A publication for Staff and Physicians of IH
Dr. Halpenny talks about our organization as he sees it from his day-to-day perspective.
Preparing for the 2015 Employee Engagement Survey, we want to know what each Gallup Q12 question means to you.
IH and community partners work together with complex clients. For Ashley, it’s been life saving.
Coordinating MS services across Interior Health.
Kelowna unit provides highest level of care for youth with mental illness.
A stroke leaves John, a professional speaker, unable to speak. John shares how speech therapy helped make him whole again.
Nurse practitioners join multi-disciplinary teams at five residential care sites in IH.
IH certifies the first two Lean implementation specialists from its in-house program.
Shining a spotlight on the many communities that make up where we live, work, and play.
Snapshots of our staff in action over the last month.
Kathy Lepp (L) and Brigette McMaster provide quality care to residents living at Pleasant Valley Manor. Story p. 16
The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: IHAcommunications@interiorhealth.ca Deadline for submissions to the June 2014 @InteriorHealth magazine is May 13. Editors: Amanda Fisher, Breanna Pickett Designers: Breanna Pickett, Kara Visinski, Tracy Watson IH Communications Contributors: Lisa Braman, Lesley Coates, Susan Duncan, Karl Hardt, Erin Toews, Tracy Watson
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e’re on YouTube! I never thought those words would excite me – but I couldn’t be happier to appear alongside dozens of IH employees in a new video sharing the message “I am the Patient Experience.” Dr. Halpenny participates in the making of “I am the Patient Experience” – a video featuring IH employees in support of Patient Experience Week.
At Interior Health, we want to set new standards of excellence in the delivery of health services in B.C. and to also promote healthy lifestyles and provide needed health services in a timely, caring, and efficient manner. To achieve this, we are guided by the following strategic goals: Goal 1 Improve Health and Wellness
Goal 2 Deliver High Quality Care Goal 3 Ensure Sustainable Health Care by Improving Innovation, Productivity, and Efficiency Goal 4 Cultivate an Engaged Workforce and Healthy Workplace
The articles featured in the @IH newsletter are great examples of how we’re achieving our goals … and realizing our vision and mission.
The video, created by the Quality, Risk and Accreditation team and partners, supports Patient Experience Week (April 28-May 2). The message reinforces that no matter our role, we all form part of the patient’s experience. I urge each of you to remember this every day because, as evidence shows, when we partner with patients to improve their experience, the result is improved health outcomes.
Earlier in April, I presented at the joint meeting of IH and the local regional hospital districts (RHDs). I was pleased to share updates on our telehealth, Stop HIV, and cardiac surgery programs, and proud to tell them that we had (again!) been honoured as one of B.C.’s top employers. I also used this opportunity to introduce the RHDs to the Ministry of Health’s strategic direction document, Setting Priorities for the BC Health System. I’ve referenced Setting Priorities in this space previously, and I hope you have found some time to take a look at the document as it sets out the Ministry’s eight priorities – the first of which is providing patientcentred care.
Those priorities were reinforced at a meeting I attended with our Board Chair, Improving population health, enhancing Norman Embree, the other health patient and provider experience of care, authority board chairs and CEOs, the and reducing the costs of providing health deputy minister, and the Minister of care are the system outcomes outlined in Health on April 15. It is important that the IH Strategy Map. The Senior Executive we not only understand the priorities, but Team’s (SET) commitment to these that we also have a clear plan of how we outcomes was reinforced at a recent are going to achieve those priorities. On planning day on April 24. This day that point, there are still significant details provided SET and the Health Authority to come. Medical Advisory Committee (HAMAC) with an opportunity to look at where we An important piece of any discussion on are and where we are going in terms of priorities is, of course, budget. As I shared quality and patient experience. in my April 22 memo, the final reporting period for Interior Health’s 2013/14 fiscal The IH quality journey was also the focus year closed on March 31. The results to of my presentation to the Interior Chapter this point indicate that we are in a positive of Canadian College of Health Leaders position and will meet our goal of a (CCHL) on April 29 in Kelowna. The balanced budget. This is due to focused Interior Chapter enables health leaders efforts across the organization to help us to connect and collectively advance achieve the majority of budget strategies issues that are important in their local put forward in 2013 as well as realizing communities. Providing the chapter with additional savings through reductions a picture of our quality improvements in discretionary spending (e.g., travel – e.g. establishment of the Medicine & restrictions, education restrictions, hiring Quality portfolio; implementing Clinical freezes, etc.). I thank everyone for Care Management Guidelines; introducing helping us achieve this. the National Surgical Quality Improvement Program; and obtaining accreditation with Going forward, our goal is to live within commendation – reminded me yet again our means, while continuing to improve how dedicated IH employees are to quality through the programs and providing high quality health care. services we provide.
your
opinions
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Which level best describes where you are in Maslow’s Hierarchy of Needs, and what would motivate you to be fulfilled and move to the next level? Visit the Engagement web page on the InsideNet to view the complete list of responses.
