
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Extraordinary people working to keep you healthy
Dr.Leslie Sutherland Scientist AMRIC Dr. Leslie Sutherland is a principal investigator and scientist at the AMRIC and associate professor at the Northern Ontario School of Medicine. She conducted research around the world before coming to Sudbury to study tumour biology in 2001.
When I first began my job in Sudbury, I didn’t know what to expect. I had been in Europe for post-doctorate studies and had just left a research position in Pennsylvania when I came here. Most of my early studies focused on one specific gene, and how it regulated cell death. When I came to Sudbury, this research expanded to include a broader application to cancer. Lung cancer and the effects of smoking cigarettes has become my primary area of research. Being a researcher is like being a detective, I solve mysteries. I read the literature, determine what the facts are, create a hypothesis, get some preliminary results, get a grant, hire a team and then, after all that hard work, get results. It’s phenomenal. It’s such a fulfilling job. Becoming an academic health sciences centre creates a culture of continuous evolution of knowledge. That challenge, having professionals who are constantly keeping themselves up to date with the latest in evidence-based care, is extremely important. That drive for research and innovation means there are people here with questioning minds that don’t settle for the basic knowledge. The professionals here want to solve the North’s health care problems. So much has changed since I first started. The biggest and most noticeable change is technology. The machines that we have now and the software allows researchers to do things that we only dreamed about years ago.”
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Improving patient care
through research By Jesse Brady
Just over a decade ago, an outbreak of Clostridium difficile (C. difficile) in hospitals in Quebec and British Columbia killed more than 80 patients. While C. difficile was not a new problem, media reports highlighted to the public just how serious emerging more virulent bacteria had become. Since then, medical researchers have been seeking a solution to safeguard hospitals and patients. Part of that global effort is taking place right here in Sudbury at Health Sciences North’s research affiliate, the Advanced Medical Research Institute of Canada (AMRIC). While a relatively new research institute, AMRIC’s integration with HSN has given it a unique edge. “Working in a hospital is a lot different than in an academic setting,” explains Dr. Reza Nokhbeh, who worked as a professor at the University of Ottawa before joining AMRIC as a scientist and principal investigator in May 2012. “I see and talk to patients all the time. I keep track of how they are doing. It is a big motivation to know that the work my colleagues and I are doing is going to help these people. In an academic setting you don’t get that.” That sentiment is echoed by one of Dr. Nokhbeh’s colleagues. Before coming to work in Sudbury, Dr. Yanal Murad had worked at some of North America’s top academic medical research facilities, including the National Research Council in Ottawa and North Carolina’s Duke University. However, since coming to work at AMRIC, Dr. Murad has found a whole new level of motivation for his research. “Conducting research in a hospital setting really gives you a sense of the value of your work,” says Dr. Murad. “You not only see what the patients are facing, you also see the patients themselves. It’s that connection that provides the value to our work. It really motivates you.”
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For AMRIC scientists this close connection provides an excellent environment to tackle one of the biggest problems facing modern medicine today: the rise of drug resistant bacteria. For nearly a hundred years, antibiotics have been a savior in health care. Their development was a major milestone in modern medical research and they have gone on to save millions of lives around the world. During the 1960s, there was a general feeling we had won the war over bacteria because antibiotics
were so effective. According to the Centre for Disease Control, antibiotics are one of the most commonly prescribed drugs on the planet, yet close to half of them are either not needed or not optimally effective. “Part of the rise of these antibiotic threats has been the misuse and abuse of antibiotics,” says Dr. Murad. “This has accelerated the quick adaptation that bacteria have made to overcome antibiotics.” It took just a few decades to realize harmful bacteria were not going away.
Worse still, antibiotics were losing their potency as bacteria began to mutate and adapt to these drugs. Soon new multi-drug resistant pathogens and pan-resistant bacteria (those that are resistant to virtually all antibiotics) began to emerge. “The problem we face in fighting pathogens like C. difficile is that we are trying to control a living, dynamic system like bacteria, with a static system, antibiotics,” Dr. Nokhbeh explains. “The bacteria adapt, but the antibiotics do
Conducting research in a hospital setting really gives you a sense of the value of your work.You not only see what the patients are facing, you also see the patients themselves. It’s that connection that provides the value to our work. It really motivates you.”
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not. As a result, we now see antibiotics becoming less effective day-by-day.”” For hospitals, the fight against infection is constant and drug resistant bacteria pose a serious risk to patients. While infection prevention programs are still the best way to keep outbreaks from happening, C. difficile and other “superbugs” can still cause major problems for patients. For most healthy people, C. difficile does not pose much of a risk. According to AMRIC’s Dr. Justo Perez, C. difficile
becomes dangerous when it begins to overpopulate in the bowel. The bacteria starts to produce toxins that damage the intestinal wall causing diarrhea. The effects are usually mild, but sometimes can be more severe for some people. C. difficile has proven to be a particularly difficult problem for patients who receive antibiotic treatments as its spores can survive and quickly spread and cause recurring infection in the patient. That is why the Centre for Disease Control has ranked it number one among the most needed to be managed in hospitals. While C. difficile can still be treated with some antibiotics such as metronidazole and vancomycin, it can have devastating effects for seniors and patients with weakened immune systems. It is not only antibiotics that have problems with C. difficile spores, but cleaning products too. The only effective way of cleaning it off a surface is through chlorine-based cleaners such as bleach and Clorox. While antibiotic resistant bacteria continue to increase, the number of new antibiotics approved by the United States Food and Drug Administration has fallen dramatically in the last five years. In fact, none of the major pharmaceutical companies are currently exploring new antibiotics as their success rate and effectiveness can no longer justify the large capital investment. For Dr. Murad, we are moving back to a time before the innovation of antibiotics. “It’s like we are back in the 19th century. We have no effective treatment for many of these pathogens.” While pharmaceutical solutions have not been effective in dealing with these bacteria, other, more systematic approaches are having an impact. To help reduce over-prescription of antibiotics to patients, HSN has established an Antibiotic Stewardship Committee to promote the proper use of antibiotics in the hospital. Infectious disease control measures are also in place such as policies around doctors and nurses washing their hands every time they enter a room or touch a patient. Rooms and equipment only have
material that can be properly cleaned with chlorine based cleaners. At the same time, any patient who tests positive for C. difficile is quickly isolated and monitored to ensure that it does not spread to other patients. These measures are good steps but they do not completely eliminate the threat that C. difficile poses to patients. That is why the research at AMRIC is so important. Under the supervision of AMRIC’s CEO and Scientific Director, Dr. Francisco Diaz-Mitoma, a number of different research projects have been developed to better understand and combat C. difficile. Dr. Murad and Dr. Perez are conducting innovative research by testing surfaces across the hospital for C. difficile at the same time as screening patients for C. difficile as they are admitted. Dr. Perez is also researching a vaccine that will be able to adapt with C. difficile and prevent the infection. Dr. Nokhbeh’s research is exploring an anti- C. difficile bacteria and virus (called bacteriophages) that can help treat the infection without antibiotics. AMRIC was created in 2011 to conduct research into the health issues prominent in Northern Ontario. AMRIC has benefited significantly from funding from the Northern Cancer Foundation, the HSN Foundation and the City of Greater Sudbury Development Corporation. Funds have been used to acquire new specialized equipment and maintain core equipment to advance and support research in Tumour Biology, Vaccine Development and Immunotherapy. The HSN Volunteer Association is also a great supporter of AMRIC and funds the Research Chair in Healthy Aging. “The research that Dr. Perez, Dr. Nokhbeh and Dr. Murad and the rest of the team is focused on is a priority for us here at AMRIC,” said Dr. Diaz-Mitoma. “This work is at the forefront of keeping our patients healthy and safe. Our research may have a direct impact, not only for patients in Sudbury, but also benefit people around the world.”
