VOLUME 11, NUMBER 1 - FEBRUARY 2013

Learning a new approach to life

One for the heart – On Oct. 9, 2012, Denniss Souvannarath became the fi rst patient at the Hamilton General Hospital to receive the assistance of an Impella device, a life-saving technology used in emergency cardiac cases. Pictured here holding his 18-month-old daughter, Vienna, Denniss returned to the General on Jan. 18, 2013 to visit with the cardiac team who helped to save his life. From left to right: Trish Vanderlee RN; Dr. Richard Whitlock, Dr. James Velianou, Dr. Nick Valettas, Patti Beamsley RN, Caitlyn Panton MRT, and Anna Gasior MRT.

While Donna Souvannarath waited patiently in the Heart Investigation Unit waiting room with emotional anticipation, the doctors delivered the news four separate times that her husband Denniss was passing.

Earlier that day, Denniss was visiting friends when suddenly everything got very bright and he collapsed.

“I didn’t feel any pain, but can’t remember much else after I collapsed,” recalls Denniss. “I woke up three weeks later in the hospital.”

The 28-year-old father of two led a typically healthy lifestyle: he ate right, went to the gym, and didn’t smoke or drink alcohol. He had no prior knowledge of a heart condition, but had been experiencing heartburn symptoms for several months. That day, Denniss had suffered a heart attack. Scar tissue discovered during a later heart surgery indicated he had previously suffered small heart attacks without knowing.

Denniss was deteriorating quickly when paramedics brought him to Hamilton General’s emergency department. Had he arrived two weeks prior, he would have died.

On October 9, 2012, Denniss was the fi rst patient at the General Hospital to receive the assistance of a new life-saving technology used only in emergency cardiac cases. The Impella device is a pen-sized instrument that is inserted through the artery in the groin to the heart.

Once the device is inside the heart, a propeller is turned on to pump blood.

“This new device provides many benefi ts, especially to young patients,” said Dr. Richard Whitlock, cardiac surgeon at Hamilton General Hospital. “We’re able to fully support the body’s circulation when the patient’s own heart is too sick to do so, enabling their blood to start circulating sooner, which means potentially preventing brain injury and better survival outcomes.”

The device stayed in Denniss’ heart for four days, until doctors determined that he was a candidate for a more permanent assist device.

Although his other organs have recovered and the Impella device was removed, Denniss needs a new heart. He currently lives each day with an implantable cardioverter-defi brilator (ICD) to prevent harmful heart rhythm problems, and a left ventricle assist device (LVAD) - a more permanent, yet still temporary device worn on the outside of his chest to keep blood pumping through his heart.

“My son calls me a real life Ironman,” says Denniss.

Now on the transplant list, Denniss will wear the LVAD until he gets a new heart, which may take up to two years.

Denniss remains very optimistic. “How can I not be, when I have a beautiful baby girl and family to spend each day with.”

A message from Murray Martin, President & CEO

Sharing the Employee and Physician Survey Results

Over the next several years, together we will transform Hamilton Health Sciences to achieve our vision of Best Care for All.

Three main initiatives are driving our pursuit of quality and excellence, realizing the best use of resources, and ensuring that the health care system is sustainable for generations to come.

These initiatives are:

• our newly defi ned 2013-2023 Corporate Strategic Plan which provides direction and unites us all in a common purpose

• a new approach to streamlining our system to responsibly manage resources called Multi-Year Operational Planning – so that we can not only fi nd savings but more importantly, reinvest in priorities, and

• inspiring everyone at Hamilton Health Sciences to support this transformation by identifying what matters most, and truly motivates us to go above and beyond for the patients and families we serve.

These initiatives will allow us to address our challenges and to meet our obligations today and in the future. I want to assure you that you will be hearing more about our new Corporate Strategic Plan and Multi-Year Operational Planning in the days and weeks ahead.

The focus of this edition of the Insider is to share the results of our recent Employee and Physician Survey, and to inform you about the next steps.

I would like to acknowledge everyone who took the time to complete the survey. 6,237 staff and physicians provided great insight about what is working well at HHS and where we have opportunities to make positive change.

HHS is committed to taking action on what really matters to staff and physicians, and sharing the survey results is a critical fi rst step.

Continued on next page

Sharing the Employee and Physician Survey Results – continued from cover

In January, I was pleased to be able to share the overall survey results with everyone at Hamilton Health Sciences.