“I picture myself as a large tree near a brook, with my roots growing deep within the ground. Even though the wind may blow (life’s uncertainties) I am not moved because my roots are deep (strong values and beliefs).”
“I love my present position and can honestly say I have many best friends at work. I have personal growth and fulfillment. I fall into the higher levels in many ways…”
“I am at the level of self-actualization. I enjoy personal growth and being able to know and acknowledge when this happens.”
In June 2015, we will once again be asking staff to take the Gallup Engagement Survey. There are often uncertainties behind the meaning of the Gallup Q12 questions. So, in each @IH issue leading up to the next survey, we will pose each Q12 question and ask what it means to you. Keeping this in mind, the topic for June discussion is:
I know what is expected of me at work. Please send your feedback to YourOpinionsCount@interiorhealth.ca and we’ll share excerpts in the next @IH, along with a new topic for discussion.
Patient STORY
ast year, Ashley was addicted to crystal meth and either homeless or in jail. This spring, she has hope. Although her pretty green eyes show the struggles that continue within, her demeanour suggests she wants to make something of her life. “My goal is to have my own normal housing where no one tells me what to do,” she says, as she sits chatting during an interview in a local coffee shop.
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You don’t really overdose on crystal meth. You just go insane.
The transformation has not been easy for Ashley, or for the Intensive Case Management (ICM) team in Kelowna who works with her. It may not even last, which is the way with complex mental health issues and addiction.
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For right now, though, her supporters – and they are extensive – celebrate her successes day-by-day. When Ashley was released from jail in October, she had nowhere to turn. She was banned from almost every service in Penticton. Even the mental health agencies that had helped her for years were no longer open to her because of the behaviours provoked by her meth highs. But the Penticton Mental Health team was not ready to let this 29-year-old fall through the cracks. They referred her to their Kelowna colleagues. Sarah, ICM’s Therapist Assistant, says the best way to describe the widespread efforts to help Ashley is to quote Registered Psychiatric Nurse Mike, who has been her primary contact since she was added to his
caseload in the fall. “Mike said it takes a community to care for Ashley, and he has encouraged everyone to come to the table for her.” The ICM team was set up through the Ministry of Health’s Accelerated Funding initiative, which supports the most complex mental health clients who have severe mental, physical, and often substance abuse conditions, all of which regularly land them in a hospital ER. Ashley talks openly about her life of despair. “I have a drinking problem and a pill problem. My mom and dad are drug addicts. I lived in foster care for two and a half years. My boyfriend sold me meth and it was bad. You don’t really overdose on crystal meth. You just go insane.” She has three sons, aged 2, 7, and 10, who she is not able to see, but she has their photos framed on the wall of her new room in supportive housing. Their names are tattooed on her shoulder. “Good looking boys,” says Mike. “Thank you,” Ashley responds softly. “They are my three soldiers. I call them that because they’re strong like me.” She admits she can be difficult to handle. She doesn’t like rules. But she is happy to have her own living unit and Mike congratulates her efforts to make it a comfy, homey place. How she got her new quarters is a story in itself. She was not doing well when she first arrived in Kelowna. She was in a women’s shelter, but “that didn’t last long because she is so unmanageable when she uses meth.” She ended up back in hospital and after she was stabilized, she went into a psychiatric facility, which is primarily for
We are Kelowna’s Intensive Case Management Team! We work with complex mental health and substance use clients to keep them safe, housed, and healthy.
At Outreach Urban Health in Kelowna, I work with complex clients every day.