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Caring
for Seniors In Hospital and at Home
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Health Sciences North/Horizon SantĂŠ-Nord
By Briana Fram
When Norma Nikitin came to the Emergency Department at Health Sciences North, she was scared. Like most seniors, Norma, aged 73, feared what a hospital visit might bring. In severe pain, Norma was admitted to hospital and required surgery to correct a detached vertebra. Her greatest fear was not about the surgery, but whether she would be able to return home. “When I was told I may have to go to a nursing home, I was devastated. The thought of leaving my husband and family made me feel abandoned and alone. I wanted to be at home to take care of my husband, even though he was taking care of me.” Thanks to the Short Term Assessment and Treatment Centre (STAT) at HSN’s Sudbury Outpatient Centre, Norma was able to remain in her home. If not for STAT, she believes she would not be living an independent life at home.
Now, I no longer feel isolated, I feel the same as everybody else. Because of STAT I feel like a new person. My husband says I am my old me and that means everything.” It does not matter how old you are, the idea of leaving home is difficult for anyone. If you look around your home today, there are many reasons why you wouldn’t want to leave. It could be your children’s bedroom, your favourite reading nook, your grandchildren’s growth chart or just the simple fact that it is home to you. Your home is a place of memories and comfort. “At HSN, our goals are to preserve the health of frail seniors to allow them to continue to live in the community, and prevent their health from deteriorating,” says Dr. Janet McElhaney, Medical Lead for Seniors Care at HSN and
HSN Volunteer Association Research for caregivers to take time to rest, Chair in Health Aging. She was relax and recharge. By not taking care recruited to Sudbury two years ago by of yourself, it makes you vulnerable the Advanced Medical Research Institute to caregiver burnout, which can have a of Canada, HSN’s affiliated research negative effect on your health and your institute. “STAT reduces readmissions ability to care for loved ones. to hospital or admission to long-term “Your partner, family and friends are care facilities by providing patients with also affected,” says Norma. “I was very resources they require to continue their fortunate to have met Gail, a social care.” STAT is a unique program that is geared to frail seniors 65 years and older who have been discharged from the hospital and are without a primary care provider. These patients are able to live safely in the community, but are at risk for placement in a nursing home. Upon discharge Dr. Janet McElhaney, Medical Lead for Seniors Care and HSN from hospital, eligible Volunteer Association Research Chair in Healthy Aging patients are referred to the program by their care provider. STAT team members worker at STAT. For years I had been will develop an individualized care plan dealing with pain and I felt like I for each patient, based on common health was becoming a burden to my husband factors for seniors such as medication and family. I did not want to tell management, mobility challenges, chronic them how much pain I was in pain, urinary incontinence, hearing loss, because when you hurt, your visual impairment, weight loss or malnufamily hurts too. With Gail, I was able to trition, depression and dementia. talk about my concerns and she provided “What makes STAT effective is we me the support I needed.” also look at factors that go beyond the With STAT, patients have access to standard health issues of seniors such a number of services to provide an all-enas frailty and pain,” said Linda Smith, compassing approach to their health care Occupational Therapist and Clinical Lead needs. The multidisciplinary treatment for STAT. “Our team reviews the social team includes a physician, nurse factors of our patients to ensure they practitioner, registered nurse, pharmacist, are maintaining a healthy lifestyle both dietician, occupational therapist, physiomentally and physically. Another therapist, speech language pathologist, important factor we consider is caregiver and social worker. burden or burnout.” “We have seen a high success rate Caring for a loved one can be a with our patients because STAT provides rewarding experience, but it can also them with the services they need to be overwhelming. As caregivers, your recover quickly,” says Smith. “We help health is just as important as the them manage day-to-day activities such person you are taking care of. Often, we as walking, cooking, and cleaning.” put the needs of the person we are carOnce a patient is discharged from ing for before our own. It’s necessary hospital, their health care concerns can
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continue to be monitored and resolved through STAT’s multidisciplinary team approach. It also provides them with access to proper resources in the community. “Many STAT patients have already been seen by HSN’s COACH (Consultation for Older Adults with Acutely Compromised Health) team,” says Dr. McElhaney. “A comprehensive health assessment has been provided by this unique team which specifically targets frail seniors over the age of 65 living independently in the community.” Under the COACH initiative, a multidisciplinary care team will assess the patient and develop a plan of care that will follow the patient during their hospital stay and upon discharge. The key element of the COACH initiative is the 48/5 principle. The COACH team monitor five key health indicators during the first 48 hours after the patient is admitted to hospital: delirium, medication appropriateness and reconciliation, functional mobility, nutrition/hydration, and bowel and bladder function. The COACH initiative is being led by Dr. McElhaney who helped develop the 48/5 principle during her time at St. Paul’s Hospital in Vancouver, B.C. The 48/5 model is now practiced in hospitals throughout Canada. “With the demonstrated success of COACH, we wanted to bring that care model to HSN to improve the health of frail seniors who are admitted to hospital,” says Dr. McElhaney. “The staff at HSN are excited about the positive results it has had on patients. We have been able to improve outcomes, limit functional decline and reduce the time they have to stay in hospital.” A two-year study of the COACH initiative is being conducted by AMRIC, thanks to a $100,000 grant from the Northern Ontario Academic Medicine Association’s Clinical Innovation Opportunities Fund. Preliminary results from the study are expected next summer. “COACH is a great example of where research and patient care converge,” says Dr. Denis Roy, HSN’s President and CEO. “Dr. McElhaney is one of North America’s foremost experts in geriatric medicine
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and research, and she’s applying that world-class knowledge to our patients.”
