Hospital News November 2023 Edition by Hospital News

Inside: From the CEO’s Desk | Nursing Pulse | Long-term Care | Special Focus: Medtech

November 2023 Edition

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Contents November 2023 Edition

IN THIS ISSUE:

Inside: From the CEO’s Desk | Nursing Pulse | Long-term Care | Special Focus: Medtech

MEDTECH 2023

SPECIAL FOCUS November 2023 Edition

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FEATURED

Using technology

Engineered platelets can induce anti-inflammatory, immunosuppressive response

to address healthcare challenges MEDICAL TECHNOLOGY MAKING A DIFFERENCE

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▲ Cover story: Technology solutions to address health system challenges

NOVEMBER 2023 HOSPITAL NEWS 17

▲ Special Focus: Medtech Canada 2023

COLUMNS Guest editorial ................4 In brief .............................6 Nursing pulse ................14 From the CEO’s desk .....16 Long term care ..............37

▲ Toronto Rehab partners with Baycrest in dementia support program

▲ New virtual program enhances support for nurses

▲ Reducing wait times through a collaborative approach

Healthy aging strategies can help Canada cope with its growing senior population By John Muscedere anada is growing. In June, our population reached 40 million – but we are not only getting bigger, we are getting older. There are now over 7.3 million Canadians who are 65 years or older and that number is climbing as the Baby Boomers age. By 2051, seniors are expected to make up 25 per cent of the population, with the number of seniors over 85 years tripling to 2.5 million. This rapidly expanding demographic will have a profound effect on our society. While many younger seniors remain healthy and active in their communities, working and volunteering, a significant proportion of older seniors have complex health-related issues and many require the supports of long-term care settings. Seniors in Canada account for almost half of all health care spending. As they continue to grow in numbers, older Canadians could overwhelm our healthcare and social services budgets unless we change the way we view aging and make the necessary investments in programs, technologies, and research that foster healthy aging or aging in place. Fortunately, we are starting to see changes. In the wake of the COVID-19 pandemic and its devastating effect on older Canadians, governments and other orga-

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Kristie Jones

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nizations are becoming increasingly interested in healthy aging. For instance, last fall, Kingston, Ontario became home to the first centre for healthy aging in Canada and this past spring, the federal government held public consultations on how to better support seniors living in their own homes. What is healthy aging? It is about creating environments and opportunities that enable people to maintain their functional abilities as they get older. It challenges the mindset that as we age, we inevitably will have more diseases and health conditions, lose mental and physical capacity, and have a reduced quality of life. While older people are more susceptible to many diseases and illnesses, there are things we can do to reduce this and increase their healthspan, or the time that they are in good health, can live independently on their own, engage in social relationships, and contribute to society. Healthy aging covers a range of strategies. It includes things like getting regular exercise and doing strength training, eating a healthy diet, keeping vaccinations up to date, limiting medications to only what is necessary, and staying socially connected to others. There is a lot that governments and other organizations can do to encourage and support these behaviours. Continued on page 6

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Monthly Focus: Medical Imaging/Year in Review/Future of Healthcare/Accreditation/Hospital Performance Indicators: Overview of advancements and trends in healthcare in 2023 and a look ahead at trends and advancements in healthcare for 2024. An examination of how hospitals are improving the quality of services through accreditation. Overview of health system performance based on hospitals performance indicators and successful initiatives hospitals have undertaken to measure and improve performance. A look at medical imaging techniques for diagnosis, treatment and prevention of diseases.

Monthly Focus: Professional Development/Continuing Medical Education (CME)/Human Resources: Continuing Medical Education (CME) for healthcare professionals. The use of simulation in training. Human resource programs implemented to manage stress in the workplace and attract and retain healthcare staff. Health and safety issues for healthcare professionals. Quality work environment initiatives and outcomes. + PROFESSIONAL DEVELOPMENT SUPPLEMENT

+ SPECIAL FOCUS: ANNUAL RADIOLOGY SUPPLEMENT THANKS TO OUR ADVERTISERS Hospital News is provided at no cost in hospitals. When you visit our advertisers, please mention you saw their ads in Hospital News. 4 HOSPITAL NEWS NOVEMBER 2023

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Publicist Health-Care Communications

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NEWS

Study to examine impact of pandemic’s public health measures on

opioid users and their supporters By Kristi Lalonde new Canadian Institutes of Health Research study will seek to understand the effects of pandemic public health measures on people who use opioids and their closest supporters, aiming to safeguard lives during future pandemics. “The COVID-19 pandemic has not treated everyone equally. Some people, such as those who use opioids, have been hit particularly hard,” says Linda Adams, Principal Investigator and Waypoint Vice-President Patient Experience and Chief Nursing Executive. “Throughout history, pandemics have affected certain groups of people more than others, and this pandemic has been no different. The disruption of services and increased isolation have left people who use opioids especially vulnerable. We are very concerned about the number of deaths

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related to opioid use and the results of this study could serve as a lifeline in future pandemics.” According to the Public Health Agency of Canada, there was a shocking 96 per cent increase in opioid-related deaths from April 2020 to March 2021, reaching an alarming 7,362 deaths compared to the previous year’s

3,747 deaths. In Ontario, opioid-related fatalities among individuals aged 24-44 surged by a staggering 79 per cent, while the Simcoe County Muskoka region saw a distressing 70 per cent surge. Equipped with a $149K grant from the Canadian Institutes for Health Research, Waypoint has joined forces

with two other specialty mental health hospitals and community organizations in Simcoe County/Muskoka and Toronto to form a learning community. This diverse group includes people with personal experiences, service providers, researchers, policy experts, and academics, all united in their commitment to prevent similar challenges in future pandemics. In alignment with one of Waypoint’s key strategic objectives, the study will use a patient-oriented research approach. This approach ensures the meaningful participation of people who use opioids, care providers, and families as equal partners throughout the study. This high level of engagement ensures that future pandemic responses align with the priorities of those most impacted, leading to better outcomes. Continued on page 12

NOVEMBER 2023 HOSPITAL NEWS 5

IN BRIEF

Comprehensive new Canadian guideline for skeletal health and fracture prevention comprehensive guideline from Osteoporosis Canada aims to help primary care professionals deliver care to optimize skeletal health and prevent fractures in postmenopausal females and males who are age 50 years and older. It is published in CMAJ (Canadian Medical Association Journal). With 25 recommendations and 10 good practice statements, this update to the 2010 guideline contains sections on exercise, nutrition, fracture risk assessment, treatment and more, reflecting advances in risk assessment, and nonpharmacologic and pharmacologic management of osteoporosis.

In Canada, there are more than two million people living with osteoporosis, defined as bone mineral density (BMD) at a level below peak bone mass, which increases risk of fracture. Fractures usually occur after a fall and can affect the hip, wrist, arm and spine, in particular. “We are hopeful that this Canadian guideline will empower health care professionals and patients to have meaningful discussions on the importance of skeletal health and fracture prevention to preserve mobility and autonomy across adulthood,” says Dr. Suzanne Morin, lead author and chair of the guideline steering committee.

Continued from page 4

Healthy aging strategies Examples include funding community centres so that they can offer senior-focused exercise and nutrition classes, making vaccination more accessible through local community hubs, and offering more opportunities for seniors to engage with others either through community-based programs or online. Healthy aging is also about finding ways to make it easier for seniors to continue to live at home or in their community. Governments and communities need to ensure that there are more and better home care options, not just to meet healthcare needs, but also to help seniors maintain their homes. Governments should also consider financial support for unpaid caregivers, more flexible public transportation choices, and investing in a range of housing options that truly meet seniors’ needs. Technology is also an important tool in healthy aging. During the early months of the COVID-19 pandemic, we saw how vital cell phones and tablets were for families trying to stay connected to their older relatives and how important telemedicine was for seniors to connect with their doctors.

Other technology innovations such as smart or wearable devices, virtual reality, and artificial intelligence, can help seniors set and monitor health goals, track medication use, and participate in physiotherapy and other activities to retain or regain physical function. Research into the biology of aging and disease is also essential for healthy aging. Health researchers in the field of geroscience are working to understand the genetic, molecular, and cellular biological mechanisms and determinants of aging and the diseases and conditions that are more prevalent as we get older. Our goal is to find ways to prevent, diagnose, and treat age-related diseases and conditions so that aging does not have to be synonymous with illness and frailty. Geroscientists are pursing many promising research avenues that could profoundly change how we view and treat aging – but they need policy makers to help put those ideas into widespread action. With research advances and more investments in healthy aging initiatives, older Canadians can live healthier, more independent lives H longer, to all of society’s benefit. ■

John Muscedere is CEO of the Canadian Frailty Network and a Professor in the School of Medicine at Queen’s University. 6 HOSPITAL NEWS NOVEMBER 2023

The guideline is based on the latest evidence and included patient partners in developing the recommendations.

KEY POINTS: • Prior fracture is a strong risk predictor of subsequent fracture (particularly in the subsequent 12–24 months); however, other risk factors are also important to identify individuals who would benefit from pharmacotherapy. • The management of osteoporosis should be guided by the patient’s risk of fracture based on clinical assessment, including risk for falls, and using a validated fracture risk assessment tool. • Exercise, nutrition, fall prevention and pharmacotherapy are key elements of the management strategy for fracture prevention, and should be individualized. • Clinicians and patients should collaborate in developing care plans that consider patients’ priorities and preferences. The guideline emphasizes key components to ensuring bone health and contains several recommendations for patients, including the following:

EXERCISE • Balance and functional training at least twice a week to reduce the risk of falls • Progressive resistance training at least twice a week, including exercises targeting abdominal and back extensor muscles “Create a plan to do balance, functional, and strength training twice a week or more to prevent falls and fractures and improve functioning and quality of life,” advises Dr. Lora Giangregorio, a coauthor and chair of the Exercise Working Group. “Progress the difficulty of the exercise program over time and monitor your progress.”

NUTRITION • For people who meet the recommended dietary allowance for calcium with a variety of calcium-rich

foods, no supplementation to prevent fractures is needed. • Follow Health Canada’s recommendation on vitamin D for bone health: 600 IU/d (age 51–70 yr) and 800 IU/d (age > 70 yr) for males and females.

FRACTURE RISK ASSESSMENT • A clinical assessment for osteoporosis and fracture that includes identifying risk factors and assessing for signs of undiagnosed vertebral fracture(s). This includes BMD testing in postmenopausal females and males who are – aged 50–64 years with a previous osteoporosis-related fracture or ≥ 2 clinical risk factors OR – aged ≥ 65 years with 1 clinical risk factor for fracture OR – aged ≥ 70 years Pharmacotherapy is an important component of fracture prevention management and should be individualized.

