Our Shared Purpose Newsletter - July/August 2018

OUR SHARED PURPOSE July/August 2018

Supporting healthy eating in our community Dietitians teach kitchen skills in health class (pg. 3)

Providing rapid care How a new clinic is making a difference for heart failure patients (pg. 7)

IT TAKES A COMMUNITY

How this patient navigator is helping kids succeed (pg. 4)

Creating a shared mission across our network How our history is guiding our integration journey (pg. 2)

Looking at the light side How a stand-up comedian went from a stroke back to the stage (pg. 8)

COMMUNITY KITCHEN ENHANCES FOOD SKILLS ONE MEAL AT A TIME

The Sisters of St. Joseph were founded in Le Puy-en-Velay, France (left) in 1650.

Beth Johnson (right) is leading work to develop the Mission and Values for the network (Photo Credit: Ramon Syyap).

BY GREG WINSON

Shaping the foundation of our network

Liza Luu (left) and Punya Puri promote healthy eating habits in the community kitchen sessions. (Photo: Yuri Makarov)

In 1650, six women – the first Sisters of St.

focused on harmonizing those of our legacy

Joseph - came together in France with a

organizations, building on what we have in

Our Shared Purpose is a

unified mission to serve the sick poor. They

common and what resonates most with

monthly newsletter highlighting

articulated this mission through the notion

staff, physicians, volunteers, patients and

of unity: “to be one with God, each other,

families.

and the dear neighbour.”

In July, 1,500 people completed the

From this simple mission blossomed

Mission and Values Survey and provided

a legacy of care around the world. In the

valuable feedback. Next month we’ll be

words of an early 20th century news

hosting in-person activities across the

reporter, the Sisters of St. Joseph of Toronto

network where you’ll hear about the

“worked amongst the people trying to meet

language that resonated with our people,

the unmet needs of the most vulnerable”

see how the draft statements are shaping

across our city.

up, and have the opportunity to provide

more feedback as we refine the statements.

The Sisters have entrusted us to carry

on the spirit of their work and now that we

We are approaching the one-year

our people and the ways they are improving care, patient experience and the health of our communities.

Learn more: www.oursharedpurpose.com

New immigrants to Canada face many social challenges,

including food insecurity, which disproportionately affects

cooking methods. Some participants are engaged in the food

newcomers.

preparation process, chopping up vegetables or mixing and

adding ingredients, while others are involved in the cooking.

With food prices rising, many are unable to afford healthy

Each session starts with a discussion of a recipe and

food options and instead turn to unhealthy processed foods,

sometimes without knowing the health consequences.

talk about the nutritional benefits of why we chose that recipe,

Others wind up relying

along with a general discussion

on take-out or fast food

about healthy eating,” said Luu.

as an alternative due to

competing obligations that

everyone has a role they are

take time away from cooking.

comfortable in.

Meanwhile, diabetes and

cardiovascular disease tend to

know how to use knives, so it

be higher among immigrant

can also offer an introduction

populations.

We sit together and eat and talk about the nutritional benefits of why we chose that recipe

to basic cooking skills,” said

St. Michael’s Hospital’s

Puri.

LIZA LUU REGISTERED DIETICIAN

“

A lot of people don’t even know how to use knives, so it can also offer an introduction to basic cooking skills PUNYA PURI REGISTERED DIETICIAN

“After we are finished cooking, we sit together and eat and

The goal is to make sure

“A lot of people don’t even

“

BY BETH JOHNSON, EXECUTIVE DIRECTOR, MISSION INTEGRATION

are one organization, it’s important that we

anniversary of our in tegration, and taking

create a single Mission statement and set of

Sumac Creek Health Centre registered dietitians Liza Luu

time to reflect on how our shared legacy

Values together.

and Punya Puri are working to address food insecurity and

has joined our organizations once again in

mission statement and strategic plan, which emphasize the

Our Mission and Values are foundational

promote health and nutrition. They partnered with the Regent

new ways. Together, we will confirm the

importance of building strong community relationships and

elements of our broader strategy - the “why”

Park Community Food Centre to run a community kitchen

Mission and Values for our new network

developing specialized services for those in need through

our hospitals exist, and the “how” we carry

with an emphasis on health promotion and prevention. The

that honour the Sisters and propel us

creative initiatives.

out our work. This is why the approach to

Regent Park Community Food Centre, a five-minute walk from

forward to a new generation of health care

our network Mission and Values has been

Sumac Creek, offers drop-in meal services, cooking programs

in Toronto.

and gardening programs to the community.

