Our Urgent Care Centres consistently have excellent wait/treatment times for non-emergency patients, who are assessed, treated and discharged in two to three hours.

ER Departments Treat
Chest pain and/or Shortness of breath Broken bones Severe abdominal pain Dizziness Sudden, severe headaches, vision problems, sudden weakness, numbness and/or tingling in the face, arm or leg, trouble speaking, or dizziness (stroke symptoms) Numbness in your arms or hands Major injuries Mental health issues Call 911 if you have severe chest pain, stroke symptoms or a serious emergency. Ambulances bring patients to Emergency Departments.
Urgent Care Centres Treat
Simple fractures, sprains, sports injuries Cuts that may need stitches Minor burns Minor abdominal pain (nausea,vomiting, flu) Ear, nose and throat problems Coughs and colds Eye problems Urgent Care Centres have access to services such as x-rays, lab tests and pharmacy. Ambulances do not bring emergency cases to Urgent Care Centres.

When to call 911
Call 911 with severe chest pain, stroke symptoms (sudden dizziness/loss of vision or numbness in face, arm or leg) or any serious condition which may be worsening. Call 911 when time is of the essence.

EMERGENCY DEPARTMENTS - Open 24/7

• Niagara Falls – Greater Niagara General Site, Portage Rd.
• St. Catharines — St. Catharines General Site, Queenston St.
• Welland — Welland Site, Third St.

URGENT CARE CENTRES - Open Daily

• Fort Erie — Douglas Memorial Site, Bertie St., Open 24 hours/day
• Port Colborne — Port Colborne Site, Sugarloaf St., Open 24 hours/day
• St. Catharines — Ontario Street Site, 8 a.m. to 10 p.m. daily

WALK-IN CLINICS - Open Monday-Friday

• Niagara-on-the-Lake — Niagara-on-the-Lake Site, Wellington St., Mon. to Fri. 9:30 a.m. to Noon, 2 to 4:30 p.m.

RN Shari Michaud has worked for more than 20 years in ERs and Urgent Care Centres at most Niagara Health sites. She now works full time at Douglas Memorial Site’s Urgent Care Centre.

When is it appropriate to use an Urgent Care Centre?

That is the question Niagara residents need the answer to, specifically so they can avoid long wait times in our three ERs.

“It’s no secret that wait and treatment times in our Niagara Falls, St. Catharines and Welland ERs continue to be higher than the provincial average,” says Vice President Patient Services Anne Atkinson. “Every week, hundreds of adults and children are spending hours in busy hospital ERs for treatment of a minor injury or ailment, when they could be in and out of an Urgent Care Centre more quickly.”

“Our Urgent Care Centres consistently have excellent wait/treatment times for non-emergency patients, who are assessed, treated and discharged in two to three hours,” Anne explains. “Compare this to the five to seven hours that non-emergency patients wait for treatment in our ERs. We are trying to get the word out that Urgent Care is the best option for quick treatment for those non-emergency patients, sometimes called low-acuity patients (Canadian Triage Acuity Scale Level 4 and 5).” See graph below.

Interestingly, the largest number (45%) of low-acuity patients using Niagara Health ERs is in the 18 to 45 age group. Each month, while about 2,600 low-acuity patients wait in an ER waiting room to be diagnosed and treated, ER physicians and nurses inside the unit are spending the bulk of their time with serious or high-acuity older patients. Clinicians are also caring for patients waiting for an inpatient bed. The result is a full ER – quite simply, there’s not enough physical space to treat more patients.

“We have several initiatives in place to address this recurring backlog,” Anne says. “We’re tightening up our hospital discharge processes, as well as our bed and room cleaning turnaround times to try and get patients into beds on the inpatient units more quickly. We’re working with community partners to safely and quickly discharge patients who no longer need hospital care but do need more care at home.

“We’ve opened Rapid Assessment or CSI areas at our three ERs to stream some patients who don’t need emergency treatment. We’ve brought in two ER physicians to be on duty during peak hours. We’re working with Niagara EMS to balance out the distribution and destination of ambulances to ERs and Urgent Care Centres, particularly in south Niagara. And last, but certainly not least, we’re recommending that non-emergency patients go to a walk-in clinic or urgent care centre in their own community or a neighbouring community.”