I’d like to thank everyone who was able to join me and Brenda Flaherty for the Town Hall which took place on January 29. For those who were not able to attend, please go to the HHS intranet to learn about the survey results. Paper copies of the information posted is also available through Organizational Development.

Since the completion of the My Voice Matters Survey, our survey partner Kenexa has analysed and interpreted the data so that we can make informed choices about where to focus our efforts, actions and planning. I want to confi rm for everyone that all of the responses are 100 per cent confi dential and anonymous. All surveys were returned directly to Kenexa and reports will only be provided for groups of 10 or more people.

We want to further engage everyone in conversation as we discuss the survey fi ndings, and begin taking action on the results.

The results get to the heart of why we care, how we feel, why we go above and beyond, and what we say to others about our experience at Hamilton Health Sciences.

The focus of the survey was to share our perspectives about:• the quality of care and service we deliver

every day • workplace heath, safety and wellness• professional development• senior leadership• manager effectiveness• team work and collaboration• communication• workload and work life balance• personal accountability and performance • awareness of our vision, goals and where

HHS is headed in the future • our experience of working and practicing

here – what motivates us.

Overall, we learned that we are proud to work and practice at Hamilton Health Sciences. Employees and physicians are very pleased with HHS’ commitment in the areas of Health and Safety, and Growth and Development.

The favourable responses in these areas showed our strong commitment to creating a safe environment for our patients and each other, and the value we place on continuous learning.

We also learned about what truly motivates and inspires us to do our best everyday, what makes us want to come to work everyday, and what makes us go the extra mile. The results showed that:• we want to feel valued for our contributions• we are motivated when leadership shows concern

for the well-being and morale of employees and physicians

• we want to be involved in decisions that affect our work

• the quality of patient care at this hospital is what we would want for a member of our family

• senior leaders need to continually communicate a vision of the future that motivates us

• we are committed to clinical quality

Based on this feedback, our opportunities for improvement will focus on:• addressing morale and well-being• looking at ways to strengthen communication

that fosters idea sharing and involvement• communicating a vision that motivates all of us• involving employees and physicians in decisions

that affect their work• ensuring that the quality of patient care is what

we would want for our family • making clinical quality a priority

These six areas were identifi ed by both staff and physicians as areas we need to work on. So although we all have different roles and responsibilities, it is apparent that we are all motivated by many of the same things.

In summary, we will focus on:• morale and well-being• strengthening communication efforts• celebrating our vision and goals for the future• and continuously improving safety and quality for our staff, physicians and patients.

While we know that there is work to do, the survey results also emphasized that there are highly motivated teams and best practices already within our organization that can we can learn from. We need to discover what these teams are doing and replicate their actions across the organization. You – Hamilton Health Sciences staff and physicians – are our best resources and teachers.

These are OUR results. Therefore, your involvement is key to the success of this work and I want to assure you that you will continue to be informed and involved every step of the way.

Together, we will take action on these results so that future surveys results are refl ective of our ongoing progress. We know that meaningful change will take some time and constant attention – there is no fi xed timeline for this work. Our anticipation and hope is that everyone will make the choice to be a part of our journey to the Best Care for All.

Ultimately, we should all be able to say: I’m proud to work here; I’m satisfi ed with HHS as a place to work; I would recommend HHS as a great place to work; and I am committed to staying here.

Thank you for being a part of this journey.

Our Strengths % FAV

I understand my roles and responsibilities in creating a safe work environment. (Health & Safety) 96%

If I became aware of a patient safety concern, I would feel comfortable reporting it. (Health & Safety) 92%

I have the required experience and education I need to do my job effectively. (Growth & Development) 91%

I have a clear understanding of what is expected of me. (My Job) 88%

If I became aware of a personal safety concern, I would feel comfortable reporting it. (Health & Safety) 86%

What motivates us Staff % FAV

Staff % Neutral

Phys % FAV

Phys % Neutral

HHS values my contribution. 32% 41% 35% 32%

Senior leadership shows concern for the well-being and morale of employees and physicians. 31% 30% 21% 30%

The quality of patient care at this hospital is what I would want for a member of my family. 60% 22% 57% 23%

The senior leadership of HHS has communicated a vision of the future that motivates me. 32% 37% 24% 31%

I am appropriately involved in decisions that affect my work. 42% 22% 37% 23%

HHS is committed to clinical quality. 69% 19% 62% 20%

The Survey Reflected our Sense of:

Advocacy

Satisfaction

Commitment

Pride “I am very proud to work here.”

