Accreditation Kudos!

Congratulations to the Chatham-Kent Health Alliance team! Surveyors from Accreditation Canada conducted a careful peer review process to assess Chatham-Kent Health Alliance’s (CKHA) services. Accreditation offers assurance to our staff, our patients, their families and the Chatham-Kent community that CKHA is meeting the expectations outlined in 32evidence based Required Operational Practices (ROPs). An ROP is defined as an essential practice that we must have in place to enhance patient safety and minimize risk. In addition to ROPs – teams were working on accreditation standards. Standards are the driver for quality improvement in the departments and programs. An entire symphony of CKHA teams and front line staff have worked diligently to create and revise policies, procedures and plans to the ROPs enhancing the quality of our hospital services.

Thanks to each of you for living our CKHA values of respect, teamwork, compassion, trust, knowledge and accountability that led to the successes of this year’s accreditation. Our shared commitment will aidthe CKHA team in embracing new ROPs and sustaining our current practice.

Oncology/Cancer Clinic Team receive certification from de Souza Institute

Congratulations to VivianneDeWitte’s Oncology/Cancer Clinic team nurses who have achieved certification through the de Souza Institute. Cheryl Jarecsni, Jeannette Rivard, Karen Kennedy, Jackie Opavsky, Diane Jacksonand Colleen Janssens each completed the 21-hour Chemotherapy and Biotherapy course. Special congratulations to Cheryl Jarecsni (RN)who is now certified as a de Souza Facilitator for the Chemotherapy and Biotherapy course. Certification through the de Souza Institute ensures each Oncology/Cancer Clinic nurse has the knowledge and skill needed to meet the Cancer Care Ontario standards for chemotherapy administration.

In 2007, the oncology team earned a Human Touch award from Cancer Care Ontario for excellence in care.This latest achievement exemplifies our oncology nurses’ commitment to evidence based practice and patient centred care. They set the bar high, and we commend them.

Protection: It begins with you

Influenza, commonly know as “the flu,” is a respiratory illness that usually circulates throughout the fall and winter. People of any age can get the flu and sickness usually lasts two to seven days. Most people who get the flu are sick for only a few days. In others, the symptoms can last for weeks. In extreme cases some people can develop complications and become very ill, requiring hospitalization. Why risk it?

Protect your family: Illness caused by the flu can be prevented with a flu shot. Protect yourself and those around you.

Help protect your workplace: Get your flu shot to protect yourself, your co-workers and the patients we care for.

Protect yourself and your patients: Influenza is a potentially severe respiratory illness and is responsible for an increased number of healthcare provider visits, hospitalizations and deaths.

Influenza vaccine is available for all staff through CKHA Occupational Health & Safety Department (you can still call the OH&S department for an appointment), through your family doctor or nurse practitioner, and through Public Health clinics.

Are you ready for flu season?

Achieving the Highest Quality Care: Our Journey continues …

At a recent Best Practice Guidelines Breakfast For Champions, Dr. Irmajean Bajnok the Registered Nurses Association of Ontario (RNAO) Director of International Affairs and Best Practices Guidelines Programs spoke about her ideas on the “journey to enhance the quality of care”. She used the letters from the word JOURNEY:

J is for the Journey that we have undertaken together to enhance quality of care
O is for the best possible Outcomes that we aim to achieve
U is for Understanding the need for continuous improvement
R is for Reflection on our role and using the best possible Resources to find our way
N is to remind us to Never forget the patient and family in the centre of all we do
E is for Evidence, available through use of the RNAO Best Practice Guidelines
Y is for Yes! Yes we can do this! Yes, we are making a difference!

Here at Chatham-Kent Health Alliance, we are one of only 21 RNAO Best Practice Spotlight Organizations. On this journey to enhance quality of patient care, we must continue to work together as a team to provide evidence-based, high quality and safe care. A healthy workplace includes a combination of the use of best evidence, team-work and collaboration, diversity and professionalism. We must be confident and competent in our own roles within the interprofessional team to do the work ahead.

An exciting professional journey, indeed!

Keeping Our Drinking Water Safer

CKHA is on the leading edge once again, with being the first hospital in Canada to implement a new container called Pharmasmart! This container that looks like a hard plastic blue and white mini suitcase (see the picture below) is built to contain waste pharmaceuticals so that they aren’t discarded in a harmful way.

Studies show that medications that are discarded in the improper way may lead to contamination of local water systems. Now that we have these containers, any medication to be wasted (other than controlled drugs and those that are potentially contaminated after being used on a patient) should be placed in the blue and white Pharmasmart container for safe disposal. These new containers are being kept on the medication carts and medication preparation areas in the Pharmacy Department and on the patient care units.