A Registered Nurse’s perspective

Registered Nurse Shari Michaud sees about two dozen patients each dayshift at Douglas Memorial Site’s Urgent Care Centre and she says there’s room for more. “We could definitely see many more patients at Port Colborne and Douglas Memorial Urgent Care Centres. We have enough nursing staff and physician coverage and we have enough space to treat them. Our treatment times are low, which shows we have good patient flow in and out.”

Shari has worked for more than 20 years at Niagara Falls and Welland ERs, as well as Port Colborne Site’s Urgent Care Centre. She is now permanently stationed at Douglas Memorial Site. “I live in nearby Sherkston and know that Fort Erie residents are very committed to their hospital,” Shari says. “They are very confident in the services we provide and that good news is spreading. We are starting to see more and more people from neighbouring communities in our Urgent Care Centres, which is great.”

“Lately, we have been seeing more serious cases than we would like – high-acuity patients who should really be in a full-service ER. It can be a struggle for us to give these patients the resources they need at the Urgent Care Centre. We can only provide that level of care temporarily. We stabilize emergency cases and then transfer them to a larger centre, where they can get the diagnostic testing and specialist support they need. We work with our partner sites and departments as a unified team, to make sure patients are being transferred as efficiently as possible. We’re generally pretty successful in achieving that, but it’s better if patients suffering chest pain, stroke symptoms or severe abdominal pain call 911.

“What is also a concern for my colleagues and me is the amount of misinformation still out there among some community elements. A lot of people don’t realize we’re open 24 hours a day. There’s been a lot of misinformation and some people actually believe the hospital is closed.

“We get a lot of phone calls to the Urgent Care Centre asking about whether they should come in with their condition. More public education is needed so patients understand their options and when to call 911 as well as when to go to a walk-in clinic or urgent care centre.” «

Donna at the Port-au-Prince airport under the Haitian flag -- just hours before the earthquake strikes.

Outpatients wait in line for X-rays and lab work at the mission hospital where Donna volunteered.

Donna, far right, and Alyson meet with doctors from Samaritan’s Purse upon their arrival. They are talking about the need for lab work and the sterilization of surgical instruments.

One of the many signs on the streets pleading for help.

An injured girl recovering in the mission hospital.

Patients and family members are squeezed into one of the women’s wards at the mission hospital. They have to supply their own blankets.

It was supposed to be an eight-day missionary trip to Haiti to teach local women how to make mats from plastic bags.

But the earthquake struck just two hours after Donna Thiessen’s plane touched down in Port-au-Prince. Donna had a new mission — to help the island country recover from the mass of death, injury and destruction caused by the Jan. 12 quake.

Donna, a Laboratory Technologist at the St. Catharines General Site of Niagara Health, had left the airport in the island country’s capital and was on her way to the Baptist Haiti Mission in Fermathe, about a 45-minute drive away in the mountains, when the quake struck. Although her plane from Canada had landed on time in Haiti, her small group was delayed at the airport for a couple of hours while awaiting the fourth member of the group to arrive.

“We were right in town when the earthquake hit,” says Donna, a 58-year-old resident of Vineland and member of St. Ann’s Community Church. “It felt like all four tires of the vehicle were shaking. Then everything just started lifting up. Buildings ahead would just go down in a big plume of dust. I was looking out the window and nothing was in focus because everything was moving.”

“People looked like they were dancing and jumping but what was really happening was they were being thrown up into the air,” says Donna. “Some people were screaming and moaning, and others were putting their hands in the air and praising God they were alive.”

Donna and her group, including her friend Alyson Stephenson of Smithville, arrived at the mission that night and began contributing to relief efforts first thing the next morning.

Food, water, medicine and supplies were all under ration at the mission. It was unknown how many people in the area had survived the quake and needed help with basic needs. Donna and Alyson straightened out the hospital supply warehouse and then went to work making up bags containing toothpaste, soap and a washcloth. They gave out plastic tarps for use as shelters as well as pillow cases filled with rice, cornmeal and bulgar wheat.

