A publication for Staff and Physicians of IH
A photo tribute to our CEO highlighting his time at IH.
Home hemodialysis program helps rural patients regain independence.
Teaching new employees the in’s and out’s of housekeeping in IH.
Multi-faceted prevention program helps reduce violence.
Buying B.C. produce has many benefits.
Hands-on program teaches students to enjoy healthy foods.
Featuring Anita Ely and the Salmon Arm Health Centre.
Staff submitted photos of the amazing place we call home.
Snapshots of our staff in action and trending health-care videos.
Staff using local produce in the kitchen at Penticton Regional. Story p. 12.
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 October 2015 @InteriorHealth magazine is September 11 Editors: Amanda Fisher, Breanna Pickett Designers: Breanna Pickett, Kara Visinski, Tracy Watson IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Megan Kavanagh, Breanna Pickett, Erin Toews, Tracy Watson
Every person matters
Renal patient Jack Brown-John hooks himself up to his home hemodialysis machine, under the watchful eye of partner Dianna MacQueen.
Home hemodialysis program helps rural patient regain his independence
J
ack Brown-John loves living in Horsefly, a rural community located about an hour east of Williams Lake. He was born there, works there, and loves spending time there with his partner, Dianna MacQueen, amid the abundance of hills, forests, and clear lake waters.
Jack, 58, is also a kidney patient. His kidneys have failed and he had been travelling three times a week to Williams Lake for life-saving dialysis to replace his kidneys’ function. Now, though, Jack can access care right in his own bedroom, thanks to Interior Health’s home hemodialysis program. “It has made it a lot nicer, the fact that I don’t have to travel anymore,” says Jack. “I just do dialysis in bed, where I’m comfortable, watching TV, or falling asleep.” Kidneys play an important role in the human body; they produce hormones, absorb minerals, filter blood, and produce urine. Those with kidney dysfunction must undergo regular treatment to cleanse their body of toxins that would
otherwise be fatal. This is usually done through conventional hemodialysis in a hospital or community dialysis unit; or through peritoneal dialysis, in which patients can have their treatments at home by instilling special fluids into their abdomen to remove toxins from the kidneys. The right treatment for the patient depends on the individual’s needs and the stability of his or her illness. But not every patient lives near a kidney dialysis unit or can tolerate peritoneal dialysis. In addition, for those people who have to drive, the cost of time and travel can also be a barrier to their care. However, for those whose health is stable and who are willing to take a greater role in their own care, there is the additional option – home hemodialysis at home. Like Jack, these people can do their own dialysis in their own home.
Described by Moses as a “crash course in dialysis,” the training included instruction on how to weigh himself and take his blood pressure, how much fluid should be removed on each run, and how to hook up, take down, and disinfect the hemodialysis machine that is permanently located in his home. Since employees aren’t footsteps away to provide support if something should go awry during treatment, Moses also taught Jack and Dianna how to handle unexpected situations. “Moses has been so amazing,” says Dianna. “He has a definite gift of making you feel really relaxed and comfortable. He made us feel at ease. There is the freedom and flexibility of being in your own home and your own bed. The whole experience has been wonderful.”
Recognizing that Interior Health covers many remote areas, the IH Renal Program, with the support of the BC Provincial Renal Agency, launched a new regional project in May 2015 focused on providing home hemodialysis training to willing patients who reside in rural communities. This initiative of providing training directly in a patient’s community as opposed to a major centre is a first for B.C. It was a collaborative effort with supplier Baxter to not only provide the supplies and machine to the closest dialysis unit to the patient’s home and then the home itself, but to provide ongoing support once training was complete. Moses Arcedo was hired as a regional home hemodialysis nurse. He travels around our health region training patients, and has discovered that patients are grateful they don’t have to travel and now have the flexibility of scheduling their own treatment. “Some do it at night while they sleep, or every other day, or short, daily treatments,” he says, with the treatment time varying depending on the patient’s needs and lifestyle choices. “Often, the more dialysis time people do, the better they feel. It’s also easier on the body to take off excess fluids over a greater timeframe.” One of Moses’ patients is Jack Brown-John, whose journey to kidney dysfunction was actually no journey at all – it was a roadblock, the result of a rare autoimmune disease that caused his kidneys to abruptly fail one year ago. Jack tried conventional hemodialysis, which worked well but was restrictive, given that he needed to travel so far to receive his four-hour treatment – two hours round trip each time. He tried peritoneal dialysis, but his body didn’t tolerate it well. Enter Moses, who recently spent six weeks training Jack and Dianna to perform home hemodialysis.