We need to look at what we can do in the health care system and in the community to support the competence, confidence and connectivity of seniors.” HSN has made seniors health a key priority. A comprehensive seniors strategy has been developed and is now being implemented. The COACH initiative and STAT program are two key elements of the plan that sees the hospital extend its care beyond its walls and into the community. In 2013, HSN unveiled a five-year Strategic Plan which envisions a “hospital without walls.” A key priority for HSN is to be a leader in care transitions. Patient and family advisors have told HSN that the transition from hospital to home can be an overwhelming experience for them. HSN is aiming to smooth this transition through stronger community partnerships and an enhanced delivery of patient-centred care. “By working closely with valuable community partners such as the North East Community Care Access Centre
Physiotherapist working with a senior patient.
(CCAS), we can greatly improve the continuity of care from hospital to home,” says Dr. Roy. “If we improve the co-ordination and communication between HSN and CCAC care teams, we know we can eliminate some of the gaps that exist when patients are discharged from hospital and need follow-up care at home.” The exchange of information and communication among HSN and CCAC begins immediately when a patient is admitted to hospital. This ensures any care requirements post discharge can be put in place before they leave the hospital. “A close relationship between the CCAC and HSN is crucial, because we know the critical point in a patient’s care is often in the transition,” says Richard Joly, NE CCAC’s Executive Director. “We also work closely together to ensure that individuals who require other venues of care – long-term care, assisted living, chronic continuing care – are able to be admitted from hospital, or wait safely at home until a bed becomes available. It is all part of ensuring the right care, at the right time, in the right place, from the right provider.” “I am grateful for the care that I received at Health Sciences North and by the great STAT team,” says Norma. “Before going to STAT, I didn’t like to socialize because I felt different. Now, I no longer feel isolated, I feel the same as everybody else. Because of STAT I feel like a new person. My husband says I am my old me and that means everything.”
Extraordinary people working to keep you healthy
Alison McMillan Medical learner Alison McMillan is a medical learner at HSN and is finishing her final year at the Northern Ontario School of Medicine. Alison will begin her residency at HSN in July.
I didn’t take the typical path to becoming a doctor. Before enrolling at NOSM, I was a teacher. I didn’t have that science background. It was very exciting to get into NOSM. Not only was it the medical school that interested me the most, it was also the one located in my hometown and more importantly in the North. Like most Sudburians, I was born in the old Sudbury General Hospital and was treated at the ED there when I was a kid. I was born here and I want to stay here. I didn’t really know what to expect. Other learners from the school sung praises of the staff and physicians at HSN, so I was very excited to get started. I wasn’t disappointed. From the very first day, staff were friendly and welcoming of the students, but what surprised me the most was the public. Patients coming in are very accepting and interested in being a part of the education experience. Each day has been interesting and has presented its own learning experience whether with a physician or in the classroom. It’s been everything I wanted. What keeps me interested is the ongoing intellectual challenge that comes with working at the hospital and being a physician. It’s one of those jobs where you can’t just sit back with a coffee for a day. You need to be on your toes and keep up-to-date with the latest evidence-based learning. I’ve found I thrive in that sort of environment. I like that I never know what’s next, that my day might have a schedule but it’s not necessarily planned. Moving forward, I’m very excited for my residency, but also a little nervous. You realize for the first time it’s going to be you writing that prescription and you signing the orders. It’s a big step. The responsibility is becoming more real and I’m looking forward to it.”
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Little Feet,
One family’s experience
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Big Strides
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By Dan Lessard
It’s not surprising that Peter Contini doesn’t sit still for very long. He’s five years old. “He’s full of energy, he never stops,” his mother Julie Contini shares as her son plays and poses for pictures in the family’s rec room in their home. “He has a great sense of humour, and he knows how to push your buttons. He’s a typical little boy.”
Dr. Sean Murray is a pediatrician and the medical director of the Family and Child Program at HSN.
What sets Peter apart from the typical five-year-old is that by the age of one he had already spent more time in hospital than most people 10 times his age. Peter was born one month prematurely, with Down syndrome and a heart condition. He spent his first 14 days in the neo-natal intensive care unit in Toronto and the next 14 days in Sudbury. He underwent abdominal surgery at four months and cardiac surgery at seven months. This past year, Peter had another operation. For the first half of his life, he was a frequent visitor to Sick Kids Hospital in Toronto and the Children’s Hospital of Eastern Ontario in Ottawa. These days, Peter spends a lot less time on the road and is thankfully, quite healthy. The Continis still travel to Ottawa once a year for follow-up care at a special clinic for children with Down syndrome. A cardiac specialist from Sick Kids also pays a yearly visit to Sudbury to check on Peter’s and other children’s progress at HSN. But the vast majority of Peter’s care is now provided in Sudbury through
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Health Sciences North and its Children’s Treatment Centre (CTC). The CTC provides Peter with speech language therapy, occupational therapy, and physiotherapy, all on different days at his school. Peter Contini’s story is one of the most compelling examples of how much pediatric health care has progressed in the past five years in Sudbury. It’s equally a strong argument for the need to broaden children’s health care in Sudbury. “Initially, it was a challenge getting services here for Peter’s needs,” Julie says. “We spent a lot of time travelling to Toronto and Ottawa. We would have to pull our other son out of school for these trips. You have to use your vacation time. You manage your life around these out -of-town appointments. I’m sure we’ve spent thousands of dollars on travel, food and hotels. The Northern Health Travel Grant is helpful, but it doesn’t cover everything. So to be able to stay here for most of Peter’s care is wonderful. The CTC has been terrific with Peter. Amazing strides have been made here.” Dr. Sean Murray is one of the many people responsible for those amazing strides.