OTHER GUIDELINES A guideline from the Canadian Task force on Preventive Health Care published in spring 2023 based on randomized controlled trials (RCTs) recommends risk assessment–first screening for the primary prevention of fragility fractures in females aged 65 years and older using the Fracture Risk Assessment Tool without BMD. The task force guideline recommends against screening younger females and males of any age. The Osteoporosis Canada guideline differs as it included a range of studies in addition to RCTs and several studies included men. The new guideline recommends screening in men and younger women, in contrast to the task force guideline. “Identification and appropriate management of skeletal fragility in Canadians can reduce fractures, and preserve mobility, autonomy and quality of life in this population,” says Dr Morin. “Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update” H was published October 10, 2023. ■ www.hospitalnews.com

IN BRIEF

Treating high-risk drinking, alcohol use disorder: new Canadian guideline A

new Canadian guideline for treating high-risk drinking and alcohol use disorder (AUD) with 15 evidence-based recommendations to reduce harms associated with highrisk drinking and to support people’s treatment and recovery from AUD is published in CMAJ (Canadian Medical Association Journal). High-risk drinking, AUD and alcohol-related harms are common in Canada. Nearly 18 per cent of people aged 15 years or older in Canada will meet the clinical criteria for an AUD in their lifetime, and over 50 per cent of people in Canada aged 15 years or older currently drink more than the amount recommended in Canada’s Guidance on Alcohol and Health. Despite the high prevalence of highrisk drinking and AUD, these conditions frequently go unrecognized and untreated in the health care system. Even if recognized, AUD does not receive evidence-based interventions. It’s estimated that less than two per cent of eligible patients receive evidence-based alcohol treatment in the form of evidence-based pharmacotherapies, likely owing to low awareness. Conversely, according to the guideline, many Canadian patients receive medications that may be ineffective and potentially harmful.

GUIDELINE DEVELOPED IN PARTNERSHIP WITH CANADIAN RESEARCH INITIATIVE ON SUBSTANCE MISUSE To address this health issue, Health Canada funded the Canadian Research Initiative on Substance Misuse (CRISM) and the BC Centre on Substance Use (BCCSU) to develop the “Canadian Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder.” The guideline provides recommendations for the clinical management of highrisk drinking and AUD to support primary health care providers to implement evidence-based screening and treatment interventions. www.hospitalnews.com

“HIGH-RISK DRINKING AND ALCOHOL USE DISORDER FREQUENTLY GO UNRECOGNIZED AND UNTREATED IN OUR HEALTH CARE SYSTEM, LEAVING INDIVIDUALS WITHOUT ACCESS TO EFFECTIVE TREATMENTS THAT CAN IMPROVE THEIR HEALTH AND WELL-BEING,”

The guideline, developed by a 36-member committee, is based on the latest evidence, expert consensus, and lived and living experience, as well as clinical experience from across Canada. It makes 15 recommendations for care providers about how to ask about alcohol, diagnose AUD, manage alcohol withdrawal, and create treatment plans based on the individual’s goals. These treatment plans can include medications, counselling, harm reduction or a combination. “High-risk drinking and alcohol use disorder frequently go unrecognized and untreated in our health care system, leaving individuals without access to effective treatments that can improve their health and well-being,” says Dr. Jürgen Rehm, co-chair of the guideline writing committee and senior scientist in the Institute for Mental Health Policy Research at the Centre for Addiction and Mental Health (CAMH), Toronto, Ontario. “These guidelines give primary care providers the tools to support early detection and treatment, and connect patients and families with specialized care services and recovery-oriented supports in their communities.” The website Helpwithdrinking.ca will be available to raise awareness of resources and treatments available to people in Canada based on the new guidelines. A related practice article highlights the complexity of providing treatment to patients with AUD and the possible negative effects of selective serotonin reuptake inhibitor (SSRI) therapy, which can worsen the disease in some people. “Although the initiation of an SSRI appeared to be a likely explanation for the escalation in this patient’s alcohol use, other factors may also have played an important role,” writes Dr. Nikki

Bozinoff, associate scientist at CAMH, with co-authors. “This case illustrates that although it may be common practice to prescribe SSRIs for people with AUD, SSRIs may not be effective for depressive symptoms in people with concurrent active AUD, and may worsen alcohol use in some.” The guideline recommends against SSRI antidepressants in patients with AUD, or AUD and concurrent anxiety or depression.

“Despite the burden of illness, there remains a tremendous gap between what we know is effective treatment and the care Canadians are actually receiving,” says Dr. Evan Wood, co-chair of the guideline writing committee and an addiction medicine specialist. “Unfortunately, in the absence of effective care, people are being routinely prescribed potentially harmful medications that can, unknown to most prescribers, actually increase alcohol use in some patients. These guidelines seek to close that gap and ensure Canadians are accessing the safest and most effective treatments that meet their needs.” “Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder” was published H October 16, 2023. ■

Predictors of opioid overdose after prescription for chronic pain large study published in CMAJ (Canadian Medical Association Journal) identified 10 predictors of opioid overdose after prescription for chronic pain, which can help clinicians engage in shared decision-making with patients around opioid prescribing. “The opioid crisis has generated interest in identifying patients at higher risk of addiction or overdose and has led to the development of several screening tools; however, these instruments have either not been validated or shown poor psychometric properties,” writes Dr. Li Wang, a researcher and methodologist at the Michael G. DeGroote Institute for Pain Research and Care, and Department of Anesthesia, McMaster University, Hamilton, Ontario, with coauthors. “Our findings suggest that awareness of, and attention to, several patient and prescription characteristics, may help reduce the risk of opioid overdose among people living with chronic pain.”

Researchers looked at 28 studies that included almost 24 million patients in the United States, Canada and the United Kingdom who had been prescribed opioids for non-cancer and cancer-related chronic pain. The risk of fatal and nonfatal opioid overdose after prescription increased two- to six-fold with high-dose opioids, fentanyl prescription, multiple opioid prescribers or pharmacies, history of overdose, current substance use disorder, depression, bipolar disorder, other mental illness or pancreatitis. “Our findings should prove helpful for conveying risks of overdose to patients when deciding whether to initiate a trial of opioids for chronic pain, and will facilitate evidence-based, shared decision-making,” write the authors. “Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies” was published October 23, H 2023. ■ NOVEMBER 2023 HOSPITAL NEWS 7

Enhancing Patient Care Through Caregiver Inclusion Family Caregivers are essential care partners, providing an estimated 75% of the care delivered in the healthcare system, making their roles vital for patients’ physical, emotional, and cognitive well-being. Different from visitors, essential care partners play an active role providing physical, psychological and emotional support to a family member, partner or close friend. This care can include support in decision making, care coordination and continuity of care. Evidence shows that including essential care partners as part of the care team leads to Improved quality of care Improved patient outcomes Improved working conditions for healthcare professionals Less pressure and reduced cost on the health system Contact the Essential Care Partner Support Hub at ontariocaregiver.ca/essentialcarepartner. The Support Hub provides hospitals with free expert guidance, coaching, and ready-to-use, evidence-informed resources to build or enhance an Essential Care Partner program and adopt essential care partner practices.

NEWS

Engineered platelets

can induce anti-inflammatory, immunosuppressive response, finds St. Michael’s researcher By Marlene Leung ew research led by a St. Michael’s Hospital scientist reveals how platelets can inhibit inflammation and immune responses. The discovery, published in the journal Research, constitutes a fundamental re-understanding of platelets and could lead to potential therapies to treat autoimmune and alloimmune diseases, says Dr. Heyu Ni, a scientist at the Keenan Research Centre for Biomedical Sciences. Platelets are small blood cells that form clots to stop or prevent bleeding. Conventional thinking is that platelets contribute to inflammation and immunity. Chronic inflammation is bad for our health, and an overactive immune system – when the body triggers an immune response when there is no threat– can lead to autoimmune disorders such as multiple sclerosis, arthritis, lupus and Type 1 diabetes. An overactive immune response may also lead to alloimmune diseases and conditions such as allergies and failed organ transplants and blood transfusions. “Traditional thinking of platelets is that they are pro-inflammation and pro-immunity, but we discovered, surprisingly, that they can do the opposite – they can inhibit inflammation and inhibit an immune response,” said Ni. “This completely shifts our understanding of how platelets behave – a possible switch from foe to friend.” June Li and other trainees in Ni’s lab made the discovery by immunizing mice that are missing two proteins: GPIba and GPIIbIIIa. These proteins, both critical for stopping bleeding, are found on the surface of normal platelets. The team immunized mice who lack these two proteins with normal platelets, expecting their immune systems to generate antibodies against GPIb and GPIIbIIIa. They found that the mice struggled to generate antibodies against GPIba. The team hypothesized

“TRADITIONAL THINKING OF PLATELETS IS THAT THEY ARE PRO-INFLAMMATION AND PRO-IMMUNITY, BUT WE DISCOVERED, SURPRISINGLY, THAT THEY CAN DO THE OPPOSITE – THEY CAN INHIBIT INFLAMMATION AND INHIBIT AN IMMUNE RESPONSE.” this was because GPIba has many sugars on its surface, making it difficult for the immune system to recognize it. The team then removed a part of these sugars, believing that by altering the sugars, they mice would recognize the protein and generate more antibodies. The team unexpectedly found that these altered platelets – called desialylated platelets – did not result in more antibodies, but rather decreased antibody generation. They also found that the desialylated platelets were cleared from the body by the liver – not the spleen, where platelets are usually cleared. After the platelets

10 HOSPITAL NEWS NOVEMBER 2023

were cleared by the liver, cells called Kupffer cells generated an immunosuppressive and anti-inflammatory response in the mice. As platelet desialylation and clearance naturally occurs for all aged platelets in our bodies, this anti-inflammatory response may provide a daily preventive mechanism against many autoimmune diseases, said Ni. Through pre-transfusion testing in mice, the team further found that desialylated platelets can also decrease the immune responses against non-platelet antigens. The team infused the mice with sheep red blood cells and

coagulation factor VIII, a blood-clotting protein missing in people with Hemophilia A. Hemophilia A patients – who are at risk of excessive bleeding in injuries or after surgery – can be given factor VIII via infusion, but there is a risk that their immune system may produce antibodies against it. Engineered desialylated platelets could reduce the immune response and reduce this risk, said Ni. Ni, also a senior scientist of Canadian Blood Services, said the discovery has important implications for autoimmune and alloimmune diseases, including cancer immunology, organ transplantation, and transfusion medicine. “This type of transfusion with engineered desialylated platelets may be further developed to control lupus, arthritis and Type 1 diabetes and be beneficial in organ and tissue transplants,” he said. “We don’t know yet the full extent of the impact, but the potential H opportunity is huge.” ■ www.hospitalnews.com