CONNIE
JASON
SARAH
MIKE JON
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seniors. She was very unhappy there and caused chaos. She constantly told Mike he had to get her out of there. A room came available at a low-barrier supportivehousing complex, but another client was slated for it.” The ICM team really advocated for her because if she ended up on the street, it would start all over again,” says Mike. “Jon, the social worker on our team, agreed her needs were greater.” Her primary care team at Outreach Urban Health (OUH), who has known Ashley for years, is thrilled at her success so far. “Right now, she is the most stable I’ve ever seen her,” says Connie, the RN at OUH. She says Ashley’s future is dim if she is on the street. Her poor body can only take so much. Currently, under Mike’s supervision, Ashley is taking her medication, and attending appointments with her psychiatrist, alcohol and drug counsellor, and her GP at OUH.
Ashley’s had a tough life, but her IH and community teams won’t give up on her.
“I’m on this sticker thing,” Ashley says. She earns points toward a $20 gift card to a store of her choice, usually Dollarama or Wal-Mart. Her desire to fix up her room motivates her to co-operate. Her most recent purchase was a plant. “I want a bookstand now to put ornaments on. I just have to follow the rules.” Mike says Ashley has had tremendous support from the health system and many community agencies such as Community Living BC, Living Positive Resource Centre, and John Howard Society, both in Penticton and Kelowna. His involvement with her, through ICM initially, meant almost daily visits for months. It’s only recently that he has been able to move into a support role. By now, though, he and Ashley have a strong connection. “I would have said a long time ago that I liked him the least of everyone, but I like him now,” Ashley smiles, with a little twinkle.
This current level of stability has also recently helped reduce the number of times Ashley has been admitted to KGH Emergency Department.
Connie says everyone wants to help Ashley because when she is not high, her sense of humour and her inner, sweet nature shines through.
Ashley’s low frustration level and her dislike of rules make her highly confrontational. Staff in her housing facility say it was rough going at first, until they came up with an incentive program.
But her lifestyle, along with her mental health issues, has left her very medically compromised. The integrated primary and mental health care team was basically her final option. Now, it’s up to Ashley.
C
heryl Daniels is a lifeline.
Oh, she would never likely characterize herself this way. But for patients living with multiple sclerosis within Interior Health, Cheryl is the nurse whose work is dedicated to helping with the management and treatment of their disease. Cheryl coordinates multiple sclerosis (MS) services across Interior Health. This includes face-to-face contact at IH’s three MS clinics located in Kelowna, the Kootenays and, most recently, in Kamloops. It also includes remote support by phone or email, whether daily, monthly, or anything in between. It’s work that Cheryl knows is vital and important, but she stops short of saying she’s the tie that binds it all together. “I don’t see it that way. I’m just doing my job!” says Cheryl, adding that her reward is not from the thanks she gets, but in seeing her patients supported and comfortable. “The MS health-care team does its best to provide the best care and support possible to people living with MS. Together, we make a difference.”
RN Cheryl Daniels coordinates MS services across Interior Health, meeting patients face-to-face as well as supporting them by phone or email.
At the three clinics, Cheryl, who is MS certified, and a neurologist, educate patients about their disease and discuss symptoms and treatment.
Multiple sclerosis is a disease in which the immune system attacks the brain and spinal cord: the two components of the central nervous system. This can result in loss of muscle control, vision and balance, and can cause numbness. It’s a chronic, progressive illness and, while there is treatment and management for it, there is no cure yet.
When it can help support their symptom management, Cheryl will also help link patients with resources such as a physiotherapist, social worker, mental health worker, housing and income assistance, mobility assistance, and speech language therapy for swallowing issues – in short, anything that can help patients enhance their quality of life.
An estimated 1,200 patients in IH have been diagnosed with MS, and about 900 are actively and regularly receiving symptom management and support for this specialized disease through IH services.
“The MS Clinic provides a coordinated service to help meet the needs of those with MS, their families and friends. The goal is to preserve and maintain quality of life, which is defined by the individual,” says Cheryl.
“Through specialized medical care, education, and support, the team of MS professionals walk the MS journey along with clients. We may be more or less involved with clients from time to time. We are always there to listen, lend a helping hand, or redirect them to get the help and support that they need.” In Kelowna, the MS Clinic is held at Kelowna General Hospital and led by Dr. Scott Meckling and Dr. Dermot Adams. It serves patients from the Okanagan to points as far as Williams Lake, Castlegar, Trail, and Nelson. Drs. Meckling and Adams also travel with Cheryl to outreach clinics based in Cranbrook to reach patients in the East Kootenay. These clinics occur twice a year, fall and spring, with the physicians each spending a week at a time with patients. They also will travel to Creston when required. The Kelowna and Kootenay clinics have been in service for more than a decade. Recognizing there was a growing population of patients in IH West traveling to KGH for MS support and treatment, Interior Health launched a clinic at Royal Inland Hospital in Kamloops in June 2013. Supported by Cheryl and neurologist Dr. Mudassir Iqbal, the RIH clinic is held about 10 times per year, approximately once per month, with breaks in December and the summer. The clinics are usually held over two days and, in the time between clinics, Cheryl provides
ongoing support by telephone. Cheryl says patients are appreciative of the RIH clinic. There have been many new referrals, both through new diagnoses and because patients are becoming aware of the Kamloops service. Some, who were travelling to Kelowna, or even Vancouver, are changing their treatment to RIH.
