A publication for Staff and Physicians of IH
Volunteers: a work of
A message from Chris Mazurkewich, Interior Health’s CEO.
Ways you can stay engaged in your day-to-day.
We couldn’t do it without them!
IH Patient Transport Office enhances B.C. Ambulance Service.
Teamwork and peer support key elements to ACT success.
Helping to prevent the most common chronic disease in children.
Featuring Okanagan Nation Alliance, first of eight Nation profiles.
Staff submitted photos of places in our region.
Snapshots of our staff in action and trending health-care videos.
Greg and Don Garrish volunteer with their dogs at RIH. 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 May 2016 @InteriorHealth magazine is April 15. Editors: Amanda Fisher, Breanna Pickett Designer: Kara Visinski IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Megan Kavanagh, Breanna Pickett, Erin Toews, Tracy Watson
Every person matters
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President & CEO Chris Mazurkewich
hroughout Interior Health, we’ve made a lot of improvements in how we care for our frail seniors.
More detailed discharge planning is helping us to transition patients with the right supports from hospital to home. End-of-life care has been enhanced through communication tools like Medical Orders for Scope of Treatment (MOST) and Advance Care Planning. We are seeing more information sharing and collaboration between ourselves and physicians, through our work with local Divisions of Family Practice and projects like the Electronic Medical Record initiative in Royal Inland’s Emergency Department. But, the fact is, we still have a lot of work to do.
with my mother and mother-in-law. Over the years, they supported their friends and they had friends support them. Often, it was just small gestures like delivering soup to someone who was sick. That social aspect of care goes a long way in allowing people to be at home. And, that “in-home” support extends to palliative and end-of-life care as well. Our family said goodbye to my mother-in-law last spring after caring for her in her home during her final stages of illness. She did not want to die in a hospice or a hospital. She was clear that when it was her time to go, she wanted to do so at home, surrounded by those she loved. This is what happened.
I encourage everyone to have conversations with their loved ones about your wishes and theirs, through the Advance One of the five key strategies we introduced earlier this year, Care Planning process. These aren’t easy conversations, our strategy to improve care for frail seniors with complex but they bring peace of mind during difficult times. chronic conditions, has the potential to impact many people. More than 22 per cent of residents within Interior Health are Another area we need to look at is medication use over 65 years, and that number is on the rise. Many of us – reviewing which medications are being prescribed and have aged parents and, of course, whether we like it or not, the reasons why. we all keep getting older. A friend told me about her elderly father-in-law, who was Take me, for example. I’ve now had cataract surgery on confused all the time, and was on all kinds of medications. both eyes (with excellent care at Kelowna General Hospital). They thought he had dementia and wanted to place him into And, I have been watching my own mother slow down residential care. But, under the careful guidance of a doctor significantly in the last few years. She remains active and with specialized knowledge, they found the confusion was enjoys a busy social life, but she is using her walker more not related to dementia. It was actually a result of all the and more these days. medications. This area is getting an increasing amount of attention nationally and I see a lot of potential to make a One of the most important ways we can improve care for big difference in people’s lives through education and this population is by supporting them to stay at home, to support around medication use. live independently, and to maintain that quality of life as long as possible. Finally, I believe our mental-health system needs to be strengthened. Not only for seniors, but for every age group. If we look at the percentage of older people living in residential care in Canada, it’s higher than some other Our seniors are rich in experience and they deserve the best countries, particularly in Denmark and Sweden. They use care possible, in the best place possible – their own homes different models and continue to transform care. We need to and communities. By helping to innovate, in collaboration with general practitioners, seniors, ensure the appropriate supports and their families, and find out what works within our are in place, we can be a part of Canadian and IH culture. More than anything, people want making this happen. It’s the to feel respected and they want to feel needed. I’ve seen this right thing to do.
pril 10-16 is National Volunteer Week, Canada’s largest celebration of volunteers, volunteerism, and civic participation. At Interior Health, we are supported by an estimated 4,800 volunteers working throughout the region. Our volunteers are welcomed, respected, and valued members of the health-care team. “I want to say thank you to all of our volunteers,” says Chris Mazurkewich, IH President and CEO. “They are a very important part of our organization and we could not do what we do without their support, dedication, and commitment.” Volunteer recognition events are being held at many local hospitals and residential care facilities this month. In other areas, gifts or cards are offered as thanks. Know a special volunteer? Send them an e-card thank you note.