Designed to meet Ministry regulations that require hospitals to separate their waste streams (biohazard and non-contaminated), these new containers are handled in the very same way as the yellow containers we are using now. The yellow Sharpsmart containers will still be used for disposal of “contaminated” items and sharps. The blue and white Pharmasmart containers will now be used for wasted pharmaceuticals (outdated injectable drugs, dropped tablets, returned unused liquids). The contents of the yellow Sharpsmart containers are specially treated and then go into landfill. The contents of the blue and white Pharmasmart containers are incinerated, keeping them out of our precious water system.

I’m proud of our hospital for being the first facility in Canada to use this new container system to divert waste and keep our communities safer.

Don’t Just Think It, Say It – Engaging Patients and Families to Enhance Patient Safety

The first week of November is designated as Canadian Patient Safety Week. The theme “Ask.Listen.Talk” promotes communication amongst patients, families, and healthcare providers. This year, patient and family advisors became actively involved in sharing this message to other patients, families, visitors and staff.

Patient & Family Advisor volunteers and hospital staff joined together to share information with patients, families, visitors and staff about best practices in patient safety. Storyboards focused on two areas of safety – the importance of the ID band and ways to be actively involved in care. The patient & family advisors talked with other patients, families, and visitors about their role in enhancing patient safety and the importance of speaking up. We handed out information on how to be involved in their care. We asked “What could we do differently to make you feel safe at Chatham-Kent Health Alliance?” We showed others how, as healthcare providers, we ask patients to tell us who they are in two ways before putting the ID band on. We taught them how we ask them to check and make sure the information on the ID band is correct, and that we check the ID band before giving medication or treatment. We also encouraged patients and families to “speak up” to be actively involved in their care.

Working with patients and families as active partners in care can improve communication that helps create safer care.

What? The Chicken Dance?

The Strategic Direction: Patients, says that we will partner with patients and their families in the delivery of safe, quality care. With a focus of falls prevention and management, we asked the Active Lifestyle Centre if we could lead a community forum about this topic. So this fall, Chatham-Kent Health Alliance staff, a patient advisor, and a public health nurse prepared poster boards, gathered information, and headed over to the Centre. Our audience was the exercise class, who listened to us talk about safety strategies related to falls. Public Health previewed a video called “Exercises at the Kitchen Sink”. Then we were invited to join the exercise class. Little did we know that the forum would include working up a sweat, let alone testing our skills doing the chicken dance? What fun we had together.

We could see by the level of activity that they already had a strategy to prevent falls. But what could we do differently? What could be done in the community to prevent falls? And how could we make a hospital stay, if needed, be as ideal as it could be? Over refreshments in the cafeteria, we listened to what they believed could make a difference. From better street lighting, to making sure we had wheelchairs at the entrances and handrails in high traffic areas, ideas were brought forward for us to consider.

In addition to sharing ideas and ways to prevent and manage falls, we connected with community partners for a common cause - to make our environment as safe as it could be and to educate each other about what we can do to prevent falls. Learning took place and relationships developed. Perhaps our next encounter we will do the Macarena – and this time we will be ready.

Celebrating Interprofessional Care—Respiratory Therapy

Respiratory Therapy evolved as a profession through advances in life support technology. Respiratory Therapy was once a very technical discipline, using wrenches and gauges, those working in the profession now have become therapists, trading their wrench for a stethoscope. Continuing to work through technology, they keep patients alive by physically supporting breathing, opening the airway and ensuring respirations.

The role of the Registered Respiratory Therapist (RRT) has grown through the years. You will find RRTs in the Operating Room, the Emergency Room, the Intensive Care Unit, the nursery and on the medical/surgical floors. They perform diagnostic testing on the heart and lungs, and teach patients how to understand and manage their chronic lung disease. Their patients range from very young to the elderly.

Like other regulated healthcare professionals in Ontario, RRTs are accountable to the public through their professional college, a group numbering approximately 2,300 in the province. At Chatham-Kent Health Alliance, there are 18 RRTs proudly practicing their profession at both campuses.

Happy Registered Respiratory Therapist Week!

Improving Computer Based Education

Six Months ago, the doors opened on Chatham-Kent Health Alliance’s (CKHA) newly furnished computer lab. Construction of the computer lab was to an area of redesigned office space attached to the Library, on the lower level of CKHA’s Chatham Campus. The computer lab initially housed 6 computers, a computer for the instructor, and a ceiling mount projector. Six additional laptops were later purchased in June. Now a dozen people can enjoy the benefits of computer-based learning in a comfortable, naturally lit environment.

