Niagara Health Now - Spring 2018 Edition

Spring 2018 issue NOWCELEBRATING5 YEARS OF CAREFind out how our St. Catharines Site has enhancedhealthcare for residents across Niagara since 2013 Cover story on page 4

NOW Message from Suzanne Johnston President4 Care closer to home Learn how our St. Catharines Site has enhanced Welcome to the latest edition of Niagara patient experiences since opening 5 years ago Health Now. The stories in this issue offer important information for our community6 How technology is changing healthcare and highlight the work of our teams to Ontario Telemedicine Network helps to provide provide extraordinary care to our patients timely care for patients from a distance and families. Inside you’ll read about the fifth birthday8 Focus on Quality celebrations at our St. Catharines Site. Highlighting the exceptional innovation The state-of-the-art hospital has been and research happening across our sites the catalyst for a number of significant enhancements to patient care over the past10 Caring for you in the Emergency Department five years. Knowing what to expect during a visit can help You will also learn about what to expect improve a patient’s experience when visiting one of our Emergency Departments, and how we work with our14 How we are living our CORE values academic partners to provide learning Acts of Kindness Workplace Challenge spreading opportunities for students. We will show you how technology is16 Learning opportunities at Niagara Health changing healthcare and improving Working with our academic partners experiences for those we serve. You will also see how our teams are embedding our18 Putting the focus back on mealtime Purpose, Vision and Values into our everyday Niagara Health part of effort to identify lives and our culture at Niagara Health. solutions to address patient malnutrition And there’s so much more inside. I hope you enjoy this issue!20 ‘The care was unbelievable’ Life-saving procedure now provided in Niagara Get the latest news from Niagara Health by signing up for email updates.22 How you can help Visit www.niagarahealth.on.ca to learn Bringing advanced breast screening how to sign up. to Niagara Health Follow us on: Please send feedback to:Niagara Health Now is produced by Niagara Health’s [email protected] Communications Team.Editor and Writer: Steven GallagherPhotography: Anna CobianContributing writers: Kim Jackson, Lisa PepperallLayout: Laurielle Allan

Staff, patientsembracingWe RoundProactive approach to roundingimproves communication Registered Practical Nurse Hope Barrett speaks with patient Lawrence Kroeker, while Registered Nurse Sarah Bertin checks medical equipment at the St. Catharines Site.The successful We Round is an Extraordinary Care strategicimplementation of any initiative aimed at reducing falls, pressure injuries,change is dependent on and improving the safe sharing and exchange ofthe people it impacts – information. It is now in place in every inpatient unit across Niagara Health sites.and thanks to an extraordinary team of nurses and Ms. Barrett said since We Round was introduced, sheinterprofessional staff who have embraced it, We believes the number of call bells from patients hasRound is helping to enhance patient care. been reduced on her unit. “They always know when I’llJust ask Hope Barrett, a Registered Practical Nurse on be back,” she says. “And they know that when I comeUnit 3A at the St. Catharines Site. She will be the first back, they can address any of their needs at that time.”to tell you that introducing We Round is positively Jocelyn Dooley, one of the many nurse educators whoimpacting her interactions with patients and helping helped implement We Round, says members of theher to use her time more effectively. team who first started making We Round part of their“At first I thought I was doing it anyway, but now using work have seen the largest impacts to patient care. SheWe Round, I get everything done at once,” she says. “It’s says charge nurses have reported a “dramatic decrease”like a checklist or a flowsheet, so I remember to do all in the number of call bells they are receiving, too.of these things every time I check on someone.” “Patients’ pain is better managed, patients are lessWe Round is a structured, proactive approach to agitated, communication with patients is improvingrounding in which nurses and other members of the because we are proactively addressing their needs,”healthcare team check on their patients at least every says Mrs. Dooley, who is now a clinical manager.two hours, and ask specific questions related to pain, “People have embraced it really well.”positioning, possessions, pumps and alarms, and Patients in isolation feel like they’re spending morepersonal needs each time. time interacting with nurses, too, Ms. Barrett adds. “They already feel isolated, so it’s comforting to them Extraordinary Care to know they won’t be alone for long.” Niagara Health Now 3

Five yearsof carecloserto homeAlexzander Carriere, the first baby bornat the St. Catharines Site, joined usto also celebrate his birthday.It was a celebration Even Alexzander Carriere, the first baby born inworthy of the successes the hospital six hours after it opened, joined us toour teams have achieved celebrate his fifth birthday. Everyone who attendedsince our St. Catharines sang Zander (as his family calls him) HappySite opened five years Birthday, before he was given a special birthdayago. gift – giant toy construction vehicles – from the physician who delivered him, Dr. Johan Viljoen,Patients – both past and present - visitors, local Chief of Obstetrics and Gynecology and Deputydignitaries and Niagara Health staff gathered on Chief of Staff.March 21 to celebrate the fifth birthday of the siteby highlighting the care thousands of people in “I was the first guy who got to see those chubbyNiagara have received closer to home. cheeks,” Dr. Viljoen said. 4 Niagara Health Now Zander said he felt special “because I was the first baby born!” he exclaimed. He said receiving so much attention made him feel like Batman, his favorite superhero. “We’re just so happy to be here, celebrating five years with the hospital and five years with Zander,” said Ashley McDermott, Zander’s mom, who has three other children, two of whom were also born at the St. Catharines Site. Since the St. Catharines Site opened on March 24, 2013, thousands of cancer, heart, mental health and other patients have had access to vital healthcare services right here in Niagara. “The state-of-the-art St. Catharines Site has been the catalyst for a number of significant enhancements to patient care,” said Niagara Health President Suzanne Johnston. “It is an exciting time at Niagara Health as we continue our work to build a world-class hospital system where the quality of patient care and the work environment are second to none.” Extraordinary Care

