OUR SHARED PURPOSE September 2019
Comfort at the most difficult time Helping families coping with a stillbirth or neonatal loss. (pg. 7)
Pets allowed at Providence Visitation policy helps patients feel a bit more at home (pg. 2)
A LIFE IMPACTED, BUT NOT DEFINED BY MS What it takespatient to shares A St. Michael’s innovate (pg. 4) her story about her journey
with multiple sclerosis. (pg. 4)
Safe and healthy at home and work One of our infection prevention and control practitioners shares advice. (pg. 8)
Connecting as a team How one of the largest inpatient units at St. Michael’s is bonding together. (pg. 3)
Communication, collaboration and cohesion
How Providence’s pet policy benefits patients
How 14CC brought back their Unit-
Pet policy contributes to the quality of
Based Council and energized the team
life of patients, residents and clients
by Amber Daugherty
by Jennifer Stranges
(from left to right) Nurses Shirley Bell, Gloria Cardinal and June Son are part of the 14CC team (Photo: Medical Media)
Providence Healthcare is helping its patients, residents and
visited by her friend who brought along her dog,” said Chow.
14CC is a big unit, the largest inpatient unit at St. Michael’s, in
that’s been done by the UBC, those shirts were one of the most
clients feel a bit more at home through its pet visitation policy.
“She was so happy to see something that was familiar to her. The
fact. With 22 nurses working during the day and 18 at night, it’s
popular. “It might sound silly but I think they really brought it all together
hospital is an unfamiliar setting with unfamiliar people. The visit gave
possible that there are some members of the same team who
to help us feel like a team,” said Jennifer Goss, Materials Coordinator 14
supervision of family members or friends and contributes to the
her a sense of calm.”
might never work together. But they now have the opportunity to
& 15. The UBC includes several subcommittees that work together to
recovery and quality of life of patients, residents and clients.
connect and learn about one another – thanks to
recovery feel a sense of purpose and encourage those with limited
the unit’s revamped council.
visitation policy is quite rare in the Greater Toronto Area. After a quick
mobility to get outside and enjoy some fresh air.
sign-in by their handlers, dogs and cats can visit patients during regular
hiatus for a number of years until Gloria Cardinal,
hours.
not just those being visited.
registered nurse, and two of her colleagues had the
“The general reaction is a lot of smiles and a lot of, ‘Hey – can I
opportunity to bring it back to life through dedicated
in the orthopedic and specialized geriatrics units at Providence, helping
pet your dog?’” said Chow. “People are quite happy and joyful and it
time provided by the Late Career Nursing Initiative.
patients achieve a high quality of life through exercise, music, art and
becomes a topic of conversation, which helps people socialize.”
They spent some time with 9CC to see how their
gardening.
UBC worked and built on those ideas to create
Providence is helping to normalize the inpatient experience.
their own. Their first priority was to set objectives:
increase communication, improve patient care and
Many hospitals offer therapeutic dog services but the pet
As a therapeutic recreationist, Charissa Chow organizes programs
Chow and her colleagues help patients engage in meaningful,
goal-oriented programs, but an inpatient stay at the hospital can have
A visit from a pet can help patients who are daunted by a long
Many patients at Providence enjoy seeing the four-legged visitors,
By allowing a reminder of home into the hospital setting, “One of the best things about the policy is that it helps patients
The Unit-Based Council (UBC) had been on
patients missing home and feeling isolated. The pet visitation policy is
behave the same way they would if they were at home. It’s so great to
create a healthy work environment.
a welcome initiative among recreational therapists.
see.”
“Just over the weekend one of my patients with dementia was
“
make improvements: the social events committee
If your team is getting along and they’re cohesive, then the care they’re providing improves because they’re happy to be at work
plans events like an outing to a Blue Jays game;
JENNIFER GOSS
into work. Everything is pulled together at monthly
the quality improvement team looks at improving patient care through initiatives like MyStory; the
“
The policy welcomes dogs and cats to visit patients under the
MATERIALS COORDINATOR
“The key thing about the UBC is that it’s inclusive
recognition committee highlights when someone has received an award or hit a milestone in their career or schooling; the professional development team is on the lookout for opportunities to share; the health and wellness group is focused on making sure people are at their healthiest when they come meetings that are now expanding into night shifts
as well due to demand, and a monthly newsletter.