What I hear from parents is that they want better accessibility, and they want care closer to home.” Dr. Murray is a pediatrician and the medical director of the Family and Child Program at HSN. He has been one of the most vocal proponents of expanded pediatric services in Sudbury and northeastern Ontario. “When I arrived here, pediatric services were fragmented,” says Dr. Murray, during a break between rounds on HSN’s Pediatric Unit. “There was less special-
ized care. Outpatient programs and the offices of pediatricians were scattered throughout the city in locations that really didn’t make sense. At that time, pediatric care also flew under the radar.” Changes were needed to augment the profile and delivery of pediatric care. A new model was developed. A pediatrician would be on-site in the hospital on a regular basis to oversee inpatient care and outpatient clinics. Once scattered across the city, the private offices of all the pediatricians were brought together in one location in the community, with a central system of triage for all patients to reduce wait times. Most of the outpatient programs were placed under one management structure at HSN, instead of being dispersed among different departments. New programs and services were also developed, both for inpatient and outpatient care. These new services include everything from standardized training for all health care professionals in the Birthing Centre to new clinics and services for children with asthma, obesity, fetal alcohol spectrum disorder, and mental health care needs. “The alignment of children’s services is a lot better now, and so is the co-ordination and continuity of care,” says Debra Lynn Lahti, the manager of Continuing Quality Improvement in the Family and Child Program. “We really want to provide family-centred care of the highest quality close to home.” This goal has taken another big stride forward with the latest evolution of kids care at HSN - the North Eastern Ontario Health Centre for Kids – or NEO Kids. Phase One of NEO Kids will see all the pediatrician offices moved again and expanded, this time on the grounds of the Ramsey Lake Health Centre. This will allow more outpatient care to be provided in closer proximity to HSN’s existing pediatric services. Phase Two of NEO Kids calls for the introduction of new outpatient services. The long-term goal of NEO Kids is to ensure all pediatric services, both in-hospital and outpatient, are provided in one central location that is child and family-friendly. “What I hear from parents is that they want better accessibility, and they want
kids care
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We want to be a growing city that attracts more p to the complex needs of children. Medical travel i we’re excited about getting more services here for 28
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care closer to home,” says Dr. Murray. “People need to understand how sick children can be. When they’re sick, they don’t travel well, and parents will do whatever it takes to get care for their kids.” “Some of our patients have been with us from birth to 18 years old,” adds Keri Shewchuk, the co-ordinator of NEO Kids at HSN. “They and their families have built a relationship and comfort level with our staff. They want to stay here for their care.” But does expanding pediatric care make sense in a part of the province where the population is declining and aging? Dr. Murray says that perception of northeastern Ontario and its health care needs is not entirely correct. “There are definitely pockets of population growth in Northern Ontario, such as Sudbury and Manitoulin Island,” says Dr. Murray. “At HSN, we’re delivering more babies than when I started, and we’re actually seeing more pediatric patients now than we used to. Advances in neo-natal care means children are surviving today who wouldn’t have before. They have complex needs and they need ongoing care.” Julie Contini also believes there’s a strong case to be made for more children’s health care in Greater Sudbury and northeastern Ontario.
“In the last year, I know of seven children born with Down syndrome. We are seeing more children with complex health conditions. We want to be a growing city that attracts more people, so we need to attend to the complex needs of children. Medical travel is stressful on families. So we’re excited about getting more services here for children,” she says. On this particular afternoon, in the family rec room, Peter’s perpetual motion stops just long enough for him to approach the visitor in his house, take him by the finger, lead him to the couch, and sit him down so they can both watch his older brother play a video hockey game. Peter laughs every time his brother scores. His mom chuckles at the sight of Peter navigating this visitor to the couch to enjoy this rare moment of stillness. “He’s a great little boy, with great potential,” she adds. “He’s making great strides.” So are the people providing Peter with his care. The Continis, and likely many other families both in Sudbury and northeastern Ontario, are waiting anxiously to see what will be the next great stride in children’s care in this part of the province. After all, family travel should be reserved for vacations.
people, so we need to attend is stressful on families. So r children.”
Children’s Mental Health
Increased mental health services have been identified as one Sudbury’s most pressing health care needs for children. In the past few years, there have been significant increases in children seeking the services of Health Sciences North for eating disorders, self-harm, and mental health crises. According to Mary Jago, Clinical Manager of Child, Adolescent and Family Mental Health at HSN, dealing with the growing demand for children’s mental health will require more trained health care workers, stronger links with community based services, and giving families a greater role in treatment. “We’re focusing more on family engagement because families are the primary source of support for children, and we’re trying to close gaps in care by partnering with community resources,” says Mary, who helped establish HSN’s First Episode program to treat youth experiencing a first episode of psychosis. “Children and youth are at that stage of development which will greatly determine what kind of adults they will be. The expansion of pediatric services at HSN under the NEO Kids umbrella is also a great idea because good physical health and good mental health go hand in hand, and we want to give kids the skills they need to be successful.
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Doctor-TeacherBy Sarah Wendorf
Sean Sullivan is in his final year of studying medicine. After six years as a medical student and resident, he’s looking forward to finally graduating and opening up his own practice as a family physician. A true northerner at heart, Sean grew up in Garson and always dreamed of one day becoming a doctor. Since elementary school, he was fascinated by the human body and knew that he wanted to make a positive difference in peoples’ lives. He completed his studies at Laurentian University and looked forward to applying to the Northern Ontario School of Medicine (NOSM). “While I was completing my undergraduate degree, NOSM was just opening so it was great knowing that there was an opportunity to study medicine here where I could be with my family and friends,” he says. Throughout his schooling, Sean participated in many placements and residencies. What stands out for him the most are his learning experiences at Health Sciences North (HSN). “In northern Ontario, the people are very welcoming. From the very beginning, patients, physicians and staff at HSN have all supported me in my education. The preceptors [physician-educators] really go above and beyond to create a supportive environment and make time for teaching”. Dr. Toner HSN ED Physician, teacher
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Learners are also challenging their teachers to stay ahead and keep up with the medical literature. In turn, they’re teaching us as well.” HSN is also investing in a new centre for medical learners. Dr. Chris Bourdon, Chief of Staff and Vice President of Medical and Academic Affairs, says that this new space allows leaners to build their skills in a controlled environment and then safely apply these new skills to patient care. “The space will house a Simulation Lab with innovative tools like high fidelity mannequins and task trainers. Learners at all stages of their careers will benefit from this space that is immediately adjacent to our busy clinical areas,” says Dr. Bourdon. The current HSN Simulation Lab is located at the Sudbury Outpatient Centre. Dr. Rob Anderson is the Lab’s Medical Lead for Clinical Simulation. He says that simulation-enhanced learning changes behaviour and even improves patient outcomes. “Plus, it is fun!” he adds, “which may not sound as important, but it gets the learner more engaged and interested, and that is the first step.” A priority of HSN Foundation is to support the Medical Learners Centre. In the past year, HSN Foundation has helped to purchase priority training equipment including high technology mannequins, ultrasound, cardiac and abdominal simulators and computers for the Simulation Laboratory. In March of 2014, HSN Foundation raised in excess of $71,000 at the inaugural TASTE Str., an event that is dedicated to raising funds to support the Learners Centre. Dr. Lee Toner also understands the importance of being a role model and teacher for medical learners who come to HSN to complete their placements and residencies. As a preceptor and practicing
physician in the Emergency Department at HSN, Dr. Toner’s teaching philosophy is guided by experiential learning and building positive working relationships with his students. “At HSN, we’ve tried to be responsive to learners’ needs.” He says that, “learners are also challenging their teachers to stay ahead and keep up with the medical literature. In turn, they’re teaching us as well.” Every day, Dr. Toner witnesses the value that medical learners bring to the patient experience. “Medical learners offer more than just extra time to patients and their families; they offer a second layer of care, someone else who can answer questions.” He takes pride in teaching a whole new generation of professionals. He recalls, “when Sean came through, I taught him in first year medical school and now I’m seeing him take part in committees and becoming a chief resident in the family medicine program. It’s amazing to see someone take that journey from medical student to young professional and to interact with them first as a student, then as a resident and now as a colleague.” Dr. Toner is among the many physicians at HSN who practice medicine but also take time to teach courses and workshops at the university. He started out teaching at the medical school during its first year and has always placed an importance on giving students a realistic view of what life is really like when you are juggling a busy career and family life. “You sort of grow into the role as a medical teacher,” he says. “I’ve had learners over for dinner to meet with our family and to discuss what it’s like to be a physician in the north. For the learners, they want someone to answer those types of questions.” Dr. Toner appreciates that he’s able to make a difference for both his learners and also for the community. “You get to set an example, especially if you’re hoping that people will stay in the north. If we have physicians from here who have trained here, not only will we be more successful with recruitment, but more
-Student successful with retention.” He adds that “at the back of my mind I’m always thinking I have to make sure these future professionals are good enough to take care of me and my family when we get sick. There’s a bit of selfishness there because I’m thinking, ‘I want you to be good because you’ll eventually have to take care of me’.” For Sean, he has chosen to remain in Sudbury and set up his practice because of the positive learning experiences he has had here. He says it’s important for HSN to continue supporting medical learners because they are the future care providers. Dr. Toner believes that these positive experiences provide opportunities for today’s physicians to mold the learners into the types of health professionals they want working here in the future.