CARE CLOSER TO HOMEAt the event, Emmy-award winning musician The St. Catharines Site usheredMichael Kisur, from Welland, performed an in a new standard of hospitalemotional song he wrote about his healthcare care in Niagara. Here’s ajourney. The song, Hope Lives Here, was inspired snapshot of examples of careby the treatment he received through our Mental our teams have provided sinceHealth program, which he credits with saving his the opening.life. CARDIAC CARE Cardiac services have signi cantly expanded in recent years due largely to the opening of the Heart Investigation Unit. 8,750 2,012 cardiac catheterizations, a Percutaneous Coronary new procedure to diagnose Interventions, a new the severity of a patient’s non-surgical procedure that cardiac disease opens blood vessels in the heart to remove blockagesWelland musician Michael Kisur performed anemotional song, Hope Lives Here, he wrote about MENTAL HEALTH AND ADDICTIONShis healthcare journey. The Mental Health and Addictions Program has introduced a“This is the place where my life was saved, literally. number of new specialized programs, including services forI was in three years of depression and it was a very patients requiring longer-term treatment in hospital anddark, dark time. All I thought about all of the time psychiatric emergency care.was dying,” he said. “Thanks to the team and thecountless people involved here, my life was saved.” 141,392 29,802John MacDonald, Chair of the Niagara Health Boardof Directors, added: “We’re excited to be celebrating outpatient visits for patients Emergency Crisis andthe fifth birthday of our St. Catharines Site and the who did not require an Psychiatric Emergency visitsmany accomplishments since the opening. Many overnight stay in hospitalhands contributed to our extraordinary successesover the past five years to enhance healthcare for CANCER CAREresidents across Niagara. Our journey togethercontinues to create a Healthier Niagara.” The Walker Family Cancer Centre brought radiation treatment and other oncology services to Niagara for theZeau Ismail, Niagara Health’s Director,Interprofessional Practice, Ethics & Research, and rst time.David Ceglie, Vice President of Clinical Operationsat Hotel Dieu Shaver Health and Rehabilitation 3,691 64,244Centre, at the birthday celebration. patients received radiation treatments radiation treatment 4,133 54,005 patients received chemotherapy treatments chemotherapy treatment Numbers projected to end of March 2018. Numbers projected to end of March 2018. Visit www.niagarahealth.on.ca for more interesting facts about the St. Catharines Site Niagara Health Now 5

How Penny Beechman participates intechnology Niagara Health’s Pain Group using theis changing Ontario Telemedicine Network insidehealthcare a room at the Greater Niagara General Site in Niagara Falls.Ontario Telemedicine Networkhelps to provide timelypatient care from a distancePenny Beechman is It is difficult for Mrs. Beechman to travel tograteful to take part in the St. Catharines from her Niagara Falls home. WhenPain Group in the Mental the Niagara Health team learned of this, they asked ifHealth and Addictions she’d be interested in joining the group through videoProgram at Niagara conferencing using the Ontario Telemedicine NetworkHealth. (OTN). Telemedicine uses telecommunications technologyEvery Monday, Mrs. Beechman, who has chronic back to provide clinical healthcare in Ontario at a distance.pain, meets with fellow group participants OTN is a not-for-profit organization funded by theand a healthcare provider. Ontario Ministry of Health and Long-Term Care charged with building a sustainable and responsiveBut while other members of the group are in a room virtual care system. (Learn more about OTN online atat the St. Catharines Site, Mrs. Beechman attends www.otn.ca)virtually through video conferencing at the Greater Niagara Health uses telemedicine for patient care inNiagara General Site in Niagara Falls. several different programs. The Mental Health and Addictions Program is a leader in this area, having used the technology more than 1,000 times for patient care last year.6 Niagara Health Now Extraordinary Innovation

HOW TECHNOLOGY IS CHANGING HEALTHCAREMrs. Beechman says she’s thankful for the technology. “It’s a big relief and it’s“It’s a big relief and it’s kind of cool,” she says of OTN. kind of cool. The group has“The group has been a great experience. I have the been a great experience.support and I know I’m not alone. I have other people I have the support and II can share my story with in the group. I’ve learned a know I’m not alone. I havelot.” other people I can share myOTN was first introduced in the Mental Health and story with in the group. I’veAddictions Program more than four years ago, so learned a lot.”psychiatrists at the St. Catharines Site could consultwith patients who presented with mental health or Penny Beechmanaddictions issues at one of our other sites, allowing for Patientmore timely care for patients.Psychiatrists who are on call can also use thetechnology from home, consulting with patients atone of our sites.Dr. Amin A. Muhammad, Niagara Health’s InterimChief of Mental Health and Addictions, saystelemedicine has been a positive experience forpatients, their families and staff.“I’m very excited about this,” says Dr. Muhammad.“I have the confidence wherever the patient is, we cansee them if we have an OTN connection there. Thereare no limitations. It’s important we can be one-to-onewith patients and be able to see them.”Barb Pizzingrilli, Director of the Mental Health andAddictions Program, adds: “I think it’s wonderful. Thiscertainly gives us the ability to provide care close tohome for patients.”The program is continuously looking at opportunitiesto expand programming offered through OTNtechnology. Penny Beechman inside her Niagara Falls home.Here are other examples of how telemedicine is used at Niagara Health to provide care:STROKE PROGRAMThe Niagara Health District Stroke Centre at the Greater Niagara General Site in Niagara Falls has been usingtelemedicine for more than a decade. Here’s an example: When a patient suffering a stroke is brought to theNiagara Falls Emergency Department, time is of the essence to care for them, which includes being seen by aneurologist immediately. If a neurologist is not at the hospital, they can evaluate the patient virtually throughtelemedicine from their office or home. The neurologist is then able to determine the next treatment steps for thepatient, including the possibility of administering t-PA, a clot-busting drug that may improve an ischemic stroke.ONCOLOGY PROGRAMTelemedicine is used extensively for patient care within Niagara Health’s Oncology Program.For example, Niagara cancer patients requiring consultation with a medical expert at another cancer centre inOntario can connect with the healthcare provider through videoconferencing, reducing the need to travel. Niagara Health Now 7