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NEWS

New Care and Connection Kiosks provide discreet life-saving harm reduction supplies 24/7 sland Health is introducing three Care and Connection Kiosks at hospitals in Campbell River, Nanaimo and Victoria British Columbia, offering community members an innovative way to access free, life-saving, harm reduction supplies and information about mental health and substance use services, supports and treatment. The Care and Connection Kiosks will electronically dispense discretely packaged harm reduction items including condoms, wound care supplies, naloxone kits, take-home drug testing strips, and syringes and safe disposal containers. Each kiosk will be located outside the emergency departments at North Island Hospital - Campbell River, Nanaimo Regional General Hospital and Victoria General Hospital. The kiosks are an alternative for people who currently visit emergency departments seeking harm reduction supplies and services, and the supplies offered through the kiosks are those most commonly requested from the emergency department. “We know that shame and blame can keep people who use drugs from

asking for help and not accessing the means they need to stay safer – which can often be fatal,” said Jennifer Whiteside, Minister of Mental Health and Addictions. “These new Care and Connection Kiosks are discreet and always open, making it easier for more people to get the life-saving supplies and treatment information they need where and when they need it.” “Stigmatization of substance use has led people to consume and die alone, and sadly, people who use alone in our communities are the most at risk of dying from unregulated substances,” says Dr. Réka Gustafson, Island Health’s vice president, Population and Public Health and chief medical health officer. “Substance use affects the health of our population in multiple ways, and our responsibility is to care for people in a way that will work for them.” In addition to harm reduction supplies, the kiosks will contain information on substance use treatment, mental health supports, community resources, and how people can connect to local services. Each kiosk will be maintained by a new full-time peer

support or addiction and recovery worker who will ensure the kiosk is well-stocked, maintain proper syringe disposal, and help ensure patients in hospital are able to connect to substance use supports, offering a personal connection. As someone who has been doing outreach work in the community for several years in Campbell River and who openly shares his past struggles with substances, Andy Speck, ‘Namgis First Nation, is well suited for the new role associated with the kiosk at North Island Hospital – Campbell River campus. “When groups get together, like doctors, lawyers, athletes, fishermen – they all speak a common language they understand, as do people who use substances,” says Speck. “When I talk to people, they know almost right away that I know, and I can identify with them, making it easier to build relationships and connect them to supports.” “We’re missing a real target group, people working in trades, primarily men, who don’t want to be associated with harm reduction services because they worry they could be seen and

then lose their job. Having a kiosk like this is amazing and will absolutely save lives,” says Speck. Starting in late October, the kiosks will be available 24 hours a day making supplies accessible for shift workers, people who work during the day, and those wanting to remain anonymous. Research shows that harm reduction supply kiosks can reduce overdose rates, decrease new HIV and Hepatitis C infections, and can distribute more life-saving naloxone and testing strips than in-person services. 304 people have died in Island Health this year (as of August 31) from toxic, unregulated substances. Island Health continues to work on a wide range of responses with multiple partners to address unregulated substances and the toxic drug crisis. In addition to harm reduction services like these kiosks, actions focus on prevention and early intervention, treatment, and recovery and relapse prevention. Together these initiatives tackle an incredibly complex public health emergency and support people throughout their health care journey to prevent, support, treat and H help recovery. ■

Continued from page 5

Opioid users and their supporters “We appreciate CIHR’s support which empowers us to analyze past policies and understand how they impacted people using opioids and their supporter networks,” says Dr. Bernard LeFoll, Principal Investigator and Waypoint’s Vice-President Research and Academics and Chief Scientific Officer. “The knowledge we gain will guide the development of better policies that address the needs of vulnerable populations in times of crisis.” The project is supported by Waypoint Research Assistant Megan Campbell along with Dr. Sara Ling (Co-Principal Investigator, CAMH), Sridevi Kundurthi (Research Assistant, CAMH), Graham Woodward (Co-Principal Investigator Policy

Lead, Mental Health and Addictions Centre of Excellence), Dr. Gillian Strudwick (Co-Investigator CAMH), Dr. Christopher Canning (Co-Investigator, Waypoint), Dr. Chris Perlman

and Dr. Carrie McAiney (Co-Investigators, University of Waterloo), Dr. Cara Evans (Co-Investigator, McMaster University), Dr Heather Bullock (Co-Investigator, Waypoint), Nicole

Need help finding services? • www.connexontario.ca to find mental health, addiction and problem gambling services in your area. • www.1door.ca for quick access to publicly funded therapy and counseling sessions, and an array of support services. • www.rvh.on.ca/areas-of-care/mental-health-and-addictions/adultaddiction-services/ for information on the Rapid Access Addiction Medicine (RAAM) Clinic. • The Canadian Mental Health Association’s Mental Health Crisis and Information Line is available 24 hours a day, 7 days a week for mental health or addiction concerns - 705-728-5044 or 1-888-893-8333 (tollfree).

Adams (Co-Investigator, Waypoint), and Indigenous Lead Germaine Elliot. Other key contributors include Sara Tilley, Mia Brown, Anissa Borneman, Dr. Ginette Poulin, Dr. Sara Lankshear, Patient Client Family Council representatives from both Waypoint and CAMH and other individuals with lived experience Waypoint remains dedicated to advancing research and improving the lives of individuals affected by mental health and substance use challenges. With CIHR’s support, the organization is confident that this study will yield profound insights into the impact of pandemic responses on vulnerable populations, paving the way for transH formative changes in the future. ■

Kristi Lalonde is a Communications Officer at Waypoint. 12 HOSPITAL NEWS NOVEMBER 2023

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NURSING PULSE

Redefining mental health By Victoria Alarcon osanra (Rosie) Yoon’s earliest childhood memories harken back to her days accompanying her mother on the streetcar for monthly visits to Toronto’s St. Michael’s Hospital. From the age of four to eight, she was scared and nervous on these outings, but as soon as she saw her mother’s nurse, she felt safe. “She was so good at acknowledging both of us… the way she talked to me and my mother at those monthly visits was so empathic, empowering and person-centred,” recalls Yoon. The experience piqued her interest in nursing, but it wasn’t until she learned her mother’s diagnosis that she knew mental health was her calling. “At 13, my father handed me a discharge summary from a psychiatrist… I read through (it) and the first thing (it said) was debilitating severe schizophrenia,” says Yoon. “I remember just being in shock. “(My father would tell me) ‘People will judge you. People will judge her. People don’t understand. So, you are never to speak of this’,” she recalls. This sparked in her a desire to be a mental health nurse. In 1999, Yoon began studying nursing at McMaster University, where she had the opportunity to do a lot of community outreach. Every Thursday night, she and her classmates supported people who were experiencing homelessness, touring the streets of Hamilton with a backpack of socks, vitamins and gloves. “We would talk to folks and provide health teaching,” she recalls. “That shaped my whole career.” After graduating, Yoon began working at St. Michael’s inpatient psychiatry unit. She began questioning what she was seeing in mental health. “I used to get really upset about things like restraints. I really hated putting them on people,” she says. She also didn’t like the layout of the nursing station, which was de-

Rosanra (Rosie) Yoon

signed as a fish bowl to continuously watch people. “I was having moral distress,” she remembers. “I didn’t know the purpose of our unit…we would admit people from emerg and discharge them in a week.” Given her concerns, Yoon’s manager encouraged her to pursue a master’s degree to see things through a bigger lens. At the University of Toronto (U of T) in 2006, she focused her master’s on nursing with a specialty in clinical practice. She developed a passion for research and evidence. “I was no longer relying on anecdotal or observational information, but really relying on a larger body of evidence to inform clinical practices,” she says. Yoon started seeing the trend to slowly move away from restraints and to offer different spaces for more therapeutic engagement. With a master’s degree in hand in 2008, she began as a clinical nurse

educator at Toronto’s St. Joseph’s Health Centre mental health and addictions program. She used her knowledge to help staff see how they could improve on clinical practice through personal reflection. After two years, Yoon moved to the Centre for Addiction and Mental Health (CAMH), as an advanced practice nurse. She had a hand in the transformation of outpatient opiate treatment clinics from “strict and had restrictive environments” to a more accessible, “person-centred and interdisciplinary team approach.” She was making improvements, but began to miss her time with patients, oneon-one. To regain that direct patient experience, Yoon went back to school to become an advanced practice NP and began working at the Jean Tweed Centre in 2013. There, she was able to help women recovering from substance use and mental health concerns. The ex-

perience was eye-opening. “The air felt different because the organization was so trauma-informed,” Yoon explains. The environment was designed to be welcoming, without cameras and extra safety policies or entry codes. “The (staff) are so attentive and everyone works in a more trauma-informed way… that intrigued me.” Yoon was so inspired that she pursued her PhD, with a focus on organizational capability in trauma-informed practice, and specifically its effect on women’s substance use programs in Ontario. Juggling her job as an NP and taking care of her kids, she completed her PhD over 10 years, then started a post-doctoral fellowship with U of T in 2021. This allowed her to work within the Mid-West Toronto Ontario Health Team (OHT) as a researcher for programs for people with substance use challenges. Most recently, she conducted an evaluation of a new program that shares the voices of people with lived experiences to help guide patients. But Yoon’s journey doesn’t end there. She is now an assistant professor at Toronto Metropolitan University (TMU). Although she never envisioned her life in academia, she says she couldn’t pass up the opportunity to develop a new mental health promotion course, which gives students “…a broad understanding of mental health, wellbeing and substance use.” It’s an area that isn’t addressed enough in undergraduate preparation, she suggests. Yoon continues to work as an NP while balancing her program of research and teaching NP students as well as third-year nursing students. She says she’s grateful to her mother for inspiring her. She’s also grateful to nursing for showing her there is no shame in mental health. “I really see my mother for who she is in her beautiful light,” Yoon says. And that’s why she will continue to dedicate her life H to improving mental health for all. ■

Victoria Alarcon is communications officer/writer for the Registered Nurses’ Association of Ontario (RNAO), the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit RNAO.ca or follow us on X (formerly Twitter), Facebook and Instagram. 14 HOSPITAL NEWS NOVEMBER 2023

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FROM THE CEO’S DESK

Culture of innovation – key to advancing an organization’s vision By Dr. Frank Martino ospitals across Ontario, and indeed across Canada, have proven themselves to be creative, solutions-focused organizations using talent and teams from within to improve patient outcomes, advance more effective treatments, generate process efficiencies, and create more effective care pathways for patients. Perhaps initially borne out of necessity, hospitals have become leaders in leveraging emerging technologies, advancing life-changing research, and inspiring new ways of thinking. Since becoming William Osler Health System’s (Osler’s) President and CEO over a year ago, I have had the privilege of witnessing this capacity for innovation first-hand in my own organization. So how do we harness this talent within our own organizations in a way that helps us advance our visions and strategic plans? The following are three critical success factors that I truly believe are key to building a strong, unified and inclusive health system of the future:

EMBRACE AN ORGANIZATIONAL COMMITMENT TO INNOVATIVE HEALTH CARE Osler has long prided itself on cultivating a thriving workplace culture that promotes, inspires and recognizes ingenuity. This means ensuring our teams have access to the timely and relevant information they need to identify barriers, pool solution-oriented ideas, and prioritize patients and their experiences when making decisions. This past year we were able to further advance informed decision-making and meaningful team dialogue and engagement through the introduction of iHuddle Boards across all inpatient and outpatient areas. Developed in-house, these electronic boards provide teams with real-time information on what is happening from an operational perspective at the

local level and across Osler sites, and were recognized by the Health Standards Organization (HSO) as a global leading practice. Workplace cultures that promote innovation deliver. From the onset of the pandemic to present day, Osler leaders, staff and physicians have built on the organization’s strong foundation for innovation by developing a series of transformative solutions, that are not only having a positive impact on patient care, but also on the way we work across our hospitals. Beyond the iHuddle Boards, other significant accomplishments include the development and operationalization of Osler’s Operational Command Centre (OCC) to better track patient flow, transfer of accountability, and patient activity, as well as the introduction of Osler’s Digital Stroke Dashboard, created inhouse to visually track more than 850 patients each year and display quality metrics in real-time for patients who have suffered a stroke.