All of us appreciate that patients let us into their lives when they are at their most vulnerable.” As for patients and their families, Dr. Toner encourages everyone to ask questions and provide feedback to medical learners. This in turn, enhances the patients’ experience in hospital and builds skills and character in the learners. “The community has been very supportive,” he says. “People appreciate that these folks, want to learn and that they have the best interest of the patient in mind. The medical learner care is also a bonus – patients are able to get two opinions from two different perspectives.” Sean agrees, “experiential learning wouldn’t happen without patients who are willing to let us be involved in their care. All of us appreciate that patients let us into their lives when they are at their most vulnerable. On behalf of all of medical learners past, present and future, we thank the people of Sudbury for their ongoing support.”
Sean Sullivan, medical learner at HSN
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Extraordinary people working to keep you healthy
Ryan Nicholls Registered Nurse Ryan is a registered nurse and clinical leader in HSN’s Surgical Unit. He joined HSN seven years ago and has never looked back.
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The reason I got into nursing is because it guaranteed me a job right after school and it also gave me an opportunity to go back and expand my knowledge if I wanted to. Out of school, I worked at Memorial for three years before the big move to the Ramsey Lake Health Centre. In terms of equipment and facility, we’re way beyond what we were at Memorial. It’s state-of-the-art here. That said; I feel like there was more of a family atmosphere at Memorial. That doesn’t mean that we’re not a close-knit group here, we just have more staff, more than double what we used to have. More importantly, we’re a bigger, better OR. We do every kind of specialty and even some firsts. It really is incredible. Just because we’ve made the move here doesn’t mean that the changes are over. The OR is constantly evolving. With new equipment coming in regularly, we’re educated on proper use and training all the time. The learning never really stops. We’re also meeting with Process Improvement Leads in the hospital to help us find areas of the OR where we can improve, so we can perform more surgeries with less wait. The job is challenging. That’s what really drives me. One day I could be scrubbing in for an open heart surgery and the next I might be behind the desk organizing the patient flow for the day ahead. There’s a really broad range in what I do but being a clinical leader is the biggest challenge for me. When you’re the guy who is responsible for making the call on whether a surgery gets the thumbs up or has to be cancelled, the responsibility is huge. After a day where everything went well and we didn’t cancel any surgeries, there’s no feeling in the world like it. Rising to the call and meeting that challenge head on is what keeps me going.”
A lot of people from Cochrane go to Sudbury for care. We thought it was a good way of giving back and helping people.”
The Heart of Giving By Jesse Brady
For Marcel and Frances Labelle of Cochrane, giving $100,000 to Health Sciences North (HSN) seemed like the right thing to do. “A lot of people from Cochrane go to Sudbury for care,” says Marcel. “We thought it was a good way of giving back and helping people.” The idea came to the Labelles after Marcel suffered a heart attack over a decade ago and was flown to Sudbury to have
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HSN Foundation Staff: Saralynn Hirsimaki, Debra Dawe , Elizabeth Taillefer, Mary Lou Hussak
quadruple bypass surgery. Since then there have been many trips back to Sudbury for check-ups, including another surgery to insert a pacemaker in 2012. “I was very grateful for that service,” says Marcel, now 91. “Dr. Ravi and the people at HSN are wonderful. They do marvelous work. Whenever we have family there, they ask about us, to see how we are doing. They don’t forget you and that’s wonderful.” The Labelles appreciate the value of hard work and money. Marcel grew up on a farm outside of Cochrane. The eldest of 15 children, he left home at the age of 14 to go work in the bush camps. The work there was hard and long; Marcel worked seven days a week for $50 a month. Later he got a job driving a truck for a local truck dealer, working highway maintenance for 25 cents an hour. Marcel found opportunity working in Northern Ontario, and went on to build one of the most successful civil construction companies in the north. M.J. Labelle Co. Ltd. built and rebuilt highways, bridges, airstrips, winter roads, ice river crossings and mine exploration roads. His company hauled more than 3.5 million cords of wood from the northern bush in the winter. They even salvaged a 10,000 lb. barge which was grounded inland on the shores of Hudson Bay. Marcel loved his work.
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He returned to the office just days after coming home from his bypass surgery. “I had to go down to the office to bring him back,” laughs Frances. “He still needed his rest.” After talking to staff at the Health Sciences North Foundation (HSN Foundation), the Labelles decided to direct their donation to the new Learners Centre; one of the three capital priorities of the hospital that will expand the scope and quality of care in Sudbury and Northern Ontario. Funds raised for the Learners Centre will go towards a new 20,000-squarefoot facility to accommodate medical learners. The centre will support up to 2,000 learners each year. The focal point of the Learners Centre is the Simulation Laboratory where rooms are adapted to replicate a hospital setting such as an ED, ICU or surgical suite. Like the aviation industry uses flight simulators to train pilots, a Sim Lab uses the latest medical technology to teach medical learners. “We were very impressed by the Learners Centre,” says Frances. “We are very happy doctors will be trained here in the north.” For the HSN Foundation, the Labelles’ donation was one of the largest personal donations ever received and demonstrates the pride people across the northeast have in their regional hospital.
