We’ve come up with Niagara Health Now as a key communications tool to help employees, physicians, volunteers and community members better understand the priorities and issues of the Niagara Health System.

Niagara Health Now is what we’re calling an ‘integrated publication’. Going forward, instead of getting separate issues of Round Up, CEO Update, HIP Update and other corporate communications publications, you’ll be turning to Niagara Health Now for a fuller picture of what’s underway across our hospital. In doing this, in keeping with our organization’s success factors, we’re also ‘using our resources wisely’. This new publication redirects the monies we used to print all of our former publications into this project, thanks to the generous support of Sun Media.

Niagara Health Now also intends to ‘bring out the best in each other’ – another success factor — by providing the opportunity to showcase the great work and wonderful efforts being made by our people across all of our sites to provide compassionate, quality care to the people of Niagara.

Read on, enjoy and let us know what you want to hear more about !!!

Christine Clark, Chief Communications Officer

Patient Safety WalkArounds

A new initiative is hitting NHS hallways and patient rooms this spring – Patient Safety Leadership WalkArounds – a way in which senior leaders demonstrate their commitment to safety and learn about the safety issues in their own organization.

The WalkArounds are increasing the awareness of safety issues among all clinicians and helping to make safety a priority. WalkArounds are happening in patient care departments (such as the emergency department, operating rooms, etc.) providing an opportunity for senior leaders to talk with front-line staff about patient safety issues and show their support for staff-reported adverse events or related issues/concerns. These WalkArounds are an opportunity to discuss matters with tangible solutions and identify areas for improvement.

Fair and Just Culture

The first theme is the promotion of the NHS Fair and Just Culture Philosophy. This means giving constructive feedback and critical analysis in skillful ways, doing assessments that are based on facts, and having respect for the complexity of the situation. In order to have the greatest impact and achieve the highest level of excellence, staff must be able to speak up about problems, errors, conflicts and misunderstandings in an environment where it is the shared goal to identify and discuss problems with curiosity and respect. To achieve excellence, unwanted or expected outcomes and inefficiencies of practice must be used as the basis for a learning process. Respect must be shown to all people at every level of the organization.

Thank you to the many units whose staff participated in the first round of Patient Safety Leadership WalkArounds! Most staff indicated that they do feel comfortable with reporting incidents and good catches, however, a small proportion of staff report they are concerned that disciplinary action may result from reporting incidents.

All staff need to know that reporting incidents is an excellent way to track trending and create opportunities for continuous improvement. Niagara Health is committed to applying the Fair and Just Culture Philosophy when dealing with incidents and good catches.

Infection Control Focus

Infection Control was a focus during this WalkAround. All staff are reminded to keep Best Practice and Universal Precautions in mind at all times. For patient and staff protection, always engage in appropriate hand-washing methods and use the waterless hand-cleaning stations equipped with alcohol gel. Proper cleaning is the key to reducing infection. On some units it may be appropriate for staff to carry an alcohol-gel bottle. Please speak to a clinical manager for clarification.

The Risk Management department is still analyzing the results of the first round of WalkArounds and early indications are that they have been an overall success. Outcomes of the analysis will be shared once it has been completed. Research reports have shown that WalkArounds are a successful mechanism to increase safety awareness for everyone in the organization. Get engaged for better healthcare! «

Events such as the April 24 Living Green Ribbon in St. Catharines raise awareness of the importance of organ and tissue donation throughout Ontario.

A Living Green Ribbon

More than 600 students and partners of the Trillium Gift of Life Network gathered April 24 at Governor Simcoe Secondary School in St. Catharines for the third annual Living Green Ribbon in Niagara.

The NHS had the sixth highest number of eye donations in the province, climbing steadily from 18 eyes in 2005 to 110 eyes to 2008. In addition, there were two multiple organ donors resulting in the recovery and transplant of seven life-saving organs, and five tissue donations (examples of tissue donations include skin, bone and heart valves). Also of note, the NHS had a 100% compliance rate in notifying Trillium Gift of Life of every potential donor in Niagara.

“We’re working hard to raise awareness about the importance of organ and tissue donations, and we are pleased with the continued progress in Niagara,” says Anne Atkinson, NHS Vice President Patient Services. “These donations are the direct result of a family’s loss of a loved one, and we are grateful to the family members who made the decision to give the gift of life by donating their loved ones’ organs and tissue.” «

135,000 Volunteer Hours!