SET THE BAR HIGH FOR QUALITY HEALTH CARE FOR PATIENTS, FAMILIES AND YOUR COMMUNITY Whatever the situation, however great the challenge, consistently reinforce an organizational commitment to high-quality, compassionate care. In Osler’s case, we frequently talk about our Vision for patient-inspired health care without boundaries, and how our teams pride themselves on going beyond to deliver exemplary, people-centred services close to home. These statements inspire our team members to be extraordinary – to go that extra mile – for our patients, our colleagues, our partners and our communities. This in turn prompts innovative thinking that often translates into creative solutions to some of the most pressing health care challenges of our time. Our teams’ ability to rally around our Vision and a collective commitment to safe, quality patient care was instrumental in Osler earning Accred-

Dr. Frank Martino is President & CEO, William Osler Health System. itation Canada’s highest designation for a hospital within the past year. Osler’s commitment to going beyond propelled us to become the first acute care hospital in the world to implement The Butterfly Approach™ – an innovative approach to dementia care. It was also demonstrated through the introduction of a robotic surgical assistant that helps patients recover more quickly after surgery, known as the ROSA Knee System – one of only approximately 10 in use in Canadian hospitals. Both ideas stemmed from team members and blossomed into improvements to our approaches to patient care.

KEEP YOUR EYE ON THE FUTURE Our potential as hospitals to positively impact the health care we deliver relies on our ability to not only develop innovative solutions in the present, but to also keep an eye on what our communities will need in the future. As a leading hospital system in Ontario, Osler is looking ahead to a bold future with exciting developments on the horizon for more accessible,

high-quality care for our communities, close to home. Transforming our Peel Memorial Centre for Integrated Health and Wellness into Brampton’s second hospital, planning for the future redevelopment of Etobicoke General Hospital, establishing a research institute, expanding cancer care services for our region, and partnering with Toronto Metropolitan University to open a new School of Medicine in Brampton are just a few examples of how we’re looking to the future and building a comprehensive health system for generations to come. Based on my Osler experience, I believe success is due in large part to a compelling Vision; Values that resonate; a comprehensive and forward-thinking strategic plan; an agile, innovative and collaborative workforce; and robust relationships with patients, families, donors, community, health care and government partners. As one of our wise staff members put it, championing a new tomorrow for health care ‘means fostering a culture of innovation and harnessing technology, but never forgetting the H importance of humanity.’ ■

Dr. Frank Martino is President & CEO, William Osler Health System. 16 HOSPITAL NEWS NOVEMBER 2023

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MEDTECH 2023

SPECIAL FOCUS

MEDICAL TECHNOLOGY MAKING A DIFFERENCE

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NOVEMBER 2023 HOSPITAL NEWS 17

MEDTECH 2023

Annual Medtech supplement e’re very pleased to once again be a part of this year’s Hospital News Medtech supplement. As the association representing Canada’s medical technology companies, we work closely with our health care partners across Canada – as well as our partners in government – to help ensure that our health care systems and patients have access to beneficial technologies that improve patient outcomes, reduce burdens on clinicians and enable greater access to care. Our member companies make the technologies used in the delivery of health care such as pacemakers, MRIs, glucose monitors, wound care products and orthopaedic implants – to name just a few. This year, our association had the honour of celebrating its 50th anniversary. We held a reception to commemorate the event and were thrilled

to play host to partners from past and present, including dignitaries such as Ontario Deputy Premier and Health Minister, Sylvia Jones, Ontario’s Associate Minister of Small Business, Nina Tangri, and the Mayor of Brampton, Patrick Brown. It was a great event and allowed for our association to celebrate our past, while looking forward to the growing and evolving future of the medtech ecosystem in Canada! A short history of our association: Medtech Canada was originally called the Canadian Association of Manufacturers of Medical Devices (CAMMD) and was founded primarily to engage with the Canadian government on matters relating to the regulatory environment for medical devices. While regulatory affairs continues to be an integral focus of the association to this day (particularly engagement with Health Canada), over the years the

Insight-driven Care

18 HOSPITAL NEWS NOVEMBER 2023

L to R: Hon. Sylvia Jones, Ontario Deputy Premier & Minister of Health, Nicole DeKort, Medtech Canada, Hon. Nina Tangri, Associate Minister of Small Business and Dehlia Blanchard, GE Healthcare Canada & Medtech Canada Board Chair at MedTech Canada’s 50th anniversary. mandate of the association broadened its advocacy to optimize the environment in Canada for medical device technology adoption and the growth of the industry in Canada. In 1987 to 2019 the association was called MEDEC (Medical Devices Canada). In 2019 the association underwent a rebranding to become Medtech Canada – a brand identity that better reflects the evolving nature of the industry, including the growing digital health offerings from our sector. As we look to the future, our association recently undertook a threeyear strategic planning process earlier this year. A key strategy within that plan is to “Help the Canadian Health Care System Address its Most Pressing Challenges.” We know it continues to be a challenging time in Canadian healthcare and this strategy seeks to align our work with the needs of our health care partners. The first priority areas of focus as a part of this strategy are utilizing medical technology to improve surgical and procedural wait times/reduce backlogs and create efficiencies that reduce the burden on clinicians to help address health human resources shortages. In subsequent years, we’ll engage with our health system partners to re-evaluate the current challenges facing the health system at that time and will align our efforts accordingly. Barriers continue to exist that impede the adoption of innovative medical technologies in Canada, including siloed funding models, lack of appropriate billing codes or an absence of dedi-

cated funding for technologies. We will continue to advocate to address these challenges – working with governments, medical associations, and many others – offering tangible solutions to break down these barriers (implementing value-based procurement is one such solution). 2024 promises to be an exciting year for our association and the medical technology ecosystem in Canada, with a world-leading medical technology conference coming to Canada. AdvaMed, our counterpart association in the United States, is bringing their MedTech Conference to the Metro Toronto Convention Centre on October 15-17, 2024. This is the largest medical technology-focused conference in North America and it’s the first time the conference is being held outside of the US. The fact that AdvaMed chose Toronto for this conference is a testament to the highly innovative medtech ecosystem in Canada and we look forward to our health system partners that are interested in health technology innovation to join us at this event! To our healthcare partners: thank you so much for all you do to provide exceptional care to patients every day. Our industry will continue to support you and your unwavering commitment to Canadians, and we look forward to continuing to work with you to address H the challenges you face. ■ Nicole DeKort President and CEO Medtech Canada www.hospitalnews.com

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COVER

The best outcomes can’t wait

Technology solutions to address health system challenges By Tim Wilson he global pandemic put the Canadian healthcare system under immense stress. This highlighted the need to address every citizen’s right to prompt and effective care that’s delivered by qualified personnel using the best medical technologies. Thankfully, Canada is seeing more examples of strategic and intelligent policy and investment to address this need, which will in turn deliver long-term value by efficiently delivering better outcomes. One such example is Nova Scotia’s recently launched Health Innovation Hub. At the Hub, clinical staff, researchers, industry, and government will be coming together to solve the province’s most pressing healthcare challenges. Critical to the Hub’s success will be the participation of companies in the medical device sector,

which will allow for accelerated clinical trials, testing, and market-ready solutions. This includes the Hub’s Network of Innovators, a program intended to turn new ideas into reality. Ontario has taken a similar approach in its most recent budget, acknowledging that the province is not only home to a vibrant ecosystem of health technology companies, but that clinicians require the necessary solutions to make health care more convenient and accessible. Importantly, Ontario’s 2023 Budget commits to providing procurement opportunities for exciting new technologies. The province’s proposed Innovation Pathway, a collaboration with Supply Ontario, is central to this plan to bring the brightest ideas to life, and to transform Ontario’s health care system for the benefit of patients. Once established, the Pathway will ideally ensure that innovations are adopted across the province’s health system, thus helping to clear backlogs and improve outcomes.

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Being innovative in care delivery is critical in a country like Canada, which is ethically and legally mandated to ensure that access to publicly funded health services is available to everyone, everywhere. It also represents immense opportunity, given that Canada is highly urbanized, with a robust information and telecommunications backbone, yet also has one of the lowest population densities in the world. Intelligent perioperative care – which involves an integrated approach to care from surgery planning until full recovery – is a must. We know we can do it, because some of the technological solutions already in place are impressive in their scope and variety. These technologies directly address the backlog by making surgeries more efficient, while improving the patient experience. One excellent example of technology’s crucial role in bringing optimal patient care comes from Toronto-headquartered TeleVU Innovation,

which has a remarkable telepresence solution. This impressive technology fosters a virtual shoulder-to-shoulder experience in procedures and patient examinations while breaking down geographical limitations. TeleVU’s cloud-based system goes far beyond traditional video calls. This connected care ecosystem involves a secure, live audio-visual communication channel enhanced by AR and AI. By providing a fully interactive and immersive virtual healthcare experience, TeleVU does more than help deliver care – it can also support educational endeavors and mentoring. The technology has been deployed successfully as part of Northwest Ontario’s regional wound care program at St. Joseph’s Care Group in Thunder Bay. The numbers speak for themselves. With TeleVU, the average wait time for community residents to receive advanced care was reduced from 11 to 1.67 days, with the majority of clients experiencing improved wound closure rates, and cost savings achieved through best-practice dressing selection. Incredibly, every three months about 45,000 km in patient travel time has been eliminated. www.hospitalnews.com

COVER “Advanced wound care is essential for managing complex chronic wounds and optimizing clinical outcomes,” says Ryan De’Larami, Founder & CEO of TeleVU Innovation. “Many remote and rural communities face significant challenges in accessing specialized wound care providers. Our technology can be of great benefit to patients, their families, and the environment.” There are many other examples in Canada besides TeleVU, all of which address the ongoing challenges related to the medical services backlog. These include state-of-the art, outpatient hip and knee replacement surgery, including assistance by robotic devices. For these and other procedures, efficient patient throughput is assured by technologies that help to drive streamlined communication, enhance productivity, and manage post-operative pain. Impressive advances in workflow include theatre management software solutions that improve operating room utilization, and reduce non-medical cancellations. (Medtech Canada has highlighted a

number of these examples at medtechinnovation.ca/medtech-solutions). Remote patient monitoring is another effective tool, and an excellent way to reduce overcrowding and provide better access to care. Canada has the information and communication’s infrastructure to drive significant benefit here, with remote patient monitoring for chronic illnesses, such as diabetes, increasingly common.

THE FUTURE IS HEALTHY At the beginning of the pandemic, hospitals across Canada suspended scheduled, non-urgent surgeries and procedures to create capacity. As a result, fewer surgeries and procedures were performed, and wait times – already a problem – ballooned. Canadians faced backlogs for millions of services. This also affected preventive care, cancer screening, routine immunizations, and diagnostic tests and scans. The result was that key stakeholders on Canada’s healthcare community were forced to take a hard look at

ENGAGING WITH THE MEDICAL TECHNOLOGY INDUSTRY HAS VALUE HERE, AS IT CAN HELP TO IDENTIFY SOLUTIONS FROM BOTH A CANADIAN AND GLOBAL BEST PRACTICE PERSPECTIVE. this new, harsh reality, wherein familiar challenges had transformed into fullblown crises. The answer to this problem, as many key decision-makers now realize, was to build systems that promoted an investment in value, wherein the total benefit to the patient, and to the system at large, is calculated alongside upfront costs. To accomplish this, technologies are now increasingly assessed according to varied criteria, with procurement removed from silos, and innovation delivered to the population at large. Importantly, bringing innovation into the system can align with other necessary investments, including in human resources and infrastructure,

to build resilience and long-term sustainability. Incremental funding to expand capacity in high-value medical interventions can preserve hospital resources, while ensuring that care teams in roles with the greatest potential impact receive the necessary funding. Engaging with the medical technology industry has value here, as it can help to identify solutions from both a Canadian and global best practice perspective. There is a lot to be learned, including how to utilize technology to leveraging alternate care sites, and to deliver high-quality, faster care for high volume procedures, while still delivering optimal care for higher resource surgeries. The good news? We’re on our way, H and the future looks healthy. ■

Tim Wilson is a freelance journalist and researcher.

