A publication for Staff and Physicians of IH
Newcomers WELCOME
A personal look at Interior Health’s five key strategies.
Ways you can stay engaged in your day-to-day.
Staff are encouraged to self identify as Aboriginal or non-Aboriginal.
Committed to quality care and safety.
Working together to provide enhanced care in mental health.
Helping first Syrian family navigate health services.
Featuring Activity Worker Simon Hilton and Arrow Lakes Hospital.
Staff submitted photos of places in our region.
Snapshots of our staff in action and trending health-care videos.
Mustafa, Yamen, and Ineam have their first medical appointment with Nurse Practitioner Colleen Regehr. 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 March 2016 @InteriorHealth magazine is Feb. 9. 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
Interior Health has identified five key strategies for shifting the health-care system, but I don’t view the proposal for change from the perspective of strategies, policy, or imperatives.
Martin McMahon shares a personal perspective on IH’s five key strategies.
For me, and I hope for all of you, it’s personal. It is about the community we live in; the kind of health care we want; the kind of service our families and friends deserve. It’s about a cultural change across the health-care system that responds to something Canadians have been telling their leaders and health-care providers for years. Our system of care has been built over decades with successive governments and professional associations all having different views on what was important for patients. However, I think we have reached both a consensus and a “tipping point,” if you will, that care should be centred around the patient.
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 Goal 2 Goal 3
Goal 4
The articles featured in the @IH newsletter are great examples of how we’re achieving our goals … and realizing our vision and mission.
The five key strategies are visionary to some, to others they are common sense. To me, they are personal. We know that if there is an alternative, people universally want to avoid being admitted to hospital. We all recognize that we may have to go to an Emergency Department or into a hospital bed while an acute medical episode is managed, but none of us want to stay there for any length of time. Patients and caregivers have been saying loudly and consistently that they want support and services as close to home as possible so that they can stay independent and lead purposeful lives. When you are sick or weak, your energy should be focused on getting better and not unnecessarily expended on efforts to navigate through our complex streams of care. These are some of the things I wanted when I was recovering from meningitis just a year ago.
As care providers, we have the opportunity to help – to offer the right kind of supports at the right time and we can make it purposeful, coordinated, and dignified. This is what the five key strategies seek to achieve – coordinated care, focused around the individual. As Vice President of Integration and Strategic Services, I have corporate responsibilities to support the successful outcomes of these key strategies. But my passion for shifting this system to be patient-centred and community-based comes from my personal life as a son, a husband, a father, and a patient myself. When I saw how the system in Scotland worked to fulfil my dad’s wish to die comfortably and with dignity in the same bed his wife died in and in the house where they lived together for 65 years, my commitment to make change deepened further. We are going to be challenged to think and organize our services differently to ensure that support and care are designed around what works best for the patient. This will increasingly mean opening up access to services at different hours and different days of the week. I believe every person working in the health-care industry will see the worth of these strategies if they consider what it means for them. Let’s bring it down to the nuts and bolts of where we live – this is our community, this is about our families, our friends, and our neighbours. That’s how I view our five key strategies and why I am committed to their successful outcome. I also believe every single person who works for Interior Health shares these same desires and can help make the health system more responsive to how people want their care provided.
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rowing up in the Nuxalk Nation on B.C.’s remote north coast, Kirsten Tallio was always taught to honour her elders.
“In our culture you give high regard to the elderly,” she says. “I was raised by my grandparents and was taught that from a very young age.” Now, in her work as an LPN with Home Health in Kamloops, the teachings of her grandparents are at the forefront as Kirsten provides care and support for frail elders in their homes. Kirsten is one of more than 700 employees who have self-identified as Aboriginal since June 2011 when Interior Health’s Aboriginal Self Identification initiative was launched. Home Health Team Leader Kirsten Tallio (R), with Linda Giles, is one
“I really enjoy community care. I feel I can provide care of over 700 employees who have self-identified as Aboriginal to date. in a very personal way. I enjoy getting to know our clients well and spending that one-on-one time with them,” says Kirsten. “I think it’s really important for our Aboriginal “We know the availability of Aboriginal health-care patients and clients to have Aboriginal people working here professionals is linked to improved health outcomes for and providing care. Aboriginal people,” says Brad. “There is a great opportunity to meet the human resource needs of our organization while also supporting the health-care needs of our communities.”