It’s St. Patrick’s Day dance night at Columbia View Lodge (CVL) in Trail. All the residents in the main common area are sporting green hats as Irish ballads and the occasional jig play on the lodge’s music system. Volunteers lead residents across the floor in tune with the songs. It has the feel of a high school dance, with other residents eagerly awaiting an invite from a volunteer to join the fun. Big smiles light the faces of both dancers and spectators. At the heart of the action is volunteer John Orr, who initially approached CVL with the idea for ballroom dancing about three years ago after taking lessons himself. It was originally only going to be four dance nights in total, but the response was so overwhelming that it grew into an ongoing weekly activity, with nine core volunteers and regular live bands. Participants in the local seniors’ day program and CVL residents’ family members now also frequently join the festivities. “When the bands come, we have 60 or 70 people there,” says John. “The residents just love it – they talk about it all week.” John has no plans of slowing down and the happiness he sees from residents each and every time is the reason why. “I enjoy the looks on their faces and seeing how much they enjoy it. You have some great fun and you just love them all,” says John. Themes keep things interesting – Valentine’s Day, cowboy nights, pyjama parties…for April, it’s disco night. “Next time we’re all going to be hippies,” John laughs.
This past October, Marina Baudin and her 14-year-old daughter Katrina moved from northern Alberta to the South Okanagan. Almost immediately after arriving, the two of them started volunteering at Penticton Regional Hospital. Initially, it was just Katrina who was going volunteer as a candy striper, but after mother and daughter took a tour of the hospital, Marina asked if she could also volunteer as an adult supervisor. Marina said she wanted to do something good and to help others, while her daughter Katrina initially wanted to volunteer at the hospital to gain exposure to the field of medicine, which she hopes to be part one day. “Ever since I was little I wanted to be in medicine,” says Katrina. “Every time there’s something new; it’s always really interesting just to see different parts of the hospital, the different people, and be able to help them.” Marina and Katrina both volunteer once a week, mainly delivering water and newspapers to patients. The two of them both say they plan to continue volunteering for the foreseeable future.
Don Garrish remembers well the day he and his dog, Saylor, visited Royal Inland Hospital’s 1 South acute psychiatric unit. He could hear low, coaxing tones being spoken by one patient to another. “Saylor’s here. It’s a good reason to get out of bed.” Moments like these keep Don (photo right) and his brother, Greg Garrish, coming back to RIH, along with their standard poodles Saylor and Tenor. The quartet is certified with the St. John Ambulance Therapy Dog Program. For the last two years, they have been regular volunteers to RIH’s Pet Visitation Program. The Garrishes, who are identical twins, are certified as joint handlers for both poodles, who also happen to be brothers, although born a year apart. Saylor is a four-year-old brown standard who usually accompanies Don on his visits to Pediatrics and the 4 North and 5 North medical units. Tenor is a three-year-old cream and joins Greg when he visits the 6 North surgical and 7 North medical units. Don and Greg knew they wanted to volunteer somewhere after they retired – Greg, from his role as a technician with the provincial Wildfire Management Branch, and Don as a business licence inspector with the City of Kamloops. They also wanted the activity to include their furry friends. Now, they come to RIH regularly once a week, sometimes more upon special requests. Dressed in their bandanas and IH photo identification badges, Saylor and Tenor are stopped often as they walk through the halls of the hospital. The Garrishes also regularly run into nursing students they’ve met through bursaries they support at Thompson Rivers University’s nursing program. But most gratifying is the poodles’ amazing work with patients – from wide grins and snuggles, to even more astounding reactions from coma patients, with whom visits are meant to stimulate visual, hearing, and touch recognition. “One amazing patient partially sat up in bed and followed Tenor from one side of the bed to the other,” Greg recalls. “It was incredible. He hadn’t moved like this for months. It was such a momentous event.” “It’s such a positive experience,” says Don. “Most days we go out feeling pretty darn good.” Adds Greg: “We’ve made people smile.”