There are 1,100 people in Niagara who generously give the gift of their time, skill, energy and kindness to patients and staff with the NHS. This group, of all ages and backgrounds, was recognized at a recent gala luncheon. They are retirees, youth and working adults who volunteer in virtually every department and program across our seven sites. They comfort and support patients, raise millions of dollars to fund capital projects and critical medical equipment, and provide leadership and administrative support. This amazing group of people contributed a combined total of 135,000 hours of their time last year. Thank You! «

Surgical or Peri-Operative Program – Moving to Centres of Excellence

Ophthalmology – Detailed meetings among NHS program leads have been taking place over the last few months, to move this service from five sites to two sites, at Ontario Street Site – St. Catharines and Welland Site, which occurred on May 19. This is the first step towards creating a Centre of Excellence in Ophthalmology.

Plastic Surgery – Also on May 19, this program moved from three sites to two – Greater Niagara General Site and St. Catharines General Site – with clinics continuing to operate at Welland Site.

Dental Surgery – Oral and Dental Surgery has consolidated from five sites to two sites on May 19. Greater Niagara General and St. Catharines General sites now offer this service.

Day Surgery Closure at Fort Erie and Port Colborne – The Operating Room suites closed on May 15 and patients have been booked into the three larger sites.

Medicine Program

Dedicated Stroke Inpatient Unit - At this time, Niagara Health is working collaboratively with the Hamilton Niagara Haldimand Brant Local Health Integration Network (LHIN) to open a 10-bed Stroke unit at Greater Niagara General Site this summer.

Diabetes Centre Hub – It is anticipated that the administrative services and some clinics from Ontario Street Site will move to Welland Site this summer.

Identification of Bed Closures – As proposed in the Hospital Improvement Plan, bed closures are being pursued to achieve operational savings. Niagara Health is working collaboratively with all stakeholders, including the LHIN, to facilitate effective and efficient patient flow as we implement these bed reductions.

Bed Changes – Staffing to Occupancy/Acuity Levels in Fort Erie and Port Colborne – Right now, over 50 per cent of the inpatients at these two sites require a different kind of care than acute hospital care. These Alternate Level of Care (ALC) patients are no longer acutely ill but are not well enough to be discharged to another type of care such as palliative care or slowpaced recovery. Many are waiting for placement in a long-term care or retirement facility. By July 6, the staffing mix for 53 acutecare beds at Douglas Memorial (25) and Port Colborne sites (28) will change to meet the care needs of these patients.

Emergency Program

Urgent Care Centres – By July 6, the staff at the Emergency Department at Port Colborne Site will be providing care as a 24-hour Urgent Care Centre. The major change resulting from this conversion is that ambulances will no longer come to this site. A major communications effort is being launched to provide much-needed public information to area residents, to ensure people go to the right location for the right care and call 911 for emergency care when appropriate. Niagara Health is working closely with Niagara Emergency Medical Services and the Ministry of Health and Long-Term Care to transition this service. On Sept. 28, the same conversion at Douglas Memorial Site is scheduled.

Longer Term Planning

These programs – Maternal/Child, Mental Health and Addiction Management – are all reviewing the feasibility of consolidating services before 2013. No decisions have been made. Stay tuned for more details. «

Working towards an integrated transit system in Niagara

A regional transit system has been long-awaited in Niagara and will become a more important requirement in the next few years from a number of perspectives, including economic development, employment, education and healthcare. The NHS is actively participating at various discussion tables with regional partners and other stakeholders.

Currently, Niagara residents use different modes of transportation to access a variety of hospital-based services:

Surgical Appointments and Outpatient Clinic Visits – These are pre-booked appointments at an NHS site. Residents use a variety of transportation methods, including Niagara Specialized Transit, taxi, municipal bus, self/family vehicle.

Inpatient Transfers – This refers to site-to-site transfers of inpatients for their ongoing care or for diagnostic tests or procedures only available at another site. This transportation is provided by the NHS using contracted service providers.

Emergency Transportation – Residents calling 911 receive paramedic treatment and ambulance transportation to the appropriate Emergency Department by Niagara Emergency Medical Services. As well, inpatients and emergency cases are transferred to an NHS site or hospital outside Niagara as required by ambulance.