“MS is a challenging disease. There is no cure.” “MS is a challenging disease. There is no cure. No two people with MS have the same disease – it is unpredictable, and patients have fear and uncertainty,” Cheryl says. “Many patients are feeling better supported closer to their home with the RIH clinic.” More information on MS services at IH can be found at www.interiorhealth.ca.
Kelowna Unit Provides Highest Level of Care for Youth with Mental Illness
(L-R) David Haiwronsky, Connie Melnyk, and Dr. Michael Ocana are part of the team at Interior Health's Adolescent Psychiatric Unit.
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t is 11 a.m. and Occupational Therapist Tara Walters is busy pulling items from the cupboards of the clean, bright kitchen. She’ll be helping youth in Kelowna General’s Adolescent Psychiatric Unit make their own pizzas today, along with homemade Caesar salad.
The meals, prepared as a group, are healthy in more ways than nutrition alone. By participating in meal preparation and eating together as a group, these young cooks are learning life skills and developing important social skills. Nobody would argue that life as a teenager can be tough, but for these teens managing home life, school work, and relationships, is an overwhelming struggle. They have complex mental disorders. Some are house bound due to agoraphobia (anxiety disorder), while others are at risk of suicide or self harm. Some are out of contact with reality or have severe mood disorders. In B.C., about one in seven young people will have some form of mental disorder at any given time. Effective support is critical because most mental disorders (about 70 per cent) surface before the age of 18. The Adolescent Psychiatric Unit (APU) at KGH is one of five tertiary mental health programs for young people in the province. The eight-bed inpatient unit serves those aged 12 to 17 within Interior Health. “I had a hard time opening up about depression and anxiety,” says 20-year old Tyler Exner, who spent four weeks at the APU when he was 16. (cont’d on p. 12)
(cont’d from p. 10) “The nurses, staff and doctors were incredible there. Everything started to come together. It was probably one of the most memorable moments through my mental health recovery. The staff really put time and effort into making sure you are happy and comfortable, and there were lots of activities like mini-golf, field trips, walks, and visits to parks," he says. “The program is made up of a group of committed and passionate staff and physicians who really care about supporting positive mental health for youth,” explains APU Manager Colleen McEwan. “While a youth is on the unit, they, and their family, will work with child psychiatrists, a psychologist, an occupational therapist, social workers, registered nurses, registered psychiatric nurses, and youth care counsellors who specialize in caring for youth.”
Occupational Therapist Tara Walters gets ready for a group lunch, another opportunity for youth to work on skills at the APU.
The unit is located on the fifth floor at KGH and a quick glance through one open doorway reveals a light-filled bedroom with expansive views over Okanagan Lake. Beside the kitchen is a bank of computers available for youth to use. It is a social media-free zone, a disappointment to some, but important for confidentiality. Besides, there is no shortage of other activities including outings, art, video games, books, basketball, and foosball. The unit also includes a classroom where a teacher and support worker help youth continue their school studies. There are family meeting rooms, a secure quiet room, and a sunny outdoor patio. “These are youth with complicated mental health problems. They are here for assessment and diagnostic clarification. We spend time observing and building trust. We use a collaborative problem-solving approach. It takes time and resources, but it allows us to work together in the face of what appear to be ‘behaviour problems’ to find mutual solutions,” says Medical Director Dr. Michael Ocana, one of two psychiatrists with the APU. “In this way, we learn more about our clients, build trust, and have reduced need for medication and almost no incidents of seclusion.” Many of the youth have longstanding problems that are not expected to resolve completely during their time in the APU. “An important part of the program is working closely with our community partners in Child and Youth Mental Health, referring hospitals and physicians to support the youth and family when they return home,” says Colleen. For more information and resources: IH APU information page and Family Smart – raising awareness on May 7, National Child & Youth Mental Health Day.
