Our Shared Purpose newsletter - June 2018

OUR SHARED PURPOSE JUNE 2018

A high school’s mission to support the homeless Teaming up with St. Michael’s to give back (pg. 2)

Collaboration across the network Students learn about supporting patients in different settings (pg 3)

Home with a new hip in 12 hours How an innovative technique is speeding up recovery

Supporting seniors in the city Education, specialized services help keep patients healthy at home, in hospital and in the Houses (pg. 4).

How proper nutrition in hospital can get you home faster A new tool being used by dietitians is helping reduce length of stay (pg. 8).

When a hospital and high school come together A city-wide campaign for the underhoused

Our Shared Purpose is a monthly newsletter highlighting

BY SELMA AL-SAMARRAI

our people and the ways they

What does it take for an idea to become a

products, lip balm and tissue - that quickly

are improving care, patient

city-wide initiative? In this case, it took a

filled 814 care packages. The campaign was

experience and the health of

high school, a local community hospital,

named Be An Angel after the St. Michael’s

a shared interest in advocacy, and a

archangel, and the care packages created

continuing friendship between a high

through it were given to patients discharged

school teacher and her former student.

from St. Michael’s emergency department,

trauma clinic and neurosurgery clinic.

“

Last December, Emily Carreiro, a

St.Michael’s Hospital administrative assistant, contacted her former high school teacher Linda Izzo with an idea to create care packages for the homeless or displaced patients upon discharge from the hospital.

Izzo, who co-ordinates

“This project really opened our eyes.

When we think of helping

This project really opened our eyes LINDA IZZO HIGH SCHOOL TEACHER

homeless and disadvantaged people, we don’t often think of a hospital,” explained Izzo.

The campaign’s success enabled the distribution to expand and support 200 clients

Marshall McLuhan Catholic Secondary

currently helped by The FOCUS Team, a

School’s Peer Ministry program, jumped

partnership between St. Michael’s and Cota

at the chance to strengthen this mission

that supports individuals living with serious

and outreach. Within three months, the

mental health illnesses that significantly

high school donated 8,704 items - various

impair their ability to live independently.

essentials such as toothbrushes, toothpaste, soap, lotion, socks, a hat, feminine hygiene 2

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our communities.

Learn more: www.oursharedpurpose.com

High-touch learning with a high-tech twist A cross-network learning placement for students

BY EMILY DAWSON

Helping patients understand ‘transitions in care’ from

acute to rehab to community settings is a person-centred

shows is an effective way for students to learn. As part of their

approach that keeps people informed, engaged, and confident

placement, students were asked to design an art installation

throughout their health-care journey. How to have these

to represent and reflect their key learnings.

conversations is a fundamental skill for students to learn and

practice.

“

In our first two network-wide collaborative

learning placements, 25 students explored this

theme, and discovered how collaborative practice better supports patients along the continuum of health-care services.

The cross-network placement opportunity

marked a milestone in the education portfolio and

The team used an arts-based program, which research

“Through art, we were able to creatively translate what we do professionally into themes, and open up

It also sparked conversations that will help us communicate

alternative avenues of communication about our

with patients

on medical jargon,” said Angie Bradley, a Social

ANGIE BRADLEY SOCIAL WORK STUDENT

was a team effort between colleagues Lindsay

roles and skills. It also sparked conversations that will help us communicate with patients using other forms of expression, rather than relying Work student who participated in the learning placement. In total, the students represented 12 professions; this diversity deepened their insight

Beavers from St. Michael’s Hospital; Melissa Goddard from

on the theme.