Niagara Health is committed to playing a key role with local partners to promote and advocate for a regional public transit system as well as improve the awareness of inter-transportation options that are currently available to our patients and their families – Niagara Specialized Transit, inter-municipal bus service and volunteer and publicly funded transportation options. «

Groundbreaking for the new health-care complex and Walker Family Cancer Centre took place April 28 when Minister of Transportation and MPP for St. Catharines Jim Bradley joined hospital officials, community members, fundraising volunteers and health-care partners for the official ceremony. It’s Our Time fundraising campaign patient heroes on four excavators officially broke ground with help from operators from Walker Industries, Matt’s Excavating, Rankin Construction and PCL Constructors.

The groundbreaking event was an opportune time for the NHS to introduce its new partner and event sponsor Plenary Health Niagara as a corporate citizen in Niagara for at least the next three decades.

Plenary Health Niagara is a partnership between Plenary Group and Borealis Infrastructure. The partnership features specialist health-care, construction and finance personnel and has as its sole focus the delivery of the project on time and on budget and its successful physical operations over the next 34 years.

In addition to Plenary’s sponsorship of the groundbreaking event, many other suppliers and partners provided donations, preferential pricing and a collaborative spirit to help make this celebratory community event a reality:

• Niagara Tents and Events (venue)
• The Green House (floral design)
• Pick Ontario, Van Geest Bros. Limited, Meyers Flowers, Prins Grow Inc., Northend Gardens, Willy’s Greenhouses, Northend Floral Inc., Pioneer Flower Farms and My Bouquet (flowers)
• Design Electronics (audiovisual services)
• Omni Media (professional editing and camera services)
• ADF Design Group (graphic design)
• Speedpro Imaging (printing)
• An Affair to Remember (food and beverage)
• Orchestrations (event coordination)
• St. Catharines Transit (shuttle transportation)
• City of St. Catharines (parking logistics)
• Niagara Regional Police Service
• Walker Industries, Rankin Construction Inc., Matt’s Excavating and PCL (excavators and operators)
• PCL (site grading and logistics)

“We are grateful to Plenary Health Niagara and the many other supporting sponsors who made this wonderful day happen,” said NHS President and CEO Debbie Sevenpifer. “The community participation and support was overwhelming with the number of suppliers who donated services and products.”

Sincere thanks are also extended to the Province of Ontario, the Regional Municipality of Niagara, the City of St. Catharines, the City of Thorold, the Town of Niagara-on-the-Lake, the It’s Our Time Campaign fundraisers and donors, local hospital foundations, our health-care providers, and the thousands of people who have played a role in achieving this milestone for Niagara. «

Elaine Davies, a 52-year-old wife and mother from Niagara Falls, is one of four patient heroes who helped break ground for the new health-care complex: “It sounds funny to say it this way, but I had the perfect heart attack. I know how lucky I was to have made it to Hamilton. I know it’s not this way for everyone.”

Heavy machinery is a telltale sign of construction of a large-scale project, especially one the size of the new health-care complex in St. Catharines.

With groundbreaking completed on April 28, there is now a tremendous amount of activity taking place at the site and with our staff and physicians regarding the new 375-bed acute care facility and Walker Family Cancer Centre.

During the month of May, the constructor for the project, PCL, is focused on preparing the site — located at the southwest corner of First Street and Fourth Avenue — for construction. This work includes removal of topsoil for future reuse, building a fence around the site, creating temporary access roads as well as establishing parking and lay-down areas for equipment.

Excavation of the building’s footprint will take place in June and July, allowing the beginnings of the concrete structure to take shape in August 2009.

Then, in May 2010, construction will begin on the building envelope, which will see the outer structure of the building take form.

Volunteers with the St. Catharines General Hospital Auxiliary share a happy moment together while helping out at the groundbreaking event.

“We are committed to engaging local labour and businesses in the delivery of this much-needed health-care facility,” said Mike Marasco, Chief Executive Officer of Plenary Health Niagara, the company responsible for the design, construction, financing and maintenance of the new building. “In addition, we will strive to keep members of the community updated on construction progress through a project website to be launched shortly as well as through open houses and other community activities.”