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Specialized teams and over 85 global digital solutions that support our customers and their patients across the continuum of care. stryker.com/AdvancedDigitalHealthcare www.hospitalnews.com

NOVEMBER 2023 HOSPITAL NEWS 21

MEDTECH 2023

Developing new technology for checking newborn heart rates hen Scarborough Health Network (SHN) launched its new Research Institute in 2022, it signaled the start of an expanded and more focused approach towards providing better health through research that matters to Scarborough. This was a calling to all of the researchers across SHN to be a part of a new movement aimed at translating research findings and knowledge into practice and policy, including Dr. Niraj Mistry, a general pediatrician at SHN for more than 10 years. As an advocate of user-centred design in healthcare technologies, Dr. Mistry aims to enhance care and treatment, as well as the patient and family experience. “Now with SHN Research Institute, clinicians have help to be able to get research started in pursuit of Scarborough-made solutions,” said Dr. Mistry. “This will be a game-changer in helping build our credibility and prominence on the most important stages of healthcare research.” The goal of Dr. Mistry’s research through the SHN Research Institute is to develop new technology for detecting a newborn baby’s heart rate. Knowing a baby’s heart rate quickly is essential, especially in situations where a newborn may be experiencing complications or require resuscitation. “Currently around the world, healthcare providers use stethoscopes for checking heart rates, including babies. But imagine the new and innovative possibilities enabled by the use of the latest technology for digitally assessing heart rates. That’s what our research is focused on,” he said. Dr. Mistry and his counterpart, Dr. Sri Krishnan, with the help of PhD student Abdelrahman (Sammy) Abdou, from Toronto Metropolitan University have developed a handheld, miniature ECG sensor. It uses baby-friendly 3D-printed dry electrodes that do not stick to the baby, and it uses machine learning software to detect the baby’s

heart rate quickly and accurately. It does all this on-board the sensor with low power consumption so the heart rate can be taken at the point of care and displayed on a screen, to enable the appropriate medical decisions and interventions to give every infant the best start at life. “One of our greatest challenges in working with babies at birth is that some are very small,” Dr. Mistry explained. “The point of our research study is to see how effective this novel ECG sensor is in detecting a heart rate in both premature and full-term newborns. It is really a proof-of-concept study. “ECG is a tried and true technology, but we don’t yet know a lot about the use of ECGs with babies, or its implications among different ethnic backgrounds. We have to ask ourselves, is there a different signal or different heart rate parameters?” For Dr. Mistry, SHN Research Institute promotes the kind of study of population health that considers these

demographic factors, resulting in better ways of delivering the high-quality, equitable care Scarborough deserves. Importantly, Dr. Mistry also has a strong, personal connection to Scarborough, its people, and the community at large. “I grew up with family members who were newcomers to Canada, living in the Markham and Ellesmere area,” he recalled. “I know the area well. It’s an awesome and hard-working group of incredible people. It is also a place where we see a lot of diverse and complex conditions that are unique to Scarborough.” This presents a huge opportunity to learn through research about delivering healthcare to diverse patient populations. But the work is only effective if the population sees that it is meaningful to them and are willing to participate. “When you’re doing research locally, a lot of patients want to contribute. This is an opportunity to have our community at-large be involved and make a difference in healthcare.

“As a doctor, the patients I’ve treated at SHN have always impacted me. They are so kind and grateful. But Scarborough hasn’t always gotten the attention it needs compared to the downtown Toronto hospitals. With the SHN Research Institute, we can leverage our diverse and engaged community to achieve the triple aim of enhancing the patient experience, improving population health, and reducing healthcare costs.” As a general pediatrician at SHN for more than 10 years, and an award-winning medical educator and assistant professor at the University of Toronto, Dr. Mistry practices hospital-based acute care pediatrics, general pediatrics and neonatology, with a subspecialty in pediatric bowel and bladder dysfunction. In addition, he brings academic pediatric fellowship training from SickKids Hospital and a Master’s degree in health informatics from McMaster H University. ■

This article was submitted by Scarborough Health Network. 22 HOSPITAL NEWS NOVEMBER 2023

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SPONSORED CONTENT

The landscape of healthcare in Canada is evolving and OBIO® is at the forefront of this transformation anada’s healthcare system is renowned for its commitment to providing universal access to medical services. However, as the demands on healthcare systems increase and medical complexities evolve, the integration of critical technologies becomes indispensable. Start-ups are playing a pivotal role in driving change by leveraging critical technologies like ethical Artificial Intelligence (AI), Blockchain, Cybersecurity, Robotics, 5G and Quantum Computing. These technologies have the potential to revolutionize healthcare, making it more efficient, accessible and effective. In a bid to address the longstanding technology development and commercialization challenges that hinder the growth of small and medium-sized enterprises (SMEs) in the health science sector, the Ontario Bioscience Innovation Organization (OBIO®) has launched the Life Sciences Critical Technologies & Commercialization (LSCTC) Centre of Excellence. With up to $9.7 million funding support from the Government of Ontario, OBIO® will catalyze Ontario start-ups in commercializing and adopting critical technologies that revolutionize healthcare in Canada. Ventures participating in the LSCTC Centre of Excellence will have access to technical & commercialization support through OBIO® and its delivery partners. Ventures will also have access to over 65 healthcare organizations and health systems that are part of OBIO® Early Adopter Health Network (EAHNTM). Adoption of critical technologies in the healthcare system will improve the delivery of care by reducing the impact of staffing shortages, increasing efficiencies in clinical workflows, decreasing the cost of care delivery, and improving patient and provider engagement.

ticularly in remote and underserved areas. Start-ups are harnessing the speed and reliability of 5G for telemedicine, enabling high-definition video consultations and remote patient monitoring. This technology will also support the growth of IoT in healthcare, allowing real-time data transmission from wearable devices and sensors. Patients living in rural Ontario regions can now access remote healthcare services by enabling providers to monitor vital signs, which improves early detection and treatment.

QUANTUM COMPUTING: This is how critical technologies are currently impacting the healthcare system:

data breaches and allows patients to have more control over their health information.

AI:

CYBERSECURITY:

Ethical AI is reshaping the healthcare landscape by demonstrating its remarkable capacity to analyze extensive volumes of medical data swiftly and precisely. Start-ups are developing AI-powered solutions for tasks like medical imaging, predictive analytics and personalized treatment plans. In Ontario, AI-driven applications are assisting physicians in diagnosing diseases, predicting patient outcomes and even managing patient schedules, making healthcare more efficient and patient-centred.

Cybersecurity is paramount in healthcare due to the sensitivity of patient information. Start-ups are developing advanced cybersecurity solutions to protect medical data, healthcare systems and Internet of Things (IoT) devices used in healthcare. Cybersecurity technologies, including advanced threat detection and encryption, are essential to safeguard patient information and maintain the integrity of healthcare systems.

BLOCKCHAIN: The decentralized and tamper-resistant ledger technology behind blockchain is significantly impacting the security and management of patient data. In a country with a strong commitment to patient privacy, blockchain ensures that health records are securely stored and accessible to authorized personnel only. It reduces the risk of

ROBOTICS: Incorporating robotics into healthcare has the potential to enhance patient care and automate repetitive tasks. Start-ups in Ontario are developing robotic devices for surgical procedures, patient rehabilitation, patient transfer and even medication dispensing.

5G: The rollout of 5G networks is expanding connectivity in Ontario, par-

Quantum computing has the potential to revolutionize drug discovery in Canadian healthcare. Its unparalleled processing power can analyze complex molecular interactions and simulate drug effects in ways that classical computers cannot. This promises faster and more efficient drug development, reducing the time and costs associated with bringing new medications to market. While the commercialization and adoption of these technologies promise to transform Canadian healthcare, there are significant challenges to consider. Ensuring data privacy, regulatory compliance and integration into existing healthcare systems are some of the primary hurdles. Startups must also focus on user-friendliness and accessibility, ensuring these technologies are readily available and usable for both healthcare professionals and patients. Furthermore, ethical concerns surrounding AI and privacy issues in blockchain need to be addressed to build trust within the healthcare sector. Lastly, the cost of implementing these technologies can be a barrier, particularly for smaller healthcare providers and H organizations.Q

Since 2009, OBIO® has engaged in strategy, programming, policy development and advocacy to further the commercialization of human health technologies that position Canada as a leader in the international marketplace. Through the LSCTC Centre, OBIO® and its delivery partners will catalyze a globally competitive collaborative ecosystem by leveraging and building on Ontario’s expertise and capabilities. If you are part of a healthcare organization and interested in joining OBIO’s Early Adopter Health Network (EAHN™) to evaluate, adopt and showcase innovative, value-producing Canadian health technologies, please submit an expression of interest. www.hospitalnews.com

NOVEMBER 2023 HOSPITAL NEWS 23

MEDTECH 2023

Unobtrusive in-home monitoring using wireless signals offers exciting possibilities for healthcare By George Shaker magine a future where your home could monitor your health and daily activities without cameras or wearable devices. There was a time this type of technology or idea only existed in science fiction, but researchers at the University of Waterloo and the Schlegel-UW Research Institute for Aging (RIA) have developed a new system that can do just that using wireless signals. The team of researchers, led by George Shaker, PhD, adjunct associate professor, University of Waterloo created a state-of-the-art demonstration facility (MIRADA) at the RIA that allows researchers to test technology-driven solutions designed to help older adults take control over their health and well-being. The Monitoring, Intervention, and Response for Aging Demo Apartment (MIRADA) is a space where Schlegel

PROMPT FALL DETECTION IN ANY LIVING SPACE, INCLUDING BATHROOMS, CAN SAVE LIVES.

Research Chairs and collaborators can study and demonstrate groundbreaking sensing technologies, advanced monitoring systems, and timely interventions to help address the unique challenges faced by aging populations. The research team recently demonstrated an in-home monitoring system that uses radar sensors and artificial intelligence to detect a person’s location and movements within a home without the use of cameras or wearable devices. The sensor emits low-power radio waves - less than those emitted by a WiFi system - that reflect off a person’s body. When combined with machine learning algorithms in the cloud, this data can identify specific activities like walking, sleeping, eating, and even falling.

