Sinai Health Magazine Fall/Winter 2016 by Sinai Health Foundation

Sinai Health A P U B L I C A T I O N O F S I NA I H EA L T H F O U N DA T I O N

A U T U M N / W I N T E R 2016

WHERE GETTING BACK ON TRACK

CONNECTS Sinai Health System is seamlessly connecting patients with the care they need so they can get back to living life to the fullest

Contents

Sinai Health A U T U M N / WI N T E R 2016 Editor-in-Chief Lindsey Hodgson

2 ��SHS News

Editor Sara Daniels

5 ��Discovery Corner 6 ��Features: Where getting back on track connects

Contributors Gerald Allain Eden Biggin Janessa Bishop Veronika Izabela Bryskiewicz ´ Kate English Marcia Kaye John Packman Heidi Singer Annie Tong

6 ��What does connected care mean to you? Patients and caregivers from across Sinai Health System share their reflections on connected care

8 ��Back on track Three orthopaedic patients — a teenage skier, young cancer survivor and mid-life patient who had an unlucky fall — share their stories of recovery, thanks to our expert orthopaedic care teams

Sinai Health System is comprised of Mount Sinai Hospital, Joseph & Wolf Lebovic Health Complex; Bridgepoint Active Healthcare; Circle of Care; and the Lunenfeld-Tanenbaum Research Institute — from healthy beginnings to healthy aging.

15 ��Behind the curtain in the ICU

ENVIRONMENTAL ATTR

A glimpse into Mount Sinai Hospital’s ICU, where a multidisciplinary team cares for the unique needs of the CHAR ACT E R I L L U S T Rpatients A T I O N S :and O R their I G I N Afamilies LS BY KBS hospital’s most vulnerable

18 ��Where the right care at the right time connects

THE FOLLOWING GUIDELINES YOUR PRINTED DOCUMENTS.

The Emergency Department (ED) team helps Helga, who fractured her spine after a fall at home, transition from the ED to inpatient rehab at Bridgepoint Active Healthcare — in the space of an afternoon

24 ��Giving patients a voice Social workers help connect patients — including Ron, an elderly, bed-bound man who was evicted from his home after suffering financial elder abuse — to care that goes beyond their medical needs

26 ��Where the comfort of home connects Circle of Care provides services at home and out in the community to help seniors live independently and comfortably at home

33 ��Community Corner

Art Director Cecilia Mok

   

Mount Sinai Hospital Joseph & Wolf Lebovic Health Complex 1001 – 522 University Avenue Toronto, Ontario, Canada M5G 1W7

THE LOGOS: may only be used on Rolland ce Sinai Health Foundation and Bridgepoint Foundation did not amalgamate. must be referred toSinai inHealth a stateme Foundation supports Sinai Health System, objects certified examples be while Bridgepoint Foundation(see concentrates on its legacy and annual donors. Gifts will be must not be altered in any way a used as intended, with great appreciation. must be of a sufficient size to m CHARITABLE REGISTRATION #119048106 RR0001 DM16–SH2 • 2016015F

EXAMPLE 1 : PAPER 100% RECYCLE RO

Printed onSinai Rolland Enviro Print, which Health Foundation is committed to reducing our environmental impact through post-consumer fiber, is EcoLogo, Proce the use of certified environmental processes ® and products. This paper is manufactured in Ancient Forest Friendly and FSC certi North America, contains FSC-certified wood manufactured fibre fromusing sustainably renewable managed forests and biogas

SH A R E

is 100% recyclable.

MyStory@supportsinai.ca

C O N N EC T @supportsinai

instagram.com/support_sinai

facebook.com/supportsinai

youtube.com/sinaihealthsystemca

www.fsc.org

The mark of responsible forestry

PRODUCT CERTIFIED FOR REDUCED ENVIRONMENTAL IMPACT. VIEW SPECIFIC ATTRIBUTES EVALUATED: UL.COM/EL UL 2771

M E S SAG E F RO M O U R L E A D E RS

Sinai Health System was created almost two years ago to help those with complex health needs. As we continue to build an integrated system that brings together acute care, rehabilitation, home care and research, our patients are now beginning to experience what it truly means to receive connected care. Patients and clients across our system are connecting to the types of care that help them get their lives

TRATIONS: ORIGI NALS BY KBS

back. Colleagues are connecting, so they can do more for the people they care for, and researchers are connecting to propel the kinds of breakthroughs that change lives. Inside this issue of Sinai Health, we bring Where Care Connects to life through stories of how patients are being helped because of donors like you. For that, we sincerely thank you. Speaking of transitions, we wanted to share the changes that are happening within the Sinai Health Foundation leadership team. As your new Board Co-Chairs we want you to know how excited we are to help further the mission of Sinai Health System and to rally our community around supporting a new era of

David G. Cynamon

connected care. We would also like to take this opportunity to thank Brent Belzberg as our outgoing Board Chair and wish him well as he embarks on his new role as Chair of the Board for Sinai Health System. We must also thank Kevin Goldthorp for his talent and passion as CEO of Sinai Health Foundation and congratulate him as he pursues a new career opportunity. To look back on what has been accomplished under Brent and Kevinâ&#x20AC;&#x2122;s leadership is inspiring, and we look forward to building on their legacy. We are also excited to congratulate Joseph Mapa, our new CEO of Sinai Health Foundation. His passion for the cause, extensive experience in health care and deep ties to the community make him extremely well suited for this role. Joseph is a firm believer, as are we, in the critical role philanthropy plays in championing health care. We also know just how important every gift is, whether it be $25 a month to

E R I L L U S T R A T I O N S : O R I G I N A L S B Y K B S support the Sinai Fund, $100,000 to buy a piece of equipment or $3 million to fund a chair in cancer

RIGI NALS BY KBS

research. The best care happens when we connect donors like you to what you care about.

Howard Sokolowski, O. Ont.

Thank you for your continued support of Sinai Health System. We look forward to working with you to shape a new era of health care that is seamless, personalized and innovative. Sincerely,

David G. Cynamon

Howard Sokolowski, O. Ont.

Co-Chair, Board of Directors

Sinai Health Foundation

TO SUPPORT CONNECTED CARE AT SINAI HEALTH SYSTEM, PLEASE VISIT:

supportsinai.ca/sinaihealth

SHS News SI NAI H EALTH SYSTE M WE LCOM ES N EW PRESI DE NT AN D CEO DR. GARY N EWTON Sinai Health System is beginning an exciting new era under new leadership. Dr. Gary Newton was appointed to the role of President and CEO of Sinai Health System in October, and Brent Belzberg became Chair of the System’s Board of Directors in June, after a highly successful tenure as Chair of Sinai Health Foundation’s Board of Directors. In Gary’s former role as Chief Medical Strategy Officer and Physician-in-Chief of Sinai Health System, he has played an instrumental part in defining the vision and long-term strategy for Sinai Health System and understands the challenges and opportunities that lie ahead.

Brent S. Belzberg

“ I am thrilled to discover the obvious enthusiasm that so many hold for the future of Sinai Health System. My new role comes with great responsibility; and I am reassured by the talent that exists across our organization and the desire to work together, along with our community of supporters, to drive our collective success.” Dr. Gary Newton

— DR. GA RY N EW TO N

THAN K YOU JOSE PH AN D MARIAN FOR YOUR LEADE RSH I P AN D VISION As we welcome our new leadership, we must also celebrate the visionaries who created Sinai Health System. Joseph Mapa, who has been at Mount Sinai Hospital and now Sinai Health System for almost 40 years, has been a trailblazer and passionate voice for caregivers and patients. His role as CEO since 2001 has helped him to identify the gaps and lack of coordination in health care and ultimately led him to partnering with another health-care pioneer, Marian Walsh, who became Associate CEO and Chief Transformation Officer of Sinai Health System. Marian’s incredible accomplishments, including the transformation of Riverdale Hospital into the award-winning Bridgepoint Active Healthcare and being named one of Canada’s 100 Most Powerful Women, has made her contribution to the long-term strategy for Sinai Health System invaluable. Sinai Health System is their legacy and we thank them for leading us on this important journey that will shape a new era of connected care for Ontarians. Joseph Mapa and Marian Walsh

MOUNT SI NAI HOSPITAL LEADE RS HOST I NTE RNATIONAL SARCOMA SYM POSIUM For the second year, Mount Sinai hosted top sarcoma leaders from around the world to share new thinking and research at the 2nd Toronto International Sarcoma Symposium. The conference Drs. Carol Swallow and Rebecca Gladdy

was co-chaired by Dr. Carol Swallow, Head of the Division

of General Surgery and Associate Member of

BRIDGEPOINT AWARDED GOVERNOR GENERAL’S MEDAL I N ARCH ITECTURE Bridgepoint Active Healthcare received a Governor General’s Medal in Architecture, considered to be the highest recognition for architecture in Canada. Administered by the Royal Architectural Institute of Canada and the Canada Council for the Arts, it is awarded every two years to celebrate outstanding design by Canadian architects. “Each of the 12 winning projects is a catalyst for change beyond its own site lines,”

the Lunenfeld-Tanenbaum Research Institute (LTRI), and Dr. Rebecca Gladdy, a gastrointestinal surgeon and Associate Member of the LTRI. Widely accepted as a North American leader in sarcoma care, Mount Sinai’s team collaborates with international partners to further research and patient care.

writes jury member Annmarie Adams, FRAIC. Bridgepoint’s “campus of wellness” is designed to inspire health and innovation, support healing and act as a welcoming, accessible focal point for patients, staff and the community. Each element of the building and grounds was planned to best support our patients.