“Health care touches all of our lives. We all want top quality care, whether it is for ourselves, our children or our parents,” says Mary-Lou Hussak, Executive Director of the HSN Foundation. The HSN Foundation is the fundraising arm of Health Sciences North. It is governed by a volunteer board of directors who live in this community and are dedicated to ensuring the very best health care for the people of Northeast Ontario. Hussak points out that the Learners Centre is key to improving front line care. “It’s not just for students. It’s also for our nurses, doctors and staff who want to further develop and expand their skills,” says Hussak. “We can already see this with the success of the Simulation Lab, where our doctors and nurses are practicing new innovative procedures. It truly has changed the level of care in Sudbury.”
Health care touches all of our lives. We all want top quality care, whether it is for ourselves, our children or our parents.” Building a new Learners Centre will ensure northerners will be among the first to benefit from breakthrough techniques and treatment methods learned on site. “We are so pleased that this donation will help keep professionals in the north. It also means patients won’t have to travel south for treatment,” says Francis Labelle. “We are very happy to give to Health Sciences North.”
We were very impressed by the Learners Centre. We are very happy doctors will be trained here in the north.�
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Extraordinary people working to keep you healthy
Martha Palys Pharmacist Martha Palys has been with the health care system in Sudbury since 1988. She currently works part time as a pharmacist in the Northeast Cancer Centre. 36
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I decided I wanted to be a pharmacist when I was in high school. I liked the sciences, but I knew I wanted to work with people. There is a real sense of fulfillment working with patients. I’ve worked at every site previous to the hospital becoming HSN and the appreciation and thankfulness of the patients you help never ceases to make you feel good. Even in my position now where I won’t necessarily see patients on a one-on-one basis you still always feel like you’re making a difference. The overall goal of the pharmacist is to make sure that the patient is receiving the right drug, in the right place at the right time with the maximum benefit and minimal harm to their health. Pharmacists have been around for a long time, but the job has changed significantly. Back when I first started, being a pharmacist meant hands-on dispensing along with reviewing prescriptions. Now we have technicians who deal directly with dispensing using advanced technology, but we still manage and review prescriptions. For example, the NECC is responsible for reviewing and managing the chemotherapy drug for patients both here in Sudbury and at our outreach clinics located all over the northeast. The outreach clinics are something we are really proud of. We treat cancer patients in areas that don’t necessarily have access to a major hospital like Kapuskasing, Mindemoya and Temiskaming Shores. Just having that ability makes all the difference for our patients. I’ve seen changes over the years at the hospital but the biggest changes are recent. When we were a multi-site hospital and through those highly-stressful transition periods, morale was at the lowest I had ever experienced. Since we became HSN, we’ve really found what our identity is as an organization. From a staff perspective, there is definitely more positivity and pride in our department and in our hospital as a whole.”
Extraordinary people working to keep you healthy
Nicole Roy Volunteer Nicole Roy has been a volunteer with HSN since 2009. Three times a week she greets and helps patients get to and from different areas of the hospital.
Volunteering at the hospital wasn’t something I had planned to do after I retired. After teaching for 33 years I couldn’t see myself doing nothing, because how rewarding is that? I started thinking that life was good to me and it’s time to give back. I was meeting with a group of friends Sunday mornings after church and one of them said, “Well, why don’t you come with me and volunteer at the hospital?” I thought about it a little and decided to give it a shot. Five years later, I definitely don’t regret my decision. My hero here is Marge, who has been volunteering for 30 years. I figure if I can be that healthy and that tough, I’d like to go that long as well. You would think with the big move and the name change that the way we volunteer has changed, but to be totally honest, other than the change of scenery that came with the move to the Ramsey Lake Health Centre, not a lot has changed. Obviously when we moved here we were all a little bit scared of this new environment and how we would adjust but the transition was very smooth. It’s not hard to get up in the morning to come to volunteer. I know this is for a good cause and the thankfulness that people here show; I’ve never been thanked so much in my whole life. People here are so appreciative and so kind and hey, if that’s not reason enough to get out of bed in the morning and come to an atmosphere like this, I don’t know what is.”
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As of March, I’ve been clean for a year. It’s a significant milestone.”
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Isabelle’s Journey By Shane Gordon
March 2014 will be remembered for its snow and cold, but for 15-year-old Isabelle Bastien-Gagnon, March holds a much larger significance. “As of March, I’ve been clean for a year. It’s a significant milestone.” Isabelle plays several musical instruments, writes poetry and journals and is active on social media. She developed scoliosis spinal fusion early in her life, leaving her with only five moveable vertebrae in her spine. “At school I was always the deformed kid,” she said, “I was bullied a lot for it. A lot of it was online. People were telling me that I was worthless, that I’d never have friends. It dragged me down.” Depression caught Isabelle early, during elementary school. Depression was only the start of a tail spin that would eventually lead to binge drinking, drug use, bulimia and self-harm. All the while, Isabelle hid her troubles from her family. “My Dad is only home two days of the week. My Mom is around, but when I’d get home I would go straight to my room. I’m really close with my brother. We’re best friends. He caught on. We made a deal to keep it between us if I promised to tell him the next time I was having a bad time. I told him I would but I never did.” In high school, Isabelle was involved in an incident in which the police were called. It was then that Isabelle put all her cards on the table. “I remember when I told my dad. He didn’t say anything; he just sat there and shook his head. He didn’t know how broken his daughter was. We decided to go to the Crisis Intervention Centre. I didn’t want to go at first, but at the same time, I didn’t want to be a disappointment to my parents anymore.” The Crisis Intervention service has been operated by the Hospital since the late 1980’s adjacent to the Emergency Department (ED). The service relocated in October 2012 to HSN’s Mental Health and Addictions Centre downtown on
Cedar Street to give people with mental health needs a place to go; other than the ED. Cedar Street is also the headquarters of the Crisis Intervention Mobile Unit. The Mobile Unit will pack up at a moment’s notice to travel to someone who is in crisis whether that person is at school, work or home. It was at the Centre downtown that Isabelle met with crisis workers. “I didn’t wait long, but every second felt like hours. I can’t say it was a happy place, but it was like a ray of sunshine in a cloudy sky. You knew that someone was there for you. I was anxious the whole time I was there, but it was comfortable. I knew I was safe there.” After her initial assessment with Crisis Intervention staff, Isabelle was admitted to the Ramsey Lake Health Centre for four days before transferring to Kirkwood Place where she stayed for three weeks. Both sites offer inpatient treatment that is fully integrated with community-based programs. “When I was at the Ramsey Lake Health Centre, every half hour or so the same nurse would come in to my room and ask to hear my story. I told her my story over and over again and every time I cried, she would sit and cry with me. Before I left for Kirkwood I asked her why she did that. She said, ‘so you never felt alone.’ Knowing a stranger would put herself out there like that… it gave me hope.” Crisis Intervention operates around the clock and is taking steps to provide people outside of Greater Sudbury with crisis support, beyond their 1-800 Crisis hotline. Using the Ontario Telemedicine Network, Crisis staff will be able to provide face-to-face service to people throughout the Sudbury-Manitoulin District. “We’re using technology to assist us in our work now more than ever,” says Thomas Smith, Clinical Manager of Crisis Intervention. “It’s making our work more efficient and more innovative, but also more client-centred. We want to