This is my story. Stroke survivor and speech therapist patient John Knapp on how, 42 weeks later, he prefers to think about how far he has come.
Written by John Knapp
Something is wrong. Dizzy, cloudiness in my brain like a giant head rush – I hit the floor with a loud thud! Karen runs up the stairs. I can tell by the look on her face and anxiety in her voice that she is scared. I am conscious and can receive and process sight and sound. “What’s wrong?” she asks in tears. I try to respond again and again, without success. I can form the words in my head, but I cannot utter them. My right side also seems to be numb.
Thirty-six hours after my stroke, my oldest daughter drops in for a visit. “Hey, kid,” I say out loud. I can talk! The two words were spoken very imperfectly, almost as though I were inebriated, but they were audible and coherent enough for her to understand. Later that day, a hospital speech therapist comes to do an assessment. I can say a few words, but much of what I try to say comes out like baby talk. I can’t form the s sound. Nor can I make the sounds we associate with f, v, r, th, sh, and many other compound sounds like br, cl, tr, etc.
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t’s 6 p.m. I am unusually weary. I walk in the door after another long day at the office. I greet my wife, Karen, and we share an intimate recap of our day’s highlights. I head upstairs and start changing.
The hospital therapist explains that with therapy and practice I may Within minutes I am in an ambulance. At the hospital, be able to make my family gathers around me. I hear and watch as the good progress. emergency doctor talks on a large screen with a stroke I can tell that she expert. “Yes,” he says. “Administer it immediately.” It doesn’t want to get was the clot-busting drug. my hopes up too high because she discusses a range of progress, all the Within a half hour I can form a strong fist and have way from partial recovery over several years to full regained full movement of my right side, but not everything recovery in less than a year. is right. End of day three and I am out of the hospital. A few days Twenty-four hours after my stroke, I still can’t say a word. later I go to my first speech therapy session. I don’t know I am communicating by e-mail to both my family and my what to expect. Speaking out loud has been an important office but I can’t talk. I am also having trouble swallowing part of my professional career. I am anxious and somewhat and the right side of my face is drooping. embarrassed about my reduced state.
24 hours after my stroke, I still can’t say a word.
The stroke specialist explains that the clot has destroyed the cells in a small part of my brain. But thanks to neuroplasticity, I may be able to help my brain build new pathways that partially or fully compensate.
To my relief, I discover quickly that my therapist is pleasant, professional, and empathetic. She works slowly and sympathetically with me, assessing which sounds I am having trouble with. We work on exercises that will help me retrain my brain to clearly articulate those sounds.
I am amazed at her patience. Before I know it, our session is over. She gives me exercises to work on and we book a second appointment. I emerge from my first therapy session tired because she has pushed a little, but emotionally up. I know I made some genuine progress over the past hour. While my therapist made me work hard, the whole experience was characterized by support, encouragement, and care. Three days later, I return, having worked diligently on my exercises. I am rewarded by the spontaneous delight of my therapist when she discovers I can now say the sh sound, as in shine. We continue to work hard over the next hour.
John and Vernon Jubilee Hospital speech therapist, Patricia Mallet, practice speech sounds using a mirror for visual feedback. This technique encourages John to match Patricia’s lip, teeth, and tongue shapes to achieve increased clarity of speech.
I begin to sense that her professional experience has given her the uncanny knack of pushing me to the edge, but not beyond my limits. I begin to understand how I need to stretch myself to make progress. Over the next several weeks, I am rewarded by big smiles as I begin to clearly articulate r, f, and v sounds. I always leave my sessions tired but encouraged. More weeks of hard work with my therapist follow. Fourteen weeks after my stroke I approach the first big test. I have to deliver a 30-minute address to a live audience of 600. Most of them know I have had a stroke. The event seems to go well and people approach me after to tell me they can’t believe how much progress I have made in so little time. More weeks of hard work with my therapist follow. I now have to deliver the keynote address at a large conference. I receive two standing ovations. Those who know me well say they couldn’t hear any sign of an impediment. I am jubilant, but know myself that I am only 97 per cent recovered. Strangely, I hear again and again from people that they
can detect the three per cent deficiency when I am interacting face to face but over the phone, or through a microphone, they can’t detect it at all. Curious. Forty-two weeks after my stroke, I am now fully weaned from seeing my speech therapist. I continue to do my exercises every day, as I work on that last three per cent. I realize that from here on, reverse logarithms will apply to the amount of work I have to do to make ever-diminishing gains in recovery. But I’m okay with that because I’m almost there. As I reflect on both my progress and my positive interaction with my speech therapist, I become conscious of a gentle epiphany about the whole experience; it has been a shared journey. My part of the journey was simple – hard work and persistence. My speech therapist had the more complex role of diagnosing my specific deficiencies, correcting them with exercises, pushing me to stretch myself, all within a framework of steady encouragement. The degree to which I am whole today is due in large measure to the skill, professionalism, and energy she brought to her part of the journey. For this, I will always be thankful.