The Professional Practice Team now has the ability to teach computer-based education in a “hands on training” environment. HOBIC (a computer documentation tool for nurses) education was completely through hands on training using the computer lab. We educated 224 nurses in the computer lab throughout the months of June and July. Laptops also allow us the ability to travel to other locations, and we were able to deliver HOBIC education at our Sydenham campus.

Nurses, Respiratory Therapists and Ward Clerks also receive clinical orientation to documentation and order entry in the computer lab. This full day of practical experience in the lab, provides an open forum for questions and answers during this hands on experience.

Computer-based education is the future as technology and learning need continues to evolve.

Advancing Diabetes Care by Partnering with Patients

For several years, Chatham-Kent Health Alliance (CKHA) has annually supported a team of allied health professionals to participate in the Dorothy Wylie Nursing Institute/Health Leaders Institute (DWNLI/HLI). The Leadership Institute offers a two-part, concentrated program of study on leadership principles, models, behaviours, skills, and tools to assist participants with the necessary knowledge and training to work effectively on inter-professional teams.

This year, the Diabetes Education Centre (DEC) was chosen to participate. Following CKHA’s strategic direction of Patient and Family Centred Care (PFCC), their project’s goal is to ensure a well coordinated, inter-professional care approach to educate, engage, and to empower staff and the patient/family in their plan of care. Their project focus is on diabetic patients being admitted to all Medicine, Rehabilitation and Continuing Care Units.

They are currently half way through their project. The Dorothy Wylie experience has had a positive influence in engaging their department in leadership and team building strategies and active collaboration around client-centred care. This opportunity has supported them by giving them access to evidence-based models and frameworks and the guidance to apply these practices in a clinical setting.

They look forward to sharing their success at our completion in November. They will continue to ‘model the way’, partner and ‘share the PFCC vision’ with all staff and committees to improve the patient experience at CKHA. If you are inspired and would like to ‘challenge a process’, I ‘encourage’ you to participate in the Dorothy Wylie Nursing /Health Leaders Institute experience.

Celebrating Interprofessional Care: October is Occupational Therapy Month

When everyday activities are interrupted by illness, injury, developmental challenges, the aging process, mental or emotional illness, a member of the occupational therapy treatment team can provide strategies to help a person work toward a more independent and productive lifestyle.

Occupational Therapists work with individuals of all ages, in a variety of settings, such as hospitals, schools, treatment centres, clinics, industrial settings and in private practice, to name a few.

At Chatham-Kent Health Alliance (CKHA), an Occupational Therapist (OT) or Occupational Therapy Assistant (OTA) helps individuals deal with challenges in self-care, cognition, visual-perception, positioning, wheelchair seating, transfers, meal planning and preparation, driving, social skills, anxiety and stress management, and many other issues one might face at home, at school, at work or in the community.

One of the assessment and treatment tools the OT team may use to help prepare a person for adjustment to the home and/or community is the Activities of Daily Living apartment, located on the inpatient rehab unit. This apartment, which includes a kitchen, bedroom and bathroom, is a setting where occupational therapy patients from both the physical health and mental health areas of the hospital can have a chance to practice their daily skills, such as a tub transfer or meal preparation. Under the guidance of an OT or OTA, patients can try adaptive equipment, and explore new ways to make the tasks easier. An assessment is often used to ensure that someone will be safe in their own environment, before they leave the hospital.

In a society where aging, chronic diseases and traumatic injuries can impact severely on a person’s lifestyle, a chance to re-establish the most basic skills become important to a person’s sense of mastery of their environment and safe re-integration into their community. Working with an Occupational Therapist or OT assistant can provide that opportunity to strive for independence in life’s daily routine.

Happy Occupational Therapy Month!

Celebrating Interprofessional Care: Pharmacy Department

The profession of Pharmacy is rapidly evolving from the “keeper of pharmaceuticals” to the “supplier of pharmaceutical care”. This means that pharmacists, as part of the health care team, are becoming more involved in providing care directly to patients, making recommendations to prescribers, reviewing medication lists and interacting with patients and other health care providers. The role of the pharmacy technician is also expanding as they are soon to be Regulated Health Professionals.

Our hospital employs more than thirty Pharmacy personnel; pharmacists, pharmacy technicians and pharmacy students working together to ensure the right medication gets to the right patient at the right time. Like an Oscar-winning production crew, these highly trained individuals work behind the scenes and on the front line to guarantee that the lead characters (that would be the patients, of course!) get the spotlight.

In a world of increasingly complex medication regimes, the role of the Pharmacy Department has never been more important in the hospital!