Providence Healthcare; and Kaitlyn Vingoe and Tina Stewart

from St. Joseph’s Health Centre.

virtually collaborate across sites, and they were taught

synchronous content before independently creating their

Collaborative learning helps students from diverse

Video conferencing technology enabled students to

disciplines learn with, from and about each other. “It’s inclusive,

artwork.

and brings in patients, families and our administrative and

support colleagues, too,” said Beavers “The transitions in care

health care, different disciplines operate in silos. Opening

theme offered a learning experience spanning our network’s

up communication and approaching our jobs in partnership

clinical settings: acute care at St. Michael’s; community care

with other practitioners builds more person-centred care,”

at St. Joe’s; and rehab at Providence.”

said Bradley.

“I think in many cases, and this is also true outside of

OUR SHARED PURPOSE

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Celebrating Senior’s Month across the network

BY SELMA AL-SAMARRAI

Debra McGraw, activation assistant, and Janny, resident, play cards

Anne Nicholson has been a patient of the ECHS clinic for 15 years and counting.

Joan Powers looks forward to every Tuesday when she

Ninety-four-year-old Anne Nicholson has been coming

gets to revisit her childhood with a game of cribbage.

to the Elderly Community Health Services (ECHS) clinic at

“It gets very competitive – it keeps me sharp,” says

St. Joseph’s Health Centre for 15 years, and has received

84-year-old Powers, a resident at the Cardinal Ambrozic

care from a rheumatologist, a respirologist, a chiropodist, a

Houses of Providence since last year. “I would not have met

dermatologist and a physiotherapist. But there’s always been

Janny otherwise,” she adds, referring to her new friend.

one constant.

“

Helping residents successfully transition to long-term

“The physician I was referred to from the very beginning,

care requires a holistic approach and activation assistants

Dr. Marcia Varga, is the one I continue to see today. She is so

like Debra McGraw have

caring, doesn’t rush you out of the office, really takes an interest

an important role in the

in your condition, and tries to be as helpful as possible,” says

Cardinal Ambrozic Houses of

Nicholson.

Providence.

It gets very competitive — it keeps me sharp JOAN POWERS RESIDENT

The outpatient ECHS’s multidisciplinary team, which cared

They pay special attention

for 3,250 elderly patients in the 2017-18 fiscal year, includes

to the unique needs of the

geriatricians, physiotherapists, occupational therapists,

nearly 288 residents and help

speech/language pathologists, social workers and nursing

them to flourish in a new

staff.

environment through the

design and development of

Program, was developed in response to a gap identified by

meaningful activities.

team members, who were hearing increased concerns from

Programs span from

caregivers about supporting a newly diagnosed family member.

The clinic’s newest service, the Caregiver Support

intellectually-geared interactive word puzzles and card games

to mindful exercises such as chair yoga – each one adapted

loved ones with dementia and includes strategies to manage

to a resident’s level of ability while placing great emphasis on

changes in behaviour, communication tips, and interactive

social inclusion and cognitive health.

sessions.

The six-week program focuses on how to help care for

“Our new Caregiver Support Program is a strong example

of how aware the clinic staff is to the needs of patients and how they appreciate the challenges our patients and their families live with,” says the Head of Geriatrics, Dr. Fiona Menzies.

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OUR SHARED PURPOSE

BY THE NUMBERS 34,460

visits TO OUR EMERGENCY DEPARTMENTS

BY PATIENTS OVER THE AGE OF 65

18,604

VISITS TO ST. MICHAEL’S HOSPITAL’S EYE CLINIC

4,724

VISITS TO PROVIDENCE HEALTHCARE’S STROKE/NEURO OUTPATIENT CLINIC

3,250

VISITS BY ELDERLY PATIENTS TO OUR ELDERLY COMMUNITY HEALTH CLINIC

353

TOTAL RESIDENTS IN THE HOUSE OF PROVIDENCE ALL NUMBERS FROM THE 2017-18 FISCAL YEAR

Laura Shapiro, occupational therapist, tries on an age simulation suit with the help of Lindsay Beavers, collaborative learning specialist.

Frances Carbonel began her nursing career in General

improvement specialist for St. Micheal’s Senior Friendly

Internal Medicine at St. Michael’s Hospital just over 11 years

Hospital Strategy.

ago and often worked with elderly patients who had multiple

health conditions, occasionally including frailties and cognitive impairments.