The 100-bed hospital at the mission quickly turned into a 300-bed hospital, as residents brought seriously-injured family members, friends and neighbours for help. Many required limb amputations and other emergency care. The hospital consisted of four big wards: separate men’s and women’s wards, a maternity ward and a ward for children.

“People were on the floors, in the hallways, outside,” says Donna, who as a Laboratory Technologist with Niagara Health System works in the Pathology Department of the St. Catharines General Site, processing, cutting and staining tissue samples.

She shared her expertise in the Haitian hospital lab and helped serve patients rice and beans.

There weren’t enough plates to feed all the patients, so they would serve them in intervals, washing the plates as they went.

Aid to the mission hospital flowed quickly and included the arrival of three doctors, truckloads of healthcare supplies, including splints and gauzes, and a water filtration system, all thanks to Samaritan’s Purse, an international relief agency based out of Calgary.

Funerals were held daily at the mission church.

In Haiti, Donna was able to communicate daily by e-mail with her husband Jake and her three grown children, but she was unable to leave the mission property for personal safety reasons.

Aftershocks went on for days and nights afterwards, leading people to sleep in the streets. “People were terrified of going into buildings. They were afraid buildings would go down.”

Safely back home in Niagara since Jan. 20, Donna attended the Hope for Haiti fundraiser held at St. Catharines Collegiate recently.

The sponsor of two children in the impoverished country, she had hoped to visit them in January but was unable to due to the earthquake. She doesn’t know if the children survived and is trying to find out.

Donna often thinks of the suffering and challenges the people of Haiti continue to face following the earthquake. She wishes she could have done more and hopes to return to Haiti for a fourth visit in the future.

“These people were poor before but at least they had a roof over their heads,” she says. “Now they don’t even have that.” «

“We are very proud of the way the people who work at the Niagara Health System stepped up individually and collectively to help the people of Haiti in their time of need following the January earthquake,” says President and CEO Debbie Sevenpifer.

Many in the NHS family didn’t hesitate to make personal donations to the relief effort, and several members of our healthcare team worked tirelessly in the devastated country, putting their skills to use as part of the massive relief effort.

Donna Thiessen, featured in this issue of Niagara Health Now, was on a missionary trip when the quake occurred, and spent the next eight days helping with emergency relief and recovery efforts at the Baptist Haiti Mission.

Another staff member, Else Marie Regier, an RN in the Intensive Care Unit at Greater Niagara General Site, just returned from a two-week volunteer trip to Haiti. Else Marie worked with the Mission of Hope, north of Port-au-Prince, reaching out and helping the people of this devastated country.

Back home, Engineering Manager Bill Lewis helped arrange the delivery of out-of-service equipment (anaesthetic machines, an X-ray fluoroscopy machine and two infant warmers) to St. Joseph Health System in Hamilton, the co-ordinating body for LHIN hospitals to send equipment to Haiti for use in the medical relief effort. «

Debbie Sevenpifer,
President and Chief Executive Officer

This March marks a significant milestone for the Niagara Health System – it’s been 10 years since eight hospitals amalgamated to one system, the largest number of hospitals amalgamated in Ontario.
Amalgamation brought many opportunities to create an integrated hospital system. Before 2000, the stand-alone hospitals in our Niagara communities had very few connections, both from a technological and relationship perspective. Different computer systems, different clinical standards, and multiple employers made it difficult for both patients and staff to manoeuvre between sites to ensure effective and efficient delivery of service.

The amalgamation has not been an easy one. And yet, despite our sometimes bumpy road, we continue to integrate our programs and services successfully and have become a model for the province. The past decade of hard work means our clinical and support programs span the region for the 500,000 patient visits each year at our seven sites. And our future holds great opportunity with our successful securing of new regional services of cancer, cardiac catheterization and tertiary mental health.