About Pain

Pain is very personal and we each experience pain differently. Unlike a fever, where a thermometer can show if you have a high temperature, there is no objective way to measure how much pain you are feeling.

Simply put, pain is an uncomfortable feeling that tells you something could be wrong in your body. For example, if you twist your ankle, the sharp feeling of pain actually lets you know that you have done some damage to your body. The pain will keep you from putting weight on the injured ankle and will protect it from further harm. Pain also acts as your body’s warning system. It lets you know when there is something wrong and it stimulates you to do something about it. In general, we learn from painful experience to avoid danger, and not to repeat injurious behaviour.

Pain is commonly viewed as either acute or chronic. Acute pain is temporary. It is usually immediate and may last from a few seconds to several months. Some sources of acute pain are sport injuries, childbirth, postoperative pain, fractures, burn and medical procedures. Acute pain will usually go away once normal healing occurs.

Contrary to acute pain, chronic pain persists beyond the time of normal healing. The chronic pain could be the result of an acute injury that did not heal properly or it could be from a host of other reasons such as cancer, nerve damage or arthritis. In some cases, the pain may not make sense because it may travel from the original site of the injury to unrelated areas of the body. Some examples of chronic pain include fibromyalgia syndrome, migraine headache and lower back pain. Chronic pain commonly produces psychological effects, from feelings of anger, sadness, hopelessness and despair. It can alter personalities, disrupt sleep and interfere with work and personal relationships.

Check in for a follow-up blog that will tell you some options on how you can treat pain.

“FALLING” - Not an Option

Patient safety is a top priority at Chatham-Kent Health Alliance (CKHA) and keeping our patients safe includes decreasing falls. Our Falls Task Team and the Professional Practice Team have made falls a priority and we are including everyone - physicians, nurses, housekeepers and visitors in our falls prevention efforts. We all play a role in keeping patients safe.

There are 7 strategies that have been proven to keep everyone safe:

1. Make sure the call light is within reach;
2. Bring in comfortable non-slip shoes for your loved one to use when walking;
3. Keep side rails down on the bed;
4. Leave the light on in the bathroom before you leave to go home;
5. Remove all unnecessary clutter from the room;
6. Keep the bed in its lowest position;
7. Make sure the brakes on the bed, chair or walker are on.

If you are out and about in the hospital and you see a patient with an orange bracelet, or an orange star above their bed, don’t despair. If that patient has had a history of falls or is at a higher risk for falls they will receive an orange bracelet to wear; this helps everyone in the hospital know that they may need assistance while walking.

Together we can make sure that our patients and loved ones are safe and injury free.

Patient Safety: The Surgical Safety Checklist

One in 13 admissions in Canada is associated with an adverse event. The estimate that up to 23,000 people died in 2004 in Canadian hospitals because of preventable adverse events is staggering.

Quality care requires quality communication. Communication failure amongst clinicians is the leading source of adverse events in healthcare.

At Chatham-Kent Health Alliance (CKHA), we are committed to ensuring that our patients receive the safest surgical care possible. There are many critical co-dependant steps needed for a team to achieve successful surgical outcomes. Research and experience of many Operating Room teams confirm that implementing a Checklist has an impact on surgical safety and team communication.

Checklists incorporate key principles that rely on standardized processes and better access to information and feedback. A Checklist ensures that teams share critical information and deliver evidence-based interventions for every single patient, in every surgical procedure at the right time. We have always used checklists…now it’s time for the whole team to be present and involved, including the patient.

This year, based on a checklist developed by the World Health Organization, CKHA’s Operating Room team created and implemented its own Surgical Safety Checklist. The checklist is discussed at three critical points in surgery with all team members present; (a) with the awake patient, (b) immediately before the incision and (c) prior to the patient leaving the operating room.

CKHA’s compliance with using the Surgical Safety Checklist, (all three phases) was 96.9% for the 1st reporting quarter – a solid result in improving patient safety.

We did it again!

Our Chatham-Kent Health Alliance family has once again heard the plea for backpacks and school supplies for area children in need and responded in a BIG way!

Last year with United Way leading the project, more than 1000 area children in need returned to school with brand new backpacks and supplies. This year the need is even greater so that area schools and families have asked for assistance with backpacks and school supplies for more than 1100 children.

In the photo below you’ll see Colin Patey (our CEO) and I standing beside an impressive CKHA collection of backpacks and supplies that included more than 30 kg of lined paper and notebooks, 25 boxes of coloured pencils, 30 boxes of crayons, 10 math sets, rulers, and packages of pens, markers, erasers, pencil sharpeners, duo-tang folders, rulers, liquid glue, binders, glue sticks, pencils and highlighters.