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24 HOSPITAL NEWS NOVEMBER 2023

According to Shaker, this technology has exciting potential for healthcare, especially for older adults. “Continuously monitoring health and activities at home could allow for early detection of changes that indicate declining health. This would enable proactive interventions that could prolong independent living,” he explains. Prompt fall detection in any living space, including bathrooms, can save lives. The technology can also monitor bathroom visit frequency and duration, which provides insight into hydration status and potential onset of medical conditions such as, urinary tract infections. Beyond falls and bathroom monitoring, gait changes often precede cognitive and physical decline. The radar-based system can unobtrusively measure walking speed and other gait metrics daily rather than periodically at clinic visits. Doctors can use the system to monitor subtle gait changes, triggering a closer evaluation when needed. The system’s activity recognition capability provides insight into functional health. Decreased time upright and walking may reflect emerging mobility limitations or depression. From a safety perspective, the technology holds promise for monitoring high-risk individuals without intrusive cameras. Beyond health applications, the technology could also help smart home devices better support people by adjusting to their activities and needs.

EVALUATING THE SYSTEM To develop and evaluate the system, Shaker’s team installed radar units in MIRADA - which resembles a typical multi-room living space. Participants performed daily living activities

like walking, washing dishes, vacuuming, and sitting, which generated over 300,000 radar data samples. Artificial Intelligence algorithms extracted informative features from the radar signals to classify the different activities. The researchers tested several types of artificial neural networks on the radar data before finding a candidate network that achieved excellent performance. When tested on new subjects, the system accurately identified activities like sitting, washing dishes, and walking around 87 per cent of the time. “A key advantage of our machine learning approach is the ability to learn what motions characterize particular activities across individuals without needing complex rules programmed by hand,” he explains. While further refinements are needed before real-world use, the system represents an important step towards accessible in-home health monitoring. Shaker believes the technology could be commercialized using inexpensive radar sensors like those in smartphones paired with cloud-based AI services. The biggest barrier may be user acceptance of radar monitoring despite its unobtrusive nature. The research team is exploring how to communicate the technology’s privacy-preserving benefits and healthcare value proposition to help drive adoption. “Wireless sensing technologies stand to transform home-based healthcare,” believes the research team. “However, we need to ensure these innovative technologies are implemented in a human-centered way that promotes comfort and autonomy.” With its healthcare potential and ability to assess gait, detect falls, and monitor activities, this radar monitoring system offers an exciting glimpse into how wireless sensing and artificial intelligence could support healthier independent living. While further research is still required, the future looks bright for in-home technologies that enhance care options without H jeopardizing privacy. ■

George Shaker, PhD is an adjunct associate professor, University of Waterloo; Research scientist, Schlegel-UW Research Institute for Aging. www.hospitalnews.com

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MEDTECH 2023

mymobility® app empowers orthopaedic patients at Humber River Health s North America’s first fully digital hospital, Humber River Health (Humber) has innovation embedded into its core, maintaining this focus through years of expansion and evolution. Innovation extends to every facet of Humber’s programs, practice areas, and operations. This includes Humber’s surgical program, where revolutionary robotics have transformed surgery in the North York region. Innovation also means optimizing the patient experience outside of surgery through pre-operative and post-operative care, such as that facilitated by the mymobility® App. While healthcare innovation is often referred to as breakthroughs in diagnostic tools or treatment methods, it also encompasses inventive ways to improve patient outcomes through existing tools. In essence, innovation ad-

dresses traditional barriers to the best possible care journey. mymobility® does just that. The user-friendly app is designed to improve clinical outcomes for hip and knee patients throughout their pre- and post-operative care process. When users open the app, they access on-demand educational content pertinent to their upcoming surgery, reminders, step tracking, and a task list to ensure preparedness for surgery and subsequent recovery. The app also shares easy ways for patients to track their recovery progress and guidance for reducing the risk of complications and improving overall health outcomes. Humber’s surgical program launched the mymobility® App in April 2023, marking the first time a Canadian hospital introduced this technology to orthopaedic surgery recipients. Participation and interest

NAFLD: A Worldwide Health Burden What sets NAFLD apart from other common liver diseases is the volume of patients: estimated 64 million in the U.S. and 52 million in Europe. Nonalcoholic fatty liver disease (NAFLD) NAFLD is a condition in which excess fat that is not caused by heavy alcohol use is stored in the liver. Disease progression is strongly linked to liver fibrosis. Known as the “silent killer,” NAFLD is often asymptomatic and difficult to identify because of the way it can progress unnoticed until an urgent situation arises. • NAFLD is found in up to 90% of obese patients and up to 80% of type 2 diabetes patients. • NAFLD is projected to become the leading cause of liver-related mortality within 20 years. • If left untreated, NAFLD may progress to nonalcoholic steatohepatitis (NASH) - a severe form of NAFLD, which can lead to more-severe advanced fibrosis, cirrhosis, or liver-related events (LREs).

WHILE HEALTHCARE INNOVATION IS OFTEN REFERRED TO AS BREAKTHROUGHS IN DIAGNOSTIC TOOLS OR TREATMENT METHODS, IT ALSO ENCOMPASSES INVENTIVE WAYS TO IMPROVE PATIENT OUTCOMES THROUGH EXISTING TOOLS.

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EMPOWERING PATIENTS IN THEIR CARE JOURNEY “Innovation is one of the key differentiators of our surgical program. Every technology or new application that we introduce is done to strengthen how we deliver patient-centred

26 HOSPITAL NEWS NOVEMBER 2023

care,” comments Ledor Babatinca, Manager of Ambulatory Surgical Clinics at Humber. “We introduced mymobility® because we recognized the significant role it could play in helping patients achieve better outcomes from hip and knee surgery, and with that, how it aligned with our strategic pillar of advancing how we empower our patients to take ownership of their health.” Continued on page 28 www.hospitalnews.com

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MEDTECH 2023 Continued from page 26

mymobility® app Humber’s vision for empowering patients extends beyond information-sharing; it involves equipping patients with resources for better health results and experiences. mymobility® achieves this by providing a resource that can always be accessed, is user-friendly and easy to engage with, and enables patients to play a more active role in surgery preparation and recovery without requiring high levels of touchpoints with clinicians. Patients often lose motivation to keep up with recommendations they are given during their surgical journey, such as mobility exercise regimens. Humber has found that having a concerted and organized space for information and accountability – such as mymobility® – has succeeded at facilitating stronger levels of patient engagement and keeping them motivated to follow through on those recommendations. Clinicians also benefit from the app as they can use the information it col-

lects to track patient progress, including a specific clinician dashboard that provides insights and results on each patient’s postoperative recovery. This information makes patient appointments more efficient, informative, and helpful. Orthopedic surgeons Dr. Justin Chang and Dr. Sebastian Rodriguez-Elizalde are at the forefront of this technological leap at Humber. They have played an instrumental role in championing the mymobility® App, recognizing its potential to revolutionize patient care in their specialty. Dr. Chang and Dr. Rodriguez-Elizalde believe in a holistic approach to patient care where technology complements traditional methods, and view the app as a bridge between the surgeon and patient, ensuring clear communication and better surgical outcomes. Their combined efforts and advocacy have not only highlighted the importance of the app, but have also been integral to its successful integration at Humber.

“THE APP IS A REALLY USEFUL AND BENEFICIAL AUGMENTATION TO THE TRADITIONAL CARE PATHWAY FOR ORTHOPAEDIC PATIENTS.” ENSURING CONTINUITY OF CARE mymobility® also facilitates continuity of care, ensuring that healthcare professionals and patients can effectively partner in ongoing health management and outcome optimization. This is especially true of situations in which a patient’s recovery is overseen by two or more health professionals, such as the process for hip and knee surgery patients, which consists of pre-operative and post-operative appointments paired with a separate engagement with physiotherapists for rehabilitation. “The app is a really useful and beneficial augmentation to the traditional care pathway for orthopaedic patients,” adds Babatinca. “mymobility® helps bridge the gaps between various appointments, keeping patients on track with recovery activities and ensuring streamlined communication between patients and their clinicians and physiotherapists.” By integrating technology into the day-to-day recovery of patients, my-

28 HOSPITAL NEWS NOVEMBER 2023

mobility® ensures they have access to all the documents and materials they need, when and where they need them. It is a true initiator of care continuity.

EXPANDING SERVICES AND THE DELIVERY OF CARE mymobility® is just one example of how Humber is expanding the services it offers to patients and reflects its larger mandate to develop services beyond those of an acute care hospital. Every new initiative, program, or offering is centred on Humber’s mission of working with its community to deliver innovative, safe, and equitable healthcare. The way that patients use and engage with the mymobility® App will help Humber make data-driven decisions in the future, applying learnings of how the app impacts and improves patient outcomes. Such initiatives ensure that Humber continuously maximizes how technology is used to augment and support the best possible H patient outcomes. ■ www.hospitalnews.com

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MEDTECH 2023

Trusting your gut check: Canadian study demonstrates costeffectiveness of AI-aided colonoscopy By Roxane Belanger t goes without saying that no one looks forward to a colonoscopy. The good news is that Canadian patients can benefit from a colorectal cancer screening tool that democratizes access to the best diagnostic care thanks to artificial intelligence. Canadian researchers have shown that adding artificial intelligence (AI)-aided computer assisted adenoma detection (CADe) to a colonoscopy program not only increases a patient’s quality of life through advanced detection but doing so can be cost-effective within the Canadian health system. Where previous studies have demonstrated the effectiveness of AI in colorectal adenoma detection rates, this recent

study determined that detecting and treating more lesions in advance can help lower healthcare costs before lesions become more problematic. AI-aided CADe system for colonoscopy, such as GI GeniusTM from Medtronic, uses enhanced visualization, analyzing imagery in real-time to help identify polyps, particularly subtle adenomas. Think of it as a second pair of tireless eyes supporting a specialist who may look at hours of colonoscopy footage in a day. The study, Cost-effectiveness of Artificial Intelligence-Aided Colonoscopy for Adenoma Detection in Colon Cancer Screening,* is based on a standardized model in a Canadian healthcare setting using positive fecal immunochem-

Digital technologies can help achieve operational excellence in the laboratory Read more here

navify.roche.com

30 HOSPITAL NEWS NOVEMBER 2023

ical test (FIT) patients. Researchers posited that increasing advanced adenoma detection with CADe technology would make it more feasible to use the technology compared to the risk and added cost of treating colorectal cancer downstream. Their results established a per-procedure savings of $14 ($3,005 versus $2,991, factoring in a cost of $27 for AI-aided colonoscopy). Earlier detection with AI-aided CADe can increase patient quality-adjusted life years, help attenuate staff burnout, provide population health insights, and increase health equity by standardizing care. Add in feasibility results from this recent study, and the technology qualifies for a healthcare improvement framework known as the quintuple aim. “From a provincial payer’s perspective, using CADe in a colonoscopy program is feasible. From a ‘patient’s point of view, they should be demanding this as a significant diagnostic advantage. At the end of the day, everybody can benefit,” says Hamid Sadri, one of the

study’s authors and head of health economics at Medtronic Canada. Colorectal cancer is the second leading cause of cancer death and the third most diagnosed cancer in Canada. Though rates of colorectal cancer were in decline between 2007 and 2018, likely due to increased screening, the pandemic backlog has led to a higher rate of advanced cases that could have been more manageable if discovered earlier. While raising awareness of colon cancer screening is one of the most effective means of addressing colon cancer, the proliferation of AI-aided CADe can be a powerful contributor H to increased health equity. ■

Roxane Belanger is a communications specialist with Medtronic Canada www.hospitalnews.com

How digital technologies can help achieve operational excellence in the lab Resource constraints and increasing demand for faster, more accurate results mean labs have to do more with less. Every day, we work together with healthcare leaders around the world to understand their daily operational challenges and to find the latest digital technologies that can help resolve them. Tech and healthcare players are creating digital open ecosystems - connected, secure yet open platforms that make it easier for labs to access the latest digital technologies they need to improve operational excellence, drive efficiencies, and generate the meaningful clinical data insights that can help improve patient care. As labs play an increasingly visible and critical role in the overall performance of modern healthcare systems, there are a number of key ways in which digital solutions can relieve the mounting pressures they are facing. \Ø ®ę ÀÀýǩ ®¦®æ À æÍÍÀß ÇǪ • Reduce the burden on already understaffed labs and healthcare organizations as well as on overburdened staff members* • Integrate data streams across the care continuum to reduce the soaring costs caused by a lack of interoperability amongst systems and solutions* • Create greater transparency and secure access to information, ultimately improving the cross-collaboration that occurs between the different functional teams across the healthcare system*

In the full article available online @https://lableaders. roche.com, author Corinne Dive-Reclus has highlighted real life examples of digital solutions that have been implemented in different organizations across the world and the range of benefits labs have experienced in terms of productivity, efficiency and performance.