to all members of the unit, including not just nursing but clerical,
“If your team is getting along and they’re cohesive, then the care
physicians, volunteers – everyone,” she said. “We’re getting a lot of
they’re providing improves because they’re happy to be at work and
positive feedback.”
they like working with each other,” said Kim Grootveld, one of the unit’s
Our Shared Purpose is a monthly newsletter highlighting our people and the ways they are improving care, patient experience and the health of our communities.
clinical leader managers. “Now we’re seeing increased communication
Learn more: www.unityhealth.to
team members could share their pride for the unit. Out of everything
2
OUR SHARED PURPOSE
Along with the objectives, Cardinal also helped create T-shirts so
and collaboration.” OUR SHARED PURPOSE
3
Bibianne Yu sits still before her piano.
Watch Bibianne’s story at
Yu pounds two dramatic staccato chords to break
features.unityhealth.to/MS
the silence and then a flood of notes — fast and winding — flow from her fingers. Her passion and skill pierce through the hum of static on the recording of one of her old auditions, a performance of the Poulenc concerto for two pianos.
Listening to the performance now, the former concert pianist and
instructor feels humbled. Yu, 47, hasn’t touched a piano in close to three years.
She sold her beloved piano in 2016, eight years after she was first
diagnosed with multiple sclerosis (MS). The disease affected the agility of her fingers and gradually took away her ability to enjoy one of her life’s greatest passions.
A life impacted, but not defined by MS
4
“At times, it felt like I had gloves on,” Yu says of her increasing
struggles to practice and perform.
A photo of Bibianne Yu as a child with her beloved piano.
Dr. Montalban’s optimism impressed Yu. When she came in for her first
“Playing just didn’t have the same satisfaction. But now, I cannot
help but feel proud. Not boastful, but proud to have accomplished so
appointment, she had the same mentality as many patients.
much in music. I am thankful.”
a different perspective.
MS is a degenerative disease that impacts the central nervous
“I said, ‘I’m going to fight this,” Yu recalls. Dr. Montalban suggested
system by breaking down nerves’ protective layering and causing
damage.
lose, anything you have going on, we’ll find ways to treat it together.”
That message left Yu feeling ready to embrace the challenges she knew
Though there are treatments, there is currently no known cause
He told her: “A fight implies that you could lose. You’re not going to
or cure. It strikes at the prime of life – when people are in their 20s and
would come.
30s – and most often impacts women.
along the way,” Yu says. “St. Michael’s has given me that.”
Yu’s MS started with bouts of numbness. When she finally saw a
“It’s good to have confidence that someone is going to help you
neurologist in Michigan, where she was living and working at the time —
as the director of the Music Preparatory Division of Oakland University —
well-rounded team of specialists — occupational therapists, nurses,
magnetic resonance imaging (MRI) scans revealed lesions on her brain.
social workers, neurologists and scientists — will collaborate to provide
personalized care for patients.
She eventually returned home to Toronto and was referred to
Part of what will make the BARLO MS Centre unique is how a
St. Michael’s Hospital to continue to face the disease.
Patient Care Tower will reimagine access to care, clinic design and
MS is “Canada’s disease,” with one of the world’s highest rates of
The space occupying the top two floors of the new Peter Gilgan
the condition. One in every 385 Canadians are living with the disease.
knowledge generation, creating a “one-stop shop” for patients.
St. Michael’s is the country’s largest MS centre, with more than
Yu now spends her days living a life impacted, but not defined, by
8,000 patients receiving treatment at its clinic. The hospital has a unique
MS. “Piano was a bridge for me to connect with people,” she says. “So
opportunity to change the trajectory of MS for its patients through
I’ve set out to create relationships in different ways.”
world-class, specialty care and leading research and innovation.
church to teach English as a second language to newcomers. She
“We are one of the largest clinics in the world, which makes a
Instead of piano, she now serves on the ESL Cafe Team at her
difference,” says Dr. Xavier Montalban, a world-renowned neurologist
participates in activities through church and goes to the gym.
Bibianne Yu has found strength in her treatment for multiple sclerosis at St. Michael’s and is optimistic about the ongoing research into tackling “Canada’s disease.”
and researcher who came from Barcelona to lead the BARLO MS Centre
at the hospital, which is under construction.
child, beaming with her first piano. That smile still lives on Yu’s face,
now powered by different things. “Resilience is a good word to use for
the natural history of in the last three decades. The prognosis of a
learning piano,” Yu says.