More than $675 dollars in cash donations and enough supplies were collected to purchase and fill 90 brand new backpacks! These items and the money donated by our CKHA family will make a positive impact on many children in our area communities including Wallaceburg, Tilbury (Merlin & Wheatley), Ridgetown, Blenheim, Dresden, Thamesville, Bothwell and Chatham.

I am so proud to say that we are ‘caring people, caring for people’ both in our hospital and in our area communities. Thanks for stepping up and making a difference!

Getting Ready to Go Back to School …

Remember the excitement of starting a new school year with brand new school supplies? A new notebook, the smell of freshly sharpened pencils, a bright new pink eraser, a brand new pencil case …

In 2000, while listening to the radio on her way to work at Chatham-Kent Health Alliance (CKHA), a former Emergency Department Nurse Practitioner, Debbie Selkirk, heard about a program where donations of new school supplies and backpacks made it possible for less fortunate children to return to school, ready for success.

2010 marks the 10th Annual CKHA Backpacks For Kids event and because of your generous support and with United Way leading the project, more than 1000 area children will return to opening day of school feeling good about their chances and knowing they are just like everyone else in their class.

As you go out to purchase school supplies for your children this year, please think about picking up a few extra items and dropping them off in the “shopping carts” in the Chatham Campus cafeteria, or in the Emergency Departments at either CKHA campus.
This campaign ends on August 26th.

Let’s show these kids in need, that we believe they can succeed!

“The Artistic Gift”

Music is a language that everyone can understand. Put together a few singers, a guitar player and music composer (thanks Michelle!), and the results are a gift to send a message that can be enjoyed by others.

This is just what employees of Chatham-Kent Health Alliance (CKHA) did at last week’s BBQ hosted by the Professional Practice Team and Patient & Family Centred Care Steering Committee. What a great way to continue to spread the word about the NOD – a service excellence standard being rolled out at CKHA. The NOD acronym stands for Name, Occupation and Duty. We are asking all employees to consistently use the NOD when introducing themselves.

Artistic talent beyond the profession came into play by singing a song to the tune of “Locomotion”. Here is a little snippet of the song:

It doesn’t matter where you work or who you might be
It only takes a moment for this courtesy
So come on, come on, take the time to NOD with me!

Singing was complemented by an actress who encouraged the audience to use the NOD as she mingled with the crowd during her visit to CKHA. The audience participated and created a “locomotion” train, sharing the NOD with others.

What a fun way to learn and enjoy as others share talents beyond their profession.

Thanks team, for a job well done!

Huddles…coming to your area soon

One of the service excellence standards communication tools being rolled out across the Chatham-Kent Health Alliance is the “huddle”. To be a culture of excellence, huddles, known as a frequent briefings of 8 minutes or less, are encouraged weekly (minimum), involving managers and staff in all hospital departments. Huddles can also be conducted between staff at change of shift, or when anyone identifies a need for a brief communication between members of a team.
These frequent briefings provide a venue that can address the following:

1. Are there any patient/staff safety concerns today?
2. What has been working well on the unit today?
3. Are there any patients with special considerations others should be aware of?
4. Is there any shortage of supplies, or any broken equipment? Do you have the tools and equipment to do your work?
5. Is there any staff requiring extra assistance?
6. Is there any staff that may have extra time to assist others?

Other questions that can be asked include:

1. Are there any individuals (staff, physicians, other) I should be recognizing today?
2. Is there anything we can do better? (Studer, 2003).

Huddles provide an opportunity for managers and staff to develop relationships and a limate of trust. It is a way to foster a culture of safety as well as recognize employees’ needs. Employees want a good relationship with a leader who is approachable, efficient, and willing to work with staff. Huddles create this opportunity and in turn leaders can recognize, and better yet, can act to meet employee and patient needs (Studer, 2003). Focusing on what went well creates a positive approach that supports a culture of excellence. Staff and patient safety can be addressed and acted upon in order to continue to make the departments not only safer for patients, but for staff as well.

This standard has started to be rolled out over the summer. Managers are holding huddles with staff in all departments. If you have not yet participated in a huddle, ask your manager if huddles are…coming to your area soon.

Celebrating Interprofessional Care: Physiotherapists

Over the next few months I'll collect and share information on the different health professionals that work here at CKHA. We'll start with the Physiotherapist group.

Physiotherapy is a healthcare profession directed at evaluating, restoring and maintaining physical function. There are 7,000 registered physiotherapists in Ontario and 12 of the very best work here at CKHA. As primary healthcare professionals, Physiotherapists combine in-depth knowledge of how the body works with specialized hands-on clinical skills to assess, and treat symptoms of illness, injury or disability. With independence in mind, a Physiotherapist's goal is to restore, maintain and maximize strength, function, movement and overall wellbeing.