Ç ęæß • .ÆØÛÍö®Ç¦ ÷ÍÛ½ĚÍ÷ß æÍ Û ë ßæ ¥¥ ëÛ Ç • .ÆØÛÍö®Ç¦ cëÛÇ ÛÍëÇ c®Æ Ƿc cǸ • \æÛ ÆÀ®Ç®Ç¦ ÷ÍÛ½ĚÍ÷ß • X ë ®Ç¦ ÛÛÍÛß ÷®æ«®Ç æ« À À® ½ « Û æÍ À ÛÇ ÆÍÛ ÍÇ Ç ęæß üØ Û® Ç ý À ß ÷«Í ÍØæ ®¦®æ À ßÍÀëæ®ÍÇß ®Ç æ« ®Û ®Àý ÍØ Û æ®ÍÇǨ The future of operational excellence in the lab Embracing digital technologies in laboratories through automation, streamlined workflows, robust data management, and immersive visualization techniques, can unleash increased levels of effectiveness and efficiency. By harnessing the power of digital technologies, labs can Û ë ßæ ¥¥ ëÛ ÇŮ ®ÆØÛÍö c cßŮ ßæÛ ÆÀ®Ç ÷ÍÛ½ĚÍ÷ßŮ Ç Û ë ÛÛÍÛßŮ ßëØØÍÛæ®Ç¦ ®Ç Û ß À ¥ę ® Ç ýŮ Ç ß result, improved patient outcomes.

* Full article and references: https://lableaders.roche.com/global/en/articles/digital-technologies-improve-lab-operational-excellence.html Contributing lab leader: Corinne Dive-Reclus

Lableaders.com Join our community and stay up to date with the latest laboratory innovations and insights. Subscribe now!

Connected insights for better care. It’s personal. navify.roche.com

MEDTECH 2023

New virtual program enhances support for nurses By Alexandra Macgregor or many people, the first days, weeks and even years of their career can feel daunting, regardless of how much education and training is under their belt. Nurses are no exception, which is why Hamilton Health Sciences (HHS) decided to launch an innovative new program called the Virtual Nurse-to-Nurse (N2N) Support Line. Staffed by experienced, senior registered nurses (RNs) with previous charge nurse or educator experience, the Virtual N2N Support Line provides additional on-demand night and weekend support for RNs and registered practical nurses (RPNs). The virtual nurses can provide help with general, non-urgent inquiries by phone, Zoom, secure chat and/or

email. This model mimics how nurses support their peers on the floor in an in-person capacity. The virtual nurses do not provide direct patient care. “Recently, I was working an overnight shift when I encountered a newto-me evaluation for a post-stroke patient,” says Jacqueline Mallari, a nurse who has been working at HHS for 18 months and currently cares for acute medicine patients at HHS’ Juravinski Hospital and Cancer Centre. “The evaluation used a specific acronym – STAND – and I needed help understanding what the letters stood for. That’s when I decided to call the Virtual N2N Support Line.” Upon calling the Virtual N2N Support Line, Mallari was able to connect with a virtual nurse who had a lot of experience with the STAND evalua-

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For more information, visit www.cepheid.com 32 HOSPITAL NEWS NOVEMBER 2023

THE VIRTUAL NURSES CAN PROVIDE HELP WITH GENERAL, NON-URGENT INQUIRIES BY PHONE, ZOOM, SECURE CHAT AND/OR EMAIL tion. “She explained the procedure to me step-by-step and answered all of my questions,” says Mallari. “Sometimes in nursing you encounter medical procedures or acronyms that you can’t Google – you need a more experienced person to explain them to you. I was very grateful to the Virtual N2N team for supporting me in that situation.”

THE IMPETUS TO INNOVATE Nurses are essential to patient care, but in recent years, a high number of nurses have retired or left the profession for other reasons. This has created staffing challenges for hospitals around the world, including HHS. “The purpose of the Virtual N2N Support Line is to provide nurses with a safe and judgement-free space to call after hours, when we know in-person staffing resources are more limited,” says Kara Langdon, Manager, Virtual Care. “The N2N program enables HHS to retain some incredible experienced nurses who in turn are helping the next generation find their way in this rewarding yet challenging career.” Beginning in early April, the program was piloted in select units at HHS’ Satellite Health Facility, West Lincoln Memorial Hospital, Juravinski Hospital and Cancer Centre, and St. Peter’s Hospital. As of August 1, the Virtual N2N Support Line is available to nurses at all adult sites. To date, the Virtual N2N Support Line has received more than 200 calls.

LEAVING RETIREMENT TO GIVE BACK Many of the virtual nurses are retirees with a passion for nursing who want to give back and support their peers. Darlene Creed, who retired from being a critical care and Rapid

Assessment of Critical Events (RACE) nurse after 37 years, says that’s exactly what made her want to join the N2N program. “I was excited to be a part of something so positive and supportive, especially for novice nurses,” Creed says. “Nurses are often required to think on their feet, and their shifts are typically hectic. Making a quick phone call to the Virtual N2N Support Line allows nurses to debrief with a more experienced nurse and gain the appropriate information or guidance they need to obtain the best outcomes for their patients.” Like Creed, John Sheppard came out of retirement to join the Virtual N2N team. Having worked at HHS for more than 45 years, Sheppard says it was his daughters – also HHS nurses – who encouraged him to become a virtual nurse. “They said I was always good with the young ones and happy to share my knowledge,” Sheppard says, adding that he has really enjoyed being a part of a team again, meeting new people, and getting re-acquainted with many old friends and colleagues.

SHARING EXPERIENCE AND MAKING AN IMPACT Any nurse at any HHS site can contact the Virtual N2N Support Line for help. Some of the reasons why a nurse might reach out for support include non-urgent clinical guidance questions related to their patient assignments, such as patient condition changes or medication administration, preparing for an escalation, understanding clinical scenarios or decisions, and policy or procedural inquiries. Nurses can also reach out for social support and to debrief with a peer during a challenging shift. If a concern is related to www.hospitalnews.com

MEDTECH 2023

a specialized area of patient care, the Virtual N2N team will help nurses get connected to the appropriate unit resources. “We’re a safe and non-judgmental sounding board for nurses,” says Creed. “We’re here to listen and use our experience and knowledge to provide relevant, timely and constructive guidance and support.” “I would tell a new nurse to call us for anything, even if it seems mundane, silly, or unimportant,” adds Sheppard. “We’ve all been rookies at one time and we’ve all had self-doubts. Nursing is a stressful job, and you can always give us a call, even if it’s just to validate that your thinking is sound.” Francesca Schaaf and Gillian Crawford are resource nurses at Juravinski Hospital and Cancer Centre who supported the Virtual N2N Support Line from its inception. “We see the

Jacqueline Mallari used the Virtual Nurseto-Nurse Support Line recently. Photo credit: Josh Carey Hamilton Health Sciences

support line as an extension of what we offer,” says Schaaf. “We feel good knowing that when we leave at the end of the day, there is someone that our staff can reach out to.”

“Given the staffing challenges that HHS and many other hospitals are facing, peer-to-peer support for new nurses at the bedside is limited,” adds Crawford. “The Virtual N2N Support

Line bridges that gap on night shifts and weekends.” The Virtual N2N Support Line is available to nurses at all HHS adult H hospital sites. ■

Alexandra Macgregor works in communications at Hamilton Health Sciences.

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MEDTECH 2023

North America’s largest medtech conference coming to Canada for the first time ever he Advanced Medical Technology Association (AdvaMed), Medtech Canada’s counterpart association in the United States, is bringing its annual MedTech Conference to the Metro Toronto Convention Centre on October 15-17, 2024. With this decision, organizers have chosen Canada to be the first host country for the conference outside the United States. The conference was originally scheduled to come to Toronto in the Fall of 2020, but the pandemic forced organizers to postpone its arrival on Canadian soil. The MedTech Conference, which is the largest medical technology-focused conference in North America, typically attracts more than 3,500 attendees and over 200 exhibitors from around the world each year for three days of educational programming, patient stories, technology showcases, networking opportunities and more. AdvaMed’s decision to bring the conference to Canada was based on

multiple factors, but a significant impetus is Canada’s strong medical technology innovation environment.

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The 2023 edition of the conference took place in Anaheim, attracting over 3,500 attendees from 45 countries and had a strong Canadian presence to build momentum for Toronto 2024. The Conference gathers the world’s top medtech executives and innovators to network and share insights in an engaging environment. The exhibit floor is also a key opportunity for health care providers to learn about new technologies and for companies to showcase their innovations. “We’re really excited for the Medtech Conference to come to Canada – it’s going to be incredible!”, says Nicole DeKort, President and CEO of Medtech Canada. “Mark your calendars – the entire health technology ecosystem in Canada will want to be a part of this event and in collaboration with our partners, we’re going to be showcasing what Canada has to offer.” In a video address to 2023 conference attendees, Toronto Mayor Olivia Chow said, “Toronto is a caring city – home to some of the world’s leading

hospitals, incubators and thinkers all working tirelessly to keep us healthy and strong while driving global innovation – you’re going to love it here. I know MedTech 2024 will fit right in, and I can’t wait to bring you all together here next fall.” The conference has previously hosted Canadian dignitaries such as the Hon. Pierre Fitzgibbon, Quebec’s Minister of the Economy and Innovation; the Hon. Nina Tangri, Ontario’s Associate Minister of Small Business; Patrick Brown, Mayor of Brampton; and Frank Scarpitti, Mayor of Markham. AdvaMed is working with Medtech Canada and other Canadian partners to ensure that the conference reflects and highlights the local Canadian medtech community, which is home to more than 1,500 medical technology companies. There will be a Canadian pavilion, as well as off-site tours being planned to showcase innovation adoption, collaboration, and R&D opportunities in Canada. To see learn more, visit: themedH techconference.com ■ www.hospitalnews.com

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NEWS

Reducing wait times through a collaborative approach t started as a collaborative project between UHN and Sinai Health. The goal: to provide fast, high-quality outpatient geriatric services that deliver better patient and system outcomes. “The need for geriatric care and rehabilitation services in Canada is rapidly growing because of our aging population,” says Lindy Romanovsky, Medical Director of MSK, Geriatrics and Complex Care Rehab at Toronto Rehab. “As health care system partners, we saw it is as our duty to better integrate our services to get ahead of the curve to serve more people sooner.” Now, after only a year of operation, this service has cut wait times in half by providing physicians with a centralized referral process that enhances patient flow across a number of outpatient and community-based services. The service is called the Geriatric Care Hub (Geri-Hub) – a partnership that involves the coordination of UHN and Sinai Health’s geriatric outpatient and community-based services in order to connect older patients with the right care, in the right place at the right time. “We are proud to provide a variety of specialized programming, but with so much choice, it can be challenging for referring physicians to know which services best align with their patients’ goals,” says Jennifer Mokry, Manager of Geriatric Outpatient Service Programs at Toronto Rehab. “With a centralized hub, we’re looking at how we can best meet each patient’s individual needs across the continuum of care through a single lens to give patients the exact care they need in a more timely matter.”