“I found myself wanting to help

improve their health outcomes so that they can function well and subsequently as independently as possible in their own homes,” explains Carbonel.

It was through this interest that

she decided to pursue one of the four evidence-based geriatric education courses at St. Michael’s, which launched

To date, 106 staff members have completed at least one of

I found myself wanting to improve their health outcomes

“

FRANCES CARBONEL NURSE

the courses. Carbonel took the Geriatric Resource Nurse course, which is designed to educate nurses on providing acute care for hospitalized older adults, and includes an Interprofessional Geriatric Education day along with other health disciplines to enhance collaborative learning.

“I especially appreciated being able to dialogue with a multidisciplinary team during the Education Day because it

in 2017. After taking the course, Carbonel transitioned her

really does require a group effort, at all levels, to improve

career towards geriatric care by joining the Elders Clinic at

outcomes for older adults,” said Carbonel.

St. Michael’s.

“The need for standardized, accessible geriatric

focused education was identified through staff feedback in previous needs assessments,” explains Lori Whelan, quality OUR SHARED PURPOSE

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Questions & Answers with Leonard Benoit, Aboriginal Navigator

BY AMBER DAUGHERTY

Leonard Benoit is a nurse and understands how to navigate the health-care system. But for other First Nations, Inuit and Métis peoples, concern about stigma, discrimination and other factors can prevent them from coming into the hospital – even at the expense of their own health. Indigenous People disproportionately show rising rates of cancer and are diagnosed at a stage when it’s too late to talk about a cure.

with institutions because of perceived stigma and

To support these patients, Leonard became an aboriginal

for staff – I bring the perspective of the patient to the care

navigator with with the Toronto Central Regional Cancer

team to help them understand issues that may be at play

Program, a position that supports patients at hospitals across Toronto – including St. Joseph’s and St. Michael’s – as they navigate the healthcare system. We caught up with him to learn more about his role and how he’s helping enhance patient experience.

Why is a role like this necessary?

A lot of people don’t know Indigenous culture or language,

including smudging, which some hospitals have policies for and others are still working on. It’s important that we educate health-care professionals about different cultural needs so that when anyone walks into a space they feel welcome and safe.

Indigenous Peoples also have a complicated relationship

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patients feel more comfortable navigating the health system, I think we would see them access care faster and serious issues caught earlier through screening.

How do you provide support in this role?

A cancer diagnosis can prompt a lot of fear – I can help

by going to appointments, asking questions and explaining anything the patient doesn’t understand. I’m also a resource

“

Nations, Inuit and Métis peoples have different spiritual needs,

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are and what I can help them with. If we can help Indigenous

including historical trauma, PTSD, perception

Reaching out to me is another layer of wraparound support

which can create barriers in providing appropriate care. First

discrimination, so I work with them to learn what their needs

of stigma and so on. Having these conversations makes it easier for patients to access care and hopefully have a better outcome. Reaching out to me is another layer of wraparound support.

Why is it important to you to support the Indigenous community in this way?

This role was created to get people screened

and into treatment sooner so that they have better outcomes and I’m happy to contribute to that goal. I am First Nations and this allows me to do amazing things with my brothers and sisters, to dabble in a little bit of nursing and to help connect people to the care they need – both in hospital and in the community.

Leonard is one of ten Aboriginal navigators across the

province with CCO. He has an office at St. Michael’s Hospital and can be reached anytime via email: benoitl@smh.ca.

HOME WITH A NEW HIP IN 12 HOURS

BY ANA GAJIC

Dr. Khoshbin and his team perform a same-day hip replacement surgery on a patient in late May.

Sportscaster Vic Rauter is famous for announcing major sports wins, but earlier this year he participated in a novel hip replacement surgery that has become a win for patients and staff alike at St. Michael’s

“It’s a culture change.” Dr. Khoshbin said. “It takes the

right team, the right hospital and the right patient to make this surgery successful.”