Working under the direction of the CKHA Physiotherapists are 10 Physiotherapy Assistants (PTA's) and 1 Kinesiologist to complete the team that provides the patient and family a therapeutic treatment plan and essential education about the body and how to keep it healthy.

Change Management

Even though we know change in healthcare is inevitable, change requires effort and in some cases a substantial amount of effort to sustain it. Recently the Professional Practice Team and I had the opportunity to review a video “All Washed Up”.

In the video Hyrum Grenny, a junior researcher works with 80 children to change their hand washing behaviour, prior to being treated to some very delicious looking cupcakes. The children are challenged to complete a group activity where they are asked to put together an interesting puzzle. Hyrum’s research is to try to understand what works best to get the kids to wash their hands: personal motivation, changing the environment to make the task easier or social influence, peer pressure. Hyrum’s findings suggest that both motivation and ability are key and that personal influence, social influence and the influence of the structure of our environments are all important. He identifies that to make change stick, you need to include at least 4 of the influencers, preferably all 6. What is most interesting is that the motivators to get kids to wash their hands before they touch the cupcakes are easily transferred to our hospital environment. We are always trying to improve how we make change; we think Hyrum has some great ideas. I invite you to take a look at Hyrum’s research: http://bit.ly/3tkgNr .

Any suggestions you can offer to help us with making change stick would be greatly appreciated.

The NOD

During the Service Excellence training in the spring, we learned there are behaviours that will demonstrate to patients and visitors how we intend to improve their experience and the public image of CKHA. Those behaviours are outlined in the service excellence standards we adopted in January 2010 and which we were all invited to sign. The plan is to roll out at least one service excellence standard every couple of months. The first standard we are implementing is “the NOD”.

We all use the NOD - name, occupation and duty, in many of our daily encounters with patients. It is the right thing to do, shows patients our respect and gives them dignity. But we need to ask ourselves do we treat others in our work environment with the same dignity and respect? By introducing ourselves to others we are acknowledging each person we come into contact through our work are important to us. Unfortunately, we miss opportunities to assist others and make a good first impression when we don’t ask if we can help. If we are truly to embrace Patient and Family Centred Care/Service Excellence (PFCC/SE) each and everyone one of us needs to go the extra step, of aiding the lost or elderly, our co-workers and patients. Simply by using the NOD, introducing ourselves, my name is, I am______ (fill in your job or role), and duty (I’m here to do, or how can I help) we demonstrate our personal commitment to PFCC/SE. Over the next few weeks you may meet someone who needs the NOD.

Patient and Family Centred Care/Service Excellence Signature Boards

In the spring, Chatham-Kent Health Alliance undertook the huge task of educating all staff, physicians and board members about our strategic direction of partnering with our patients and families to provide the best service possible. All patients expect and should receive excellent care through partnership with their care providers. All staff, physicians and board members were invited to demonstrate their personal commitment to these strategic directions by signing both the service excellence standards as well as poster signature boards which were to be put on display at both the Sydenham site and the Chatham site. In the last week of June those signature boards were posted, at the Sydenham Campus and across the hall from Tim Hortons at the Chatham Campus. What an amazing tribute to the dedication of everyone at CKHA to make every patient experience our passion!

Mentoring Others and Sharing in the Spotlight

Chatham-Kent Health Alliance, one of 21 Best Practice Spotlight Organizations (BPSO) in Ontario, assists others after being through the experience ourselves. In our three years as a Registered Nurses Association of Ontario BPSO candidate and one year as a BPSO designate, CKHA has learned a great deal about moving research and best practice guidelines into practice. We have agreed to act as mentors to two other organizations (Kitchener Grand River Hospital and Guelph General Hospital) in their journeys as BPSO candidates.

On May 26th, Denise Dodman of the Professional Practice Team and co-lead for CKHA’s BPSO activities traveled to Grand River hospital and met with the team of best practice champions. The group spent time exploring strategies for champions and how to use knowledge translation theory to explore their own units and clinical situations. At CKHA, we are committed to sharing the lessons we have learned about implementing best practice and best practice guidelines with other organizations. We are also learning lessons from them – a mutually beneficial relationship, sharing in the Spotlight.

Benner

“I was filling out the performance evaluation program and I just don’t know….
am I an expert or just competent? How do I tell?”