2

OUR SHARED PURPOSE

This partnership aligns well with St. Michael’s Hospital’s

OUR SHARED PURPOSE

3

IT TAKES A COMMUNITY

vocabulary, but also his vital social interactions.

parental stress, they can be better prepared to parent in

complex situations.”

“He’s not good at socializing,” Mendoza explains. “He’s by

himself a lot, and the doctors told me that’s not good. They

According to an interim report, a frequent request from

referred him to swimming lessons, and through Kerry’s Place

families is for financial assistance.

Autism Services he will go to summer camp, where there will

be music and cooking, and he’ll be with children his own age.”

income,” says Vojvoda. “They often can’t work, and there are

“That’s the biggest challenge, trying to maximize families’

40%

How K!DConnect’s patient navigator is changing lives

50%

Have no support network

Are children with autism spectrum disorders

30%

BY MARY DICKIE

215

Have difficulty communicating in French or English Dorjana Vojvoda (left) and Arlene Mendoza worked together to find support for Brian (Photo: Katie Cooper)

Arlene Mendoza’s son Brian was three when she noticed he

dismantle some of the many barriers young patients and their

was having trouble talking.

families face when trying to access mental health care and

services.

But, living in the Philippines at that time, she couldn’t

Referrals to the patient navigator July 2017- January 2018

25%

50%

Have specific mental-health concerns

Have a household income of under $30,000

(including ADHD, mood disorders or behavioral difficulties)

afford to take him to a doctor.

it can be finding a translator, researching financial assistance

Vojvoda even helped Mendoza’s daughter get a walker through

language barriers. A lot of times they don’t have anyone to

programs or just listening with a sympathetic ear.

the Holland Bloorview Kids Rehabilitation Centre.

talk things through with. But they are so appreciative. Often

“Getting a diagnosis is only the beginning,”

it’s just having another person who will listen.”

explains Dr. Tony Barozzino, director of

Mendoza says. ” I’m so happy I brought them here.”

community outreach and ambulatory

wants to see the K!DConnect program expanded.

services for St. Michael’s Department of

with many beginning in childhood.

Pediatrics and K!DConnect’s medical director.

barrier for them,” she says. “If they could avoid having a wait

It wasn’t until last fall - after Brian, now 14, joined his

mother in Canada - that he was diagnosed with autism by

Sometimes it’s as simple as filling out a form. Other times

Dr. Joelene Huber, a St. Michael’s pediatrician who participates in the hospital’s school outreach program. Knowing the family would need support through this journey, Dr. Huber referred them to a new St. Michael’s initiative,

Getting a diagnosis is only the beginning DR. TONY BAROZZINO DIRECTOR OF COMMUNITY OUTREACH

“Without Dorjana, I couldn’t get these things for my kids,” One in five Canadians faces mental health challenges, “Anxiety is prevalent, and seven to 10 per cent have ADHD

Vojvoda is fully booked - with a waiting list - and she “There’s a wait list for everything, and it’s just another

the RBC-K!DConnect Pediatric Patient Navigator Program for

Children and Youth with Developmental and Mental Health

food and housing security, literacy —that make life challenging

Conditions.

at the best of times, let alone with a mental health issue. We

and can have a huge effect on your future

Mendoza, a single mother who also has a 17-year-

knew we could improve our support of these families, and

productivity and happiness. If we can move

old daughter with a physical disability, is thankful that

that a connector, somewhere between a social worker and a

toward earlier intervention and better

K!DConnect introduced her to Dorjana Vojvoda, the patient

nurse, would be beneficial.”

connectivity with resources - and support

navigator who has helped her access the treatment and

Funded by a 10-year grant from RBC, Dr. Barozzino and

not just the child but the family - we’ll get

resources Brian needs.

his team — which now includes research lead Dr. Shazeen

better outcomes.” Still, those outcomes are

“It was overwhelming at the beginning,” says Mendoza,

Suleman plus two administrators and several students

not so easy to measure.

and that we should have two navigators, or five, or whatever

who works nights as a caregiver. “There were so many

— devised a pilot program, and in July 2017 St. Michael’s

the right number might be. And if we can share this, it might

appointments, I was confused, and I don’t speak English well.

pediatricians started referring patients ranging from toddlers

down a job and having meaningful social contacts, and we

One time I was supposed to go to my daughter’s appointment

to teens. More than half have received a diagnosis of autism.

might not be around to measure those,” says Dr. Barozzino.

and I ended up at my son’s caregiver instead.”