Moses standing with an independent home dialysis system.
Jack says it took time to learn and understand it. “But it seems quite simple now that I’ve done it a few times,” says Jack. “Moses is a good trainer.” Jack also says it’s important that he isn’t really alone when he’s at home dialyzing because of the “amazing” support system built in through Interior Health and the BC Renal Agency. “I am overwhelmed by all the help. There are probably six people we could call – the technicians who run the machines, the clinic in Kamloops or Williams Lake. They bend over backwards to help you.” These kinds of sentiments are music to Moses’ ears. He finds his work more rewarding than ever, because he’s helping people take ownership of their health again. “It’s giving somebody their independence back. Empowering clients to take care of their own health is a great reward,” says Moses.
E
ach fall, Jackie Marsh begins putting her materials together for another round of classes and students. Jackie is Interior Health’s Housekeeping Educator and Quality Control expert, a role she helped create when the Housekeeping School first opened at Kelowna General Hospital (KGH) four years ago. The Housekeeping School is exactly what it sounds like – a series of classes to teach new employees the in’s and out’s of housekeeping in a clinical setting. This academic approach wasn’t always how housekeeping was taught at IH. “Prior to the Housekeeping School, our training and orientation was somewhat hit or miss,” says Jackie. “New staff members were orientated by existing staff members who did not necessarily want to train or educate.” Jackie says this often resulted in varying levels of training being delivered. New staff members’ training was often skipped altogether, put off, or cancelled due to staff shortages. Overall, says Jackie, there was a real sense the process was not setting up new staff members for success. In conversations with her manager at the time, Juanita Yuill, Jackie proposed the idea of opening a dedicated Housekeeping School that would have designated time for education, instruction, and hands-on training. Juanita approved the idea and worked with Jackie to create the school with the first class held in November 2011.
Jackie Marsh (second from left) delivering a class to students at Kelowna General Hospital.
If you’re a new housekeeping staff member, attending the school for the first time takes three days. Two additional days of orientation is held with a trainer in a typical working environment. For existing staff members, a one-day, annual refresher course is held to ensure housekeeping skills are kept fresh. Jackie also travels to provide a mobile version of the Housekeeping School to employees from all corners of IH. To date, more than 50 staff from outside the Okanagan have received the education and training. Most are now providing that same education and training to employees in their own areas.
Since then, a total of 327 IH employees have passed through the Housekeeping School’s doors. Of those, 213 have been new staff and 59 were existing staff attending a mandatory annual refresher course. There have also been 12 employees who attended the school and received specialty training to allow them to train others.
So, what’s next for the Housekeeping School? Jackie says with the support of her current manager Lorne Cooke, the school will continue to grow and evolve. As new buildings and areas open, IH will continue to hire new housekeeping staff members who require the school.
Jackie says these “trainers” are selected because they are passionate about educating new staff and making sure everyone is on the same page. “They are often chosen to orientate new staff because of their knowledge, work ethic, and passion for training and educating.”
She also says the processes, chemicals, and technologies regarding housekeeping duties are always changing. This means the classes and training also need to continually evolve to ensure all housekeeping practices are up-to-date and employees are educated and knowledgeable.
O
n a warm summer afternoon, a patient in the Shuswap Lake General Hospital emergency department was becoming increasingly agitated.
He had been brought in under a mental health warrant, assessed by a physician, and was awaiting transfer to a larger site to receive the appropriate level of psychiatric care. His doctor had ordered medication and he needed to be sedated, but his delusions and frustration were increasing and his behaviour was erratic. This would be no easy task.
Mark estimates the hospital has about four or five code whites each month. The team is highly multidisciplinary, with employees from virtually every hospital department trained to recognize risk and de-escalate violent and aggressive behaviour. Code White, a provincial standard, is a response that a health-care site has to an aggressive incident. What that response looks like is different at each site depending on the nature of the facility, but the focus is always de-escalation and prevention.
Recognizing a situation that could quickly escalate, his nurse called a proactive Code White via the overhead pager. Several Code White team members – employees from throughout the hospital with special training – arrived to assist.
“Preventing violence is a priority for everyone. Ministry, Worksafe BC, the unions, and the health authorities have been working together, recognizing how important safety is for our patients and staff,” says Shannon Campbell, Workplace Health & Safety Lead.
Acute Health Services Manager Mark Pugh was one of the team to respond that day.
Since 2008, Interior Health has been developing the Violence Prevention Program, which includes tools and resources such as the Site Violence Prevention Workplace Risk Assessment Process and standardized Code White responses.