NPs
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Pleasant Valley Manor resident is complaining of a sore leg and that has the full attention of Nurse Practitioner Kathy Lepp. She’s going to book an urgent ultrasound to rule out a blood clot.
When she has set up that appointment, the NP for residential care is off down the hall and up the stairs to another section of the residential care facility in Armstrong to check the blood pressure of a 93-year-old woman.
DEPTH elevated heart rate, and showing other signs of distress. Navy logs in to Meditech, where she is able to call up his latest medical tests, including blood work and a recent chest X-ray. After carefully reviewing all his symptoms with the nurse, she asks for a urine test and prescribes medication to alleviate the immediate concerns, but she’s not completely satisfied.
This resident is mentally cognizant and, through conversation, discovers Kathy is looking after another resident at Parkview Place in Enderby, who was a former neighbour when they were both raising their families. “Say hi to her for me,” says the tiny woman, clearly frail, but eyes bright and happy to have learned about a connection to an old friend. “I will,” Kathy promises. That was a straightforward case today, but Kathy, who started working as an NP last August, has discovered simple cases with elderly people are few and far between. “Most residents have multiple chronic diseases often with an overlay of dementia, so they can’t always tell us how they are feeling. They also don’t have symptoms you would normally expect. They could have full-blown pneumonia without any signs other than perhaps a change in behaviour. We have to figure it out for ourselves. I feel like I am always trying to solve a puzzle,” she adds. Kathy’s colleague in Kamloops, Nurse Practitioner Navy Sahota, agrees that caring for frail elders requires using every skill learned in their nursing careers, which makes her even more appreciative of the multi-disciplinary team approach to providing care for these complex patients. Kathy and Navy are the first nurse practitioners to be hired for a residential care practice in Interior Health. The positions came open through the NP4BC program and their presence is welcomed by residential care staff and physicians alike. Navy’s caseload consists of residents from Ponderosa Lodge and Overlander residential care sites. Her diagnostic skills are put to the test on the day we visit at Ponderosa Lodge. She receives a call from a nurse at Overlander who is worried about a man who is running a fever, has an
Nurse Practitioner Navy Sahota is a new team member at Overlander and Ponderosa Lodge residential care sites in Kamloops.
“I am going over to Overlander because this is the second call today about a resident who is not doing well. I want to have a look at them both. I don’t want them to go to the ER. I want to treat them there.” Both Navy and Kathy enjoy the team atmosphere at the residential care sites. They respect the knowledge each person – physicians to nurses to care aides – brings to the bedside. “Staff are amazing in these sites,” says Navy.
“They are so dedicated and they know these residents really well. We all work together with the families to figure out best care for our residents,” adds Kathy, who also covers Bastion Place in Salmon Arm.
A major goal for NPs in residential care is to enhance care through a shared-care model with physicians and staff. The NPs both note that partnering with the GPs is important, specifically when issues arise that are outside of the NP scope of practice.
Brigette McMaster, Residential Care Coordinator at Pleasant Valley Manor, is equally pleased with Kathy’s role.
“We also want to decrease the use of anti-psychotic medications and be on site to deal with urgent issues and “We are so happy she is here. Initially, we wondered manage acuity right here to reduce trips to the ER,” says how a nurse practitioner would fit in, but she complements Kathy. our team so well. We don’t have to wait for a physician because Kathy is here. She’s present and can diagnose In a bright sitting room at Pleasant Valley, a very old a problem and prescribe medication, or another option, woman is adjusting a bonnet around the head of a life-like immediately.” doll. Her weathered hands that likely once caressed her own babies gently touch the doll’s cheek. The same realization is happening at the Overlander and Ponderosa Lodge sites as staff learn more about how the “We’ve found that if female residents in particular are NP can support their residents. having some behavioural issues, they calm right down when they are given a doll,” Kathy explains. “It’s important to try various approaches, rather than go directly to medication.” Since Navy started in her residential NP role in January, she has acquired 30 patients on her caseload. They were either unattached to a family physician or referred to her by a physician. She is also available for Overlander or Ponderosa Lodge residents belonging to GPs. “I really enjoy geriatrics and being the primary care provider for my residents. It’s great that staff are able to call on me to get immediate care for people who can be so compromised with many conditions from diabetes, heart failure, COPD, frailties, and hypertension, and almost all with dementia of one stage or another.” Kathy and Navy are also in regular contact with each other to discuss approaches to difficult cases. They constantly seek out new ideas, because what works for a while with this specialized population often stops working and something else must be tried. “We are partners in this,” says Navy.