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I think it’s really important for our Aboriginal patients and clients to have Aboriginal people working here and providing care. “If you look at something like pain level, or other issues that are bothering them, sometimes people may not tell the truth. They may view it as complaining, which is not their custom. But if I start talking to them about what band they are from, their family relations and cultural practices, they feel more comfortable and open up more.”
The Aboriginal Self Identification initiative supports various elements of the Aboriginal Health and Wellness Strategy, as well as the Aboriginal Human Resources Strategy. “From a staff perspective, I think it’s important to see other Aboriginal staff and to hear their stories. I find it inspiring,” says Kirsten. “I’d love to eventually become an RN, and knowing others have been on that journey and accomplished their goals is inspiring.” Visit the Aboriginal Self Identification Project on InsideNet to learn more about the initiative. Collection of employee Aboriginal Self Identification information is completely voluntary and does not impact your employment in any way.
Brad Anderson, Director of IH Aboriginal Health, says the self identification information helps develop and implement To voluntarily update your status, visit i-Site and click on Aboriginal human resource strategies that encourage Request/Change My Information > Change Aboriginal Aboriginal people to pursue health-care careers. Identification from the My Information menu on the left.
Just a few of our accreditation champions (L-R): Reed Scott, Lia Briceno, Sherry Belanger, Lisa Davidson, Nial Helgason, Jamie Kyle, Kaylie Holdsworth, Megan Cail, Darlene Miller, and James Chan.
WE’VE DONE IT AGAIN
THANKS TO YOU! IH recognized for commitment to quality care and safety
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or Interior Health, accreditation is all about striving to improve the services we provide to patients, clients, and residents. In September 2015, Accreditation Canada visited many of our sites and spoke to countless staff and physicians.
The results are in. Following successful site visits, Accreditation Canada has awarded Interior Health with the achievement of Accredited and has high praise for our commitment to quality care and safety. Who helped get us there? Just look around you. “Kudos to our staff and physicians! Quality is at the core of the work you do every day, and this achievement reflects your energy and commitment to high-quality, patient-centred care,” says Chris Mazurkewich, IH President & CEO.
“In IH we believe that every person matters. This was clearly demonstrated to our accreditation surveyors throughout their interviews and site/program visits. I am proud of IH’s quality improvement progress and look forward to our continued efforts on this journey.” When evaluated according to the national standards, IH is definitely making the grade. This thorough evaluation involved 16 surveyors visiting 39 of our facilities and assessing 19 service areas. IH met 95 per cent of the 2,200 criteria used – an impressive accomplishment!
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Quality is at the core of the work you do every day, and this achievement reflects your energy and commitment to high-quality, patient-centred care.
“A considerable amount of work and energy went into preparing for our on-site visits,” says Lia Briceno, Accreditation Leader. “I personally know how dedicated teams have been and I’d like to thank everyone for their commitment to the accreditation process.” In their debrief presentation after the visit, the surveyors highlighted a number of organization-wide strengths they observed, including: increased community engagement; improved access and care transitions; our investment in education; our approach to health equity; the focus on Clinical Care Management guidelines; standardization at regional and provincial levels; our engaged Board of Directors; the pursuit of client and family-centred care; and being an “employer of choice.” They also identified opportunities for improvement in areas such as: developing leadership; focusing on the aging population; managing change fatigue; de-cluttering our work spaces; and escalating strategies to turn data into action. Accreditation Canada requires organizations to submit evidence on unmet Required Organizational Practices (ROPs) and other unmet high-priority criteria observed during the on-site survey. Teams across IH have initiated plans and actions that address identified gaps and ensure that improvements are sustained. The Quality, Risk and Accreditation Department will ensure our organization continues our work on accreditation as part of our central focus on quality. “Accreditation isn’t an event for IH, it’s more of a process that helps us focus our improvement efforts, employ leading practices, and further advance our quality journey,” explains James Chan, Manager of Quality and Patient Safety (IH East & Central) and Accreditation. “I would also like to commend everyone for their attention to accreditation. The sense of caring and the pride in the work we do was noted by our accreditors and is visible to all the people we serve.” View the full report for more details or visit the Accreditation web page on InsideNet.