Every department that would care for the same-day

patients worked closely with orthopedics to plan the safest

Hospital.

possible experience.

With a deteriorating hip, Rauter was introduced to

The team determined how to screen for patients eligible

Dr. Amir Khoshbin, an orthopaedic surgeon

for same-day hip surgery.

at St. Michael’s who was touting a new, same-

day discharge option for hip replacements.

day discharge hip replacement procedures.

St. Michael’s had become the first hospital in

Each procedure saves the hospital about 20

Toronto to offer same-day discharge for hip

per cent of the costs associated with a longer

replacement surgery in January 2018. Rauter

recovery in-hospital. More importantly, it

was intrigued.

offers patients rapid and safe healing.

St. Michael’s has completed about 15 same-

“I had heard about this rapid discharge

“To say it was miracle-like is not an

option in the United States,” he said. “But now

overstatement,” Rauter said. Within three

that it was an option at my hospital, where I

weeks, he was gardening without any arthritic

was born and had my first joint replacement, I knew I had to sign up.”

VIC RAUTER SPORTSCASTER, PATIENT

Since November 2017, Dr. Khoshbin had been laying the

groundwork to give suitable patients the option of a same-day discharge for hip replacements.

pain. “I’m very grateful to the entire team.”

To see extended coverage of our same day hip surgery visit us online at www.stmichaelshospital.com

OUR SHARED PURPOSE

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Reducing pressure injuries and length of stay — with food

BY AMBER DAUGHERTY

Sharon Chandra, dietitian, performs an SGA on a patient

One of the most important medications you may take in

risk for pressure injuries, an increased length of stay and

hospital is food. Eating properly helps you recover faster,

general decrease in stamina and health. The SGA is a tool that

reduces your chances of developing additional complications

can be used to identify potential malnutrition so the care team

and helps ensure you don’t have to come back again after

can help intervene. Strategies for supporting malnourished

you’ve gone home. A new process at St. Joseph’s is making it

patients can include changing their diet, referring them to

easier for staff to have important conversations about nutrition

a speech-language pathologist if there are functional issues

with patients and help them get the nutrients they need.

with eating, or adding additional protein to the food they are

consuming.

When a patient is admitted to the hospital, they’re asked

questions about their diet – have they recently lost weight

without trying and are they eating less than usual? If the

any of these measures because it’s critical they appreciate

patient answers yes to both, a dietitian follows up with them

how significant food is to their health,” Morganti said. “I always

to conduct a subjective global assessment (SGA).

want people to understand that it’s not OK that they’re not

eating well and that we’ll do everything we can to work with

“It’s a mix of questions and a physical exam,” said Antonia

“We work with patients to get consent before beginning

Morganti, registered dietitian. “We’ll look at factors that may

them to change that.

be impacting their ability to eat and also show them if they

have signs of muscle wasting or fat loss so they can understand

possible,” she said. “We’re really focused on working with our

that their ability to recover is reduced when they’re not eating

patients and families to help make nutrition a key part of their

properly.”

stay so that they’re strong enough to recover and then know

how to maintain a healthy diet when they’re back in their own

The Canadian Malnutrition Task Force highlights that

almost half of patients admitted to hospital are malnourished,

“Our goal is to get people home healthy as quickly as

homes.”

which can contribute to a range of issues including increased

Providence opens new Knowledge Centre Providence Healthcare opened its new Knowledge Centre, a dedicated environment that is supporting education, professional development and innovation.

Accessible for both staff and students, the Knowledge Centre houses the BMO Resource Centre, simulation labs, classrooms and coaching rooms. It also provides flexible space that can be configured as full rooms, hubs, or pods.

To promote teamwork, inclusion and sharing best practices, Providence’s nursing and professional practice leads are co-located to enable better connectivity among our leaders.

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