“So we use indirect measures: the number of services,

Brian access resources not only to improve his speech and

4

The K!DConnect program has helped Vojvoda to OUR SHARED PURPOSE

“Our focus is often on children facing barriers — poverty,

Vojvoda, who has a background in social work, has helped

or a learning disability,” says Dr. Barozzino.

“Those issues impact you every day,

list to see me, that would be wonderful.”

Without Dorjana, I couldn’t get these things for my kids...I’m so happy I brought them here.

LIZA LUU REGISTERED DIETICIAN

“It might be functionality 20 years down the road, holding

Research into the program is

continuing, and Dr. Barozzino and the team have been spreading the word.

“A number of institutions have

asked to see our template,” he says. “We hope to share it. We’re fortunate to have 10 years to prove that this makes sense

be great, and we’ll be leaders in this field.”

financial supports, parental health. If we can just minimize OUR SHARED PURPOSE

5

PARTNERING WITH PATIENTS

QUALITY IN ACTION

Patients are at the centre of everything we do and involving them in our projects and decision-making helps ensure their perspectives are always being considered.

St. Joseph’s is Diane McKenzie’s community hospital and she’s been a patient and family advisor with us for almost five years, working on a number of projects including helping increase hand-hygiene rates with our infection prevention team.

In addition to making sure our projects are patientfocused, we’re ensuring our hiring practices are as well.

McKenzie is currently sitting on the interview committee to hire a Chief Financial Officer for our network.

“Patients should be the centre of your universe,” she said.

“The ultimate goal is that every project will have a patient partner to help guide their way.”

Out of the emergency room and into the Rapid Heart Failure Clinic A cross-network learning placement for students

BY MADISON THAKORE

A patient enters the emergency department experiencing swelling and shortness of breath. Usually, the physician would consider two options for patients presenting signs of heart failure such as these: admit the patient, or discharge them for future treatment by a family doctor.

Now, with the Rapid Heart Failure Clinic at St. Joseph’s Health

Centre, there’s another option. Cardiologist Dr. Peter Mitoff and the clinic’s team provide alternative treatment for low-risk heart failure

AI ACCURACY IMPROVED WITH SIMULATED IMAGES St. Michael’s radiologists might get a new assistant in the coming years that never sleeps or leaves the hospital.

Since founding the Machine Intelligence in Medicine Lab in April 2016, Drs. Tim Dowdell, Joe Barfett and Errol Colak – all St. Michael’s radiologists – and artificial intelligence expert Hojjat Salehinejad have been teaching computers with AI how to interpret medical images. And make them.

Early on, the team realized hospital databases of medical images had numerous examples of common ailments for the AI to analyze , but too few of the more rare life-threatening conditions.

So the MIMLab programmed its AI to create computergenerated chest X-rays, which are now fuelling the technology that could one day help radiologists reduce errors and improve care.

Hojjat Salehinejad has been teaching computers with AI how to interpret and make medical images.

patients. Patient status is determined by emergency department physicians using a risk score calculator, which provides a seven-day and 30-day risk analysis of hospitalization and mortality rates.

If a patient is considered low-risk, they are discharged and follow

up is done by the clinic within 48 to 72 hours, where they continue to receive treatment for about 30 days. If they are high-risk, they are

“

they are admitted for treatment.

This allows us to expedite testing and appointments to help keep people out of the emergency room

Dr. Peter Mitoff, cardiologist, St.Joseph’s Health Centre

JENNIFER COMELLO, REGISTERED NURSE

In operation since January as one of 10 sites participating in the

Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial, the Rapid Heart Failure Clinic aims to improve care and reduce emergency department readmission.

6

SPACE KIDS

High school students have discovered that roundworms can survive in space for 69 days while living in a special container.