provide the best Crisis Intervention program possible regardless of where the person lives in our District.” In the past year, HSN experienced an 18% decline in mental health presentations to the ED, but a 200% increase in services provided by the Crisis Intervention team. Youth visits are at an all-time high. There are times when the mobile unit will visit multiple schools per day, both primary and secondary. “Crisis can happen at any age,” said Valerie Larocque, a registered social worker and senior staff member at Crisis Intervention, “There’s no age limit to our services. We’re available 24 hours a day, seven days a week, and 365 days a year. We’re here to listen and to help no matter who you are.” One year after her crisis, Isabelle finds it easier to reflect on her past. “No one deserves to go through what I’ve gone through. Battling through it alone is hard. People should know that they aren’t alone. There’s a hand in any direction you reach, you just need to try.” • Mental Health related visits to the ED have decreased by 18% in the past year. • Crisis Intervention Mobile Team response increased by 39% during this past year. • Greater Sudbury Police Services report a 21% decrease in Mental Health apprehensions, and also a 2.7 hour decrease in time spent at the ED with a mental health client. • In 2012-13, Crisis Intervention services provided to youth increased from 382 to 1040, a 172% increase. If you or someone you love is going through a crisis situation, visit Crisis Intervention Services at 127 Cedar Street or call the 24-hour Crisis Line at 705.675.4760.
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Jill was treated close to home. Thanks to you. Every dollar raised stays here.
DONATE TODAY. 705.523.4673
Northern Cancer Foundation
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Giving
Health Sciences North/Horizon SantĂŠ-Nord
By Sarah Wendorf
Hope
Life changes when you are diagnosed with cancer. For Terry Ames, his life changed in 2007 when he was diagnosed with non-Hodgkin’s lymphoma. He was 34 years old, married, with three young children. Feeling alone and in disbelief, Terry sat with the oncologists and nursing staff in the Northeast Cancer Centre at Health Sciences North (HSN) to begin planning his treatments. Over the next four years, he underwent several rounds of chemotherapy and radiation. It was a long and difficult road that took an emotional and physical toll. Soon after, the financial burden of having to leave work to focus on his health caught up to him. His friends offered to help by hosting a “Tee it Up for Terry” fundraising golf tournament. Through these kind gestures, Terry says, “We really felt we had so many people rooting for us. It gave us the extra push to keep fighting and beat my cancer.” By spring 2011, Terry returned to his oncologist for a final check-up and was in awe at the news he received. His PET scans indicated there was no more active lymphoma. “It was the best news that a cancer patient could ever get,” Terry says. Reflecting on his experiences at the Northeast Cancer Centre, Terry decided to pay it forward by launching
It was the best news that a cancer patient could ever get.” www.hsnsudbury.ca
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the Terry Ames Supportive Care Fund through the Northern Cancer Foundation. He appreciated the professionalism, compassion and quality of care he received, while still enjoying the comforts of home. He also wanted to continue raising money for those who were battling cancer and facing the same challenges he and his family had faced. In July 2012, Terry held his third golf tournament and dubbed it a victory celebration to commemorate the good news that he was cancer-free. Much of his healing came from the support of others who offered help in so many different ways. Whether the help is financial, spiritual or just a visit, any friendly gesture means so much to cancer patients and their families. It was important for the money to stay in Sudbury so he could make a difference and see the benefits at work. “When you help someone in a time of need, especially those who have cancer, you gain as much
out of it as the person receiving your donation. I do it because it feels good every time we can help someone.” “As a northerner myself, I’m proud of where I live, I’m proud of where I
It’s the volunteer who lent a hand, the oncologist who extends compassionate care beyond a patient’s expectations… donors come through our door because of these positive experiences.”
grew up,” says Anna Sampson, Manager of Community Development with the Northern Cancer Foundation. She says many patients come into the Foundation looking for a way to give back and in turn, they become donors. “It’s the volunteer who lent a hand, the oncologist who extends compassionate care beyond a patient’s expectations… donors come through our door because of these positive experiences.” It’s not just Terry and his family; several other groups have also come forward. Each year, from large and small events such as the Luncheon of Hope, Rally for Dad Motorcycle Ride, Strokes for Hope Golf Classic and several others, close to $2 million is raised through the Northern Cancer Foundation for families right here in Northern Ontario; approximately $30 million since its inception in 1992 and all of it remains in the north. No other cancer charity offers such a direct benefit to our community. Tannys Laughren is the Executive Director of the Northern Cancer Foundation. She appreciates that donors want to see their money at work. “They want to walk into the Cancer Centre and see a new piece of technology, or go into a chemotherapy room and see that new pump or a new bed or new chemo chair that we’ve purchased. They want to go into pediatrics and see toys. Our donors give us money with confidence that they can see it working.” Northern Cancer Foundation Board Chair Jim Marchbank says donors want to be assured their funds are directed to cancer research and investments in cancer-patient care. “They hope
Northern Cancer Foundation Staff: Denise Foucault, Lorraine, Anna Sampson, and Tannys Laughren.
I created the fund but this money comes from financial and positive support to cancer patien the chances of beating cancer, one person at a 44
Health Sciences North/Horizon Santé-Nord
the Foundation’s investments will lead to better outcomes for cancer patients. Most of our families include someone who has been stricken with cancer. We all want them to receive prompt diagnosis and better treatment that will mean more positive treatment experiences and a more positive prognosis.” Looking back, Terry says this is why he started the Terry Ames Supportive Care Fund. It is important that people going through cancer treatments are able to continue living a high quality of life. “If you have to worry about financial issues it’s really hard to focus on beating cancer. We’re using the fund to say we’re behind you and here’s a little financial assistance,” he says. As the needs of the community continue to grow and change, the Northern Cancer Foundation will continue to be there every step of the way. “In the beginning, donors gave with the vision of supporting a cure for cancer right here in Sudbury,” says Tannys. “People are now giving because of the work that is happening here.” For Terry, he hopes to continue raising money through his fund for many years to come. “You hear a lot of sad stories but there are also many more happy stories. We wanted to share in that feeling with everyone who has donated to the fund and let people know there is hope.”