N EW VI DEO SHOWCASES MOUNT SI NAI PE RI NATAL M E NTAL H EALTH PROGRAM

DR. SABINE CORDES RECEIVES LLOYD S.D. FOGLER, QC, AWARD OF EXCELLENCE Dr. Sabine Cordes, Senior Investigator at the Lunenfeld-Tanenbaum Research Institute (LTRI), recently received the Lloyd S.D. Fogler, QC, Award of Excellence for her work on mood disorders. Established in 1997 in recognition of Mr. Lloyd Fogler’s outstanding tenure as Chairman of

The Ontario Telemedicine Network highlighted

the Board (1992-1997), this award is

Mount Sinai’s Perinatal Mental Health program

presented annually to an investigator or

in a new video to celebrate our success in

group of investigators within the LTRI

providing care for new mothers in their own

whose recent research contributions

homes. Supported by Gary and Donna Slaight and

have had a significant impact at the

Ada Slaight, the telemedicine component of the

highest level of international excellence. The focus of Dr. Cordes’ research is the

Perinatal Mental Health program, led by Dr. Ariel

serotonergic system. Serotonergic neurons produce the neurotransmitter serotonin

Dalfen, makes it easier for patients to access care

and modulate many behaviours including appetite, anxiety and aggression in humans

while juggling the demands of being a new mother.

Dr. Jim Woodgett, Dr. Sabine Cordes and Joseph Mapa

and animals. Dr. Cordes and her team are interested in identifying new genes required for the development and maintenance of a healthy serotonergic system, with the hope

WA T C H T H E V I D E O :

that ultimately these will help improve diagnoses and treatments for patients.

http://bit.ly/OTNperinatal 3

SHS NEWS

RECOMMENDED READING

CI RCLE OF CARE CE LE BRATES ON E YEAR OF I RI DE PLUS

Love, Fear, and Health: How Our Attachments to Others Shape Health and Health Care by Dr. Robert Maunder and Dr. Jonathan Hunter

Ross Sternberg, an iRide Plus driver, with Circle of Care client Suzy Karpat

Can the way in which we relate to others seriously affect our health? Can understanding those attachments help health-care providers treat us better?

In Love, Fear, and Health, Mount Sinai iRide Plus, an assisted door-to-door transportation service for seniors and adults with disabilities psychiatrists Drs. Robert Maunder and Jonathan Hunter explain how attachment managed by Circle of Care and CHATS – Community & Home Assistance to Seniors, a home-care style — the ways in which people seek partner north of Steeles Avenue, celebrated its one-year anniversary. In its first year, more than 93,000 security in their close relationships rides were provided across the south region. With a fleet of over 30 vehicles and close to 60 drivers — can influence an individual’s risk across the south region, iRide Plus aims to support independence through affordable, non-emergency of disease and the effectiveness of their interactions with health-care transportation to medical appointments, programs and other services. iRide Plus vehicles make frequent providers. Drawing on evidence from stops at Mount Sinai Hospital and Bridgepoint to drop off and pick up clients. neuroscience, stress physiology, social psychology and evolutionary biology, as well as more than 50 HOSPITALITY SUITES GET I KEA TREATM E NT years of combined experience as health-care providers, teachers and researchers, Drs. Maunder and Hunter reveal how understanding attachment can transform patient outcomes. Dr. Maunder is Head of Research in the Department of Psychiatry and Dr. Hunter is Head of the ConsultationLiaison Service at Mount Sinai Hospital and of Psychosocial Services in the Marvelle Koffler Breast Centre.

IKEA staff assembles new hospitality suites at Mount Sinai Hospital

In May, Mount Sinai Hospital launched the Alternative Accommodation

selected in collaboration with various hospital departments, such as

Program, an innovative pilot project to provide accommodation for

infection control, to ensure adherence to hospital safety and quality

high-risk obstetric patients who live a distance from the hospital

regulations — for each of the four self-care hospitality suites. On

and require immediate access to tertiary services, but do not yet

Thursday, July 21 a team of interior designers and co-workers from

require medical or nursing care.

four IKEA locations in the GTA joined Foundation staff to implement

“As a high-risk pregnancy patient, it is comforting to know that I’m so

the make-over and make each suite bright and comfortable.

close to Canada’s top experts in this area,” said Raman, the first guest

“We are very grateful to IKEA Canada for helping to make these

to use the hospitality suites.

suites function as a home away from home,” said Dr. Wendy Whittle,

To help create a home-like environment for women like Raman, IKEA Canada generously donated home furnishing products and décor —

Maternal Fetal Medicine Specialist at Mount Sinai. “These patients are already in a high stress situation, and anything that we can do to improve their experience is very gratifying.”

Discovery Corner N EW BLOOD TEST I DE NTI FI ES WOM E N AT RISK OF PRETE RM DE LIVE RY AS EARLY AS 17 WE E KS OF PREGNANCY A blood test developed by a team at the Lunenfeld-Tanenbaum Research Institute (LTRI) has been shown to predict if a pregnant woman is at risk of delivering her baby prematurely. The test is the most accurate one to date and provides the earliest detection of premature birth, with 86 per cent accuracy in determining mothers at risk of early delivery. The new test, not yet available, will allow clinicians to screen expectant mothers during routine antenatal care, and provide more time to implement personalized approaches to prevent preterm delivery. Researchers collected maternal blood from pregnant women at two clinically relevant time points: approximately 17 weeks when fetal ultrasound is conducted and at approximately 27 weeks of gestation when gestational diabetes screening is performed. The team then used gene expression profiling and bioinformatics to develop gene sets, coupled with a patientâ&#x20AC;&#x2122;s clinical information such as history of preterm birth, abortion or anaemia, to predict whether or not a woman will deliver prematurely. The study, published in PLOS ONE, was led by Dr. Jan Heng, a former post-doc at the LTRI; Dr. Stephen Lye, Scotiabank Scientist in Child and Adolescent Development Health Research and Senior Investigator at the LTRI; and Dr. Suzanne Tough at the University of Calgary.

SHORT-TE RM I NSULI N TH E RAPY SUCCESSFULLY I N DUCES RE M ISSION I N TYPE 2 DIABETES Dr. Ravi Retnakaran, an endocrinologist with Leadership Sinai Centre for Diabetes at Mount Sinai Hospital and an investigator at Lunenfeld-Tanenbaum Research

DE M E NTIA ADVISOR APP DESIGN E D TO H E LP FAM I LY CAREGIVE RS OF PATI E NTS WITH DE M E NTIA

Institute, is leading a major clinical trial called RESET IT, aimed at inducing

The geriatric psychiatry team at the Cyril & Dorothy,

remission in patients with diabetes by administering intensive short-term

Joel & Jill Reitman Centre for Alzheimerâ&#x20AC;&#x2122;s Support

insulin therapy. Short-term intensive insulin therapy is typically administered

and Training, in close collaboration with former family

for a period of two to four weeks and can decrease insulin resistance, reduce

caregiver Teresa Manley and her company Acquian,

glucagonemia and improve pancreatic beta-cell function. According to a new

have developed a new app called Dementia Advisor

study by Dr. Retnakaran, early intervention with short-term intensive insulin

that they have specifically designed for individuals

therapy for four weeks can also induce a remission that can last up to one year

caring for a family member with dementia. The app

following treatment in just under 50 per cent of patients. The earlier that short-

helps family caregivers learn effective coping skills

term intensive insulin therapy was administered after the diagnosis of diabetes,

and get expert coaching through scenario-based

the more successful it was, with those who had been diagnosed within two years

training using interactive chat-based role playing.

prior to receiving treatment showing the longest sustained remission. The study

Each scenario simulates a real-life situation and takes

was published in BMJ Open Diabetes Research and Care earlier this year.

only minutes to complete. Caregivers can find help solving practical caregiving problems, managing challenging dementia-related behaviours such as denial, paranoia and aggression, and reducing stress that can arise from caregiving. The app is scheduled to be available for download in 2017.

To learn more about the RESET IT clinical trial, please contact Ms. Haysook Choi at 416-586-8778 or haysook.choi@sinaihealthsystem.ca

TO LEARN MORE ABOUT TH E LTRI, WA T C H O U R V I D E O :

http://bit.ly/theLTRI

WHAT DOES CONNECTED CARE

MEAN TO YOU?

S N O I T A R T S UL L I R E TCA R A H C

R I LLUSTRATIONS: ORIGI NALS BY KBS

C H A R ACT E R I L LU S T R A T I O N S: O R I G I N A L S BY K B S

Sinai Health System was created to help forge connections that make health care more seamless and person-centred for all of the patients and families who rely on us for their care. We asked some of our patients and caregivers what it would mean to fulfill the promise of connected care. C H A R ACT E R I L LU S T R A T I O N S: O R I G I N A L S BY K B S

Here’s what they told us.