In late winter CKHA launched a new performance evaluation program, PEP for short. The nursing and allied health evaluation tools were developed using the work of Patricia Benner, who describes the different stages of professional growth and development using “Novice to Expert”. Benner notes all professionals will have expertise with certain tasks and knowledge throughout their careers but there are few true experts in any field as experts have the ability to always see the big picture, always think intuitively about all situations and are able to recognize and work through ethical dilemmas and situations as a matter of course in their professional world and this may take a lifetime of work to achieve.

“I’ve been here a lifetime…does that make me an expert according to Benner model?”

Benner suggests that most professionals will fall within the competent to proficient categories. Competent members of a profession think independently, are able to work autonomously in most complex professional situations and are able to recognize that a situation has ethical components and perform much of their work. Proficient professionals do much of their work intuitively, they have much experience and through those experiences are able see, feel, know and recognize new situations through those past experiences. They require little or no supervision in complex situations and are able to not only recognize ethical situations but have a developing ability to work through ethical issues.

“How long does it take to become competent or proficient?”

At CKHA we strive to have our professionals working to their maximum capabilities and hope everyone can master their profession to be competent or proficient. We also know that there are times when staff will function as novices or advanced beginners, just because of the nature of the work or because they are new to the environment or profession. Novices require clear direction and multiple supports, they are new to the profession or clinical area, can manage simple professional skills, they are learners. Advanced beginners continue to develop their skills, are starting to think independently, can manage situations with low to medium levels of complexity but still need mentorship to grow into fully functioning members of the profession. Advanced beginners usually move to becoming competent and proficient within 3 to 5 years of entering the profession.

“Are you telling me it is ok to not be an expert in all things even if I’ve been here for 30 years?”

Though it is admirable to aspire to develop expertise in an area, we also need to acknowledge it is okay to be competent; with in the Benner model competent is not mediocre but what patients expect and need. So as you complete your next evaluation, no matter what your job or role is, challenge yourself to look for opportunities for professional growth, be realistic about who you are and what you bring to the organization, and seek out feedback. Take advantage of the PEP process and recharge your professional career by meeting with your manager and Professional Practice nurse to look for new opportunities to enhance your practice, scope of care and professional knowledge.

7th Annual Stroke Garden Party Reunites Survivors, Families and Caregivers

Continuing Care Program is hosting a Stroke Garden Party at Chatham-Kent Health Alliance on Friday, June 25, 2010 from 1 – 3:30 pm. Dozens of former stroke patients are expected to attend and share their personal stories with each other. They will enjoy displays, entertainment, prizes and refreshments at the tented, riverfront venue.

The Stroke Garden Party is hosted by the Chatham-Kent Health Alliance in partnership with the Heart and Stroke Foundation of Ontario Mission Committee and is free of charge.

For more information, visit:

http://bit.ly/bjD9Eo

Better Information Better Care Better Outcomes

On May 17, 2010 CKHA welcomed Elizabeth Krestick, the Regional Coordinator of HOBIC (Health Outcomes for Better Information and Care) program. HOBIC is an exciting provincially funded initiatives that will help us measure the impact of our professional care on the health outcomes of our patients. Only hospitals that have computerized charting are able to participate. Our CKHA charting screens were updated to be able to capture the standardized information from the HOBIC questions. HOBIC information will shed light on the impact of care on a patient’s clinical status. The interprofessional team will have access to the HOBIC information in real time. The information will also assist us in the evaluation and measurement of some of our key projects such as RNAO best practice guidelines and our accreditation Required Operational Practices (ROPs) such as falls prevention. CKHA can expect our first meaningful data from HOBIC in the early fall. We look forward to how this new information will help us to provide better care in the moment and plan for better health outcomes for the people we serve.

Philip Taylor, Professional Practice-Corporate is the CKHA HOBIC lead. In our first phase education sessions will begin on June 9th for our medicine program staff and July 15th for our complex continuing care. The go-live date for the medicine program is June 22nd and the complex continuing care go-live date is July 26th. The education is separate for these two groups as the HOBIC measures are different, recognizing the difference in these patient populations.

Congratulations Leadership Academy Participants

May 26, 2010 was “Graduation Day” for the first ever CKHA Leadership Academy. Nineteen frontline staff, all of whom work as a Unit Clinical Leader or take the “charge role” on our clinical units participated in 10 educational sessions directed towards development of personal and professional leadership knowledge and skills.

Professional sessions included such topics as leadership theory, governance of healthcare organizations, roles and accountabilities of leadership. The personal growth topics covered emotional intelligence of leadership, personal styles of leadership, and change management. Discussions were often dynamic and thought-provoking for both the participants and course facilitators.