FOCUS ON QUALITY“At Niagara Health, we allow fornatural labour whenever possible.”Dr. Johan Viljoen, Niagara HealthDeputy Chief of Staff, Chief of Obstetricsand GynecologyFocus on QualityWe’re proud of the exceptional work, research and innovation happening acrossour sites to improve patient care and safety. Throughout the year, this work,which includes many quality initiatives, is also being recognized and highlightedoutside Niagara. Here are some examples:Women’s and Babies’ team delivers top results nationwideNiagara Health was rated as a top-performing hospital Chief of Obstetrics and Gynecology, says that whilefor conducting fewer low-risk caesarean sections c-sections have become more commonplace overcompared with the national average. the last decade, there has been a greater emphasis among healthcare providers everywhere to reduce theThe Canadian Institute for Health Information procedure unless clinically essential.rated Niagara Health in the top 10 per cent of largecommunity hospitals nationwide for performing fewer “At Niagara Health, we allow for natural labourlow-risk c-sections in the last three years than the whenever possible. Less intervention leads to betterCanadian average. Niagara Health has achieved this outcomes for mom and baby,” he says. “This significantrating since centralizing maternal services at the shift has occurred since we created one specializedSt. Catharines Site when it opened in 2013. unit because it allowed us to standardize our practices and enhance the team approach to patient care.”Dr. Johan Viljoen, Niagara Health Deputy Chief of Staff, Extraordinary Care 8 Niagara Health Now

FOCUS ON QUALITYProgram earns national patient safety awardNiagara Health’s Venous Thromboembolism (VTE) care,” says Debbie Smith, the VTE project lead andprogram received the Excellence in Patient Safety Clinical Director at the Welland Site. “I am pleased toAward from the Canadian College of Health Leaders. report that Niagara Health is achieving this goal.”VTE is the formation of blood clots in a vein. It is one The VTE prophylaxis project is a strong exampleof the most common complications of hospitalization of a patient safety initiative that has achievedand the most common preventable cause of hospital sustainability, scale and spread, by collaboratingdeath. The Niagara Health initiative focused on across all levels of the organization, engaging patients,improving VTE daily risk assessment processes for and following through on implementation andevery admitted patient, and starting preventative measurement, Ms. Smith says.treatment if needed. “This makes our patients markedly safer, strengthens“The goal of this initiative is to ensure patients with our systems, and improves the safety culture of ourVTE consistently receive safe, reliable, high quality organization.”AHEAD program in the spotlight within 24 hours and some have even gone home the day of their surgery with the support of a dischargeThe Anterior Hip Early Ambulation and Discharge planner.(AHEAD) Project team was recently recognized fortheir innovative work to perform minimally invasive The team works together to continually evaluate thehip surgeries at the Welland Site. The surgery is care needs of this patient population through ongoingperformed using an advanced operating room table nursing, physiotherapist and occupational therapistand minimally invasive techniques under a fine-tuned feedback along with patient follow-up phone calls. Theanesthesia practice. AHEAD program team recently had their work featured at the Ontario Hospital Association’s HealthAchieveThis allows the patient to be mobile approximately Conference in Toronto.five hours after surgery with the assistance of speciallytrained physiotherapists. Most patients are homeNiagara Health recognized for leadership on Never EventsThe Never Events for Hospital Care Safety Initiative (CPSI) recognizing Niagara Health’s leadership onis a series of strategies that were put into place at Never Events.Niagara Health to reduce the number of Never Events CPSI interviewed Niagara Health to highlight the roleand increase prevention awareness. A Never Event the organization has taken in shifting the culture onis a patient safety incident that results in serious Never Events and to share processes other hospitalspatient harm or death that can be prevented by using could use to identify their own improvementorganizational checks and balances. opportunities. The initiative was also featured at theThis concentrated effort to reduce and prevent Never HealthAchieve conference.Events resulted in the Canadian Patient Safety InstituteOccupational Therapist Michelle Lowry, PatientCare Director Patty Welychka and ClinicalManager Ruth Peters with the AHEAD Programposter that was featured at the Ontario HospitalAssociation HealthAchieve Conference in Toronto. Niagara Health Now 9

How we care Extraordinary Carefor you in theEmergencyDepartmentNiagara Health teams committedto providing safe, quality carein a timely mannerRegistered Nurse Laura Blakely, left, and Nurse PractitionerSandi Pullano inside the Emergency Department at theGreater Niagara General Site in Niagara Falls.10 Niagara Health Now