C H A R ACT E R I L LU S T R A T I O N S: O R I G I N A L S BY K B S

“ Connected care to me means the team includes the family and the patient. The patient isn’t a body, the patient is a real person. When we do family meetings, one of the first questions that’s always asked is, ‘Tell me about the patient. What is important to the patient? What do they like doing? What would an ordinary day be for the patient?’ ” — R EVE R E N D NO L A CR EWE, ICU CHA P L A I N

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

“ My family doctor is at Mount Sinai. My surgery was at Mount Sinai. My rehab and outpatient therapy were at Bridgepoint. Having all of those pieces connect to one another so that there is a continuity of care, means the burden is not on me as a patient to take this information from all these different siloes and try and figure out some program that might work. It means that information flows with me, between providers, between services, so I get the information at Point A that I’m going to need at Point B.” — CH A R L E S S H O RRO C K, PAT I E NT

“ Connected care, I feel like to me it just means that they’re trying to improve your recovery based on your lifestyle. They care about your wellbeing outside of the hospital itself.” — RO H I T M A TH E WS, PAT I E NT

“ I think it means a seamless flow of patient care, from the patient being referred by the family physician to seeing the surgeon, to having surgery and then going to rehab and then basically getting home and getting better. Mount Sinai, by connecting with Bridgepoint, has really improved that process.” — D R . PAU L KU Z Y K , O R T H O PA E D I C S U R G E O N , GR ANOVSKY G LUSKI N D I V I S I O N O F O RT HOPAE D IC S

“ Connected care means open flow of communication amongst all team members, patients, family.” — DE N N IS NG, P HYS ICA L TH E R A P IS T

“ Connecting patients, using our ability to get rapid access to advanced diagnostics and consultations and allied health assessments, allows us to pretty rapidly figure out what a patient needs and where they should be. By being part of Sinai Health System, it gives us an enhanced ability to make some of these connections directly from the emergency department in a time-efficient fashion.” — DR. HOWA R D OVE NS, CH I E F O F E M E RGE NCY M E DI C I N E , S CHWA RTZ /R E IS MA N E M E RGE NCY CE NT RE

“ Often in the ED, you’re only involved in somebody’s care for a very short amount of time. It’s nice to know that I’m handing over a patient to really capable colleagues and Bridgepoint’s obviously an invaluable partner in that way. It’s nice to have that peace of mind that somebody will be taking a patient’s care forward when I can’t anymore.” — R E BECCA DETJ E, S O CIA L WO R K E R, S CHWA RTZ /R E IS MA N E M E RGE NCY CE NT RE

BACK ON

TRACK Written by: Marcia Kaye Photos by: John Packman

When you think “orthopaedic surgery,” what springs to mind? Probably a hip or knee replacement of an aging joint. But that’s only one part of a very large picture. In fact, Sinai Health System treats a wide variety of orthopaedic needs and patients, including young people, athletes and others in their prime who may have suffered sports injuries, illness or accidents. The Granovsky Gluskin Division of Orthopaedics at Mount Sinai Hospital, part of Sinai Health System, performs more than 700 surgeries a year, many of them on patients under the age of 50, and some under 20. Led by Dr. David Backstein, who is consistently named by Canadian and U.S. colleagues as one of the top knee surgeons in North America, it has become a power hub of orthopaedic surgery, with a team of world-renowned experts with particular skill in complex and even unique procedures. Combined with the expertise within the ortho rehab program at Bridgepoint Active Healthcare, part of Sinai Health System, the multidisciplinary orthopaedic care teams help facilitate seamless care, helping patients of all ages return to active and engaged lives. Meet three recent orthopaedic patients — a teenage ski racer, a young cancer survivor and a midlife patient who had an unlucky fall — and find out how we helped them all get back on track.

Maddy and her trainer working on strengthening exercises in Toronto

M E ET MADDY I N OUR B E H I N D -T H E - S C E N E S V I D E O :

youtube.com/sinaihealthsystemca

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

Meet Maddy It was the final run of the day, and 15-year-old Maddy Sullivan was in fine

these young athletes put on the knee,” says Dr. Theo, who is also the

form last November as she executed precision turns at electrifying speeds

orthopaedic surgeon for the Toronto Maple Leafs and Toronto Blue

down the giant slalom course on Austria’s magnificent Hintertux glacier.

Jays. He removed the middle third of Maddy’s kneecap tendon, with

But suddenly, on a sharp left turn, Maddy’s gloved hand got hooked

a bone plug on each end from her kneecap and tibia, and fashioned

between the double poles of the gate. That swung her back, causing her

a brand-new ACL, reattaching the graft with screws on either end.

right ski to twist outward as her body still pointed inward. As she fell, she sensed a pop in her knee. “I can still remember feeling it tear,” she says.

Dr. Theo kept Maddy informed every step of the way, just as he does with his pro athletes and other patients. He discussed surgery details

Maddy, an elite ski racer who had reached the highest possible level for

with her, kept her updated with the latest research on recovery

her age — she won the Nancy Greene Award at the international Whistler

timelines and talked about the anxiety athletes can feel when they

Cup at 13 — had suffered her first-ever injury: an ACL tear. A tear of the

return to play.

anterior cruciate ligament typically happens when the upper leg and lower leg twist in opposite directions. It’s the most common injury in teenage athletes, who often put superhuman stresses on young knees.

“Every time I met with Dr. Theo, we had conversations that weren’t just about my knee,” Maddy says, “but about how it was relative to my life — skiing is a big part of my life — and how it impacts

Flying back to Toronto two days later with her mom, Maddy was determined

the things that are important to me.” She adds, “Surgery is a scary

to do whatever it took to get back to the sport she loves. A consult with

thing to think about, but I wasn’t feeling any of those fears because

Sinai Health System’s orthopaedic surgeon Dr. John Theodoropoulos

everyone was very informative and helpful and considerate, and they

— known to his patients and colleagues as “Dr. Theo” — revealed she

just wanted to put my best interests ahead of everything else.”

would need not just a repair but a reconstruction: a new ACL. To optimize her surgical outcome, Maddy underwent close to a month of pre-op physiotherapy to eliminate swelling and regain her full range of motion. Typical ACL reconstruction options include using a patient’s own tendon (taken from the hamstring or kneecap) or a cadaver tendon, but in this case Dr. Theo and Maddy made the decision to use her own kneecap tendon, even though it would mean a more painful recovery. “For my elite athletes I like to use a patellar tendon because it’s a stronger graft that can withstand the increased stress

Maddy with Dr. John Theodoropoulos, Orthopaedic Surgeon

P H O T O C R E D I T: B R I A N M C G R E G O R , N AT I O N A L S K I A C A D E M Y, C O A C H

Maddy in competition

Dr. Theo, who works with a team of athletic therapists, physiotherapists,

paramedicine at University of Toronto Scarborough and working

strength coaches and nutritionists, says his biggest challenge with

as a lifeguard. Two years earlier he’d been treated for Hodgkin’s

Maddy, as with other elite athletes, was to hold her back from doing too

Lymphoma, a cancer of the lymphatic system, and was cured. Life

much too soon. But after a nine-month physio program, with her

was good — until Rohit noticed some pain in his right hip.

new ACL at least as strong as her old one was, Maddy was cleared to head back to the ski hills. A member of the Ontario Ski Team, she’s currently training in Switzerland to prepare for the racing season, which begins in December.

At first he attributed it to muscle strain from his daily bicycle commute. But when the soreness became unbearable — “I was in so much pain I couldn’t put my socks on” — his mom, a nurse, insisted Rohit get an X-ray. The surprising diagnosis: avascular necrosis to the

“She’s going to be a supertalent like Lindsey Vonn,” predicts Dr. Theo,

femoral head. In other words, the bone tissue at the top of Rohit’s thigh

referring to the U.S. ski sensation who came back after similar ACL

bone — the ball that fits into the hip socket — had begun to die.

surgery to win a World Cup.

The cause became clear. His course of cancer treatment, which involved

On reflection, Maddy says it wasn’t too big a deal to miss last year’s

four months of chemotherapy and one month of radiation, had also included

racing season. “I’m still really young, and there’ll be tons of races,”

high doses of prednisone, a corticosteroid that can boost the efficacy

says the eleventh-grader, now 16 and with an eye on future Olympic

and reduce the negative side effects of chemotherapy. Unfortunately,

Games. “I’m nothing compared to what I’ll do in the future.”

long-term high-dose prednisone can sometimes cause reduced blood flow to joints. Rohit was free of cancer but had essentially lost a hip.

Meet Rohit

Conventional hip replacement involves a titanium-and-polyethylene

As a teenage survivor of cancer, Rohit Mathews was just getting

prosthetic, but in young patients there are caveats. Despite better

his life nicely back on track. The 18-year-old was studying

materials, coatings and contours, the implants last only about 11

Rohit with Dr. Paul Kuzyk

20 years, with each successive implant

area where the ball had collapsed,” says

at Sinai Heatlh System, and her research

becoming a trickier surgery.

Dr. Paul Kuzyk, the orthopaedic surgeon

team are working on using stem cells

who performed the delicate procedure. It

through 3D printing to build replacement

worked. No one can predict with certainty

joints not of metal and plastic but from a

how long it will last, because there’s no

patient’s own cells and tissues. If successful,

long-term data yet, but Dr. Kuzyk says, “It

the promising technology has the potential

has the potential to last forever. But it’s

to revolutionize orthopaedic medicine.