Terry Ames being treated for non-Hodgkin’s lymphoma.
hundreds of Sudbury families who want to provide nts and their families. Our goal is to help improve time.” www.hsnsudbury.ca
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www.hsnfoundation.com 705.523.7130
A strong Foundation in health care
Paying it By Chris Pollesel
Volunteering is one of the most positive activities people can do to enrich the lives of others, as well as their own.” 48
Health Sciences North/Horizon Santé-Nord
Volunteering is one of the most positive activities people can do to enrich the lives of others, as well as their own,” says president of the HSN Volunteer Association, Cliff Richardson. Over the past five years, Richardson has given a great deal of his own time back to the community by playing an active role with the Volunteer Association. He has held several positions while on the Board of Directors for the Association, including Director of Fundraising and Grants, Treasurer, Co-President and most recently President. At Health Sciences North (HSN), hundreds of volunteers donate their time to our health centre, and through their dedicated work, enhance the hospital experience. By coming together and donating their time to an organization such as HSN, they are able to give back to their community, knowing that the work they are doing is making a difference. It goes without saying that volunteers play an important role at HSN and rooted within the organization is the HSN Volunteer Association. The Association is instrumental in supporting Health Sciences North and the community. Its goal is to enhance health care through education, volunteer services, public relations and fundraising for the hospital. The Association is made up of current and inactive volunteers, as well as employees who work together within their office or fundraising operations. “I am proud to be a part of the HSN Volunteer Association Board and to take part in its renewed vision and mission of partnering with HSN to create a healthier community and give back knowing that The Association’s fundraising is supporting health initiatives locally,” says Richardson. In order to support HSN and in turn, the community, fundraising is at the
forward HSN CEO Dr. Roy and HSN Volunteer Association President Cliff Richardson at launch of Pennies for Pediatrics campaign
basis of what the Association does. When walking through the main entrance of the Ramsey Lake Health Centre, it is hard to miss the boutique gift shop and the OLG Lotto kiosk. The boutique features a wide variety of gifts and confectionary items for patients and visitors. The boutique and OLG Lotto kiosk are operated by the HSN Volunteer Association and play large roles in raising funds for the association by providing a continuous stream of revenue. The HSN Volunteer Association also takes part in several other fundraising initiatives. Over the years, those efforts have led to the purchasing of several pieces of equipment and technology for HSN, allowing for cutting-edge patient care. Most recently, the HSN Volunteer Association led the largest penny drive in the history of Greater Sudbury with their Pennies for Pediatrics Campaign. The goal of the campaign was to raise $100,000 or 10 million pennies, in order to convert the existing therapeutic pool into a Snoezelen pool. A Snoezelen pool is specially equipped with lighting and other sensory stimulation equipment. It is used primarily for the treatment of children with autism and other
developmental conditions. It can also be used for the treatment of adults with developmental conditions. “This campaign began as a community -wide initiative and through the help of the community, the association surpassed its initial goal to raise a total of $130,000,” says Richardson, pointing out that an additional $20,000 was also donated by the United Way, bringing the amount of funds raised by Pennies for Pediatrics to $150,000. “The success of this campaign demonstrates the generous nature of our community and their willingness to help us expand care at HSN.” The HSN Volunteer Association is also interested in how innovation and research play a strong part in keeping people healthy especially as they grow older. That is why the Association was eager to work with HSN’s research affiliate, the Advanced Medical Research Institute of Canada, to attract a world-renowned physician in the field of seniors care to Sudbury. The HSN Volunteer Association played an instrumental role in attracting Dr. Janet McElhaney, an expert in seniors health, by providing the endowment for the HSN Volunteer Association Chair
in Healthy Aging, through an annual commitment of $150,000 over the next three years. Already this investment has seen dividends. Since arriving in Sudbury, Dr. McElhaney has not only changed how seniors care is delivered at HSN, but has also changed the way we think about aging. “The more we research healthy aging, the more we are able to have a direct impact on the health and well-being of older adults.” says Dr. McElhaney. Seniors health care is a very important area of medicine, and by having a local expert, it speaks volumes to the commitment of care for Greater Sudbury’s aging population. The HSN Volunteer Association’s endowment for Dr. McElhaney’s Research Chair is another way it is supporting HSN and allowing for innovative care within the community. Moving forward, Richardson says the association will continue to support HSN on its strategic plan to provide innovative, evidence-based and patientcentred care. By supporting the HSN Volunteer Association, you’re helping to fund innovations in health care at the local level.
www.hsnsudbury.ca
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Last word from the experts Hello, I’m Nik the host of MythFracture, a series where we at HSN take hospital and health care myths and put them to the test. On MythFracture we’ve covered some well-known myths and will definitely take on more in the future. Which brings us to today’s myth. Today we are tackling the big C… Cancer. There are a lot of myths and misunderstandings surrounding this disease. To help get to the bottom of a couple of myths we’ve asked two of our experts at HSN to help confirm or debunk the ones we frequently hear.” Nik Geer, Radiation Therapist and host of MythFracture
Myth: Cancer can’t be prevented. There is a strong association between modifiable health risk factors and the most common chronic diseases including cancer. In fact, up to 50% of cancers can be either prevented or detected early, before becoming a serious health concern. Avoiding tobacco, being physically active, maintaining a healthy weight, eating a healthy diet, limiting alcohol and avoiding excess exposure to the sun are behaviours you can change to contribute to your overall health and to reduce your risk for cancer.” Jessica Diplock, Manager, Preventative Oncology and Screening, Northeast Cancer Centre
Myth: Cancer is contagious. Often the truth is in the details. There is a strong link between human papillomavirus (HPV) infection and cancer of the cervix. So people could think this cancer is contagious. But it is the virus that’s contagious, not the cancer. Cancers themselves are not contagious. This was a common misconception in the early to mid-20th century, but that myth has been discarded for decades now.” Dr. Amadeo Parissenti, Affiliate Scientist and Principal Investigator, AMRIC
Check out more at MythFracture on HSN’s YouTube page at www.youtube.com/healthsciencesnorth. If you have a hospital or health care myth you would like to share with us, email it to communications@hsnsudbury.ca and you might see it on a future episode!
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