HOW WE CARE FOR YOU IN THE EDNiagara Health’s URGENT CASES SEEN FIRSTEmergency Departments “Emergency Departments do not see patients on aand Urgent Care Centres first-come, first-served basis,” says Dr. Tom Stewart,see more than 200,000 Chief of Staff.visits in a year – about 550a day – making them the “Hospitals across Canada use the same triage scalebusiest areas when assessing patients to ensure the most urgentof the hospital. cases are seen first.”“There is always a lot of activity in our Emergency Although Niagara Health does its best to see everyoneDepartments and Urgent Care Centres. They are on a timely basis, things can change quickly in anunpredictable environments and no two days are the Emergency Department.same,” says Derek McNally, Executive Vice President,Clinical Services and Chief Nursing Executive at “Many factors contribute to the overall length of timeNiagara Health. a patient will spend in an Emergency Department. For example, if someone is brought in suffering from“What is certain is our healthcare team’s commitment a heart attack or has been in a serious car accident,to provide patients with safe, quality care in a timely they will be seen before other patients who have lessmanner.” urgent conditions and can safely wait,” says Dr. Stewart.Knowing what to expect during a visit can help “We recognize that waiting can be stressful,improve a patient’s experience. inconvenient and frustrating for our patients and families and appreciate people’s understanding andEmergency Department care focuses first on patience.”diagnosing the patient and second on determiningwhether they can be safely treated within the When the patient is brought inside the EmergencyEmergency Department and discharged home, or Department, a nurse may do another assessment beforewhether they need to be admitted to hospital for the patient is seen by a physician or nurse practitionerfurther treatment. (a specially trained advanced practice nurse).Urgent care is medical attention and treatment for To diagnose the patient, the physician or nursepeople needing immediate care for illness or injury practitioner may order bloodwork, X-rays, ultrasound,that is not serious enough for a visit to the Emergency and other tests, a process that could take several hoursDepartment. No appointments are necessary, and wait to complete.times are typically shorter in Urgent Care Centres thanin Emergency Departments. Throughout this period, the patient could expect to see a number of different members of theEmergency Departments are significantly busier than healthcare team, including lab assistants, medicalUrgent Care Centres, and there are often questions imaging technologists and respiratory therapists. Theabout how Emergency Departments are organized to Emergency Department physician may also requestcare for patients. a consultation with a specialist in cardiology, for example, if the patient is having heart issues, or anThe patient’s journey starts with a specially trained orthopedic surgeon for a serious bone break.Triage Nurse, who is located at the front of theEmergency Department and conducts the initial The Emergency Department physician or nurseassessment of the patient. This assessment may also practitioner will review the test results with the patientinclude some initial testing. and discuss suggested next steps in care. It is at this point that the patient will either be discharged, with instructions for follow-up care if required, or admitted to an inpatient unit. About one in eight patients who come to Niagara Health’s Emergency Departments is admitted. Continue reading on page 14 Niagara Health Now 11

HOW WE CARE FOR YOU IN THE ED Registered Nurse Jennifer Cox speaks with patient Daniel Pattison at the St. Catharines Emergency Department.SAFE, QUALITY CARE DID YOU KNOW?“Our healthcare teams work hard to serve everyone • Emergency Departments are busiest in theas quickly as they can, but we know people have afternoon and early evening.concerns and are sometimes frustrated by how longan Emergency Department visit can take,” • About 32,000 Emergency Department visitssays Mr. McNally. (20 per cent of the total number) in Niagara last year were for minor concerns, like soreAlthough not obvious, activity in other areas of the throats or prescription renewals that couldhospital can significantly influence wait times in the have been looked after more quickly at aEmergency Department. This also includes the length family physician’s office, walk-in clinic or otherof time patients admitted to an inpatient unit from the primary care setting in the community.Emergency Department may have to wait before theyare transferred to a bed. • Taking an ambulance to hospital may not impact the time it takes to see an EmergencyFor example, like other hospitals, Niagara Health cares Department physician. You will be seen by thefor a number of patients who may no longer require physician based on the severity of your healththe resources of the hospital. Many of these patients condition. Depending on your condition, youcannot be safely discharged to another setting without may be placed in a chair in the waiting roomhome care or additional services. And some may need to wait.different levels of care and wait in hospital beds forspace at other healthcare facilities, such as a • Niagara Health displays real-time wait times inlong-term care home. its Emergency Departments and Urgent Care Centres on its website (www.niagarahealth.“In addition to caring for patients who cannot be on.ca) and in waiting rooms to help peoplesafely discharged, we continue to see a high number make decisions about their care.of patients who are admitted to hospital with serioushealth conditions,” says Mr. McNally. “These increased • Niagara Health runs a year-long educationalpressures impact the movement of patients through campaign (www.niagarahealth.on.ca/options)our Emergency Departments and create backlogs to help the community understand medicalbecause our inpatient units are full. options and receive the right level of care as quickly as possible.“Improving access to care is a provincial priority, andNiagara Health works closely with the Local Health • It is important to bring an up-to-date list ofIntegration Network, Ministry of Health and Long-Term medications (prescriptions, over-the-counterCare and other important community partners to find medications and natural health products)solutions. Our commitment to all of our patients and when coming to an Emergency Department.families is to continue to introduce new initiatives thatenhance the experience for everyone.”12 Niagara Health Now Extraordinary Care