Doctors at Mount Sinai offered Rohit a better option: a fresh osteochondral allograft. This would involve harvesting bone and cartilage from a recently deceased donor and transplanting them into his hip. Mount Sinai is one of the only centres in the world doing such a procedure on hips. It has now done 23 procedures. “In Rohit’s case we used a large graft from a donated hip and put it into his hip in the

a win if it even lasts 10 years, because it gives him 10 years of pain-free activity before he has to have a hip replacement.”

In the weeks following the surgery, Rohit did the prescribed exercises — with a lot of motivation from his mom — and it paid

And by then, there may be even better

off. After three months he was walking

options. Clinician-scientist Dr. Rita Kandel,

unassisted. Today he’s pretty well back to

Chief of Pathology and Laboratory Medicine

normal. “I’m physically active, I can walk

young age, the surgeons chose to suture together the trimmed edges of the torn tendons. It would extend his recovery time but minimize the long-term impact on his knees. To ensure healing, his legs would need to be in splints, locked straight, for most of the next 14 weeks. Three days after his surgery, and just a week after his fall, Charles was relocated to Bridgepoint for rehabilitation. Since he wasn’t allowed to bend his knees, his exercises included a stiff-legged “Frankenstein” walk with a walker, standing on tiptoes and small leg swings — or as Charles calls them, “ballet barre exercises” — using the waisthigh railings in Bridgepoint’s hallways, which are active therapy areas. His physiotherapist, Charles with Dennis Ng, physiotherapist at Bridgepoint Active Healthcare

Dennis Ng, says these small movements made a big difference in helping Charles achieve his therapy milestones quickly: “It’s all about

an unlimited amount of kilometres, I ride

from a friend’s Toronto apartment. He’d

a bike,” he says. “I had a full-time summer

arrived on the bottom stair when for no

job in golf operations at a country club that

apparent reason — the stair was sound,

Once the splints were off, Charles could

required me to carry stuff, and my femur is

the lighting was good and he wasn’t on

begin bent-knee exercises. Dennis and

holding strong.”

his phone or otherwise distracted — he

Charles’s occupational therapist also went

stumbled and fell onto his hands and

with Charles to his house, which has narrow

knees on the lobby’s hardwood floor. He

doors and steep staircases, to assess when

instantly felt a fiery sensation spreading up

he could safely return home.

Although Rohit, now 20, has gone through two serious medical conditions, he has nothing but gratitude for his current state of good health and the medical team that helped him get there. “I’m really grateful for the work the doctors did. The staff were very good, the physiotherapist was super helpful and Dr. Kuzyk himself was a really

from his knees. “The pain was so sudden and intense I couldn’t breathe,” he recalls. His legs wouldn’t move. His phone had bounced out and skittered across the lobby, so he couldn’t even call for help.

trying to maintain the strength that you have.”

Charles had to give up his old job of demonstrating and selling heavy commercial restaurant equipment. But during his 15-week hospital stay, he became a very engaged patient. Having spent seven years improving

good orthopaedic surgeon. He was really

Fortunately a passerby spotted Charles

and restructuring customer service processes

kind, too. He’s a good guy.”

through the building’s glass front doors and

for a global information company, Charles

called 911. When the paramedics asked

became interested in the quality improvement

Charles if he had a preference among three

process for patients, families and caregivers.

equidistant hospitals, he immediately said,

Last March, soon after he was discharged, he

“Mount Sinai!” He’d visited Sinai’s Schwartz/

was hired as Sinai Health System’s first-ever

Reisman Emergency Centre a few years before

patient advisor on staff. His latest initiatives

and says, “I was blown away by the care and

involve orientation sessions for patients

consideration I got in the ER, and I was so

and families, engaging patients for trial

impressed at how well the staff flowed and

projects and training staff in patient and

how they engaged with patients.” He was also

family engagement.

There was one disappointment. Rohit had to give up his long-held ambition of becoming a paramedic, since the physical demands would overly stress his hip. “That was a bummer,” he admits. Instead, he switched majors and is now in his second year of forensic science at University of Toronto Mississauga. “I’m definitely enjoying it. I have no regrets.”

Meet Charles People sometimes fall into a new job. For Charles Shorrock, that happened quite literally. It was an actual physical fall that led the former sales and customer service manager into an entirely new career as a patient advisor at Sinai Health System. On a Friday evening last October, Charles, 45, was walking down three flights of stairs

a user of Sinai’s family medicine program.

Today Charles goes for walks every

Charles was triaged right away. Medical imaging

evening, cycles two or three times a week

showed that his injury was a devastating one:

and even does a little yoga at home. “I’m

complete bilateral quadriceps tendon rupture.

more flexible than I ever was because I’m

His one-stair tumble had torn the tendons in

consciously doing stretching,” he says.

both knees, effectively severing the four quad muscles in his upper legs from his lower legs.

Dennis, who often sees Charles at work now, says, “It’s miraculous. If I saw him on

A common repair involves connecting the

the street I would never have known he’d

muscles to fibres on a metal plate drilled

had those injuries.”

into the knee. But because of Charles’s 13

“ We are inspired by the exceptional orthopaedic care at Sinai Health System that is enabling many people to live vibrant, meaningful and fulfilling lives. We hope our gift will help more people live their lives more fully.” — I R A GLUS K I N A N D M AX I N E GRANOVSKY, P H I L A NTH RO P IS TS

P H O T O C R E D I T: P R AT T E I N T E R N AT I O N A L

YOU CAN HELP PEOPLE

GET BACK

ON TRACK One in five Canadians suffer from long-term pain and disability as a result of musculoskeletal disorders or injuries, and that number is on the rise. Toronto philanthropists Ira Gluskin and Maxine Granovsky felt inspired to help Sinai Health System address Canadians’ growing need for orthopaedic care. With their extraordinary support, The Granovsky Gluskin Division of Orthopaedics is transforming orthopaedic care for patients who require corrective bone and joint procedures. You can help more Canadians — like Maddy, Rohit and Charles — benefit from improved access to world-class orthopaedic care including complex reconstructive surgeries and customized rehabilitation, as well as leading-edge research that will help us develop innovative treatments to better serve our patients. Donate today at: supportsinai.ca/sinaihealth To find out more about how you can support orthopaedic care, please contact: Sarah Hurrle, CFRE, Advancement Director T 416-586-4800 x 6006 sarah.hurrle@sinaihealthsystem.ca

S U P P O R T S I NA I . C A

Dr. Stephen Lapinsky

Written by: Marcia Kaye Photos by: John Packman

BEHIND THE

CURTAIN IN

THE ICU

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

Members of the ICU team gather for weekly “bullet rounds” to address the needs of patients

Dr. Stephen Lapinsky was momentarily puzzled when a pregnant woman, coming into the hospital in labour, gave him a smile of recognition across the lobby. He wasn’t sure who she was — until he recognized her husband, who was accompanying her. The woman had spent several weeks in the intensive care unit on life

of its own, it sends the most vulnerable patients, such as those who

support after contracting a deadly influenza during her pregnancy,

have just received a bone marrow transplant, to Mount Sinai’s ICU

and her husband visited often. She had recovered and was now

via a connecting bridge. Patients may also include pregnant women

back in the hospital a month later, but this time to give birth. “That

with serious conditions or women who have just gone through a

was nice,” says Dr. Lapinsky with characteristic understatement.

life-threatening childbirth. “We get more obstetrical ICU patients

Dr. Lapinsky didn’t recognize the woman at first because he generally

than pretty much any other site in the world,” says Dr. Lapinsky.

sees people at their very worst. He’s the Director of the Intensive Care

Two common conditions among ICU patients in general are septic

Unit (ICU) at Mount Sinai Hospital, part of Sinai Health System. While

shock, a body-wide infection resulting in multiple organ failure, and

most people have had some experience with hospitals, the majority

acute respiratory distress syndrome (ARDS), a life-threatening lung

have never been in an ICU. “Many people don’t really understand

condition that requires mechanical ventilation. About two-thirds of all

what the ICU is,” he says. Some confuse it with the emergency

ICU patients are on ventilators, also called life support. Fortunately, 80

room or the operating room, while others view it only as a place of

to 85 per cent of all ICU patients get well enough to leave the ICU.

mystery, with complex machines beeping behind closed curtains.

One of them is Dr. Richard Kirsch, a surgical pathologist at Sinai

That’s why Dr. Lapinsky and his team want to shed some light on what

Health System who himself became an ICU patient in 2007 when

actually goes on there. “Basically, the ICU is for the sickest patients in the

flu symptoms quickly escalated to ARDS. He was kept alive through

hospital,” he explains. “It’s ongoing support while a patient gets better.”

a method of ventilation called high-frequency oscillation, one of the

Patients receive more specialized treatment and closer monitoring

ICU’s areas of research and expertise. Dr. Kirsch recovered and returned

than in a regular hospital bed. There’s usually one nurse for each

to work in the hospital. “He’s happy for us to bring families down to

patient. The 16-bed unit treats about 900 patients a year. Stays range

talk to him to show that you can get better, or to discuss the ICU

from 24 hours to a month or more, the average being four or five days.

stay,” says Dr. Lapinsky.