C. Elegans, the type of worm, had not been previously shown to survive in space in a Fluid Mixing Enclosure – the container – long-term.

Annie Gravely, 16, approached Dr. Jane Batt at the Keenan Research Centre for Biomedical Science (KRCBS) to study enzymes in worms and send them to space through the Student Spaceflight Experiment Program. On Earth, they analyzed the worms in the KRCBS lab. Their discoveries will be published in the journal Gravitational Space Research.

“Our experiment can be used by scientists to build on this knowledge,” Gravely said.

Jennifer Comello. “This allows us to expedite testing and appointments

Annie Gravely (left), 16, led a team of student scientists, including Alice Vlasov (middle) and Kay Wu (right), over the course of this unique experiment.

(Photo: Katie Cooper) OUR SHARED PURPOSE

“We’re able to take more time to delve into our patients’ health

history and risk factors,” says registered nurse and nurse navigator to help keep people out of the emergency room.”

Dr. Mitoff explains that as a community teaching hospital, the clinic

offers St. Joseph’s an exciting opportunity to improve patient care and better manage hospital resources.

“We tend to gravitate towards projects that will make a meaningful

difference in the care of patients we look after,” says Dr. Mitoff. “What really motivated us to participate in this trial is that it seemed good for patient care and offered us an opportunity to improve our own practices.”

Jennifer Comello, registered nurse, St.Joseph’s Health Centre OUR SHARED PURPOSE

7

Laughter is the best medicine for recovering stroke patient

BY RAMON SYYAP

Rob Hills reflects on stage before his performance at the Bad Dog Theatre Company on June 26, 2018. (Photo: Ramon Syyap)

The most basic elements of being a stand-up comedian are,

for an assistive cane.

quite obviously, standing up and telling jokes. After suffering a

stroke, Rob Hills wondered if he would ever be able to do either

their constant encouragement.

again.

sense of confidence, which isn’t easy when you wake up one

For Hills, the recuperation process began at Providence

Hills attributes much of his success to his care team and “They made me the person I am today. They gave me a

Healthcare’s Stroke and Neuro Rehabilitation Program. He

day and find that half your body is locked away.”

worked tirelessly with therapists towards small but significant

goals, like standing up from his wheelchair and regaining

troupe and returned to the stage at The Social Capital, a

strength on the left side of his body.

second-floor establishment in east Toronto.

Facing the very real prospect that he would never again

Almost a year after his stroke, Hills rejoined his improv

“It was one of the greatest accomplishments of my life and

be able to walk, Hills was motivated by the belief that he might

it was the most normal I’ve felt in years,” he says of ascending

someday return to the stage.

two flights of stairs at the venue.

“My first goal was to climb steps,” he explains. “The majority

Born with hypertrophic cardiomyopathy, a condition that

of comedy clubs in Toronto are on the second floor.”

limits his heart from pumping blood effectively, Hills’s health

After months of rehabilitation, Hills’s goal was slowly

has been and may always be an uncertainty. What remains

becoming a reality. By then, his therapy included short distance

constant is his resilience and love of humour. So it’s no surprise

walking exercises and visits to Variety Village, a sports and life

that looking back on one of his most challenging moments, he

skills facility partnered with Providence, where he could hone

can still make light of it.

the skills he had started to develop with his therapists. Stints

on a stationary bicycle soon evolved into laps around a walking

here and be glum or try to get my act together.”

track and as his stamina increased, he traded the wheelchair

NO SHORTAGE OF DISCOVERIES IN SIGHT Nearly 10 years ago, a team at the Keenan Research Centre for Biomedical Science made the discovery that the human eye has a lymphatic system, which clears fluid and waste.

Recent discoveries by Dr. Yeni Yucel, Dr. Neeru Gupta and their team also showed the eye is connected to the larger lymphatic system and highlighted a new pathway for fluid from the brain to reach the eye.

“There would be no excitement in this research if we didn’t feel it was connected to the patients who sit in our exam rooms every day,” says Dr. Gupta of their contributions to glaucoma research.

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Dr. Yeni Yucel is a clinician-scientist at the OURResearch SHARED PURPOSE Keenan Centre for Biomedical Science. (Photo: Yuri Markarov)

“I’ve got a lot of life left in me,” he remarks. “I can either sit