By: Ana Gajic
patient recently diagnosed relative to one diagnosed 25 years ago is
incomparable. The potential to improve is exponential.”
and you need to strive forward.”
OUR SHARED PURPOSE
“MS is one of the only neurological conditions we have modified
Behind her bedroom door, she keeps a photo of herself as a
“Living with MS is similar. There are frustrating days but those pass,
OUR SHARED PURPOSE
5
IMPROVING SOCIODEMOGRAPHIC DATA COLLECTION Patients tend to be comfortable disclosing their race and ethnicity on a sociodemographic data questionnaire, but they often have difficulty selecting a response, suggests a study co-led by Dr. Tara Kiran, an associate scientist at the MAP Centre for Urban Health Solutions. Published in Canadian Family Physician, the study emphasizes the need for future research to gather recommendations from patients across Canada on how to best explain the purpose of race and ethnicity data collection, optimal wording to ask the question and related response options. “Collecting data on patients’ race and ethnicity is important to understand and address racial and ethnic disparities in health care and health outcomes,” said Dr. Kiran. “But we need to ensure that questionnaires are user friendly and informed by patients’ lived experience.” MAP scientist Dr. Tara Kiran is dedicated to quality improvement research at the St. Michael’s Hospital Academic Family Health Team. (Photo: Medical Media)
BASIC SCIENTIST SEEKS TO UNCOVER CAUSE OF MS When Dr. Shannon Dunn was two years old, her mother was diagnosed with multiple sclerosis (MS). “Her experience, though very difficult to witness, was a source of inspiration,” Dr. Dunn says. Now, Dr. Dunn is a recently recruited researcher in the Keenan Research Centre for Biomedical Science and is committed to understanding the science behind the disease that shaped her family’s life. She is focused on what causes MS and why certain risk factors seem to be associated with the disease. For example, she looks at the reasons behind why women get MS more often than men do and why childhood obesity is linked with MS. She models these risk factors in lab models of MS and studies the mechanisms of how these factors alter progression of disease in these models. “The ultimate goal is to identify early biomarkers for MS and treat people before they even know they have symptoms,” says Dr. Dunn. MS shaped Dr. Shannon Dunn’s life. Now, at the KRCBS, she’s uncovering new knowledge about it. (Photo: Yuri Markarov)
BARIATRICMEDICAL CENTREIMAGING OF EXCELLENCE SHARING DATA TO CUT RADIATION DOSES While Ontario is home to a rapidly growing bariatric population,
6
access to bariatric surgery remains a challenge locally across Patients might expect radiation doses for CT and scans to the be province. To help more receive the carebut they their comparable from onepeople hospital to the next, a need teamwithin at own communities, our three Healthvariance sites, together with Michael St. Michael’s Hospital saysUnity the dose can be startling. Garron Hospital, are nowand designated asdata the Unity Bariatric The team is collecting analyzing from Health eight hospitals Centre Excellence through the Ontario BariatricofNetwork. for the of Medical Imaging Metadata Repository Ontario (MIMRO) to help “Ourreduce person-centred modelaverage aims to improve access bariatric the province’s radiation doseto per scan. services, reduceintelligence wait times for ease care transitions for Using artificial tosurgery, sort theand hospitals’ data, the team patients,” said Sonya Canzian, andexam Chief Nursing generated comparative dataVP byClinical facility,Programs scanner and to help & Health Professions Officer.MIMRO is funded primarily by determine best practices. St. Michael’s The acute-care sites have by been bariatric surgery for and was created twoproviding of its radiologists, many years and Providence was recently Drs. Timothy Dowdell and Bruce Gray. approved as a Surgical Assessment Centre to round out the range of services we can Radiologist Dr. Bruce Gray and data analyst Lianne Concepcion review data provide. Providence will supportsubmitted patientstowith pre-(Photo: and post-surgical MIMRO. Katie Cooper) assessments and care in a new clinic slated to open in September. OUR SHARED PURPOSE
Providing families with more time after still births or neonatal loss The Cuddle Cot was brought to the Family Birthing Centre at St. Joseph’s Health Centre earlier this year. by Selma Al-Samarrai
The Cuddle Cot (pictured above) provides bereaved families the opportunity to spend more time with their baby. (Photo: Medical Media)
A new device at St. Joseph’s Health Centre is being offered to
and to build a community of witness, we’re punctuating the existence
families coping with a stillbirth or neonatal loss.
of their baby in the world,” explained Guerrera.