Some patients have had a heart attack or stroke; have undergone

While TV hospital dramas often show ICUs as places that keep families

major surgery and need extra care; have had a medical or surgical

out, Mount Sinai’s ICU welcomes family members anytime. Visiting

complication or require advanced support such as round-the-clock

hours are 24/7, and have been that way for 20 years. Families are

dialysis. Since next-door Princess Margaret Cancer Centre has no ICU

welcome to listen in during the medical team’s morning rounds, stay

To support the ICU, please contact Pamela Osorio-Kettle at 416-586-4800 x 2076 or pamela.osorio-kettle@sinaihealthsystem.ca

“ We’ve been doing multidisciplinary clinical research in the ICU for the last 20 years. It’s very much a team effort.”

Though always looking ahead to improve care

progress, jot down questions for the doctor,

for future patients, the ICU team dedicates

write thoughts or prayers, encourage visitors

itself with equal fervor to each and every

to add their well wishes or communicate

patient. Morning rounds take place every day,

daily events to their unconscious loved one,

right by each patient’s room. The bedside

such as, “The Toronto Maple Leafs won last

nurse updates the rest of the team, including

night! I’ve taped the game so you can see it

the attending physician (one of six, who

when you get better.” Also, when patients do

rotate weekly), several fellows and residents,

start to get better, the journal — an initiative

a pharmacist, a respiratory therapist, a

supported by the Mount Sinai Physicians

physiotherapist and a dietitian, and they

Campaign Fund — can help their recovery by

discuss treatment for that day. The team

filling in the memory blanks of their ICU stay.

— DR. SA N GE E TA M E H TA , I CU R ES EA RCH D I R E CTO R

also includes two other important people: a chaplain and a social worker, who offer intense emotional, psychosocial and spiritual support to families and facilitate meetings between the family and the full medical team. “They’re really

during procedures and even be present

our conduit to the families,” says Dr. Lapinsky.

during resuscitation if they choose to.

It’s a reality in the ICU that, unfortunately, some patients will not get better. Rev. Crewe makes herself available to talk about death with families and prepare them for the removal of life support. Sometimes, she says, the healing that happens is not about the patient’s

Research has shown that family presence

Just as an ICU is a foreign concept to

body but about the family relationships.

can offer comfort and reduce anxiety in

many, so is a chaplain, says Reverend

She tells of a woman who, after a 10-year

both patients and family members.

Nola Crewe, ICU Chaplain, who along with

estrangement from her whole family, flew

Rabbi Bernie Schulman takes care of all the

home to visit her ailing father in the ICU. The

Research, like most of what happens in the

spiritual needs in the ICU. Some think she’s

original rift was long forgotten, and by the

ICU, involves teamwork among colleagues

there to baptize people or even to convert

time the father passed away, the family was

in various disciplines. “We’ve been doing

them. But actually, her role is to provide a

united. “In his dying, he reminded the family

multidisciplinary clinical research in the ICU

caring, compassionate presence, encourage

of how important he was to everybody,” Rev.

for the last 20 years,” says Dr. Sangeeta

families to talk about their concerns and

Crewe says, “and that led them to realize

Mehta, who cares for patients in the ICU and

generally take the “tense” out of “intensive

how important they were to each other.”

is also the ICU’s Research Director. “Our ICU

care.” Plus, she adds with a grin, “I’m an

is recognized nationally and internationally

authority on all the best restaurants in the

for the quality and the importance of the

neighbourhood, and I know where the

research we do. It’s very much a team effort.”

better washrooms are located.”

Clinical staff work alongside research

Her role often overlaps with that of social

imaging department on that floor and closer

personnel and other health-care

worker Andrea Moore. But if a family

to the operating room on the seventh floor.

professionals, as well as fellows and

member requires help navigating the

There will be a satellite pharmacy and lab.

residents, to do research that is focused

health-care system or needs a letter written

Negative pressure rooms with dedicated

both on improving outcomes for ICU

to explain to their boss why they’re missing

anterooms for gowning and de-gowning

patients, and on better understanding the

work, Andrea will do it. And if patients or

will prevent the spread of airborne illnesses

perspectives and needs of family members.

families have a religious request — a kosher

such as tuberculosis and SARS.

Dr. Mehta’s research deals with managing

diet, prayers for a patient, communion at

issues around sedation — “how to relieve

the bedside — Rev. Crewe will arrange it.

pain, anxiety and inability to sleep, how best

An ordained Anglican minister, she has

to give sedatives and pain drugs to patients

even officiated at marriage ceremonies

and the impact of these drugs and how

involving critically ill patients.

we can get people off breathing machines

The current ICU is 40 years old, but there’s a new ICU in the planning, with a scheduled 2021 opening. It will relocate from the 18th floor to the fifth floor, handy to the diagnostic

The new ICU will be much more spacious. Almost all rooms will have large windows with outside views, providing exposure to natural daylight to help reduce delirium and confusion and speed recovery. The waiting

sooner,” she explains — as well as delirium.

Rev. Crewe goes to each new patient’s room

area for families will be larger, too, with

A common condition in hospitals, delirium is

to connect with family members, gives them

comfortable seating, a kitchenette, a shower

particularly traumatic for ICU patients, and is

a leaflet about what to expect in the ICU and

and a quiet room. Dr. Lapinsky says that

associated with worse outcomes. Dr. Mehta

offers her card, letting them know she’s there

while “patient-centred care” has become a

and the ICU team are looking at how to

to talk, or to listen, anytime. When a lengthy

buzzword in hospitals, “We’ve actually been

prevent or improve treatment for delirium.

patient stay is anticipated, she gives the family

doing it for a long time.” The new ICU will

a journal so they can record the patient’s

help facilitate that even more. 17

WHERE THE RIGHT CARE AT THE RIGHT TIME

CONNECTS Written by: Heidi Singer Photos by: John Packman

Helga doing aquafit exercises in the neighbourhood pool

Helga Humphreys, 78, was up early one morning last summer. It was 4 a.m. and the energetic senior was puttering around her Deer Park bedroom, preparing for her daily two-kilometre walk to a downtown swimming class. That changed when she slipped and landed on her back in terrible pain.

80,000 patients a year and reorganize care based on the best evidence. The redesign will be senior-friendly, with more washrooms and handrails, and more clocks and natural light to keep people oriented. The revitalized ED will have more isolation rooms for people with suspected cases of infectious disease like tuberculosis and even the flu. Hand sanitizers and hand-washing stations will be placed to encourage maximum use. Seven nursing stations (there are currently three) will Helga in her home

be located to maximize the number of patients in the direct eyesight of staff. There will be a separate entrance for patients arriving by ambulance or police. And the department will have its own next-generation CT scanner and X-ray. The goal is for success stories like Helga’s to become commonplace. But timely care

Terrified that she had broken her spine and would end up paralyzed, Helga managed to drag herself to the kitchen phone to call 911.

Ambitious plans In less than a decade, the number of patients coming through one of the city’s smallest

isn’t just a matter of convenience, says Dr. Howard Ovens, Chief of Emergency Medicine. Extensive research shows that longer wait times mean higher risks for

It was an unfortunate moment for an

emergency departments (EDs) has doubled.

independent woman who had enjoyed

Staff responded with an array of evidence-

good health all her life. But Helga got lucky

based changes that cut wait times in half, to

in one way — the ambulance took her to

the shortest in the city. Still, walk into the ED

Mount Sinai Hospital’s Schwartz/Reisman

on any given day and you’ll see stretchers

“The philosophy is the right care at the right

Emergency Centre. In a matter of hours,

full of patients lining the hallways.

place at the right time,” says Dr. Ovens, who

hospital-acquired infection and accidents. Overstretched EDs are associated with more mistakes and worse health outcomes.

she was diagnosed with a fractured spine,

is also the Ontario Provincial

treated by a geriatric emergency medicine

Expert Lead in Emergency

nurse and settled into a comfortable room

Medicine. “Helga didn’t need

at Bridgepoint Active Healthcare.

all the sophisticated diagnostic facilities of an acute care

“It was such a relief, arriving at Bridgepoint,”

hospital, but she did need

recalls Helga, now back in her apartment and

intensive rehabilitation, and

steadily recovering her mobility. “I went from

she would get more of that at

a little gurney in a hallway with lights flashing

Bridgepoint, in a more home-

and things beeping and a lot of traumas going

like setting.” Timely care meant

on, to a room with a pleasant view and friendly

that she started physiotherapy

staff. I was so amazed; I couldn’t believe it.”

on the day of her injury — not days or even weeks later.

All too often, stories about the world of emergency medicine tell of events that go

“The speed with which staff

badly wrong. This is a story of everything

were able to transfer Helga to

that went right —when bureaucracy didn’t get in the way, when staff were plugged into a network of resources and the right

Social worker Rebecca Detje and Dr. Howard Ovens, Chief of Emergency Medicine

care was delivered at the right time. It’s a glimpse into the kind of care that Sinai

To cope with this growth, Mount Sinai will

Health System is actively working toward,

soon see even bigger changes. The hospital

where emergency management is fully,

is embarking on an ambitious expansion

deeply connected to the rest of the medical

and renovation that will more than double

system, where diagnosis, treatment and

its space, to 28,000 square feet, add new

transition are handled seamlessly.

technology with the capacity to treat

Bridgepoint is highly unusual for any hospital, probably anywhere in the world,” Dr. Ovens says. Under normal

procedures, “she would have been admitted to the hospital during the paperwork and application process, so there would be a stay of at least a few days that would add almost no value to her care.”