In the meantime, the architects are busy behind the scenes meeting with user groups made up of staff, physicians and volunteers who continue providing input into the design development process. These groups are assisting the architects in defining floor plans of every level of the health-care complex, showing walls, partitions, doors and windows, and other details.

Construction of the new facility is expected to be completed by the end of 2012, meaning the doors would open to patients in 2013.

“This health-care complex is our legacy – a legacy that will enable a healthier and more prosperous community for our children, our grandchildren and for generations to come,” said Betty-Lou Souter, Chair of the Niagara Health System Board of Trustees. “Thousands of individuals and organizations have helped make this new health-care complex come to life, all with a common cause to improve the lives and well being of friends, family members, neighbours and residents across Niagara.”

The new health-care complex project will provide a sizeable boost to the regional and Ontario economies during construction by directly and indirectly supporting and creating approximately 5,400 jobs, many of which will be in the Niagara region. At the peak of construction activity, about 1,000 workers are expected on the site daily. Approximately 200 new health-care jobs will be created once the facility opens to support the new regional services in cancer, cardiac and mental health disease.

The health-care complex will be approximately 970,000 square feet. It will be environmentally friendly and has been designed to achieve Leadership in Energy and Environmental Design (LEED) certification. Environmental features include energy efficient lighting, cooling and heating, which will help to reduce greenhouse gas emissions.

The 375-bed replacement facility for the aging St. Catharines General and Ontario Street sites of the NHS will offer acute and critical inpatient services, surgical, emergency and ambulatory services available under one roof for the residents of St. Catharines, Thorold, Niagara-on-the Lake and the area. The facility will feature 80 per cent single patient rooms, the most available in a community hospital in Ontario. «

The 1,800 Nurse Practitioners, Registered Nurses and Registered Practical Nurses working at Niagara Health are the health-care providers patients see most often during their care. And when it comes to the most trusted and respected professionals in Canada, nurses consistently rank as number one.

Each year, the nursing profession is honoured during National Nursing Week in May and at this year’s NHS Nursing Dinner May 13, 10 nurses received Nursing Awards of Excellence. Niagara Health’s Nursing Professional Development Council selected the winners from a field of 32 nominations.

“We thank and congratulate all the nominees for their hard work and dedication to our patients,” said Pam Sheptenko, Co-Chair of the Nursing Professional Development Council and Bargaining Unit President, NHS Local 26, Ontario Nurses Association. “Making the decisions and choosing the award winners was extremely difficult as all the nominees were most deserving.”

The following RNs and RPNs have been recognized by their peers with Nursing Awards of Excellence.

Nursing Award for Excellence in Direct Care:

Douglas Memorial Site
 Bev Ashton, RN, Medicine
Greater Niagara General Site
 Charity Gilmore, RN, Emergency
Niagara-on-the-Lake Site
 Sally Weber, RPN, Medicine
Ontario Street Site
 Cindy Bryson, RN, Hemodialysis
Port Colborne Site
 Dianna Concessi, RPN, Medicine
St. Catharines General Site
 Julie Moscher, RN, Outpatient Oncology
Welland Site
 Judy Dean, RN, Hemodialysis

Baxter Education Awards: One RN and one RPN receive $500 to further their education

Janet Heywood, RN, Ontario Street Site Day Surgery
Robin MacAulay, RPN, Greater Niagara General Site Maternal/Child

Nursing Leadership Award:

Jeanette Dempster, Clinical Manager, St. Catharines General Site Mental Health

Betty-Lou Souter,
Chair of the NHS Board of Trustees

The Niagara Health System Board of Trustees is made up of volunteers who live and work in Niagara. Each Board member brings unique skills and expertise to this leadership role. The Board is responsible for governing the NHS and providing strategic direction to the Hospital to ensure it meets the health-care needs of the community within the resources that are available to provide services.

Community Board members serve terms of three years, and can serve a maximum of three consecutive three-year terms. They devote a minimum of 10 to 15 hours a month to their Board role and do not receive any remuneration for their work. In addition, the NHS President and CEO, Chief of Staff, and Medical Staff Association President and Vice- President are Ex Officio members of the Board.

Beginning with this inaugural issue, Niagara Health Now will publish a series of question-and-answer profiles on individual members of the NHS Board of Trustees to help our readers get better acquainted with them. This week’s profile is of Trustee Betty- Lou Souter, who is Chair of the Board.