“The end result was that the patient was able get the medication he required in order to be transferred to a higher level of care to deal with his psychiatric needs,” “Several years ago, Worksafe BC funded the Health Safety in he says. Action initiative, which developed five projects. The Violence Prevention Curriculum was one of them, so since 2012 all Our front-line staff work closely with patients, residents, and health authorities have the same educational platform,” says families, often in difficult situations. Stress, medication, Shannon. mental illness, dementia, or drugs can all play a factor in violent incidences. While the risk of violence in health care “We’ve also implemented the Aggressive Alert system, which can never be completely eliminated, within Interior Health uses a variety of means to communicate risk associated with the number of violent incidents in acute care has decreased a particular patient or resident and includes further over the past three years and the rate of injuries to staff per education about violence prevention.” incident is down. This is the result of better prevention practices and training and hands-off interventions. In addition to these efforts, capital investments in personal alarm systems and video monitoring are ongoing. Every “I have been involved in many code whites and they tend to inpatient psychiatry unit has some form of personal duress have good resolutions,” says Mark. “It’s very rare that button. All new facilities in Interior Health have built-in fixed they develop into a hands-on scenario, or that someone gets alarm systems located in rooms, hallways, and nursing injured.” stations.
Left: Duress badges, such as this one worn by Jolene SteevesEschyschyn at Hillside, and fixed code white buttons help employees call for help. Right: Shannon Campbell and Trevor Speed work together along with others to reduce violence within the workplace.
“Alarms are a way to call for help when something goes wrong, which is important for our staff and part of the regulations. However, it doesn’t prevent such incidents,” says Trevor Speed, Manager, Protection, Parking and Fleet Services. “Our focus remains on prevention and education – understanding warning signs in individuals, watching for changing behaviour.” Interior Health is moving into Phase 2 of Health Safety in Action, which focuses on ensuring all staff in the high-risk areas (emergency and mental health) are 100-per-cent trained in the basic provincial violence prevention classroom education by the end of 2018. Visit Interior Health’s Violence Prevention Program on InsideNet for more information and resources, including supports for staff who have experienced a violent incident.
Four high priority health-care sites in B.C. will be safer thanks to collaboration between the Ministry of Health and the BC Nurses’ Union (BCNU). As part of the Ministry's Violence Prevention Action Plan, the Ministry and BCNU have each committed $1 million to fund violence prevention at sites that deal with some of the province’s most complex patients. The first four priority sites are Hillside Centre in Kamloops, Forensic Psychiatric Hospital in Port Coquitlam, Seven Oaks Tertiary Mental Health in Victoria, and Abbotsford Regional Hospital. Additional sites are expected to be selected by this fall. Staff and leadership at the four sites have identified priority actions to improve safety that will be carried out over the next few months. Each site has a plan tailored to its specific needs and challenges, developed in consultation with the Ministry, the BCNU, and other unions. For Hillside, the plan includes increasing staffing levels to ensure employees can safely care for patients, as well as introducing new and improved training and education. Refinement of the personal staff alarm and video security systems are also anticipated. More information is available on the BC Government News website, including the complete news release and backgrounder.
T
hese days, there is a growing movement to buy local food. Aside from environmental benefits and support for the local economy, there is something so rewarding about biting into a juicy peach at peak season, purchased from a farmer who lives down the road. But for an organization the size of Interior Health, which provides about five million meals each year across 55 sites, buying local isn’t such a simple matter. Food safety is key, logistics are a challenge, and the financial implications must be weighed. Still, leaders within Interior Health believe it is important to buy fresh local food and support the local agricultural industry. “We have been working steadily with suppliers to take advantage of all the great food that is grown, produced, and processed right here in B.C.,” says Alan Davies, Interior Health Regional Director of Support Services. “We use as much locally grown produce as possible in our care homes and hospitals, plus cheeses, herbs, sausages, and more. We also highlight locally grown foods on our cafeteria menus, such as Armstrong carrots. We try to purchase as many fresh fruits and vegetables in season as possible. Overall, there has been a shift within Interior Health’s Food Services to provide fresher meals, with less sodium and using sustainable, green practices in our kitchens. “We’re always looking at new areas in which we can purchase locally,” he continues. “I would estimate that about 25 per cent of the produce we buy is locally grown, depending on seasonal availability. If you include bread and dairy, I would say about 30 per cent of all our food is purchased from within B.C.” Interior Health works closely with food distribution company Sysco to ensure food is not only of good quality and locally sourced when possible, but also that strict food safety measures are in place. “If a recall occurs, we can have every customer notified within a two- to three-hour period,” says Ryan Thiessen, Sysco Kelowna Account Executive.