Heather Kwok, Clinical Practice Lead for Physiotherapy, in the BMO Financial Group Therapy Gym at Bridgepoint

A seamless connection Helga’s experience illustrates the possibilities of “connected care,” an idea that hospital staff and health leaders are eagerly putting into practice. Last year, Mount Sinai Hospital and its research arm, the Lunenfeld-Tanenbaum Research Institute, joined with Bridgepoint and Circle of Care to form Sinai Health System. That connection allowed ED staff to transfer Helga straight from a hallway stretcher to a rehabilitation unit. “It’s great to have a partnership with an acute care facility,” says Heather Kwok, Clinical Practice Lead for Physiotherapy at Bridgepoint. “At a hospital, patients aren’t as active as they could be. This can delay recovery. The earlier you get rehab, the shorter your recovery time and the faster you can return to the community.” This, in turn, frees up precious space at Bridgepoint for the next patient. Social worker Rebecca Detje, who was instrumental in finding

Understanding how her care would unfold brought Helga a peace of mind that enabled her to make some decisions. She recalls lying on the hallway gurney, groggy from painkillers and worrying that her daughter didn’t know what had happened. But she was equally concerned about the panic that a phone call from an emergency room would cause. Knowing that she would be comfortably settled at Bridgepoint by the afternoon helped her decide to postpone calling until then. Connecting patients to the right care at the right time has ripple effects that extend beyond the patients’ own experience. With Ontario’s growing and aging population, the strain on hospital resources is like a coming tsunami. In the crowded ED that summer afternoon, one fewer patient took up a valuable stretcher; one fewer patient was admitted to a ward upstairs to wait for a spot in a rehab facility. What if Helga’s experience, admittedly a small victory for the health of Ontario’s health system, could be multiplied by hundreds every day, in every emergency department in Toronto?

Helga a place at Bridgepoint, helped her understand what was happening every step of the way. “Many people are intimidated, staying in the hospital needing an uncertain element like rehab,” Ms. Detje says. “So being able to let them know right away where they’ll go and when they’ll be on their way is usually reassuring. I think Helga’s experience is a really positive example of the possibilities for collaborative work inside the ED, as well as between the ED and rehab at Bridgepoint.”

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

Dr. Bjug Borgundvaag, Director, Schwartz/Reisman Emergency Medicine Institute

“ We can’t control how long it takes to get imaging and test results. One of the few things we can control in the ED is who needs what care and how do we best treat them?”

Building best practices Nobody can control the ebb and flow of patients who need emergency care. That’s where Dr. Bjug Borgundvaaag comes in. Dr. Borgundvaag is an emergency physician and researcher specializing in finding the sweet spot where the best care and the most efficient delivery meet. Recently, he helped develop a way for ED staff to more accurately treat patients in alcohol withdrawal, cutting an average of three hours off their care. And Dr. Borgundvaag has helped determine when patients with infections, pregnancy complications or congestive heart failure need immediate hospitalization and when they can be sent home. “Our work is geared toward common problems that we see lots of — areas where there’s a great opportunity to improve care,” says Dr. Borgundvaag. “We can’t control how long it takes to get imaging and test results. Blood tests take a certain amount of time. And we can’t control how long it takes for patients to move out of the ED and up to a bed. One of the few

— DR. BJU G B O RGUN DVA AG

things we can control in the ED is who needs what care and how do we best treat them?” Dr. Borgundvaag is the inaugural director of Canada’s first emergency academic institute, the Schwartz/Reisman Emergency Medicine Institute. His research has directly contributed to the lowering of waiting times in Mount Sinai’s ED in recent years. Now, as part of the new Sinai Health System, he will have access to more data to inform future research. “Information in the ED is one of the hardest things to get your hands on, especially when you need it for a patient you’re transferring,” he says. “That’s why I have high hopes that our partnership with Bridgepoint and Circle of Care will help us expedite people to the right level of care.”

To support the Schwartz/Reisman Emergency Centre, please contact Sarah Koch-Schulte at 416-586-4800 x 8402 or sarah.koch-schulte@sinaihealthsystem.ca

Artist rendering of what a waiting area in the expanded Schwartz/Reisman Emergency Centre may look like

Visionary support Dr. Borgundvaag’s work has been greatly helped by the vision of supporters like Gerald Schwartz, CEO of Onex Corporation and former Vice-Chair of Mount Sinai Hospital, and his wife, Heather Reisman, CEO of Indigo Books and a member of Sinai Health System’s Board of Directors. Understanding that care is only as good as the evidence that underpins it, the couple established the research and knowledge translation centre, which boasts a director and three researcher-clinicians. In total, they have given $15 million toward both the Schwartz/Reisman Emergency

Another pair of long-term supporters,

which is helping to transform the

Howard Sokolowski, O.Ont., Co-Chair

facilities and delivery of care across

of Sinai Health Foundation’s Board of

the entire system and grow many of its

Directors, and his wife, the Honourable

internationally-recognized clinical and

Linda Frum, a Sinai Health System Board

research programs.

Member, have generously donated $7 million toward the project, including $1 million for research. Patients will feel the impact of their generosity in many ways, but most visibly, the current, tightly packed ED waiting room will be replaced by a

— and back to her morning stroll, albeit shorter and with a walker for now. “I do everything myself,” she says, sitting at the kitchen table of her immaculate

Waiting Area.

apartment with its beautiful city views.

Reisman Emergency Centre expansion —

expectations — their polite way of challenging

allowing hospital leaders to build a state-of-

us — is a big part of our success,” says

the-art facility that could become a model

Dr. Ovens. “I’m personally so grateful for the

for other Canadian emergency rooms. Their

variety of ways they elevate our performance.”

layout and patient flow of the new ED.

at the right time brought her home faster

Sokolowski/Frum Reception, Triage and

“Their support, interest and also their

helpful to hospital leaders in rethinking the

already being felt. For Helga, the right care

new, family-friendly space, named the

Medicine Institute and the Schwartz/

management expertise has been particularly

The ambition is huge, but the payoff is

She vividly remembers how the fear and pain of that morning gave way to comfort and reassurance, and by nightfall, she can even recall thinking, ‘My God, it’s my lucky day.”

These gifts are part of the Sinai Health System’s “Campaign to Renew Sinai”,

Written by: Â´ Veronika Izabela Bryskiewicz Photos by: John Packman

Ron and social worker Sabrina Gaon

The way Ron Marks remembers it: It was a bitter cold winter night in December 2012. He was in bed as usual — a chronic lower back injury had limited his ability to walk for more than a decade. Suddenly, there was a loud knock at the door. Some men stormed in, and told Ron he was being evicted from his home. Making connections

Going above and beyond

Because of the confidential nature of

“We know that patients are happiest back

their role, Sinai Health System’s 48 social

in their community,” says Sabrina, who

workers are rarely in the health-care

today is the Manager of Interprofessional

spotlight. Yet, what they do is essential

Allied Health at Mount Sinai. “When we

Only much later, and thanks to tireless

to maintaining the wellbeing and

can connect a patient to a community

digging by Mount Sinai’s social workers,

independence of patients, which in turn

organization who can best serve them, we

would it emerge that a trusted acquaintance

prevents hospital re-admissions.

do. But sometimes we have to first help the

He was utterly dumbfounded as two policemen transferred him out of bed and onto a gurney. He was then taken to Mount Sinai Hospital, where he would end up staying for the next few months of his life.

had been stealing rent money from his bank account for an entire year, including $300

“By the time a patient sees us, their health

patient before they can be discharged.”

crisis is over and what ends up coming out

Sabrina was determined to help Ron

is a lot of everything else,” explains Wendy

transition out of the hospital and into a

Months later, when the hospital had done

Cameron, who is the Practice Lead for Social

place he could call home. She helped

everything it could for Ron and told him

Work at Bridgepoint Active Healthcare, part

restart Ron’s lapsed government cheques

it was time for him to find a long-term

of Sinai Health System. “The reality sets in.”

— which was like detective work since Ron

in overdraft, leaving Ron with nothing.

residence, he was worried. He felt vulnerable going back into the community without any money, and worried about how he would fare with his injury.

Moving on out When things seemed like they could not get worse for him, Ron met Sabrina Gaon, a social worker at Mount Sinai who was assigned to help him transition back into the community, which, at the time, was a scary thought for him.

had no identifying documentation, and

“ As a social worker, you can go home feeling like you’ve made a real difference in people’s lives.” — SA BRI NA GAO N, SO CIA L WO RKE R

could begin to rebuild his savings. She also helped Ron file a police report against the acquaintance who had stolen from him, found a community volunteer who helped him file his taxes, persuaded him to move to the group residence she had found and ensured that Ron left the hospital with clothes, toiletries and first and last month’s rent covered. Today, the Hanson Fund, supported by the generosity of donor Mark Hanson, provides funding to cover these types of miscellaneous but critical needs

“He wasn’t too happy about me at first,” Sabrina recalls, laughing.

not even a birth certificate — so that he

for patients like Ron at the time of their “Sometimes, our work can start with

discharge from the hospital.