A PATIENT-ORIENTED CARE MODEL The way this plays out is as follows: instead of a physician making a referral to a specific geriatric service, they simply fill out the hub’s common referral form outlining the reasons for referral. Once the form is completed, the ex-

THROUGH THE GERI-HUB, WAIT TIMES FOR PATIENTS HAVE BEEN REDUCED BY UP TO 50 PER CENT FOR SOME GERI-HUB SERVICES, NOW ACHIEVING THE LOWEST WAIT TIMES FOR THE SERVICES ACROSS THE GREATER TORONTO AREA. perienced service coordinator at the Geri-Hub reviews the information and identifies the best specialized geriatric services to meet the patient’s needs. The hub hosts more than seven services between the two intuitions, including programs such as Falls Prevention and the Geriatric Medicine Clinics. Bindhu Sadasivan, service coordinator for the Geri-Hub, says this model has also helped with program optimization and flow. “By having real-time knowledge of referral volumes, team resources and wait times, we are able to make adjustments to our services and triaging pathways to be more responsive to our patients’ needs.”

CONTINUAL IMPROVEMENT ACROSS CARE TEAMS For older patients, lower wait times can make all the difference in their outcomes. “The health of an older patient can shift rapidly, so we are really aiming to provide services in the most timely manner to respond to their current concerns,” says Bindhu. “Geri-Hub services assist patients by helping to maximize their overall health and function, and by connecting them with ongoing community-based supports and services when needed.” Through the Geri-Hub, wait times for patients have been reduced by up

to 50 per cent for some Geri-Hub services, now achieving the lowest wait times for the services across the Greater Toronto Area. Propelled forward by this significant accomplishment, the Geri-Hub team has set their sights on a new goal: reducing wait times even more and creating new connections with other organizations to better provide a continuum of care for older adult patients. This includes Geri-Hub’s current partnership with Reconnect Community Health Services and the exploration of a partnership with The Centre for Addiction and Mental Health’s Geriatric Psychiatry Services. “We are focused on continuous quality improvement, and the work being done through the Geri-Hub is dynamic and constantly evolving,” says Bindhu. “The Hub has been instrumental in helping us to understand the geriatric population needs of our community, which has in turn allowed us to provide better service H outcomes.” ■

This article was submitted by UHN News. 36 HOSPITAL NEWS NOVEMBER 2023

www.hospitalnews.com

LONG-TERM CARE NEWS

Enhancing the patient experience with essential care partner programs ccording to research published in the Canadian Medical Association Journal, caregivers provide approximately 75 per cent of the care delivered in our healthcare system, making their roles vital for patients’ physical, emotional, and cognitive well-being. Different from visitors, caregivers play an active role supporting patients, assisting with a range of activities, such as emotional support, assistance with decision-making, meal preparation, dental hygiene, bathing, and changing clothes. Evidence shows that formally including caregivers as part of the care team improves not only the health outcomes for patients but decreases the risk of psychological harm and burnout for care providers as well. The Ontario Caregiver Organization (OCO), in partnership with Ontario Health, launched the Essential Care Partner Support Hub to help

healthcare organizations (with an initial focus on hospitals and long-term care homes) formally identify, include, and support caregivers as essential care partners (ECPs) – even during times of health system pressures. The Support Hub offers a trusted space for hospitals to gain expert guidance, coaching, and ready-to-use resources to build or enhance an ECP program – facilitating collaboration between ECPs and care providers to promote patients’ well-being and quality of life. At a recent session of OCO’s Learning Collaborative, an interactive forum for healthcare organizations with a focus on caregiver inclusion, Lakeridge Health shared how their Essential Partner-in-Care (EPC) Program helps to advance person-centred care and, in turn, enhance patient safety, while demystifying a common concern for care providers: that implementing the program will require extra work and risk consuming their already limited resources.

Marina Gaziani, Lakeridge Health’s Person-Centred Care Practice Specialist, explained how enhancing person-centred care through their EPC program isn’t about developing new systems, but about reframing their current approach with a new lens. “Consider how it looks different when, in the work you’re already doing, the EPC is embedded in it.” For example, EPCs at Lakeridge Health are critical to supporting patients’ safe transition home, which decreases the chances that they’re going to be readmitted into the hospital. By including EPCs as members of the care team, family members and friends can take care of tasks such as arranging safe transportation home, sharing proactive communication with care providers, and collaborating in care planning and decision-making. This has proven especially valuable when it comes to engaging caregivers who, without an ECP Program, may ex-

perience challenges in communicating with care providers which may then lead to frustration. This often leads to escalation through emails, phone calls, and meetings that ultimately require more time and resources from care providers. In an effort to engage more people with their EPC program, Lakeridge Health created a video where staff explain how the program works, including how EPCs play a crucial role improving health outcomes for patients, clients, and residents while enhancing the experience for all members of the healthcare team. If you’re interested in implementing or enhancing an ECP program, OCO’s ECP Support Hub offers guidance and coaching, leading practices, resources, tools, templates, and connections to settings and peers that have successfully implemented their own programs. Contact the Essential Care Partner Support Hub at ecpsupporthub@onH tariocaregiver.ca to get started. ■

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LONG-TERM CARE NEWS

Toronto Rehab partners with Baycrest in dementia support program obert Harker was an active member of a day program located on the same campus of the long-term care (LTC) home where he lives, when symptoms of his dementia started to intensify. That resulted in responsive behaviours, such as verbal intimidation, which were potentially putting him and others at risk in the day program, and in his residential home area in the LTC. When staff called his sister, Norma, who is also his substitute decision maker, the message was gentle but clear: if it kept happening, they’d have to transfer Robert to the hospital, where he would find the right psychiatric care. However, they said, he did need to be removed from the day program, which was a place offering him additional opportunities for social engagement and recreational activities.

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“I understand you can’t have someone being aggressive in that type of environment,” Norma says. “But at the same time I started to worry, thinking: ‘he needs this – what will happen to him?’” In the meantime, the nursing team at Robert’s LTC, Shepherd Lodge, started working behind the scenes, searching for person-centred solutions. That included connecting with Baycrest’s Virtual Behavioural Medicine (VBM) program and the team at Toronto Rehab. The result was dramatic. Within two months, Robert’s symptoms were being effectively managed, and Norma rests easier, knowing that her brother can continue to live comfortably in his own community. Toronto Rehab offers an inpatient Specialized Dementia Unit (SDU) and outreach services, to better support adults with advanced behavioural symptoms of dementia.

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It’s also the newest partner in Baycrest’s VBM program – an integrated service between Baycrest’s Pamela & Paul Austin Centre for Neurology and Behavioural Support, Inpatient Behavioural Neurology Unit, and Toronto Central Behavioural Support for Seniors Program (TC-BSSP). The VBM team sees patients through virtual visits over secure video networks, allowing patients to gain psychiatric support, in place, from wherever they call home. “We’re excited to be able to offer this new, innovative approach to patients because there is a growing need for our specialized services to support long-term care centres,” says Dr. Andrea Iaboni, geriatric psychiatrist at Toronto Rehab and Senior Scientist at UHN’s Kite Research Institute.

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“This program allows us to use the expertise we’ve developed on the SDU to help more people – and help them faster.” For Robert, that included his team of nurses and care providers at Shepherd Lodge and a lead from Behavioural Support Ontario, connecting for weekly virtual sessions with Dr. Iaboni, a pharmacist colleague, and two nurse practitioners (NPs). When possible, Robert and Norma would join the sessions, too. “The family side of the story is very important for us to make sure we’re treating the ‘whole’ patient and understanding their goals,” says Lynn Haslam-Larmer, one of the two NPs who started working with the SDU team as a geriatric psychiatry postdoctoral fellow. During the initial consult, the VBM team members say, “Take us through the day.” They want to know what’s happening, how often, what the indi-

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LONG-TERM CARE NEWS vidual’s triggers for the undesired behaviours are, and what coping strategies have already been tried. If medications have been tried, the team will look at what’s working and what’s not, and if they can align the medications to better suit the person’s behavioural patterns to optimize their effectiveness. “We’re always thinking and working with the LTC home to understand what they’re doing now and what they can do differently,” says Lynn. After the initial consult, the team from Toronto Rehab sends their recommendations to the LTC team, and then the NP regularly connects with the home for status updates. “That’s where our team really shines,” says Lynn. “We reach out weekly, and we’re on top of it. If things aren’t going well, we can loop in the pharmacist or geriatric psychiatrist in real time. It’s a faster response.” VBM recommendations can help manage a resident’s symptoms in the LTC and avoid admission to the SDU. In Robert’s case, adjusting his medications helped address the feelings leading to his verbal outbursts.

“Robert was getting agitated because he was feeling anxious,” says Lynn.

DEVELOPING NEW MODELS OF COLLABORATION “Every behaviour is a response to something else. If we can figure out why a patient is feeling anxious, scared or resistant to care, we can respond and help manage those behaviours.” The team members at Toronto Rehab say they know their work is done when the LTC staff feel armed with effective behavioural strategies, and the intensity and frequency of a patient’s responsive behaviours have reduced to the point where they no longer require one-on-one attention in LTC. They also feel good knowing staff in the LTC feel supported. “We see ourselves as complimentary to their work – walking with them, as they embrace our suggestions and try new things,” says Lynn. Robert’s success story demonstrates what is possible through partnerships within the health care community. “We are proud to expand Baycrest’s VBM program through this new partnership with Toronto Rehab,” says Scott

Ovenden, President and CEO, Baycrest Hospital and Long-Term Care Home. “The growth of this sector-leading program showcases the collaborative relationship with our system partners and our unified goal to provide innovative solutions for more individuals living with dementia.” It’s also a reflection of the impact programs such as the VBM can have

on the patient experience, hospital capacity and expertise within an LTC environment. “This new, innovative service has the potential to support more patients with dementia and responsive behaviours in their long-term care home and over time to build the skills and capacity of long-term care staff,” says H Dr. Iaboni. ■

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NOVEMBER 2023 HOSPITAL NEWS 39

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