Nurse Practitioner Kathy Lepp makes sure new blood pressure medication is providing the desired results for a frail elder.
Kathy and Navy are two of 35 nurse practitioners working in Interior Health. NPs also work in community and acute settings. They will join with the registered and licensed practical nurses employed by Interior Health to celebrate National Nurses Week from May 12–18.
Nurse practitioners provide health-care services from a holistic nursing perspective, incorporated with diagnosis and treatment of acute and chronic illnesses, including ordering tests, prescribing medications, and performing specific procedures within their legislated scope of practice.
Certification through IH’s Own In-house Program
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journey of self-improvement is difficult, but we take it because we know we will be better for it in the long run. When Interior Health decided to “go Lean,” it was for the same reason – the good of our patients and staff. The idea behind Lean implementation is to eliminate activities that do not add value to our clients and cause staff an unnecessary burden. Although one of the benefits of Lean is that it often results in a savings of time or resources, the end goal is really about improving the quality of services we deliver. In order for Lean principles to take root, leaders must first create an organizational culture that is receptive to Lean thinking. “Lean is not a temporary trend or a way to reduce costs,” says John Johnston, VP People & Clinical Services. “It’s about thinking and acting in a new way and, like any transformation, it can take time.” An important part of that journey is ensuring there is ongoing support and leadership across Interior Health to model Lean principles and “walk the walk.” That’s where the Lean Promotion Office’s in-house certification program comes in. It’s an in-depth education program geared toward those who will act as leaders, coaches, mentors, and teachers of the Lean philosophy throughout the organization. As the leader of the Lean Promotion Office, Erin McGarvey knows all too well that “going Lean” requires significant planning and involvement.
(L-R) Beverly Sieker, KGH Health Service Director, Surgical, Women’s & Children’s Services; Renee Caillier, Lean Promotion Office Consultant; Nichola Deakin, KGH Manager, Perioperative Services; and Andrew Hughes, KGH Health Services Director, Medical, Mental Health & Utlization.
on patient care; changes which everyone can be proud of.” The program reached a milestone recently by certifying its first two Lean implementation specialists – Nichola Deakin, Manager Perioperative Services at Kelowna General Hospital, and Shelley Smillie, Manager Volunteer Services, Quality Improvement Consultant, and Operational Support at Penticton Regional Hospital. “I’d like to congratulate Nicky and Shelley for their hard work, dedication, and passion,” says Susan Brown, VP Acute Services. “Their expertise will not only result in increased efficiency but will also improve the quality of care we provide patients and provide a positive work environment for staff.”
“This certification program is based on a combination of intense theory and practical application of the concepts and principles of Lean, which takes about 10-12 months Currently there are 17 additional leaders enrolled in the to complete,” she says. “Lean is a mindset of continuous certification program, with more candidates completing improvement, but changes made will have a lasting impact certification in the coming months.
There are many who think that an improvement methodology that originated in the manufacturing world couldn’t possibly work in the health-care setting because, after all, patients are not widgets. However, Lean has been applied successfully in many different areas throughout IH. One example is the dedicated staff at the Larissa Yarr Microbiology Lab in Kelowna who participated in a Lean event in March 2013. This event focused on the flow of wound specimens from time of receipt into the lab to the time the final report was complete. From this work, 41 improvements were trialed resulting in increased flow within this process and faster turnaround times – improving the service to clinicians and patients.
Healthy Community
Lumby
Lumby is the little village that could. The Village of Lumby signed a partnership agreement with Interior Health’s Healthy Communities Initiative in February of 2013. Since then, it has been moving full steam ahead in promoting the health of residents.
Third year UBCO nursing students have recently played a key role by working with IH, School District 22, and the Canadian Cancer Society to survey local high school students about tobacco use. They also introduced a mentoring program at the school by creating the resource binder and participated in a presentation about Lumby going smoke free to the Village of Lumby Council.