Better Together Enhancing primary and community care for mental health clients
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uinn Smith has not had an easy life.
With a past history of drug use and an ongoing struggle with alcoholism, his life was made even more challenging last year when he was hit by a car. The accident landed the Kamloops man in a coma in the hospital’s intensive care unit and he now suffers from chronic pain. Despite this setback, Quinn is putting his life back in order – thanks in part to the team at King Street. Located on the north shore of Kamloops, King Street is a homey feeling clinic that offers a team-based approach to health care. Mental health and substance use clients access a general practice doctor to discuss medications, side-effects, rehabilitation, chronic disease management, prevention strategies such as smoking cessation, and other health concerns.
In addition to doctor appointments, the clinic offers a range of other services such as intake assessments, referrals to other resources, diabetes education, life skills including kitchen groups, counselling, assistance with disability applications, access to psychiatry, and pharmacist services. A Street Nurse Clinic runs weekly. “I am so proud of what I’ve done since working with King Street. I would tell everyone to go to King Street,” Quinn says adamantly. “They make your head come back together… I’m still working on it, but I’m proud of what I’ve done.” A traditional system, in which mental health and primary care services are provided in different places, in two separate ‘streams,’ can leave vulnerable people with no access to important health services. “Issues like homelessness and drug addiction are barriers when it comes to making and keeping doctor appointments, but many people with chronic mental health issues have health-care needs that require consistent monitoring and management,” says Tara Mochizuki, Interior Health Practice Lead. “By working together, the team helps ensure patients are able to access care they need so their illness isn’t exacerbated, helping them avoid emergency department visits, hospital admissions, or other health crises.” Family physician Dr. Kyle Stevens, who works with South Okanagan patients on the methadone program out of Penticton’s new Martin Street Outreach Centre, agrees the approach is beneficial. The Martin Street centre houses programs such as the Intensive Case Management team, Community Crisis Response team, a Stop HIV nurse, and other service providers and partners as well as a range of services including intake assessments, referrals to other resources, counselling, and psychiatry. “The opening of this expanded clinic for patients with mental health and substance use issues allows those without family doctors to now become attached to primary care resources,” Kyle says. “In addition to intensive mental health and substance use therapies, we also have the chance to offer preventative and chronic disease treatment, such as diabetic care, which is a critical missing piece for this population.”
Left: Dr. David Stoll and IH staff member Tannis Bertrand are part of the multidisciplinary team at the new Martin Street Outreach Centre. Right: Practice Lead Tara Mochizuki at King Street clinic in Kamloops.
Both King Street and the Martin Street Outreach Centre are the result of a partnership between local physicians (Divisions of Family Practice) and Interior Health. Similar team-based care, offering primary care for mental health and substance use clients, is also offered at Kelowna’s Outreach Urban Health and Rutland Aurora Health centres and the Vernon Downtown Primary Care Centre, while some communities in the Kootenays have nurse practitioners offering primary care services in partnership with Interior Health Mental Health & Substance Use services. “King Street has been a huge asset to the community as a whole,” says Bob Hughes, Executive Director, ASK Wellness Centre in Kamloops. “Through the provision of a wide range of medical, therapeutic, and support services, many of our mutual clients are receiving appropriate and timely services that did not exist in our community before.” Improving primary and community care outcomes and delivery for mental health and substance use clients is one of IH’s five key strategies for 2016 to 2018. Learn more about these strategies on InsideNet under About IH > What We Do > Our Five Key Strategies.