During the graduation ceremony, each participant was given the opportunity to describe one of the most important learning’s for them. Comments included the opportunity to network and put a face to the name in different units; the time to reflect upon what is the same yet different in each of the clinical areas; and the chance to do a personal inventory of leadership skills - both strengths and weaknesses - which could be applied to both home and work situations. One member of the group indicated it was great that the education was not about giving “pat” answers but rather about exploring, listening and hearing about others’ experiences and then being able to take the information and make it practical to the nursing units. The ceremony ended with presentation of certificates and cake for everyone.

One of the messages we heard throughout the sessions was the importance of relationships between units and how over years due to the busyness of the important work we do, we have not taken the time to build relationships. The group noted they would like to continue to meet both for education and for networking to maintain the important relationships they had developed. The formal leadership team has committed to make this happen and the next session is booked for October. As well, the intent is to roll the program out into a broader intra-professional model to include frontline leaders throughout CKHA in both clinical and support services.

On behalf of the professional practice team, and myself, thank you to all of our internal “experts” and external presenters for sharing your knowledge and skills. Appreciation as well to the managers and directors for making it possible for staff to attend. And to our graduates..... Way to go...great work...it is team members like you who make CKHA a great place to work!

Best Practice Spot Light Organization: It’s not just for Nurses!

By now, most of you will know that CKHA is one of only 21 Registered Nurses’ Association of Ontario (RNAO) Best Practice Spotlight Organizations (BPSO). As a BPSO, we are tasked with demonstrating creative ways to successfully use best practice guidelines, evaluate their use and measure the outcomes for research and improved patient care as well as share lessons learned with other organizations. Best Practice Guidelines (BPG) are not just for nurses; they are also highly applicable to care provided by the inter-professional team.

At our quarterly BPG Breakfast for Champions held on May 12, the Emergency and Mental Health & Addictions program representatives demonstrated expertise in promoting client centred care. Hazel McDonald spoke of some of her experiences in the Honduras, and Becky Elgie spoke of her very unique role with the CK Police Service with caring for those with mental health disorders in our community. Ann Marie "Cookie" Stokes from the Emergency Department at Sydenham Campus shared a photo slide show and presented on her experiences with a care team in Haiti last year. And finally, Michelle O’Rourke spoke about her experience as an author of a book about spirituality in palliative care. It was a good morning of pride, fellowship and camaraderie.

A Compassionate Care Giver: She didn’t see it coming!

She was asked if she could lead a class on the new use of Epidural Pumps for pain control, and when she arrived in the cafeteria to take part in the ice cream bar and have a visit before the class, she didn’t seem to suspect that anything special at all was about to happen. When the name of the Compassionate Caregiver Award of Distinction recipient was announced, Pam Joyce RN seemed completely surprised by the accolades shared about her spirit of caring for her patients and her peers.

The award is a Royal Copenhagen figurine, gifted to CKHA in 2008 by an anonymous donor in appreciation of care provided to their loved one. The award comes with a financial gift to be used towards education at CKHA to further staff expertise in caring for patients at the end of life. Congratulations, Pam. This award is well deserved.

Link to full News Release on CKHA website: http://bit.ly/awCXPe

Last week was a week of celebrations that I’d like to take a few minutes to reflect on. A group of Professional Practice Team representatives joined me for the kick off of Nursing Week 2010. We met in the Education Centre at the Chatham Campus and in the Cafeteria at the Sydenham Campus, and spent the mornings reviewing some of the poster presentations that had been prepared by our CKHA inter-professional team members. We also participated in a presentation made by Margaret Campbell, our Librarian, on some of the wonderful education and research possibilities that are being made available through our membership with the Western Ontario Health Knowledge Network (WOHKN). And finally, we had a "tour" of the new CNE/PPT web site that includes this weekly blog. Both the Sydenham and the Chatham campuses enjoyed ice cream served by CKHA’s Executive Leadership Council in honour of Nurses Week. See some of the photos attached to witness the positive environment that surrounds us at CKHA!

Nursing: You Can’t Live Without It!

As we kick off the 2010 National Nursing Week celebrations, let’s take a few minutes to reflect on the theme for this occasion:

Nursing: You Can’t Live Without It!

CKHA nurses are not only “caring people, caring for people”, they are skilled and intelligent providers who prevent suffering and save lives. Here at CKHA we value our nurses for their strength and knowledge; they are kind and they are smart. Our nurses participate in research, make provisional diagnoses, prescribe evidence-based best practice treatments, and identify the need for medications to relieve symptoms and cure diseases.

Nurses possess scientific knowledge, skills and compassion that helps to keep individuals, families and communities healthy. The commitment to health promotion, disease prevention, and client-centred care make a difference in people’s lives. Thank you to our nurses for your commitment and for strengthening health care here at CKHA, in our community and in the province.