Penticton Regional Hospital kitchen staff with local produce.
Sysco only buys products from farmers who are certified GAP (Good Agricultural Practice). GAP codes, standards, and regulations have been developed by the international food industry, governments, and non-governmental organizations (NGOs) to provide consistent food safety and quality standards, as well as meet requirements for certain trade needs and niche markets. “Over the years, more co-ops have been established and more farmers are signing on to GAP, so we can take advantage of those items being available,” says Ryan. “We can pretty much guarantee a B.C. apple about eight months out of the year.” Growers such as Kelowna-based Angelo De Simone and his son Pierre, of De Simone Farms, are an important part of that supply. “It’s very good to see more people interested in buying local food, including large organizations like Interior Health. It means fewer greenhouse gas emissions and support for family-run farms like ours,” says Angelo. “We are doing what we can and we encourage others in the community to look at their own purchases. B.C. has so much to offer in terms of buying locally produced food,” says Alan.
I
homemade granola, fruit and yogurt parfaits, mini pizzas on whole grain pitas, smoothies with assorted fruits and greens, black bean quesadillas, and roasted vegetables.
Children are not strangers to the game; they strategically counter with manoeuvres designed to create the illusion of eaten vegetables – moving veggies around the plate, “accidentally” dropping them on the floor or discreetly feeding them to the family dog.
Simone adds that feedback from educators, parents, and the students themselves shows how well the program is working.
t’s dinner time and an all-too-familiar scene plays out in homes across the region. It’s the “eat your vegetables” game. Parents bring out all their best moves – they try to disguise vegetables, dress them up or give them creative names in hopes those veggies will be eaten.
If this sounds familiar, you are not alone. Simone Jennings, public health dietitian, says that encouraging kids to eat healthy foods like vegetables can be challenging, but there are ways to create interest without trickery and game playing.
Students are encouraged to smell, touch, and taste different ingredients during recipe preparation while following food safety guidelines.
“We continually hear stories about how excited students are about their next class and parents tell us they see a ripple effect at home as their children show more interest in eating healthier foods and cooking.”
Cook it, Try it, Like it! was developed and piloted in Kamloops in 2011. It has since become an integral part “Research shows that if a child is involved in preparing of after-school programming offered in that community. a food, that child will be more likely to try it,” says Simone. Its success can be contributed to the ongoing partnership “When we get kids chopping, stirring, and handling between the City of Kamloops, Kamloops Thompson School different foods, they are more likely to want to try them District, and Interior Health. – and that includes vegetables.” Since the pilot, Simone and her public health dietitian That’s the motivation behind Cook it. Try it. Like it! colleagues have worked with their community partners – a food skills program designed to provide elementary across IH to expand the program. This includes schools school students with hands-on experience cooking and throughout School District 73 including Clearwater, tasting nutritious food. Students learn about nutrition, Barriere, Blue River, Heffley Creek, Logan Lake, and Chase how food is grown, and where it comes from, while also and it continues to grow. learning valuable lifelong skills such as safe food handling, food preparation, and grocery shopping. Seven schools in the North Okanagan are now offering the program in conjunction with community agencies. “With the increasing availability of packaged and With the help of grant funding from the United Way, ready-to-eat food, children are becoming less exposed to the upcoming school year will see the program expand cooking nutritious meals. The overall goal of this program to Merritt, Ashcroft, and Cache Creek. Expansion to the is to improve food skills in children to help them build a Kootenay region is also being explored. foundation for lifelong, healthy-eating habits,” says Simone. To learn more or for information on how to implement the Cook it, Try It, Like It! program in your community, During the classes, students prepare a healthy recipe check out the comprehensive Program Leader’s Guide and take part in a lesson. Recipes include things such as on our website.
Words of Wisdom (according to a kid):
Anita Ely, Environmental Health Officer Anita works at the Salmon Arm Health Centre as an Environmental Health Officer. She’s been with us for 11 years as an employee, but she started even earlier as a summer student in 2000.