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he triage nurse at Royal Inland Hospital took one look at the 40-year-old patient in front of her and knew she was dealing with a very sick man. Within minutes, he was in an Emergency Department bed and a team was assessing his condition. Quickly diagnosed with severe pneumonia, his breathing became so compromised that the patient was put on life support and a decision was made to transfer him to Kelowna General Hospital. Upon arrival, the KGH Intensive Care Unit team would decide whether he needed to go on ECMO (Extracorporeal Membrane Oxygenation), a modified form of heart and lung bypass. In layman’s terms – the highest level of life support. The physician adviser at the BC Patient Transfer Network, who decides how transfers across B.C. should occur, determined that Interior Health’s High Acuity Response Team (HART) would take charge of this highly compromised patient who, just days ago, was active and healthy. HART is a partnership with the BC Ambulance Service (BCAS). IH puts a specialized transport team on board an ambulance to either stabilize or transport a seriously ill or injured
patient from a rural area when air transfer is not an option. They also care for compromised patients being transferred between health sites. The team includes a critical care nurse, a respiratory therapist when required, and two BCAS basic life-support paramedics. With the decision to use HART, control of the situation moves to Interior Health’s on-call physician transport adviser, which in this case was Dr. Todd Ring who is also Regional Medical Director of Patient Transport for IH. Critical Care RN Diane Cooper contacted Todd by phone and they, along with RT Tannis Gilbert, began planning the transfer. “HART members are highly trained and able to assess the patient and provide the detail that helps me paint a picture in my mind of what the patient looks like,” Todd explains. “At bedside, we can tell so much just by looking at a patient, but when it’s over the telephone, the physician really has to rely on members of the team. The more confident you are in your team, the better you can provide advice.”
on medication to support his heart and blood pressure. “His pneumonia was so severe, his lungs couldn’t provide oxygen. For every transfer, we have to make sure the patient is receiving all the right treatment and therapy before the transport begins. Then we work through any scenarios that might arise mid-transfer – what if his breathing changes; what if his blood pressure drops? “Being in the back of an ambulance is not the same as having a patient on a stretcher in the ICU or ED. We have to cover all the possible complications before the team starts out.” In this case, the transport went smoothly. The team did not need to call the physician en route, the patient was able to avoid ECMO, and is now recovering. High Acuity Response Teams are based out of Cranbrook, Trail, Penticton, and Kamloops and this partnership with BCAS has “saved many lives,” says Todd.
The teams are also busy. In Kamloops alone, the specialized transport team is usually on the road at least once a day. The emergency department physician In 2014-15, HART was involved with says this patient was on a ventilator and 1,230 patient transfers within IH.
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igh Acuity Response Teams are one part of a robust patient transportation system that is crucial for a health authority with the geographical expanse of Interior Health.
When Chris Mazurkewich returned to IH as CEO after six years away, he was pleased to see what he described as an outstanding achievement with the establishment of a Patient Transport Office (PTO), unique among the five health authorities in B.C. “This work has significantly improved patient care and is an invaluable support to rural communities including rural-based clinicians,” he notes.
helicopter – depending on the circumstances. Brent is also enthusiastic about the Regional Repatriation pilot program underway within the PTO, which is co-ordinating the movement of patients either to home or from larger hospitals to facilities in their home communities. “Proactive, advanced planning allows for seamless transitions. No one is waiting for the transport provider because it has been scheduled in advance,” says Brent. He reflects on a recent transfer that occurred because the PTO transition nurse was aware of the patient’s care plan and proactively began planning her transfer. The South Okanagan resident was in Kelowna General Hospital, post-operative from a wound-care procedure.