Where do you live?
St. Catharines

Where were you born?
Antrim, Ontario

Number of years living in Niagara:
32 years

Occupation:
Chief Executive Officer, Community Care of St. Catharines & Thorold

What are the greatest rewards from your job?
Being able to make a difference in the lives of others.

What influenced you to become a member of the NHS Board of Trustees?
I wanted to have a greater understanding of the health system so that I could help my clients which are amongst the most vulnerable who navigate the system.

How many years have you served on the NHS Board?
Inaugural member. Previously on St. Catharines 1997-2000.

What is your greatest achievement or reward as a member of the Board?
Groundbreaking for the new local acute care facility for St. Catharines, Thorold and Niagara-on-the-Lake and Walker Family Cancer Centre was perhaps the most gratifying. Other highlights include the 2005 transfer of governance and services with the former Hotel Dieu Hospital to resolve longstanding issues and gaps in the delivery of acute care in St. Catharines.

What is the greatest strength of the NHS?
The commitment of staff and volunteers.

What is its greatest weakness?
Lack of financial resources.

What community causes are closest to your heart?
Poverty, hungry and homeless, vulnerable population, mental health

Other involvement as a member of a volunteer Board, past or present?
Past Chair Ontario Trillium Foundation 1994-1996; Past President Rotary Club of St. Catharines; Past President Ladies Association Multiple Sclerosis; Past President Niagara Community Foundation; Currently serving on Brock University Board of Trustees, Board Chair YMCA Niagara and Board Member for Cancer Care Ontario, the provincial agency responsible for continually improving cancer services across Ontario.

How would you describe yourself to someone who doesn’t know you?
Off the wall!!!! Seriously though, I live my life trying to be a more compassionate and understanding person with every day that passes.

Who inspires you?
My mother inspired me. She taught me the importance of giving back to my community and gave me a strong value system.

What is your greatest personal achievement?
We never do things for recognition but when it happens it is a very wonderful feeling. The Citizen of the Year in 2002 for the City of St. Catharines and the Red Cross Power of Humanity Award 2007 stand out in my mind. «

Quality. Safety.

Two words that speak volumes about what every patient depends on when coming through the doors of the Niagara Health System’s seven sites.

Two words that also speak volumes about the hospital’s commitment to care.

“The NHS has many quality and safety initiatives underway to make our hospital programs and services the best they can be,” says Frank Demizio, Vice President Patient Safety. “These initiatives allow us to measure our performance so we can constantly improve everything from wait times for CT scans to infection rates. These initiatives also help to educate the public about the hospital system and provide them with a greater role in their healthcare.”

It is in this spirit of performance measurement, quality enhancement and public education that the NHS welcomes the provincial Ministry of Health and Long-Term Care’s four new patient safety indicators for hospitals across the province.

“Our hospital strongly supports the provincial government’s new public reporting regime,” says NHS President and CEO Debbie Sevenpifer. “These initiatives are consistent with our organization’s patient safety initiatives, and we believe they will inspire improved performance, enhance patient safety and strengthen the public’s confidence in Ontario’s hospitals.”

The patient safety indicators are Central-Line Associated Blood Stream Infection; Ventilator-Associated Pneumonia; Surgical Site Infection Prevention and Hand Hygiene. These indicators are establishing new standards to increase safety for patients in our hospitals.

The recent baseline data for Hand Hygiene shows that Niagara Health needs to improve on hand washing by its health-care providers. In the next month, there will be an increased focus on hand hygiene initiatives, which will include more staff education and audits on the patient units to measure performance.

“We will be counting on all staff to meet this requirement and will be encouraging them to provide feedback on how to improve hand hygiene at all of our sites,” says Frank.

The four new indicators are posted on the NHS website, along with many other performance measurements, in the Quality and Performance Section at www.niagarahealth.on.ca/quality-and-performance/ and on the Ministry’s website at www.health.gov.on.ca/patient safety/public/ps pub.html.

Niagara Health has been regularly updating its website for some time with new performance indicators, and it will continue to provide as much information as possible to educate the public. Much of this information goes above and beyond the public reporting standards set for hospitals in Ontario.

