A publication for Staff and Physicians of IH
A message from Chris Mazurkewich, Interior Health’s new CEO.
Ways you can stay engaged in your day-to-day.
Employees across IH volunteer their time and service around the world.
Enhanced Recovery surgical initiative puts patients at the centre.
Help the seniors and elders in your life.
Exercise crucial for people with COPD.
Featuring Debra Boone, and Nicola Valley Hospital and Health Centre.
Staff submitted photos from across our region.
Snapshots of our staff in action and trending health-care videos.
Brenda Lowe volunteers with the One Person Project in Africa. Story p. 6.
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 January 2016 @InteriorHealth magazine is Dec. 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
Six weeks in, and I have learned a lot in my new role as CEO.
Vernon and Kelowna; the newly opened Interior Heart and Surgical Centre that is serving all of IH; the expanded Over the last month in particular, I have emergency department at Kootenay Lake had the opportunity to chat with front-line Hospital in Nelson; and the ICU under staff and managers, physicians, construction at East Kootenay Regional volunteers, community leaders, and Hospital in Cranbrook. I was also able to politicians in many areas of Interior see the Clinical Services Building taking Health. I have also spent time touring shape at Royal Inland in Kamloops and sites, seeing firsthand the full gamut of hear the latest project update for our new the work we do. patient care tower at Penticton Regional Hospital. These capital investments allow I’ve listened to what people say about us to provide a higher quality of care in IH, noting the successes as well as the modern environments – a win/win for challenges. Overall, I’m impressed with patients, health-care providers, and our the progress made in the time I’ve been communities. away, and I am excited about the possibilities for the future. I’d like to touch on just a few highlights from what I have seen and heard. In Kamloops and Penticton, I was introduced to a couple of innovative programs, King Street Centre and Martin Street Outreach Centre respectively, where partnerships with local physicians have improved care for mental health and substance use clients by connecting them with the services they need, from primary care to specialists. And I was pleased to see that collaborative solutions have also proven to be the key to success in a number of other areas.
experience across our region to further improve the patient journey. And that’s how we can also maintain the momentum of “One IH.” Taking all of this into account – and bearing in mind the government’s expectation for health authorities to increase system integration, focus on key populations, and relieve pressure on acute care, while living within our means – I recently announced changes to our senior executive portfolios that better enable us to achieve our goals and meet key Ministry of Health objectives. You can read more detail in my Nov. 25 message to staff, and also take a look at our new organization chart to see functional responsibilities for each portfolio. In making these strategic leadership changes I can’t emphasize enough that it is only one piece that will help us to be successful – what really matters and what we are counting on is the people in IH. We need all of you – your innovative ideas, your clinical wisdom, and your energy – to build on the great job done over the last five years and accomplish even more.
Plant Services Manager Norbert Fischer shows CEO Chris Mazurkewich some of the equipment in the new ICU at EKRH in Cranbrook.
Princeton offers a great example of what can be achieved when all parties join together to work toward a common goal. I was energized by the positive changes in this community and how we worked with community leaders to develop a shared understanding of the complexity of the health-care issues, explore ideas, and develop a recruitment and retention plan for a stable physician complement. Along with that, a successful partnership with the Specialist Services Committee now has Penticton specialists coming to Princeton to see patients.
On top of the visible changes, other significant actions are improving quality of care by standardizing our processes and practices across IH. A focus on falls prevention initiatives, actions to reduce surgical site infections, and implementation of medication reconciliation programs to reduce errors and potential harms are a few excellent examples of the many quality initiatives implemented. I am excited about this progress and our continued work in this area.
In addition, I have certainly heard excitement and pride over the improvements to patient care that have come, or will come, through new spaces and structures. This came across clearly in my visits to the patient care towers in
The common thread in what I’ve seen since returning to the organization is the need to share and spread the learnings – to capitalize on the collective knowledge of people working across the system by Wishing you a happy, healthy holiday applying the best evidence and best season … and the best for 2016!
I will sign off by encouraging you to read on from here because the following pages tell your stories – and how health care is making a difference in so many lives. It’s “Every person matters” in action, from progressive community programs, to volunteering in other countries, to simply doing a good job every day and being a team player. And, it’s inspiring.