At a glance Population: Approx 1,700 (6,000 with surrounding districts) Health Services: Lumby Health Centre, as well as community and residential programs and services. Economy: Tourism, service, manufacturing, and agriculture.
Lumby has now embarked upon a new adventure in health promotion, proposing a health bylaw that would prohibit the use of tobacco products by anyone on municipal property, including parks, trails, and sidewalks, to demonstrate healthy behaviour to youth and children.
In our own words...
“I’ve worked in Lumby for nine years, and I love it. This is a small town, so small there are no traffic lights, just one blinking red light in the centre of town. I would describe Lumby and Cherryville as communities that rely mostly on farming and ranching to keep the economy going. I enjoy the diversity of the work out here. As the only public health nurse in town, I get invited to a number of different tables, so I feel like a valued participant in community development. The infants I saw during my first baby visits nine years ago, I am now seeing as grade three students in the local elementary school. That’s a feeling that is difficult to describe.” – Heather Serafin, Public Health Nurse, Lumby Health Centre
McCulloch Lake Submitted by: Donna Fazan
Stump Lake Submitted by: Lianne Berst Arrow Lakes Submitted by: Kelly Waage
Cranbrook Submitted by: Sjaane Beattie
Where We Live & Work ... A Spotlight on Our Communities Our employees regularly share photos of the spectacular scenery that surrounds them wherever they are in the IH region. Majestic mountain ranges, pristine pine-fringed lakes, blossom-filled orchards, abundant vineyards, and thick forests alive with wildlife are just some of the beautiful things that make up these places we call home. Covering over 215,000 square kilometres, Interior Health is diverse in nature and composed of vibrant urban centres and unique rural communities. This @IH feature shines a spotlight on many of these places ‌ and perhaps will entice you to add them to your travel wish list. This month we feature photos near Cranbrook, Kelowna, Merritt, and Castlegar.
Submit your photos of the beautiful places that make up IH: InsideNetWebmaster@interiorhealth.ca
snapshots from the region ... The staff who work on the 9th floor at Royal Inland Hospital were hoping their “Beach Day” on April 11 would help usher in the summer season. Here, those from Human Resources, IH Renal, Quality Improvement, Housekeeping, CIHS, and Communications are ready to bring on the heat in their beachiest wear.
Staff in the East Kootenay incorporate fun into the workplace with “Spirit Day,” which takes place on the first Friday of every month. Carla McDonald, EK’s new Administrative Services Coordinator, did a test run of “Spirit Day” on April 4 by engaging her admin staff. She chose the theme “team attire” and discovered a solid display of spirit as staff, like this Sparwood team, don their favourite team jersey. Carla encourages all staff to participate in “Spirit Day” at their own sites.
April 10 was “Wacky Clothes Day” at David Lloyd-Jones Care Home in Kelowna. Leisure department staff including (L-R) Volunteer Coordinator Dolorese Rudnicki, Therapy Assistant Yvonne Svensson, Therapy Assistant Lisa Wynn, and Recreation Therapist Jen Schellenberger sported their wackiest ensembles while vying for a prize and bringing smiles to residents’ faces.
Simulation facilitators recently gathered at the Clinical Academic Campus in Kelowna for the annual “Simmitt,” a planning day for the IH Mobile Simulation Program. The program uses highly realistic, computerized mannequins and/or real people to simulate patient care situations similar to real experiences in practice. For more information about the Mobile Simulation Program and the Pritchard Simulation Centre, contact Simulation Coordinator Shelly Koochin at 250-980-1378.
The Kootenay Smoke-Free Coalition presented on Smoke-Free Communities at the Association of Kootenay Boundary Local Governments Conference in Creston on April 9. Local government delegates later visited the coalition’s booth for more information and to peruse QuitNow materials. Presenters (L-R) included Trish Hill, CIHS Tobacco Reduction Coordinator; Kerri Wall, CIHS Community Health Facilitator; and Jenny Byford, Canadian Cancer Society. For more information about smoke-free parks, playgrounds, and beaches in your community, email tobacco@interiorhealth.ca.
This dynamic team from the IH Professional Practice Office worked hard to bring the 2014 Rural Health Services Research Conference to fruition. Pictured here are (L-R) Katrina Plamondon, Paula Araujo, Bonnie Ressler, and Holly Buhler. Check out more conference photos on the IH Facebook page.