“I recommend HHS as a great place

to work.”

“I am very satisfi ed with HHS as a place

to work.”

“I am committed to staying here.”

Not just another typical day in the McMaster Children’s Emergency Department

House Calls

Q: I have Celiac disease and follow a gluten free diet.

Recently when eating at a chain restaurant I was told that deep frying food removes gluten, making it safe for people on a gluten free diet to eat. Is this true?

A: The gluten free diet has become increasingly popular, and many people follow it for a variety of reasons. For people who have Celiac disease, a serious autoimmune disease, a strict gluten free diet for life is the only treatment. Failing to follow a gluten free diet results in serious health consequences which can include but are not limited to osteoporosis, anemia, depression, and infertility.

Gluten is a protein that is found in wheat, rye and barley. But, wheat can go by many other names including bulgur, couscous, spelt, emmer, graham flour, kamut, and semolina, to name a few. Barley in the form of malt is also found in a variety of foods as a flavouring and is found in beer. You must also consider sources of gluten contamination during the food preparation process. For example, while making a gluten free sandwich you can’t use the same knife or cutting board that was used to make a regular sandwich unless it’s thoroughly cleaned first. Because of the complexity of a gluten free diet, it’s easy for people who are not well-informed to think that a product is “safe” when it actually contains gluten.

The increase in popularity of the gluten free diet has led to more gluten free products becoming available at grocery stores and restaurants. Labeling laws in Canada require that food products containing gluten must clearly state it on the label. However, eating out at restaurants is still difficult because ingredients aren’t usually listed on menus, and you never know what practices the restaurant’s kitchen follows to avoid contamination with gluten.

Deep frying is a common issue that’s raised when eating out at a restaurant. Deep frying does not remove gluten from foods, nor does it make gluten safe. Also, if oil is used to deep fry foods that contain gluten (such as battered fish or chicken), any other foods fried in that same oil – even if they are “gluten free” – are not safe to eat. So, a restaurant’s French fries may not contain any ingredients with gluten, but if they are deep fried in the same fryer as chicken fingers, they’re no longer safe to consume.

Education is an important yet ongoing challenge with a gluten free diet. Always consider the sources of your information. The Canadian Celiac Association (www.celiac.ca) has great resources. Registered dietitians are also a great source and can be accessed through many family doctors or at www.dietitians.ca.

When eating at a restaurant, be sure to ask questions about food ingredients and food preparation. If in doubt, you are better to avoid that food and stick with what you know to be safe.

House Calls is written weekly by experts at Hamilton Health Sciences. Heather Mileski is a registered dietitian with the Centre for Child and Youth Digestive Health at McMaster Children’s Hospital.

HOUSE CALLS

It might have been a typical day in the new, major treatment area of McMaster Children’s Hospital Emergency Department. Doctors treated children with minor injuries, a team of specialists rushed to resuscitate a collapsed child, staff comforted both children and parents.

But the “typical” day was actually happening on the other side of the emergency department walls, the one that has been in operation for more than a year. Here, in this new area, the doctors, nurses, staff and administration were actually treating fake patients – actors and volunteers and high fi delity simulation mannequins. But they were dealing, for the most part, with a typical day in the children’s emergency. In what may have been the largest simulation exercise to take place in a Canadian hospital, this team was testing out a new environment by mirroring everything that was truly happening in the existing emergency department.

“The best way to create a typical day is to use a typical day,” explained Dr. Ehud Rosenbloom, a pediatric emergency physician and one of the masterminds behind this simulation exercise. A multi-disciplinary team – known as the “A-team” - pulled it all together. Hospital simulation leaders supported this work: Dr. Lennox Huang, chief of pediatrics, and Dianne Norman, clinical outreach specialist.

The plan was to see how the new and fi nal phase of the children’s emergency department, set to open a few weeks later, would function in a real-life day. Did the process work well, did it need adjustments, were effi cient work principles being applied?

“We weren’t monitoring performance, we were looking at the space,” Ehud said. Multiple systems were tested: communication, process, equipment, physical space, work fl ow, patient fl ow and patient safety.

Through months of planning, the simulation leaders brought together a clinical pediatric emergency team, including nurses, respiratory therapists, business clerks, environmental aides, child life,

social work, managers, medical students, residents, fellows, attending physicians, security, and assisted by radiology and lab. A multidisciplinary team of doctors, administrators, front line staff and capital development observed the team through a four-hour simulation exercise held Jan. 14.