Name: Annette Borkent Worksite: Shuswap Lake General Hospital Occupation: Maternity Nurse Organization: Safe Motherhood Project Country: Guatemala For the 14th straight year, Annette Borkent will travel to Guatemala to teach traditional midwifery to birth attendants in the poverty-stricken country. It’s all part of the Safe Motherhood Project Guatemala, a member project of Rose Charities Canada that Annette and her friend Dr. Ruth Brighouse, a GP who specializes in obstetrics, pioneered in 2003. Annette was struck by the idea after volunteering as part of a medical surgical team in Guatemala in 2001 and hearing sad stories of traditional birth attendants helping in labour, often with no previous training other than their own personal experience. The result was higher infant and maternal mortality rates, often due to knowledge gaps that she knew she could help fill. To date, the Safe Motherhood Project has helped train more than 800 midwives, many of whom are now training others.
Annette
“It is a great privilege to respond to this call and work where there is such great need.”
Guatemala
A Helping Hand
“Everyone should have the rights to good health care, the opportunity for an education, and feel safe and loved.”
Name: Dr. Steve McVicar Worksite: KBRH, Trail Occupation: Orthopedic Surgeon Organization: Doctors Without Borders Country: Afghanistan
“There is no other experience that gives this kind of satisfaction while making a difference for so many.”
Dr. Steve McVicar volunteered his surgical services in the Kunduz province of northern Afghanistan with Doctors Without Borders in 2013 and then again in 2014. With his help, the first-ever orthopedic clinic in the region was built in an area filled with civil and military conflict. In his regular job at Kootenay Boundary Regional Hospital, Dr. McVicar sees about 10 to 15 patients a day. However, when he is in Kunduz, a typical day involves between 75 and 100 patients, many suffering from gunshot wounds, bomb blasts or car-crash trauma inflicted on Afghanistan’s notoriously treacherous roads.
Afghanistan
Tanzania/Rwanda Name: Brenda Lowe Worksite: Penticton Health Centre Occupation: Community Living Support Worker Organization: The One Person Project Country: Tanzania/Rwanda The inspiration for Brenda Lowe’s humanitarian work in Africa came after she lost her mother to cancer in 2004. “Shortly before my mom died, she reminded me that you never know what lies ahead in life and she emphasized the importance of following your dreams,” says Brenda. In 2006, she travelled to East Africa on a World Vision sponsor trip. When Brenda returned to the Okanagan, she and a group of supporters founded The One Person Project charity. The goal of the charity is to improve the lives of children and families living in poverty. Since 2007, Brenda has led seven trips with her charity and volunteers. They’ve sent four shipping containers filled with resources and equipment to Kahama, Tanzania; built an orphanage, which houses 50 sponsored children; and contributed to many other projects. Brenda’s charity is currently in the process of filling a fifth shipping container and is also working on plans to build a school.
F
or so long, surgery has been something we do to patients. Thanks to a grassroots quality initiative called Enhanced Recovery After Surgery (ERAS), that way of thinking is going by the wayside.
“Enhanced Recovery is about doing with patients, and not to patients,” says Garth Vatkin, IH’s Quality Improvement Consultant for surgical initiatives. “When patients are partners in their care, it results in better outcomes.”
before about what to expect with their surgery, before, during and after. They are really willing partners in their treatment and recovery.” Enhanced Recovery was introduced within Interior Health in 2011, through a pilot project at Kelowna General Hospital led by Dr. Ron Collins that focused on colorectal surgery.
Colorectal was chosen because research is strong in this area and indicated that patient outcomes can be improved by Enhanced Recovery consists of applying best practices through implementing an Enhanced Recovery program. a multidisciplinary approach, and is designed to help patients recover from major surgery more safely and easily than ever The principles of Enhanced Recovery are: pre-operative before. Every health-care professional who touches the patient patient education; narcotic sparing analgesia; avoidance is included and involved along the way, from initial of fluid overload; early mobilization; and early feeding. consultation in the surgeon’s office, to pre-surgical screening, to the anesthesiologist and OR staff, to the post-operative The actions associated challenge traditional practices, such as: recovery team, which includes nurses, pharmacists, carbohydrate loading before surgery, as opposed to starving physiotherapists, occupational therapists, and dietitians. patients; chewing gum in post-op, and feeding people earlier, to stimulate bowels; speeding up mobility by encouraging “This team approach has a huge benefit – it breaks down the patients to walk from the stretcher to their beds; silos between departments, so everyone works in conjunction, and removing the catheter earlier. with the goal of best patient care in mind,” Garth says. “Patients themselves take a larger role and responsibility Dr. Collins and his team began seeing positive outcomes from in their care. They are given more information than ever the work. Length of stay for patients started to decrease and patients expressed higher levels of satisfaction by being more involved and accountable in their care. “I think the real success of ERAS is that it demonstrates how a multidisciplinary team of committed front-line providers can positively impact the health-care system,” Dr. Collins says. “This initiative very deliberately mobilized patients to participate more actively in their own recovery, and they prove to be willing and capable partners. We also now clearly understand that many, if not most, complications can be avoided by changing the way we provide care.” Others in IH took notice of KGH’s
results. By October 2013, through the sponsorship of Doctors of BC’s Special Services Committee, ERAS had spread to six other hospitals across IH – Royal Inland Hospital in Kamloops, Penticton Regional Hospital, Vernon Jubilee Hospital, Kootenay Boundary Regional Hospital in Trail, East Kootenay Regional Hospital in Cranbrook, and Cariboo Memorial Hospital in Williams Lake. Each site has introduced ERAS in varying ways, depending on what best suited their individual site and patient needs.