By then, Ron had become quite acclimatized

counselling, which can then turn into

to the specialized ACE (Acute Care for

getting the person connected with

Although it took time to gain Ron’s trust, in

Elders) Unit. The care team accommodated

community resources based on their needs,

the end things worked out for the best.

his back injury by placing a mattress on

such as housing, mental health services,

the floor. He was warm, safe, fed and free

Meals on Wheels, home care and many

from anyone taking advantage of him.

more,” says Patricia Wendy, a social worker

There was also a great social atmosphere.

at Circle of Care, a home care provider and

Young volunteers visited regularly, as did

part of Sinai Health System.

the hospital’s Rabbi Schulman and his wife, bringing by books and magazines.

This past March, The Max and Larry Enkin

“Maybe there are frustrations, maybe there is bureaucracy, but at the end of the day you give a voice to people who don’t always have a voice,” says Sabrina. “And you can go home feeling like you’ve made a real difference in people’s lives.”

Family Foundation gave a generous gift

So when Sabrina came by with a

that will help provide much needed support

computer full of pictures of a group

for Sinai’s social workers, allowing them to

residence in Cabbagetown where he

connect more patients to resources in the

could live, the idea of moving yet again, at

community that can help keep them healthy

the age of 80, was daunting.

after treatment ends. 25

WHERE THE COMFORT OF HOME

CONNECTS

Written by: Janessa Bishop Photos by: Gerald Allain

 Mr. Marcus and personal support worker Leonora Durango

Ask most people who have spent time in a hospital where they want to be and the answer is likely unanimous: at home. Home is where we feel most connected to ourselves and the people we love, where our memories surround us in the photos and treasured items we have collected over the years. It’s where we feel most comfortable, safe and in control of our lives. Circle of Care, part of Sinai Health System, is committed to connecting clients to care that allows them to preserve what matters most — living comfortably and independently in their own homes. “Circle of Care started as a tiny, grassroots organization in a small house 42 years ago, and it’s grown into so much more,” says Carey Lucki, Interim President and Vice-President of Client Services at Circle of Care. “We’re extremely dedicated to providing compassionate care to keep our clients living as independently as possible in their homes.”

TO LEARN MORE ABOUT C I R C L E O F C A R E , WA T C H O U R B E H I N D -T H E - S C E N E S V I D E O :

youtube.com/sinaihealthsystemca

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

With close to 1,000 employees and over 400 volunteers, Circle of Care helps simplify everyday life for more than 13,000 clients across the GTA each year. Circle of Care specializes in providing home personal support services, professional services and many community programs to seniors and their caregivers. “We understand the challenges that seniors and caregivers face in later life stages and can support them with compassion, expertise and experience.” says Carey. Clients referred to Circle of Care have access to in-home consultations, customized care plans, regular home visits, 24-hour on-call support and navigation assistance to other community supports as required. Circle of Care also offers Kosher Meals  Carey Lucki in Circle of Care’s intake and call centre, where up to 1400 calls are received every day

on Wheels, transportation services and an Adult Day Centre for Seniors, as well as falls prevention and exercise classes.

We understand the challenges that seniors and caregivers face in later life stages and can support them with compassion, expertise and experience. — CA RE Y LU C KI, I NT E RI M PRESI DE NT, V I C E- P R ESI D E NT, C LI E NT SE RV IC ES, CI RCLE O F CA R E

A free exercise class provided by Circle of Care

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S



An exercise class participant stretching

 Occupational therapist Patricia Bartley leads the class in ball exercises.

“ I enjoy the exercise classes because it’s a great way to stay active and meet new people.” — SU Z Y KA R PA T, C I RC L E O F CARE C LI E NT

 An exercise class participant performs stretches with a resistance band.



An exercise class participant works with weights.

Ross Sternberg helps Suzy Karpat into an iRide Plus vehicle after her exercise class.

Connecting clients to care in the community For clients who need assistance getting to and from places, Circle of Care’s iRide Plus is a flexible, friendly transportation service. Ross Sternberg has worked as a driver for over 10 years, providing lifts back and forth for clients to social events, medical appointments and discharges from hospital to home. Some clients, like Suzy Karpat, simply need help getting to and from one of the 152 exercise or falls prevention classes Circle of Care offers at multiple locations across North York and South West York Region. These classes are run by registered occupational therapists, physiotherapists and physiotherapy assistants. “I was a volunteer with Meals on Wheels for years, but had to stop after having a bad fall,” says Suzy. “I enjoy the exercise classes because it’s a great way to stay active and meet new people.” Circle of Care also offers specialized programs, such as an adult day program for clients with dementia and a Holocaust survivors program, which provides additional personal support hours, emergency medical and dental assistance, mental health support, Kosher Meals on Wheels and transportation services. 29

 Meals on Wheels provides Kosher meals, prepared under the Kashruth Council of Toronto.



Leonora receives the Marcuses’ lunch from a Meals on Wheels volunteer.



Leonora prepares and serves the meal for the Marcuses.

And care at home Getting out of bed, eating breakfast, taking a shower — these simple tasks that many of us take for granted can become challenging as we age, or if our health is compromised. As a personal support worker (PSW), Leonora Durango assists clients with these daily tasks, providing critical support so they can continue to live comfortably at home. Leonora has worked at Circle of Care for over six years. As a PSW, she helps clients with daily tasks at home, seeing as many as five clients per day. She has worked for Mrs. Marcus, 86, and Mr. Marcus, 99, for five years and visits them daily in their North York apartment. “I have a close relationship with Mr. and Mrs. Marcus. I see them every day, so they’re like a part of my family,” says Leonora. “It’s a very close relationship, because I’ve become part of their daily lives.” The Marcuses rely on Circle of Care to help them live independently at home. As they both use walkers and are at risk for falls, they rely on Leonora’s support in the morning to get dressed and showered safely.

W H E R E G E T T I N G BAC K O N T R AC K CO N N E CT S

Mr. Marcus is at risk for falls, so Leonora helps him move safely to his chair.



Leonora combs Mrs. Marcus’s hair in her bedroom.

“We sit around a lot because we can’t drive anymore, and Leonora really brings us to life when she comes in,” says Mrs. Marcus. “We look forward to her visits,” adds Mr. Marcus. “She’s always got a smile on her face.” To ensure continuity of care, PSWs and clients are paired together as much as possible. Once a PSW learns a client’s routine, he or she is better able to sense any changes in a client’s behaviour or health. Leonora assists Bonnee with a glass of water.

“Personal support workers are often the first point of contact for many seniors and families,” says Carey. “In many cases, PSWs spend significant amounts of time with clients. They become very important in the client’s and family’s life.” Later in the day, Leonora visits her next client, 81-year-old Bonnee Peden. Bonnee has lived with multiple sclerosis for more than 30 years and now relies on a motorized wheelchair to get around her apartment. Leonora helps with her meals, cleaning and does her laundry. “I really adore Bonnee. She’s always so positive and warm, and I love spending time with her,” says Leonora. “Bonnee never complains, and she has such a fighting spirit.” “I feel really happy I can help someone who really needs my help,” Leonora adds. “I will always go above and beyond my duties as a PSW, because the clients really appreciate the care and support.”

THANK YOU TO OUR SPONSORS

Your support fuels groundbreaking discoveries that help change how we prevent, diagnose and treat the diseases of our time. P R ES E NTI NG S P O NS O R

E X P E RT PA N E L SPONSOR

VI P R ECE P TIO N S P O NS O R

DIS COVE RY CI RC LE

P L A TI NUM S P O NS O RS

The David & Stacey Cynamon Family Foundation

Nancy Pencer Mortgage Investment Corporation

Robert Rubinoff GO LD S P O NS O RS

Carol Mitchell & Richard Venn

Jack & Judy Winberg & Family

S I LVE R S P O NS O RS

The Harold E. Ballard Foundation

Brent & Lynn Belzberg

Cerner Canada ULC

Colliers International Group Inc.

Fasken Martineau DuMoulin LLP

Maxwell & Heather Gotlieb

The Kilmer Group

Moneris

Stephen & Suzie Pustil and Family

Jeff & Lori Rosenthal and Family

SCIEX

Sun Life Financial

M E DIA SPONS O R

P R I NT S P O NS O R

dinnerwithscientists.ca

Community Corner MOUNT SI NAI HOSPITAL UNVE I LS N EW LOBBY AN D DIGITAL DONOR WALL Earlier this year, Mount Sinai Hospital revealed its fully revitalized main floor lobby, made possible by the generosity of many Mount Sinai donors, which creates a welcoming entry into the hospital for the more than 10,000 patients, families, visitors and staff who circulate daily through the main lobby corridor. The new lobby features an expanded admitting area, accessible doors at both entrances, the RioCan Food Hall and the new state-ofthe-art digital Brent & Lynn Belzberg Donor Recognition Centre that celebrates the names of generous contributors who have supported the hospital over the past 94 years. Unique to Canada in its size and complexity, the recognition centre acts as the central art piece within the lobby, with a digital “canvas” that stands 50 feet long by 12 feet high and blends donor names with incredible moving images, messages and stories. “When we embarked on this project, our main goal was to recognize the generosity of our donors,” said Tony diCosmo, former Vice-President RioCan Food Hall

of Donor Relations at Sinai Health Foundation. “What we didn’t expect was the dynamic work of ‘living’ art we would have in the end.”