At least seven families have used the Cuddle Cot since its arrival
Lindsey Peacocke is a registered nurse and full time lactation
to St. Joseph’s Family Birthing Centre (FBC) earlier this year. It is a
consultant for the Women and Children’s Program at St. Joseph’s. She
bassinet attached to a cooling mechanism that’s designed to preserve
visits new mothers because she finds that breast care is not attended
the baby’s body to allow families to spend a bit more time with them.
to after stillbirth or neonatal loss.
“When we lose adults, depending on how long they’ve been in this
“In my experience watching families with the Cuddle Cot, I find
world, we have experiences, memories and mementos with them that
that it’s a lot more approachable for families and a lot less medical.
help us remain connected to them even when they’re gone,” explained
They’re comfortable taking the baby out of it, taking photos of the baby
Luisa Guerrera, patient care manager at the FBC.
in it and inviting visitors to come see the baby,” explained Peacocke.
Peacocke’s role involves talking to the mothers about breast care,
“But when babies pass away, they have such a short life that
families don’t have the benefit of that time and experience, and that’s
donating milk and associated concerns.
where the Cuddle Cot offers some comfort.”
explained Guerrera, who added that the Clinical Engineering team at
The Cuddle Cot provides families the opportunity to spend time
“The Cuddle Cot was born out of good-quality bereavement care,”
with their baby, take photographs, invite visitors and loved ones to
St. Joseph’s has been instrumental in providing support with the
meet them and say their goodbyes, all while the cooling mechanism
Cuddle Cot as FBC staff learn to use it.
is preserving the body’s integrity.
Foundation.
“When we can support families to spend more time with their baby
The Cuddle Cot was funded by the St. Joseph’s Health Centre
OUR SHARED PURPOSE
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How to prevent infections at work, at home and at play Tips to stay healthy from an infection prevention and control expert.
Ina Belu, an infection prevention and control practitioner at St. Joseph’s is pictured here
by Robyn Cox
working at her desk. (Photo: Medical Media)
Our world is full of bacteria and viruses and our best defence is
learning how to coexist with them safely as we go about our daily
to keep up to date on vaccinations and stay home if you are feeling
routines.
unwell,” says Belu. “Coming to work sick can put your colleagues – and
patients if you work in a health care setting – at risk.”
Ina Belu is an infection prevention and control practitioner at
“Another key way to prevent the spread of infection at work is
St. Joseph’s who advises staff on best practices for preventing
and reducing the spread of infections to support a safe and healthy
cleaning bathrooms and kitchens. Also, ensure you’re using a different
environment.
cloth or sponge in each area of the home so you aren’t transferring
germs from one space to another. Antibacterial soaps are not
No matter where you are – at work, at home or at play – Belu’s top
At home, Belu says to keep a general disinfectant on hand for
tip to prevent infection is hand hygiene. “It’s important to clean your
recommended for hand and personal hygiene.
hands often, especially before eating or handling food, after using the
bathroom or taking out the trash. Even if your hands don’t look or feel
consider putting a hand sanitizer at the starting point of the food table
dirty, bacteria and viruses may still be present.”
and be sure to use dedicated serving utensils for each dish. Refrain
from double dipping or sharing drinks. Likewise, don’t feel bad about
When washing, Belu suggests using regular soap and warm water
Belu also shared great tips for party hosts: “If you’re serving food,
and lathering your hands for at least 15 seconds. If your hands aren’t
cancelling if you’re sick; nothing tastes worse than a side of germs.”
visibly dirty, you can use a hand sanitizer instead. Belu recommends
using a hand sanitizer with an alcohol content of least 70 per cent and
Belu. “For example, a normal bacterial flora helps with digestion and
rubbing your hands together until they are dry.
metabolism. But we need to know how to protect ourselves, our
coworkers and our loved ones from bacteria and viruses that can make
At work, maintain a clean workspace. “Use disinfectant wipes to
kill germs on surfaces, especially the keyboard, mouse, telephone and armrests,” says Belu. 8
OUR SHARED PURPOSE
“Bacteria and viruses can be our friends or our foes,” adds
us sick.”