”
Enhanced Recovery is about doing with patients, and not to patients … When patients are partners in their care, it results in better outcomes. RIH, in particular, was an enthusiastic participant and has shown great gains. Surgical site infections pre-ERAS were 13 per cent; those have been greatly reduced to just 4.6 per cent. Length of stay dropped to 5.2 days, from 7.6 before ERAS.
and best practice,” Donna says. “It makes it easy. Everyone knows the expectations and can see the results. Patients are going home in two-and-a-half, three days, and they aren’t coming back. This is excellent quality patient care that is patient-centred.” IH’s success with Enhanced Recovery has made it a provincial leader in the initiative. In November 2014, RIH and KGH joined the Provincial ERAS Collaborative, which is co-chaired by Garth and Dr. Collins, along with Dr. Ahmer Karimuddin, general surgeon at St. Paul’s Hospital in Vancouver. The Collaborative’s goal is that every patient undergoing surgery in B.C. will be part of an ERAS pathway as part of his or her surgical experience. Looking ahead, the next ERAS pathway likely to be introduced will be in urology, although there is no timeframe associated with its implementation. At the moment, RIH and KBRH have expressed interest in becoming potential urology sites for Enhanced Recovery. “People know this is the best way to practice,” Garth says. “We know that complications are avoidable, and improved ‘processes of care’ equate to improved results. We are all accountable for our patients’ outcomes – and the multidisciplinary approach of Enhanced Recovery has shown to result in positive outcomes.” For more information, visit enhancedrecoverybc.ca.
One reason RIH has been able to excel is that it has coupled its Enhanced Recovery program with its National Surgical Quality Improvement Program (NSQIP). NSQIP is a data-driven, outcomes-based surgical quality improvement program that enables hospitals to identify opportunities for improvement for patient care and outcomes. The program follows the entire surgical patient’s journey from pre-operative, through intraoperative, to 30 days after their surgery. Donna Lineker, RIH’s manager of Post-Anesthetic Recovery, Day Care Surgery and Pre-Surgical Screening, says the key to the Kamloops hospital’s success has been the teamwork of the care providers, championed by surgeon Dr. Tom Wallace. “It’s a group effort. The entire team is doing what’s best for the patient, based on good, scientific research
Enhanced Recovery After Surgery has been successful due to the multidisciplinary teams of health-care professionals working together and involving the patient in his or her care. Pictured here are some of the team members at Royal Inland Hospital (left) and Kelowna General Hospital (right).
E
veryone experiences a fall now and then.
While most falls do not cause serious injury, they can be devastating to older adults. Falls are responsible for more than 95 per cent of hip fractures and 60 per cent of head injuries. A senior is hospitalized approximately every 10 minutes in B.C. because of a fall. “My grandma fell in her home, broke her ankle and two ribs, was hospitalized and then moved to residential care. Sadly, this is a common story,” says Kelly Wilson, Quality Consultant for falls and injury prevention. “Forty per cent of admissions to residential care are due to falls.” Some people think falls are a normal part of aging. Others think they are random accidents and can’t be prevented. The truth is, falls are both predictable and preventable events. As health-care workers, we see the impact that falls have on our health-care system. “Older adults are our highest-risk population for falls and the number of seniors and elders in our communities is growing rapidly,” says Dr. Kamran Golmohammadi, Medical Health Officer. “Most older adults live independently in the community and we need to make sure they are aware of the simple steps they can take in their own homes to reduce their risk.” A new provincial website was launched last month to raise awareness on this important topic. Visit findingbalancebc.ca for tools and resources you can share with your patients, clients, residents, family, and friends.
Exercise = Breath W hen Tom Lund of 100 Mile House was diagnosed with a lung disease, he was determined to find the best way to keep on living well.