@IH: Tell us about your role as an Environmental
Health Officer. As an Environmental Health Officer (a.k.a. EHO or Public Health Inspector), I am a part of the Healthy Built Environment Team of Health Protection. The primary function of an EHO is to protect the health of the public by ensuring the environment in which people live is safe and healthy. We are known mostly for preventing communicable disease transmission by focusing on safe food and water. However, with chronic health issues on the rise, a shift is occurring to protect the public from chronic illness. This is the focus of the Healthy Built Environment Team. Studies have demonstrated that the way a community is designed has a direct effect on the health of its residents. Our team provides advice to local governments and other agencies about how a proposed community design or a proposed development could impact people’s health, and suggests alternatives from a population health perspective.
@IH: Do you have any particular interesting projects that you’re working on? One thing I’m working on is to raise people’s awareness of radon gas, which is the leading cause of lung cancer for non-smokers in Canada. This gas can only be detected by testing and is relatively simple to correct in a building if it is detected. Our team has been coordinating radon testing of daycares and other public buildings for radon gas as a means to increase awareness. The IH Radon webpage shows the simple steps to test your home for radon gas
@IH: Why is your work important?
My work and the work of my colleagues helps ensure people don’t get sick in the first place.
@IH: What is most enjoyable about what you do? Teaching and working with others. To persuade others
to adopt a healthier environment or behaviour, we do one-on-one and in-group teaching or by correspondence.
@IH: What makes for a really great day at work?
Being informed that a project for which we’ve been advocating and promoting for a long time has come to fruition, because then I know the affected residents will be healthier because of it, which makes all our hard work worthwhile.
@IH: Do you have a highlight or two of a successful
project or something you helped implement that has made a difference at work or in your community? There are a few things. A big one was seeing Anglemont residents receiving safe drinking water after being on a Boil Water Advisory for 10-plus years. Also, providing support to residents and participating in emergency response during the 2012 Sicamous Flood event. And, of course, coordinating radon gas screening as part of a larger radon awareness project.
@IH: Any final thoughts, or words you live by?
I try to take time to remind myself about all the people, moments, and things that I appreciate in my day-to-day life in order to reduce stress and be more content.
Salmon Arm Health Centre
117
Active employees
6,217
3,142
22,666
Population area served
$29
Home health and community care visits
Cost to test your home for radon gas
Gathered from 2014-2015 data
Mental health and substance use visits
80%
Of B.C.’s health-care budget devoted to supporting chronic conditions
Kelowna Submitted by: Glenn Coello
Barriere Submitted by: Ken Sedore Arrow Lakes, Castlegar Submitted by: Wayne Stupnikoff
Ashcroft Submitted by: Jessi Minnabarriet
Where We Live & Work ... A Spotlight on Our Communities Covering more than 215,000 square kilometres, Interior Health is diverse in nature and composed of vibrant urban centres and unique rural communities. Photos are submitted by employees and posted to the InsideNet. Select photos are featured in @IH.
Submit your photos of the beautiful places that make up IH on InsideNet.
Trinity Care Centre residents were busy the past two months painting decorations to adorn their "Don’t Worry Be Hippy" themed bus for the recent Penticton Peachfest Parade. The residents had a great time and especially enjoyed the loud applause they received from the many spectators.
The International Committee of the Red Cross has commended Kelowna General Hospital emergency nurse Dawn Anderson (centre) with the prestigious Florence Nightingale Medal. The award honours those who have shown exceptional courage and devotion to victims in a natural disaster. Dawn’s achievements include serving as an emergency nurse in Gaza, where she assisted children in dealing with living in a conflict zone as well as improving overall emergency room management.
On July 31, an accident sent 57 patients to Royal Inland Hospital, prompting the hospital’s Incident Command System protocol to engage. As the incident wound down, those in the Command Centre commemorated their teamwork with a selfie: (L-R) Sandy da Silva, Tracy Watson, Donna Lineker, Sandy Semograd, and Jayme Scott. Kudos to all RIH staff and physicians on their great response that night! Learn more about emergency preparedness in IH at InsideNet > Emergency Response Planning > Site Emergency Response Plans.
Mark Henick is a mental health advocate and youngest member of the board of directors for the Mental Health Commission of Canada. Here he shares his personal story about suicide. Sept. 10 is World Suicide Prevention Day. Learn more at International Association for Suicide Prevention, www.iasp.info.
A Finnish man wanted to show what it is like to live with HIV-related stigma and at the same time raise awareness of HIV. Would you have touched? Learn more about what IH is doing to increase HIV awareness and reduce stigma at www.myhealthissexy.com.
IH Community Nutritionist Rose Soneff recently worked with Shaw TV in Kamloops to create a series of videos on healthy eating. The videos pack a lot of great information into just two to three minutes. Check them out on our YouTube channel under the Healthy Living playlist.