The Women’s and Babies’ team at Niagara Health donated school supplies to Community Care as part ofthe Acts of Kindness Workplace Challenge.How we are living our CORE valuesActs of Kindness Challenge is spreadingYou may see positive and Health’s Strategic Plan, given they do not provideinspiring messages like direct patient care.“You are enough” and “Be The department came up with the idea of performingKind” painted on waiting 1,000 acts of kindness to encourage our culture ofroom windows or on rocks kindness. The grassroots initiative grew from there.outside on the ground Other departments quickly jumped on board,at our sites. volunteering to participate in the Acts of Kindness Challenge.Niagara Health team members are painting the up- During the challenge, our teams have joined thelifting messages as part of our 1,000 Acts of Kindness global Kindness Rocks movement by painting inspir-Workplace Challenge. ing messages on rocks, donated school supplies, hats,The idea for the Acts of Kindness challenge was mittens and boots to children in need within the com-originally generated by our Information and Commu- munity, and purchased newborn sleepers and blanketsnications Technology team in February 2017, after the for infants who are born into the care of Family andlaunch of our workplace Be Kind Campaign on Pink Children’s Services.Shirt Day, a day when people wear a pink, blue or pur- So far, 10 departments have participated in the chal-ple shirt to symbolize a stand against bullying. lenge, completing more than 10,000 acts of kindness.Members of the team were looking for a way to sup- “That’s more than the equivalent of one act of kind-port the Extraordinary Care Area of Focus of Niagara ness for every employee at Niagara Health, working together for the best possible healthcare,” said Flo14 Niagara Health Now Paladino, Executive Vice-President, People, Organiza- tion and Development. “We know that kindness has a ripple effect. Imagine the impact.” Extraordinary Teams

LIVING OUR CORE VALUESMaking a pledge Niagara Health supportsfor positive change United WayLook up and help out. Niagara Health employees raised an incredibleIt’s a simple yet powerful pledge.It’s a pledge that Niagara Health team members have $78,714 during the United Way workplacecommitted to in support of Health Quality Ontario’sChange Day, a global movement for positive change campaign in October. In addition to generous one-that took place in November. time donations and payroll deductions, staff placedOur Interprofessional Advisory Committee, Medical change jars on their units and purchased “A HealthierAdvisory Committee and Nursing Advisory Committee Niagara Starts Here”T-shirts to wear on Dress Downmembers all pledged to live our CORE value of Com- Fridays to show their support.passion in Action. “I am so proud of our caring team and our culture of“We have committed to being aware of our environ- philanthropy here at Niagara Health,” says Suzannement and putting away our electronic devices while Johnston, Niagara Health President and Co-Chairwalking through our hospital facilities,” says Lori of the Niagara Health workplace campaign. “EveryMacCullouch, Director of Nursing Practice, Education dollar we raised came directly from our caringand Elder Care. “We are committed to helping others and compassionate team of staff, physicians, andin need through wayfinding, a friendly ‘hello’, or a volunteers. It supports essential programs andshoulder to cry on.” services in our community, many of them partners inTheir pledge was a springboard for positive change. care.”In just a few days, more than 300 staff, physicians and Staff, physician and volunteer participation continuesvolunteers had already committed to living Niagara to grow each year, which inspired our theme ofHealth’s CORE values of compassion, optimism and “getting better, every year.”achieving ambitious results.“There is also a lot of great work taking place to embed $3,000The campaign raisedour Purpose, Vision and Values into our everyday livesand our culture at Niagara Health,” says Niagara Health more than last year.President Suzanne Johnston. “It will be fun to watchthis movement build as more members of our teammake a pledge to live our values.”Niagara Health’s Interprofessional Advisory Committee, Medical Advisory Committee (shown above) andNursing Advisory Committee members all pledged to live our CORE value of Compassion in Action. Niagara Health Now 15

Learning opportunities plentiful for students Niagara Health works with academic partners to provide learning opportunities16 Niagara Health Now Kirsty Moreau says she’s grateful for her placements at Niagara Health while she was a student. Extraordinary Teams