He lobbied for community supports for people with chronic obstructive pulmonary disease (COPD) and was first on the list to join Interior Health’s Lung Health community program. The exercise portion of the program is not as intensive as the men’s hockey he was playing, but it’s incredibly important for his current health status. “I was devastated when my doctor told me I couldn’t go into the arena anymore,” Tom recalls. However, rather than feeling sorry for himself, he looked for education and exercise that would help him expand his lung capacity. He found success with IH’s Lung Health community program, first in Williams Lake and then in 100 Mile House. Now he wants to make sure everyone else in his position takes advantage of an exercise program that is crucial for COPD patients. “Exercise should be like a religion for us. We must do our exercises every day,” Tom says. His own useable lung capacity has increased with exercise and medication. He describes the community program as invaluable, and he also likes the online support now available across Interior Health with a video series offering a clinically informed home exercise program. The Move into Health video series was developed by Interior Health’s Chronic Disease Management program and the UBC Okanagan Centre for Heart, Lung & Vascular Health to offer safe exercise options for people with COPD. Wendy Cameron, a new participant to the class, was also impressed with the videos. “They are a great place to start for someone newly diagnosed with COPD or too sick to leave the house.” Professional Practice Lead Dora Foote of Williams Lake says her Allied Health team members, including respiratory therapists, physio, and occupational therapists, will inform their homebound clients about the videos and help them work through the daily exercise and physical activity log that accompanies the videos.
but they will also benefit from the research-based exercise videos for the other days of the week. As well, some people not comfortable in group sessions will have the option of following a safe, well-researched exercise program at home. In 100 Mile House, the class of four men and five women are all enthusiastic participants in the Lung Health program. The session, held each Wednesday over 11 weeks, begins with an educational discussion. On the day we visit, Respiratory Therapist Barb Liness is talking about the Anxiety-Breathlessness Cycle for people with COPD and how to break the cycle. Twenty minutes of strengthening and stretching exercises with Physiotherapist Arjay Legua follow, and the class ends with a 12-minute walk around the warm halls of the 100 Mile and District Hospital and Health Centre. Oxygen levels, blood pressure, and pulse are monitored by Barb and her colleague, Respiratory Therapist Tammy Holland. “These two gals are worth a million bucks to us,” says Tom, to a chorus of “yes, they are,” from the class. “We all feel the same way.” Tammy says there are times when people in the Cariboo community aren’t able to make the weekly class because of weather and she is pleased to have the Move into Health video series to offer as an option. All the older adults in the Lung Health program are eager to improve their health with the support of experts. Like Tom, they have partners, children, and grandchildren to live for, as well as their own personal enjoyment of life.
“I hope all our family physicians are referring their patients with COPD to the community programs and now those She says clients are encouraged to join the group videos,” says Tom. “It’s just so imperative that we do the pulmonary rehabilitation program in the community as well, right kind of exercises.”
The creators of a progressive series of exercise videos for patients with COPD are thrilled with the end product that offers evidence-based support to professionals working with older populations with compromised health conditions. The exercises seem simple to the average viewer, but the Interior Health clinicians who worked with Dr. Neil Eves and his team from the UBC Okanagan Centre for Heart, Lung & Vascular Health know how carefully each activity was studied to ensure it was the safest and most effective movement for a vulnerable patient. The series of eight videos, called Move into Health, were initially developed to assist people who are home-bound after an exacerbation of their COPD, but IH Chronic Disease Management Practice Lead Cory Bendall says they are also suitable for people with other chronic illnesses and seniors, all of whom might benefit from a safe and effective exercise program developed with a clinical, evidence-based perspective. Ideally, patients work with physiotherapists, respiratory therapists, or family physicians to build a return-to-activity plan that will assist their strength, endurance, and confidence so they can successfully join pulmonary rehabilitation programs in communities across Interior Health. However, the videos, which feature actual clients from Interior Health, also provide detailed instructions to allow people to work individually through the eight videos. They are also accompanied by a daily exercise and activity log. Cory said the videos are also a valuable resource for our rural and remote communities where there are no formal pulmonary rehab programs. These resources will build confidence and strength so that people can successfully participate in community or municipal activity programming. Move into Health exercise videos can be accessed on the Interior Health YouTube channel.
Top: Respiratory Therapist Barb Liness (R), stays close to COPD client Genevieve Jensen during a 12-minute walk ending a session of the 100 Mile House Lung Health program. Middle: Led by Physio Arjay Legua and supported by Respiratory Therapist Barb, the group works on stretching and strength exercises. Bottom: Respiratory Therapist Tammy Holland, centre, is a big part of the success being experienced by COPD clients Wendy Cameron and Tom Lund at the Lung Health program. Both Wendy and Tom are excited to add the Move into Health exercise videos into their daily exercise routine.