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veryone was smiling when the Al Mohammad family of five arrived at the Kamloops Primary Care Clinic (KPCC) in mid-January for their first medical appointment with a nurse practitioner.
An unusual air of excitement accompanied this visit since the Al Mohammads are the first Syrian family to register with Interior Health. Only little Yamen was a little fussy until his mom, Reem, soothed him in the universal way that moms do. After a little snack and a snuggle, the 18-month-old was content to watch the action in the waiting room crowded with support people for the newcomers. When it was time for the actual appointment, though, it was family members and interpreters only in the exam room with NP Colleen Regehr. “We want to make sure all the appropriate privacy rights are respected,� Colleen says diplomatically as she welcomes the family and shoos away the others. An hour later, with vitals checked and health concerns discussed, it was back out into the waiting room, where everyone was still smiling.
It hasn’t always been a happy time for the Al Mohammads who have spent the past four years in Lebanon. Yamen was born in a Lebanese hospital. It was also there that his parents realized he had some health concerns that needed addressing. He has already seen a pediatrician and will soon have surgery for a cyst that could have been life-threatening if left untreated. His sister, Ineam, 10, is well despite having limited health care in recent years. Brother Mustafa, 7, has speech impairment and will require speech rehabilitation. RN Daniela Widmer is on the Interior Health team working with primary care centres, community groups, and local municipalities to meet the health-care needs of Syrian newcomers. “We want to help them navigate the system. Most of the families don’t speak English and this will not be an easy transition for them to figure out where to access health care,” says Daniela, who previously worked for many years with the Bridge Refugee Clinic in Vancouver. KPCC Manager Kerry McLean-Small says that is the approach her team had proposed. “We will do our best to facilitate this process and make it as comfortable and welcoming as possible. The focus today is creating a caring and welcoming environment.”
From her years at the Bridge Refugee Clinic, she knows that four or six months after arrival can be difficult as reality sinks in. For the parents, it can be challenges about finding work and language barriers. For the children, it may be fitting in at school. It’s important the health system is following up at those times, Daniela says. For the Al Mohammads, the first medical visit appeared to go as intended from both the patient and caregiver perspective. For health professionals who will provide care to either government-assisted or privately sponsored refugees, the IH team is busy behind the scenes ensuring training is available for everything from billing to cultural competence. Workshops are also being offered on mental health, trauma, screening, and interpretation. Now Khaled Al Mohammad, who was a ministry clerk in Syria, and Reem, who stayed at home with her children, will begin the process of learning about Canada and how to become independent and self-sufficient. That journey will include the health system, says Daniela. Once they are familiar with things like walk-in clinics, pharmacies, and where to go in case of emergencies, they will navigate the system with the same access as every B.C. resident.
In fact, a sign – posted on the front desk in advance of the family’s appointment – reads “Welcome” in Arabic. As NPs, Colleen and Natalie Manhard practise in a way that is inclusive of different cultures and language on an ongoing basis so they were not uneasy about managing care for their new patients. “We will treat the Syrian families as we would treat any other families and bridge any challenges we come across,” they told Kerry prior to the appointment. Kerry adds, “We will let them know we are here, we have services available and we will do our best. We will also learn from the family about what they need us to do for them.” Daniela says that is Interior Health’s plan for all the newcomers who will be accessing medical services. “Many may not need a bundle of services if they are healthy. They just need to learn where to go if an issue does arise.” Her advice to health-care providers is to be mindful of the experiences these families may have endured as refugees from violent political unrest, and also what lies ahead as they adjust to a new way of life that will bring its own challenges.