Every patient who came into the real emergency was mirrored in the new emergency. Double charts were created, with identifying details erased on the simulated patient chart. The “patients” and their situation were treated as real. Several predesigned scenarios were thrown into the mix to ensure specifi c circumstances were tested.

The simulation technicians wore black and the observers wore red to ensure they could be identifi ed. A debriefi ng followed the four hours, in which both observers and participants provided feedback.

A team of specialists toured the area on a subsequent day to offer additional observation and feedback.

In the end, 40 pages of comments and observations were produced, offering suggestions on a number of areas, including work process, signage, and patient fl ow. Ehud explained that, it’s not that the space wasn’t designed well, it’s that real scenarios and the professionals using those spaces need the opportunity to make it function better and safer. The feedback produced changes.

“The exercise was intended to improve the comfort of healthcare professionals with the new space and allow them to practice functioning in the space prior to moving in with real patients,” said Lennox.

This kind of simulation was used previously, in June of last year, to test out the new Pediatric Intensive Care Unit before it opened. And now, before the new emergency department space opened Jan. 29.

“We are world leaders in the testing of new clinical environments using simulation,” Lennox explained. “To our knowledge, no other institution has carried out these exercises with this scope.”

nt

Testing new environment – As world leaders in simulation testing of environments, McMaster Children’s Hospital ran a day-long “mirror” exercise in the new Emergency Department, where patients coming into the real emergency department were replicated in the new space through actors and high fi delity simulators. Here, Crysta Balis acts as a parent of one of the simulators while clerk Dustin Jacobson collects information.

Our Family of Hospitals • CHEDOKE • CHILDREN’S • GENERAL • JURAVINSKI • McMASTER • ST. PETER’S

The Insider welcomes comments and suggestions. Contact us at: publicrelations@hhsc.ca or (905) 521-2100 ext. 75387.Visit us online at www.hamiltonhealthsciences.ca

WE WANT TO HEAR FROM YOU

T H E B I M O N T H LY N E W S L E T T E R O F H A M I L T O N H E A L T H S C I E N C E S

The Insider is published bi-monthly by Hamilton Health Sciences

Public Relations &Communications Department.

Hamilton Health Sciences

McMaster University Medical CentreRoom 1K-102

1200 Main Street WestHamilton, ON L8S 4J9

ManagerHeather Pullen

EditorCalyn Pettit

Graphic DesignNadia DiTraglia

ContributorsLillian Badzioch, Agnes Bongers

Cyprian Estrada, Peter FouldsBridget Greer, Jennifer Kramer

Danijela Stojakovic

Photo fun– Snapshots of just some of the great things happening across our family of hospitals

Health, Safety & Wellness launched its “Winning

@ Losing” weight loss challenge for Hamilton

Health Sciences employees on Jan.

14, 2013. Staff members came

together at each site to kick off

the challenge by walking together

on their lunch break. For more

information about the Winning @

Losing challenge, visit the News &

Events section on the Intranet. (image: HGH

HSW Lunch Walk)

Wellwood Cancer Support Centre held

the grand opening of its new location at

the Juravinski Hospital & Cancer Centre on

Sunday, January 27. During speeches at the event, Eric

Nanayakkara (second from right), president of Wellwood’s

Board of Directors, paid tribute to Maureen O’Connor (left), her

children, Eamonn (second from left) and Caitlin O’Connell (right), along with

their husband and father, the late Dr. Greg O’Connell as Wellwood’s founding family.

On Jan. 17, 2013, Hamilton Health Sciences undertook an emergency disaster tabletop exercise. The “déjà vu” exercise scenario was loosely based on

the Mississauga train derailment of 1979 and involved an urgent and total facility evacuation of the General Hospital, and adjacent buildings.

These types of exercises provide the opportunity for those involved to become better prepared and to work together for the safety of

patients and staff members in the event of a real emergency.

On Jan. 23, staff members and volunteers at St. Peter’s Hospital were treated to hot chocolate with all the

toppings – a welcome indulgence during one of the coldest weeks of the winter season!

The local charitable organization provides a wide range of programs and services at two sites (one in the hospital and, the other, grounds of Chedoke) to everyone affected by cancer. Everything offered is free of charge.

For more information go to www.wellwood.on.ca