Debra Boone, Nursing Unit Clerk @IH: When did you join IH? I started working in health care in July 1990. This year I will celebrate 25 years at Nicola Valley Hospital.
@IH: What do you do? I am a nursing unit clerk in our hospital. Because of its smaller size, I do a variety of jobs at the nurses’ station coordinating the work-ups for patients. I make charts, process doctors’ orders, and organize transfers to other facilities. I also do a lot of the non-stock ordering for the acute area.
@IH: Why is it important? I think it is important
because the nurses are very busy and I try to help them with whatever I can do to make their jobs easier. I am also here on a daily basis, so that helps with some consistency on the ward.
@IH: What do you enjoy about your job? There are
many things I enjoy about my job, but one thing that stands out is helping people. Doing whatever I can do to make patients’ and their families’ experience more positive. I also really enjoy the people I work with. I especially love working with the younger employees – they keep me up-to-date. They are a fantastic generation and I feel privileged to get to know them and work with them.
@IH: What makes for a really great day at work? A really great day at work would be going home knowing I have made a difference, either by having accomplished something or having helped someone.
@IH: Do you have a highlight or two? A highlight
@IH: What is great about where you work?
It’s hard to pick, as I feel there are so many. I love the small-hospital setting. I really enjoy working with the staff at Nicola Valley Hospital. Everyone helps each other, no matter what department. They all bring a different set of skills and gifts to the table.
from the last 25 years may be all that I have learned. When I started this job, I did not even have a computer, there were many more beds, and more staff. Although all changes are not @IH: Final thoughts? I hope that every day that I go always seen as good, I have come to see that all changes are to work, my eyes will be open to helping with the little things, also not always bad. I try now to embrace new things and see and that my attitude, my behaviour, and my choices will what I can improve on. create a positive experience for others.
Nominate a colleague, manager, or site for a future spotlight.
Nicola Valley Hospital & Health Centre
97,038
Pounds of laundry
3
10,795
Unscheduled ED visits
8
Acute beds
Stats gathered from 2015-2016 data.
Unit clerks
112
Employees
3,480 Trays of food
52
Years old
Peachland Submitted by: Jenalee Perepolkin
Cranbrook Submitted by: Sjaane Beattie
Cherryville Submitted by: Ben Rhebergen
Osoyoos Submitted by: Cindy Christianson
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 the InsideNet.
A contest initiated by Cranbrook Mitsubishi, and subsequent donation to the East Kootenay Regional Hospital's psychiatry unit in Cranbrook, resulted in $10,000 to purchase a variety of activity equipment. (L-R) unit clerks Danielle Evans and Rebecca Burnell challenge Cindy Golbeck, unit manager, and Liz Dimambro, RN, to a game of air hockey, one of the new items this generous donation has helped to purchase.
Two Kamloops public health nurses took a Baby Friendly message to the Cities Fit for Children Provincial Summit in Vernon on Nov. 12. The presentation by (L-R) Joanne Juras and Mary Hunter provided an overview of current strategies, as well as opportunities to promote breastfeeding in communities and identify as a Baby Friendly community through existing provincial and municipal programs. Cardboard cut-outs of breastfeeding mothers – created with funding from Make Children First – were part of the presentation.
Royal Inland Hospital went to the dogs recently, when its Pet Visitation Program held a meet and greet day with patients and staff. These beautiful animals bring much joy and comfort to patients in hospital – who couldn't help but smile when getting nose to nose with them? Many thanks to the dogs and their handlers for the countless volunteer hours they put in to make the days brighter at RIH!
Radon can seep into your home through cracks in floors, walls and foundations. You can't see it, smell it, or taste it, but it can be very harmful. Trusted contractor Mike Holmes and the radon dream team talk about radon and why it's important to get your home tested. Learn more testing for radon, visit www.radonaware.ca.
Every child and youth experiences stressful events in their lives. While not all stress is bad, it’s important to be able to recognize and take action when stress starts to have negative effects on a child’s thoughts, feelings or behaviour. BC Children’s Hospital has developed a free online resource called Stresslr that provides a fun and engaging way for children ages 9-11 to learn about stress. Learn more at www.stresslr.ca.
Between scooping up amazing deals and finding those perfect holiday gifts, your credit card is bound to get a workout this season – and many of those purchases will be made online. But the holidays are also the busiest time of year for another group of people – cyber criminals. Learn more about how to protect yourself when shopping online at Get Cyber Safe, www.getcybersafe.gc.ca.