LEARNING OPPORTUNITIESKirsty Moreau has come number of healthcare-related fields,” says Zeau Ismail,full circle with Niagara Niagara Health’s Director of Interprofessional Practice,Health. Ethics and Research. “In addition to the students learning from our teams, we also learn from them andMs. Moreau completed several student placements at their experiences.”Niagara Health while she was enrolled in the Practical As a learning organization, Niagara Health also hasNursing Program at Niagara College between 2008 medical students in residence, which means betterand 2010. care for our patients by raising the standard across theAfter graduating from Niagara College, she got a job whole interprofessional team.with Niagara Health as a Registered Practical Nurse Clinical placements for medical students are offered(RPN). at Niagara Health’s Niagara Falls, St. Catharines andA few years later, she enrolled in an RPN to Registered Welland sites through a partnership with McMasterNursing (RN) bridging program at Athabasca University’s School of Medicine – Niagara Campus.University. She completed her final placement for theprogram at the Welland Emergency Department in “Collaboration is vital in healthcareMay 2016, and she landed a position as an RN in the and we are delighted to work closelysame department after graduation. with our academic partners to provideMs. Moreau is grateful for her many placements at learning and education opportunitiesNiagara Health while she was a student. in a number of healthcare-related“It was great working with the staff,” she says. “They fields.”were friendly, helpful and approachable.”She says the placements, which included working in Zeau IsmailWomen’s and Babies, Complex Care and Surgical, show Niagara Health’s Director of Interprofessionalnurses how many “different experiences” are available Practice, Ethics and Researchat Niagara Health.“It opened up our eyes to all of the possibilities in We also partner with Brock and McMaster onnursing at Niagara Health. There were a lot of options.” I-EQUIP – the Interprofessional Education for QualityEvery year, Niagara Health supports hundreds of Improvement Program. I-EQUIP is an extension of thestudent placements like Ms. Moreau’s across our sites. classroom, providing an opportunity for Brock andLast year alone, there were more than 1,900 student McMaster students and Niagara Health’s staff to workplacements in clinical and clinical-support positions. together on a variety of quality initiatives that improveWe have more than 80 academic partners with the patient care.largest number of students coming from Niagara The program provides participants with anCollege, Brock University and McMaster University. opportunity to design and implement a quality“Collaboration is vital in healthcare and we are improvement project in an interprofessional team,delighted to work closely with our academic partners developing skills in leadership, and influencing changeto provide learning and education opportunities in a in the healthcare setting.MEDICAL STUDENTS AT NIAGARA HEALTHWe have forged a strong partnership with the Niagara Regional Campus of McMaster University’s Michael G.DeGroote School of Medicine. The campus opened in 2008 at the former St. Catharines General Hospital site, andexpanded to Brock University in 2012 and the new Niagara Health: St. Catharines Site in 2014.Each year, the Niagara Regional Campus accepts 28 new students into the three-year undergraduate program,where they will complete their clerkship at Niagara Health sites, working alongside and learning from ourhealthcare teams.The campus also has approximately 25 post-graduate residents each year, who complete their residency at NiagaraHealth sites in such areas as family medicine, general surgery, emergency and mental health. Upon completion oftheir post-graduate studies, many of the physicians have returned to practice medicine in Niagara. Niagara Health Now 17

Putting the focus back onmealtimeIt’s a shocking statistic. 2. Have you been eating less than usual for moreNearly half of all patients than a week?admitted to Canadianhospitals are malnourished. When a patient answers yes to both questions, it triggers a referral to a hospital dietitian who developsNiagara Health dietitians Andrea Digweed and a personalized nutrition plan to find foods they preferLina Vescio have seen firsthand the preventable health eating or offering supplements and fortified menuimpacts malnutrition can have on patients. items, among other options.“They may come to the Emergency Department forweakness, and they’re treated for that and sent home, “The Niagara Health team has been very successful inbut it’s the underlying issues related to aging that their activities, ensuring that patients with nutritionbring them back in,” says Mrs. Digweed. “It’s not being problems are identified on admission and treated in aable to buy groceries or prepare meals that may be timely manner,” says Professor Heather Keller, Schlegelcontributing to the problem. The more nutritious food Research Chair in Nutrition and Aging at the Schlegel-you eat, the better your overall health. Tea and toast University of Waterloo Research Institute for Aging.isn’t going to cut it.” “Patients also indicated they encounter quite aSeniors can face many challenges to eating at home number of barriers to eating even while in hospital,”such as limited income to buy groceries, lack of adds Marilee Stickles-White, Niagara Health Regionalinterest in cooking or eating when living alone and Manager, Clinical Nutrition Services. “Some of thoseage-related health changes. barriers are simple things that we take for granted like opening packages on a meal tray.”According to the Nutrition Care in Canadian Hospitalsstudy, malnutrition is a wide-spread problem that if The program also involves recruiting volunteersleft untreated could cause a continuous circle of issues to provide added support and socialization tofor patients. These patients experience longer hospital patients during mealtime. “Mealtime is a social time,”stays and are at higher risk for readmission within 30 says Mrs. Stickles-White. “It’s nice to see a friendly facedays. The majority are seniors. encouraging them to eat.”As one of five Canadian hospitals to participate in Niagara Health is already seeing positive results. Themore recent research conducted by the University average number of mealtime barriers identified byof Waterloo, Niagara Health has been involved patients in hospital has been significantly reduced.from the early stages in identifying solutions toaddress patient malnutrition. The project also helps patients return home by connecting them with community supports like MealsAs a result of our work with Waterloo’s More 2 Eat on Wheels and grocery delivery services, for example,study, new processes were introduced at Niagara as well as community dietitian services.Health to assist our teams in identifying malnourishedpatients and supporting them with resources to “It’s working with our community partners to ensureimprove nutrition both while in hospital and after they these patients have the support they need whenare discharged. Patients admitted to Niagara Falls, they go home so we don’t see them back for theSt. Catharines and Welland sites are now asked two same reasons,” Mrs. Vescio says. “We’ve noticed thescreening questions: benefits of getting to them quicker. Getting to them quicker means we can avoid barriers, get the proper 1. Have you lost weight in the last six months nourishment set up such as supplements or preferred without trying? foods - so when they get home, we can start them on the road to healthier eating.”18 Niagara Health Now Extraordinary Care

FOCUS BACK ON MEALTIMENiagara Health dietitians Andrea Digweed and Lina Vescio have seen firsthand the preventable healthimpacts malnutrition can have on patients. “Mealtime is a social time. It’s nice to see a friendly face encouraging them to eat.” Marilee Stickles-White Niagara Health Regional Manager, Clinical Nutrition Services For a list of Meal and Food Support Services in Niagara, please visit our website www.niagarahealth.on.ca and search for Meal and Food Support Services. Niagara Health Now 19