MOUNT SI NAI CE LE BRATES OPE N I NG OF TH E H E N N ICK FAM I LY WE LLN ESS GALLE RY In June, Mount Sinai Hospital celebrated the opening of The Hennick Family Wellness Gallery, supported by lead donors Barbara and Jay Hennick. Located on the main floor of the hospital and open daily from 7 a.m. to 7 p.m., the gallery is envisioned to be a key part of the healing process, providing a respite area where patients, families, visitors and staff can experience a tranquil space filled with exceptional works of art donated to Mount Sinai by the late Canadian artist Sorel Etrog. Research demonstrates that stress and psychosocial factors can significantly affect patient health outcomes, and that exposure to visual arts contributes in significant ways to improve mood, reduce stress and improve patients’ and families’ ability to cope with disease.

TO LEARN MORE ABOUT TH E HENNICK FAMILY WELLNESS G A L L E R Y, WA T C H O U R V I D E O :

http://bit.ly/Hennick

JUN E BLACK: A PARTY I N MY H EAD

P H O T O C R E D I T: G E O R G E P I M E N T E L

CLASSIC GOLF W H E N : May 30 W H A T: An annual golf tournament in support of the Lunenfeld-Tanenbaum Research Institute W H O : 1: A golfer tees off at St. Georgeâ&#x20AC;&#x2122;s Golf & Country Club W H E N : May 5 W H A T: A photography exhibit featuring

photographs by June Black in support of Bridgepoint Active Healthcare

2: Steve Miller, Co-Chair, Classic Golf; Richard Levinsky; Paul Stein; Brian Cohen, Co-Chair, Classic Golf 3: Kevin Goldthorp, former CEO, Sinai Health Foundation; Steve Miller; Miles Nadal, Co-Sponsor, Classic Golf; Andrew Moor, Co-Sponsor, Equitable Bank; Brian Cohen; and Committee Members, Jonathan Pollack, Shane Grosman, Rob Kumer

W H O : June Black and Conrad Black

H E RO RI DE W H E N : June 4-5 W H A T: A two-day biking expedition from Toronto to Blue Mountain Village and back in support of Bridgepoint Active Healthcare W H O : 1: Riders along the 250 km route

2: Team Bridgepoint

COMMUNITY CORNER

PEARLS OF WISDOM 2

W H E N : September 18 W H A T: A mentoring brunch in memory of Pearl Marcus in support of the Panov

DA VI NCI GALA W H E N : June 15

Program in Precision Chemotherapy W H O : Pearls of Wisdom event organizers, Michelle, Paul, and Jaclyn Marcus

W H A T: An annual gala in support of thyroid

cancer care and research at Mount Sinai Hospital

HUMOUR M E

W H O : 1: Enza and Joe Mancinelli, with this

W H E N : October 6

2: Sandy and Dr. Paul Walfish, with Shellianne Bedder-Green

W H A T: A night of comedy in

P H O T O C R E D I T: P M R E N D O N

yearâ&#x20AC;&#x2122;s honourees Susanne and Bill Blair, MP, COM

GEORGE KNUDSON OAKDALE PRO-AM

support of the Newton Glassman Charitable Foundation Neonatal Intensive Care Unit at Mount Sinai Hospital W H O : David Cynamon, Co-Chair

of Sinai Health Foundationâ&#x20AC;&#x2122;s Board of Directors, and Sinai Health System Board Member Honey Sherman perform a stand-up comedy routine dressed as Sonny and Cher

DE N IAL FI LM SCRE E N I NG

W H E N : September 7 W H A T: A golf tournament in memory of George

Knudson in support of cancer research at the Lunenfeld-Tanenbaum Research Institute 2 W H O : Tony diCosmo, former Vice-President of

Donor Relations, Sinai Health Foundation; Michael Steinberg, Knudson Committee Member; Jack Winberg, Knudson Committee Member and Sinai Health Foundation Board Member; Butch Mandel, Knudson Committee Member and Sinai Health Foundation Board Member; Moni Lustig, Knudson Committee Chair; Stephen Altbaum, Oakdale Golf & Country Club President

W H E N : September 15 W H A T: A private film screening of

the film Denial at The Hazelton Hotel W H O : 1. Steven and Lynda Latner 1

2. Susan and Gabriel Erem

COMMUNITY CORNER

Left: Fairchild Radio on-air personalities interviewing Mrs. Wu and daughter Riley, NICU patient. Right: Marian Walsh with Suetying Yu from Bridgepoint

I NAUGURAL SI NAI RADIOTHON RAISES $125,000 FOR SI NAI H EALTH SYSTE M On June 9, the inaugural Sinai Radiothon was broadcast live on Fairchild Radio (AM1430) from Mount Sinai Hospital in support of Sinai Health System, raising an incredible $125,000. Sinai Radiothon featured live interviews in Mandarin and Cantonese with patients and staff from across all four campuses of Sinai Health System — Mount Sinai Hospital, Bridgepoint Active Healthcare, Circle of Care and the Lunenfeld-Tanenbaum Research Institute. Listeners across Toronto tuned in to hear powerful stories from patients like Mrs. Wu, whose daughter Riley was in Mount Sinai’s Newton Glassman Charitable Foundation Neonatal Intensive Care Unit for many weeks after birth, and Mrs. Long, who was grateful for the mental health support she received from Mount Sinai’s Wellness Centre in Scarborough.

AN EVE N I NG OF BLACK, WH ITE AN D DIAMON DS AT SAKS FI FTH AVE NUE Over 300 guests gathered on May 3 at Saks Fifth Avenue in the CF Toronto Eaton Centre for an evening of black, white and diamonds, raising more than $200,000

PHOTO CRE DIT: WI LD CARD EXPE RI E NCE

in support of brain health and rehabilitation at Sinai Health System.

Above: Guests enjoying the casino games.

This event was one of the luxury retailer’s first Canadian fundraisers, and brought together some of Toronto’s finest for an evening of fashion and fine food. The event featured a unique shopping opportunity, food by Oliver & Bonacini and entertainment by The Toronto All-Star Big Band. The event was co-chaired by Carole Grafstein and Barbara Kerbel-May. Dr. Graham Collingridge, Senior Investigator at the LunenfeldTanenbaum Research Institute, shared insights into his award-winning research on brain mechanisms that play a role in learning and memory. In March, Dr. Collingridge was one of three scientists awarded the annual Brain Prize — the world’s most valuable prize for brain research — by the Grete Lundbeck European Brain Research Foundation in Denmark.

P H O T O C R E D I T: N I C K L E E

Left: Staff from the Zane Cohen Centre for Digestive Diseases. From left, Kara Semotiuk, Laura Winter, Dr. Zane Cohen, Melyssa Aronson, Salah Metwaly

N IGHT AT TH E CASI NO RAISES OVE R $155,000 On September 21, over 250 guests attended Night at the Casino at The Ritz-Carlton hotel in support of the Zane Cohen Centre for Digestive Diseases at Mount Sinai Hospital. The event, which raised more than $155,000, featured a dazzling evening of glitz and glamour,

“Our memories define who we are. Memory is a necessary

filled with Prohibition-era entertainment. Guests were treated to

human faculty — it’s the foundation of all science, music and

a cocktail reception, followed by a night of casino games, such as

literature. Without memory, we lose a sense of ourselves,”

poker, blackjack and craps. Elaborate food stations and open bar were

said Dr. Collingridge.

offered, with entertainment from The St. Royals.

WHERE THE

Mental Health and Neurodegenerative Disease

SEARCH FOR

ANSWERS

CONNECTS

Digestive Diseases Maternal and Infant Health

Diabetes Stem Cell Biology Cancer Biology and Prevention

Health Services and Solutions Arthritis

For over 30 years, Sinai Health Systemâ&#x20AC;&#x2122;s Lunenfeld-Tanenbaum Research Institute has been propelling the understanding of human health and disease. With your investment, we can make vital connections to accelerate discoveries. Support the next breakthrough today.

4 1 6. 5 8 6. 8 2 0 3 S U P P O R T S I NA I . C A

“ Because skiing is a big part of my life, it was always in the back picture, and even choosing a surgery, Dr. Theo told me, ‘This is more successful in females your age. This is going to be better for your long-term skiing.’ It wasn’t just about cutting me open, it was about why we were doing it and how it impacts the things that are important to me.” — MA DDY SU LLIVA N, PA TI E N T

TO SUPPORT CON N ECTE D CARE AT SI NAI H EALTH SYSTE M, PLEASE VISIT:

supportsinai.ca/sinaihealth

Sinai Health Magazine Fall/Winter 2016

Articles inside

Where the Comfort of Home Connects

Giving Patients a Voice

Where the Right Care at the Right Time Connects

BEHIND THE CURTAIN IN THE ICU

Back on Track