“The NHS encourages people to get more involved in their healthcare by accessing the Quality and Performance section of our website for key hospital performance measures,” says Debbie. To see hospital rates across the province, go to www.health.gov.on.ca/patient_safety/. and www.oha.com/patientsafetytips.

Another educational tool available to the public is a new consumer website unveiled recently by the Ontario Hospital Association and entitled myhospitalcare.ca. This website gives Ontarians an unprecedented opportunity to learn more about how their local hospitals are performing by location, type of care, indicator, or hospital name. «

I often say that the only constant about healthcare is change.

For this, and many other reasons, I welcome the introduction of this column and the opportunity it presents to update you, on a regular and meaningful basis, about our hospital priorities and what is happening at the Niagara Health System.

Across Ontario, hospitals are making changes to the way patient care is delivered to improve quality of care and better use our scarce resources, be they doctors and nurses, equipment or money.

Here at the Niagara Health System, there is an unprecedented amount of change taking place as we respond to the evolving needs of Niagara residents and keep pace with advances in medical procedures and technology.

Certainly, the Hospital Improvement Plan (HIP) has caused its share of controversy, and I understand the emotion and concern created by the HIP. Seldom is change easy. Modernizing and improving healthcare within available resources is also never easy and is complicated further in Niagara by the fact that we are one hospital with seven sites.

The reality is that, for many critical reasons, we have come to a point where we have to make substantial changes in order to sustain the provision of care in Niagara and take advantage of the excellent opportunities we have to advance and improve care.

The HIP has provided our medical leaders with great opportunities to improve the quality of the care we provide, and I believe that people will come to appreciate that the changes in the HIP improve quality of care for all Niagara residents.

Chief among these opportunities to advance and improve care is the creation of Centres of Excellence. These centres will allow us to pool our resources to more effectively manage the chronic – national — shortage of doctors and nurses and will offer our health-care providers the work environment, training and support they need and deserve. Centres of Excellence will also allow us to afford on an ongoing basis the facilities, equipment and technology needed to support the advances taking place in healthcare.

Please see our HIP coverage on pages 4 and 5 for the latest on the implementation of the HIP. The 2009 initiatives include the consolidation of surgical services and the transformation of the Emergency Departments in Fort Erie and Port Colborne into Urgent Care Centres. Other priorities for this year include the first phase of bed closures as new services are introduced in the community to more appropriately care for our patients who are occupying acute care beds in our hospital while awaiting alternate levels of care in the community.

Also important is the long-range planning that continues by our medical and administrative leaders to better integrate programs and services through the HIP and create of Centres of Excellence into 2013.

Monitoring performance and measuring quality are key to the HIP implementation, and any and all changes will be tracked on an ongoing basis using a set of specific performance indicators. For example, surgical performance indicators will centre around improving wait times for patients, standardizing operating procedures and reducing readmission rates to hospital.

Over the course of the year, you can read more about the HIP in Niagara Health Now as well as the other 2009 corporate priorities for the NHS which have been identified by our medical and administrative leaders.

Among these priorities is the new health-care complex, for which ground was broken on April 28, signalling the beginning of construction. Some believed this day would never come, but it did and it is very real. In 2013, the doors of this new facility will officially open, providing patients in St. Catharines, Niagara-on-the-Lake and Thorold with a much-needed replacement acutecare facility and bringing new regional health-care services closer to home to benefit all Niagara residents.

Please see page 1 of Niagara Health Now for the latest on construction milestones as we move forward with this crucial project. Frequent updates and open houses will occur during the construction process, and a new project website was recently launched in collaboration with Plenary Health Niagara at www.nhs.plenaryprojects.com or on the NHS website at www.niagarahealth.on.ca/construction/new-health-care-complex/.

Patient safety is a key priority for our hospital, and I am looking forward to the ongoing articles about the important initiatives that are underway throughout our hospital.

Please see the story on page 7 about our commitment to quality care, accountability and transparency.

In recognition of Nurses Week last week, I encourage everyone, at their next opportunity, to take a minute to thank the nurses of the NHS. They are the heart of our hospital system, and cannot be thanked enough for their hard work, commitment and dedication in these challenging times in healthcare.

In closing, as I mentioned earlier, I welcome the opportunity to communicate with you on a regular basis. As healthcare continues to evolve in Niagara, I will do my best to inform you of the changes that are taking place. «