20 Niagara Health Now Tom and Lorraine Paolone at their Welland home. Extraordinary Innovation

‘Care was unbelievable’Life-saving procedurenow provided in NiagaraTom Paolone was Post Anesthetic Recovery Room and Day Surgery.grateful when he “The introduction of this minimally invasive procedurelearned a procedure to Niagara also reflects our continued focus onto repair an aneurysm innovation.”in his aorta could beperformed in Niagara. Dr. Surianarayanan Rammohan, one of three Niagara Health Vascular Surgeons who performs the EVARThe Welland resident was the first patient to receive procedure, adds: “Our surgical teams are delighted tothe Endovascular Aneurysm Repair (EVAR) procedure be able to provide the EVAR procedure in Niagara. Theat the St. Catharines Site. The introduction of the life- introduction of this service illustrates the extraordinarysaving procedure to Niagara earlier this year is another care provided at Niagara Health.”example of care closer to home for residents in theregion. “The care was unbelievable. I felt supported totally.”“It was fantastic, especially for my wife Lorraine. Shedidn’t have to worry about travelling a long distance Lorraine Paoloneor booking a hotel room out of town. It took a lot Tom Paolone’s wifeof worry off of my shoulders,” says Mr. Paolone, whospent one night in hospital after the procedure before The aorta is the main vessel that carries blood fromreturning home. your heart to the rest of your body. An aneurysm occurs when part of this vessel has weakened and“I was very thankful to have the procedure done in ballooned out. The major complication is aneurysmNiagara. I was away from home in the hospital, but the rupture, which requires life-saving surgery.healthcare team made me feel at home. I was in good Abdominal aneurysms can be repaired in two ways,hands.” depending upon a patient’s condition:“The care was unbelievable,” adds Mrs. Paolone. “We • Open Repair, in which a large incision is madecould not ask for better care. I felt supported totally. in the abdomen to expose the aorta and theThey were beyond fabulous.” aneurysm is repaired with a graft.Niagara Health surgical teams started performing the • EVAR, a less-invasive technique in which a surgeoninnovative EVAR procedure in February 2017. makes a small incision in the groin and threads special instruments through a catheter in the“This is another example of improved access to care artery to the aneurysm, where a stent and graftfor Niagara residents,” says Jaelynne Sonke, Clinical are placed to support the aneurysm.Manager of the St. Catharines Site Operating Room, Patients who receive the EVAR procedure spend less time in hospital after the procedure, often returning home the following day. Niagara Health Now 21

Bringing advanced breast screening to Niagara HealthFor many people, a milestone birthday often consists A file photo of mammography equipment atof a celebration - gifts, party decor, friends and Niagara Health.family. For Kym G. of St. Catharines, turning 50 meant Kym says there have been a few bumps along the way,something completely different. It was the beginning or “wobbles” as she likes to call them, but overall sheof her journey with breast cancer. is grateful to have been screened locally through the Ontario Breast Screening Program at Niagara HealthBreast cancer is the most common cancer in Canadian and cared for close to home at the Walker Familywomen, affecting one in eight women during their Cancer Centre. While Kym is hopeful that her cancerlifetime. Women aged 50 to 74 are at higher risk and journey is behind her, she knows that she will needare encouraged to book regular mammograms. additional screening well into the future. By making a gift to Niagara Health’s Breast ScreeningSo, when her birthday arrived, Kym booked a Program, you can help patients like Kym celebratemammogram at Niagara Health. She had been for many more milestone birthdays.several mammograms before and didn’t think this onewould be any different. But this time it was - Kym was Dr. Nasim Hemmatidiagnosed with Stage 2 breast cancer. Niagara Health RadiologistIn order to continue providing the highest quality of To learn how you can make an impact at Niagara Health,care for patients like Kym, it is essential that screening contact Niagara Health Foundation:technology at Niagara Health is kept up to date. The 905-323-FUND (3863) | [email protected] of a special type of mammogram called www.NiagaraHealthFoundation.comTomosynthesis will ensure our patients receive thebest available care when they need it. @NiagaraHealthFdn“Tomosynthesis is the latest technology in breastimaging that was developed to improve the accuracyof mammography by capturing 3D images of thebreast,” says Niagara Health Radiologist Dr. NasimHemmati. “These 3D scans not only provide improvedimages, they also help reduce the need for recallappointments for additional assessment and biopsies.Ultimately, this spares patients a great deal of anxiety.”The advanced technology is becoming the preferredplatform for breast screening and diagnosis. The3D images allow the breast tissue to be examinedincrementally and seen with far greater detail andclarity, which is especially valuable for imagingwomen with denser breast tissue. Widely considered“mammography only better,” this state-of-the-arttechnology will help detect cancers earlier leading tobetter outcomes for patients.22 Niagara Health Now