Brent Hobbs, Network Director, Patient Transportation System, is also proud of the advancements. In particular, he notes PTO’s decision to use alternate service providers for the transfer of stable, non-emergency patients between “Our nurse explored opportunities with a KGH clinician facilities in Central Okanagan, Kamloops, and Salmon Arm. to move the patient back to either South Okanagan General Hospital or Oliver Home Health. The end result of “Using a supplier of low-acuity patient stretcher vans frees these transportation discussions was a transfer back to the up BCAS emergency ambulances for 9-1-1 responsibilities home community, which freed up a bed at KGH, avoided and also saves IH about $1.6 million a year – savings that admission to Oliver hospital, and set the patient up with are invested in other innovative transportation programs,” the right Home Health services.” he says. Brent says one of the most frightening scenarios for The desire to improve transportation options to its rural a patient or family is when a medical emergency arises communities also motivated Interior Health to invest $1.3 and hospital care is not ready available. million in Health Connections, a rural transit and volunteer driver program that helps people without means of “Working with partners, including physicians, Interior transportation reach medical appointments. Health has created a patient transportation system that means people can choose to live in rural areas of the Health Connections is a partnership between IH, BC province and know there are transport supports in place Transit, regional districts, municipalities, and local to ensure their health isn’t compromised.” not-for-profit societies. Brent uses the example of a Kaslo patient who needs to go to Trail to see a specialist. The patient, non-emergency and mobile, is able to get on a bus at a subsidized rate to safely and affordably travel to see a specialist. More than 80 per cent of rural IH communities (68 in total) have transportation options through the Health Connections program, he says, and surveys show clients rate the service as ‘excellent’ or ‘good’. As well, Volunteer Driver programs, subsidized by IH, are available in Kootenay-Boundary and Similkameen areas for rides to medical specialist appointments in larger communities. These services complement the BC Ambulance Service, which is responsible for all 9-1-1 pre-hospital care services, either by ground, airplane, or
Doctors Todd Ring (L) and Anders Ganstal are among the 12 physicians across Interior Health who serve as on-call physician transport advisers to the High Acuity Response Teams.
Left page: (L-R) Respiratory Therapist Cynthia VanHoeck, Critical Care Nurse Diane Cooper, RT Kelvin Purpur, and Critical Care Nurse Maynard Robinson are among the specially trained HART medical personnel based out of Royal Inland Hospital.
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eanette Judson, 54, has a powerful voice. Even when speaking about her struggles with mental illness, poverty, and abuse, she is unabashed.
“We need to talk about these things,” she says passionately. “We need to talk about mental health, affordable housing, and poverty. Our lives are not set in stone. I really want people to know that anyone could end up like I was.” Jeanette was found by an Assertive Community Treatment (ACT) team member living on the streets in Kamloops last summer, deep in crisis. She had been in and out of shelters for years, struggling to manage her mental health and make ends meet. Interior Health’s ACT team helped Jeanette stabilize and connected her with important social and health-care supports. Now she has a safe place to lay her head and access to a health-care team. Most of all, she has the ACT team – members of which she considers friends. “I was isolated. For years, I had no family, I had no friends. I was outside. It was cold and it was terrifying,” she says. “I am so thankful for the ACT team. I know they want me to be healthy and we are working together to the same goal. If it weren’t for them, I honestly don’t know where I would be.” Jeanette is one of about 30 ACT clients in Kamloops, while a similar team in Kelowna also has about 30 clients registered. After launching in mid-April 2015, the teams are actively reaching out to those in Kamloops and Kelowna with severe and persistent mental illness. They will eventually serve 80 clients in each community. ACT teams are involved in outreach and are on hand to stabilize crises whenever they occur. The team has on-call coverage 24/7. “These are individuals who frequently have substance use issues. They are homeless or at risk of homelessness, and
L to R) Jody Wagner, Taylor Blanleil, Lisa Wensink, and Jason Williams (rear) are part of Kelowna’s ACT team.
they are high users of hospital and police services. Their care needs are complex and they have not benefitted from our traditional mental health and substance use programs,” explains Lisa Wensink, ACT Team Leader in Kelowna. “Many are referred to the team from Interior Health’s Mental Health programs but we also hear from our partners, such as local police.” It is these partnerships and the multidisciplinary team behind ACT that makes the program so unique. ACT teams consist of: a team leader; occupational therapist; four nurses; a social worker; two community mental health workers; vocational rehab specialist; substance use specialist; peer support worker; administrative support; and a psychiatrist. “The team approach is powerful and that extends to our partners,” says Lisa. “A big part of our work is liaising with them to provide a really comprehensive service. We frequently are in contact with police, the Canadian Mental Health Association, and probation services because many of our clients have had legal issues. We also work with the hospital to ensure the transition from hospital to home is seamless. We work with the Ministry of Social Development around financial support, and also with agencies such as food banks and shelters.” To learn more about the Assertive Community Treatment approach and how these teams are making a difference for some of the most vulnerable clients in Kamloops and Kelowna, visit www.act-bc.com.