Above: Lisa Mullens (L), a medical office assistant at the Kamloops Downtown Primary Care Centre, makes a followup medical appointment for the Al Mohammad family with the help of interpreter Leena Yahia. Left: Interior Health medical professionals, the Al Mohammads of Syria, and two interpreters from Kamloops worked together in January to make the newcomers’ first medical appointment a success. Back row (L-R): RN Daniela Widmer, Khaled Al Mohammad, son Yamen, wife Reem, NP Colleen Regehr, NP Natalie Manhard, and IH Manager Kerry McLean-Small. Front row (L-R): Interpreter Hasan Kettaneh, Ineam, Mustafa, and interpreter Leena Yahia.
Simon Hilton, Activity Worker @IH: What do you do at Arrow Lakes Hospital? I do recreational therapy and activities for the residents at Minto House and also include the patients at the hospital if they can benefit from these services. I coordinate group and individual activities ranging from our music program to art therapy to exercise programs to a garden club and various outings. I started out as a volunteer and then went back to school to take my formal training.
@IH: How is your work important to clients?
I work to improve the physical, cognitive, emotional, spiritual, and social well-being of residents. Even if it is just a short interaction – in that moment you can change someone’s day for the better and that helps their overall well-being.
@IH: What is fun and exciting about your work? What makes for a great day? The residents I work with keep me on my toes and every day is a little bit different. If I can make someone laugh and bring a little light into their day, that’s really satisfying. The residents are also my friends – every day I get to come in and be with my friends.
@IH: Any highlights – a time that stands out for
you? One time I was playing my guitar for a resident who was not usually very responsive. I was playing an old Johnny Cash song and when I finished he had a big grin on his face from ear to ear and it was the first time I had seen him smile. He had tears in his eyes. That was very rewarding.
@IH: What’s great about where you work?
Nakusp is a beautiful place and we have a great team here – everyone contributes to the care we provide here. The staff is really supportive of what I do and help me out whenever they can. My managers are really flexible – they let me be creative and that freedom allows me to do a lot of interesting things.
Arrow Lakes Hospital, Nakusp
2,352
Unscheduled emergency department visits
75
Hospital staff
6
Hospital beds
71%
Patients seen who are 65+ years
Stats gathered from 2015-2016 data. Nominate a colleague, manager, or site for a future spotlight here.
40
Years old
Penticton Submitted by: Cassie Sartor
Rogers Pass Submitted by: Kelly Chernoff Cranbrook Submitted by: AJ Brekke
Grand Forks Submitted by: Evelyn McIver
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.
In partnership with the BC Nurses Union (BCNU), the Province announced over 1,600 additional regular nursing positions will be created by this spring. Recruitment team members Taya Sanders (L) and Liz Marsland are supporting the recruitment of the 300 nursing positions for Interior Health. For more information regarding the announcement, view the full news release.
The West Chilcotin Health Centre in Tatla Lake will benefit after the West Chilcotin Healthcare Society received a $50,000 grant from the Province on Jan. 14 for specialized medical equipment, such as a portable Lifepak 15 cardiac monitor/defibrillator. Displaying the monitor are (front row, L-R): Ruth Kuehl-Venn, IH remote certified nurse; Dr. Rob Coetzee; Society director Peter Culbert; (back row, L-R): Dr. Mike Smialowski, Society president; Sam Emke, Society vice-president. View the full news release for more information.
Housed in Kelowna General Hospital, the Okanagan Movement Disorder Clinic provides clinical care and improves services for people with Parkinson’s and other movement disorders throughout the Okanagan. The Movement Disorder Clinic team consists of (L-R) nurse Cheryl Daniels, medical office assistant Christine Cockings, and Dr. Daryl Wile.
If you could stand in someone else's shoes … hear what they hear … see what they see … feel what they feel, would you treat them differently?
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We all have bad days and weeks … here are some tips on self-care and ways to get past those tough days. Learn more at www.evanshealthlab.com.