Community Sponsors YMCA of NiagaraDisclaimer: We thank all the advertisers whosesupport has made this publication possible. Discover a healthier you at a YMCA Health,The appearance of the advertisements in this Fitness & Aquatics Centre in Niagara.publication should not be taken as an endorsementby our hospitals of any particular goods or services Visit ymcaofniagara.organd our hospitals cannot be responsible for the goods for a one week trial passand services which appear in those advertisements. A New 96 BedFamily Hearing Clinic.................................................. 26 Long-Term Care HomeFamily Mental Health Support Network Opening June 2016of Niagara........................................outside back coverHeart to Home Meals.................................................. 27 635 Prince Charles Dr. NorthHenley Honda................................................................ 25 Welland, ONHospice Niagara............................................................ 27Jarlette Health Services - Royal Rose Place......... 23 289.480.0400Mind Over Clutter......................................................... 26Niagara Prosthetics & Orthotics Visit www.jarlette.comand Orthocare Niagara............................................... 24 for more informationONESource Moving Solutions for Seniors........... 26Silver Cross...................................................................... 25 Making an Outstanding DifferenceSteve VanVelzen, Niagara Central in the Lives of OthersReal Estate Ltd., Brokerage........................................ 26Subaru Niagara.............................................................. 25 Niagara Health Now 23YMCA Niagara................................................................ 23 We are... ,everything print design &web ...if you can THINK it, we can INK it! Tel.: 613-475-2927 • 800-339-5662 15681 Hwy 2, Brighton ON K0K 1H0 [email protected] www.willowpublishing.com

24 Niagara Health Now

Stay home. Stay mobile. Your one-stop solution for virtually every type of mobility product. Our team of accessibility specialists will work with you and your caregivers to meet all of your mobility needs. Call us for a free in-home assessment, or visit our showroom and discover ways to improve your independence. 320 Vansickle Road #2 St. Catharines 905.685.4125 silvercrossstores.comstairlifts • porch lifts • accessible vans • walkers • daily living aids • ceiling lifts • medical bedsThank you to all the Health Care Professionals ThTahnaknykoyuoutotoalalltlhteheHHeaelathlthCCaarerePPrroofefessisoionnaallss of looking after what mattersGIVE US A CALL SALES 905-934-3379 800-934-7829 SErVICE 888-394-3079 905-934-7829 375 LAkE StrEEt ALEx DIGEnIS  ALEx DIGEnIS  308 LAkE StrEEt,St. CAthArInES, On Dealer Dealer St. CAthArInES, On Niagara Health Now 25

F A M I LY H E A R I N G C L I N I C Diagnostic Audiology & Hearing Aid Service Mike Pihura, B.Sc., M.S., AuD Doctor of Audiology - Clinical Audiologist Reg. CASLPO Owner 33 Lakeshore Road, Unit 8 Phone: 905-938-2479 Lake & Lakeshore Fax: 905-938-5544 St. Catharines, ON L2N 7B3 www.familyhearing.ca Bringing organization to your HELPING YOU MOVE FORWARD office and happiness to your home. STEVE VANVELZEN BSc SRES,Tips for organizing your space: 1. Remove or donate items you don’t SALES REPRESENTATIVE need, use or love. SENIORS REAL ESTATE SPECIALIST 2. Collect all similar items together, making groups. If there is still too (50+ REAL ESTATE PLANNING) much, donate some. 3. Place the items in a suitable container. BUS: 905.685.7474 4. Store the containers near where you DIRECT: 905.380.2214 use them. NIAGARA CENTRAL REAL ESTATE LTD., BROKERAGEYou’ll have more space and time to enjoy life. www.stevevanvelzen.com Tel: 905-563-7200 Text: 905-321-1616 See this publication and more at: [email protected] patient www.mindoverclutter.ca directoryJulie Stobbe .caTrained Professional Organizer Quality Healthcare Publications26 Niagara Health Now

Hospice Niagara focuses on improving the quality of life for people living with life-limiting illnesses, death, dying,grief and loss. We believe that no one should make this journey alone. Through a variety of programs and services, HospiceNiagara is able to provide compassionate comfort and support to families throughout the care continuum. These programsand services are offered at no cost to clients and include:Bereavement support for children, adolescents and adults.community palliative care Teams provide hospice palliative care in client’s homes.Day Hospice provides clients enjoy a day out in St. Catharines or Welland, enabling caregivers respite time.The Stabler Centre in St. Catharines is our residential hospice that provides care in a home-like setting.Trained Visiting Volunteers provide non-medical support in client’s homes. 905-984-8766 | [email protected] | hospiceniagara.ca Stay connected through Facebook and Twitter or sign up for our eNewsletter by emailing [email protected]. serViNg Families iN NiagaraHoSpiCe Niagara – THe STabler CeNTre HoSpiCe Niagara – WellaNd offiCe 403 ontario St, Unit 2 | St. Catharines, oN 555 prince Charles drive | Welland, oN Niagara Health Now 27

Good Mental Healthis a Family AffairMental Health Counselling / PsychotherapyWith 20+ years of experience, we offer common-sense strategies to increase yourinsight, self-awareness and manage your thinking. Therapeutic interventions includecognitive behavioural therapy, mindfulness meditation and motivational interviewingto challenge the symptoms of depression, anxiety, bipolar, schizophrenia andpersonality disorders.There are no magic fixes, but we offer practical solution-focused approaches that canbe learned with a commitment of 15 minutes of daily practice.Advocacy Services for the ElderlyIs there a loved one in your family who is:• Struggling to manage personal finances?• Vulnerable to exploitation by others?• Unable to understand or appreciate the consequences of mismanagement?• Distressed by a non-supportive family member?If so, we can assist with these services:Elder Mediation / Essential ConversationsCapacity Assessments to Manage Property & FinancesWe help familiesDan Silver, MS.Ed. Registered Social Worker #422500Psychotherapist, Elder Mediator, Capacity AssessorDesignated under the Substitute Decisions Act, 1992Offices in St. Catharines & Fort Erie.For consultation or appointment please call or email:(905) 641-2111 / [email protected]