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ost people don’t realize that tooth decay is prevalent in preschoolers. Dental disease is the single most common chronic disease in children and the No. 1 reason children require general anesthetic in hospitals. Lift the Lip is a dental outreach program available in communities across Interior Health. The program’s goal is to prevent childhood dental disease through early intervention with families of children from ages one to three. Laine Lowe is a Community Dental Hygienist in the North Okanagan. She and her colleague Colleen Wagner travel to Revelstoke every two months to deliver the program. “In Revelstoke, approximately 25 per cent of children have experienced tooth decay by kindergarten,” says Laine. “And this is pretty typical of what we see in other communities in Interior Health.” The first step for families participating in Lift the Lip is to complete a questionnaire to help identify risk factors that could lead to early tooth decay. “Risk factors for early tooth decay include things like drinking beverages other than water from a bottle or sippy cup, especially while in bed, and inadequate tooth brushing, which can include not brushing frequently enough, improper technique, or not using a fluoride toothpaste,” says Laine. “The sooner we identify risk factors, the more we can do to prevent decay. Prevention of cavities in primary (baby) teeth results in twice the chance of adult teeth being cavity free.” During the screening, dental staff assess the children’s teeth looking for early changes in the enamel that indicate a cavity could be forming. If a child is at risk of developing cavities, applications of fluoride varnish can help harden the teeth and often reverse the decay process. Families in the Lift the Lip Program see dental staff every four months for screening and fluoride varnish application. At a Lift the Lip session, parents also learn how to reduce the effects of risk factors by changing behaviours that can lead to cavities. The program has been well received by families. Parents have commented on how the dental staff are very good with children and do a great job creating a non-threatening environment for the kids while providing invaluable information to families on how to prevent tooth decay. To find out more about the Lift the Lip program and children’s dental health, visit the Interior Health website.
This is the first in a series of eight profiles of Aboriginal Nations within Interior Health. This month we feature the Syilx people.
Williams Lake Submitted by: Lynne Boxeur
Nelson Submitted by: Michelle Parker
East Kootenays Submitted by: Jessie Longston
Kalamalka Lake, Vernon Submitted by: Aaron Toma
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 Spotlight Photos.
IH Board Chair Erwin Malzer, Board Director Dennis Rounsville and President and CEO Chris Mazurkewich were in Elkford last month to tour the local health centre and meet with local physicians and staff. Tours like this give the Board members and CEO a sense of the successes and challenges at facilities across Interior Health. (L-R): Linda Oddo, Director of Allied Health, IH East; Erwin Malzer; Dennis Rounsville; Donna Barclay, Public Health Nurse; Karen Bloemink, Executive Director of Hospitals and Communities Integrated Services, IH East; and Chris Mazurkewich.
A diabetes skills fair, Connecting the Dots, organized by Interior Health employees and Thompson Rivers University nursing students on March 10 provided an overview of best practice and continuity of care for people living with diabetes. IH Quality Improvement Consultant Ali Gregory (L) and Kamloops Health Services Administrator Cathy Thibault discuss the sustainability of work that began through Interior Health's Diabetes Collaborative in 2012.
Home Support Supervisor Art Hayden gets a hug from his colleague Linda Giles on his last day of work March 11. Art’s dedication to patient-centred care means Home Support clients in Kamloops are able to have consistency in their care needs through a scheduling tool he developed that separates the city into community clusters. The excellent concept benefits clients, care providers, and the system.
The Canadian Centre for Addiction and Mental Health (CAMH) Education and Bell Let’s Talk held a launch event for the new Portico Network. The event showcased a new mobile app and free online resources for the publication Psychiatry in Primary Care, to help family doctors and frontline clinicians provide high-quality mental health care to more people in need. Visit www.camh.ca for more information.
Library Services is pleased share its new subscription to Ebsco’s Nursing Reference Center Plus (NRC+). This online library provides options for patient care, supports education goals, and encourages nursing students to access the original research. Get immediate access to NRC+ now! For off-site access, consult our off-site access instructions on InsideNet or contact Library Services.
This New York woman lives a "zero-waste lifestyle" and has produced only a mason jar (16 oz) of trash in three years! Check out zerowastehome.com for tips! Coming up on April 22 is Earth Day – the largest environmental event in the world. Visit Earth Day Canada, www.earthday.ca, to sign up for a community event, grow a global forest, #Rooting4Trees, and sign the #EarthFlag25, to show your commitment to being eco-friendly.