Our renovations and expansions since 2000 have been significant. Welland and Greater Niagara General sites have new Emergency Departments and renovated Ambulatory Care Units. A major expansion of Dialysis services outside St. Catharines occurred in 2008 with the newly-constructed outpatient unit at Welland. We are planning to expand Dialysis further to Niagara Falls. We are also awaiting provincial approval to create new space for the Urgent Care Centre in Port Colborne. And, of course, the major construction of the new healthcare complex and Walker Family Cancer Centre is now underway, bringing new hospital-based services to Niagara in 2013.

The benefits of an integrated system are particularly evident in emergency situations. The violent snowstorm that pummelled Fort Erie in October 2006 could have been disastrous for the hospital and the health of residents. The Douglas Memorial Site emergency generator ran for 56 hours straight – a record for any of our sites. Food for patients was thawing out and medical equipment was needed there urgently.

Our system-wide departments stepped up quickly and efficiently – whether it was maintenance staff who offered to cover shifts to monitor the generator 24 hours a day, the biomedical engineer who braved the driving conditions to get emergency patient equipment to Fort Erie, or site staff who put their own flooding problems at home on the back burner to come into work. Together, we made sure those hospital doors stayed open for the duration so Fort Erie could be served.

More recently, our system-wide response to H1N1 demonstrated tremendous collaboration to ensure continuity of services across our sites and is to be commended.

It is people who make a system, and I reflect on our first 10 years with pride for what we’ve achieved during challenging times, with gratitude for the passion and dedication of my colleagues every day, and with hope that the next 10 years will see the fulfilment of our goal to improve patient care in a sustainable hospital system.

Congratulations to our 6,000 strong team of staff, physicians and volunteers. We’ve come a long way together, and I salute you. «

Our people are making the world a better place

In this issue of Niagara Health Now, we are thrilled to shine the spotlight on two members of the Niagara Health family who are lending their time and talents as community volunteers. Although we hear it often that charity begins at home, quite frankly home is where the heart is.

For Donna Thiessen, a Laboratory Technologist at the St. Catharines General Site, what was to be a volunteer junket to help teach new skills to women in Haiti turned rapidly into a medical rescue mission. Just two hours after landing in Port-au-Prince on Jan. 12, the earthquake hit. Donna returned safely to Niagara and to her work, and in this issue she heroically shares with our readers her first-person account of the Haiti earthquake.

For Linda Howe, while it is a completely different experience, it is also life altering. This Registered Nurse experienced the 2010 Olympic Games from the frontlines as a volunteer at the Olympic Village in Whistler, B.C. In many ways, she represented the face of Canada for the athletes; before leaving for Whistler, she remarked how a smile would be an important part of her uniform while interacting regularly with the world’s best athletes.

People throughout Niagara Health are doing great things to make the world a better place, not only in their local communities but throughout our global village. From pitching in as coaches and referees at minor hockey, to manning the medical centre at rowing regattas, to ensuring there is enough to eat and plenty of warm clothes to go round at the Out of the Cold programs, every week you can find someone from our hospital helping out.

Keep up the great work and bit by bit we can make this world a better place for all.  «

Christine Clark, Chief Communications Officer

Acute beds at Douglas Memorial Site, Port Colborne Site and Niagara-on-the-Lake Site were converted last fall to mainly Complex Continuing Care beds.

The Niagara Health System is moving into Year 2 of implementing the Hospital Improvement Plan (HIP).

“We are focusing on the important issues before us as we chart a better future for healthcare in Niagara,” says Chief Operating Officer Bala Kathiresan. “There are two main factors driving the HIP – the need to improve the quality of patient care and for the NHS to operate with a balanced budget.”

Since the approval of the HIP in January 2009 by the Hamilton Niagara Haldimand Brant Local Health Integration Network, a number of important changes have occurred. This past year has seen the completion of targeted changes in the following services at Niagara Health sites.

Year 1 – 2009:

May – Consolidation of surgical services to four locations in Niagara Falls, St. Catharines and Welland and relocation of some specialty surgeries, such as ophthalmology, plastic surgery and dental surgery to one or two locations.

July – Conversion of the ER at Port Colborne Site to a 24/7 Urgent Care Centre, treating a wide range of non-emergency ailments for adults and children.

August – Installation of a new Siemens 128-slice CT Unit at Welland Site.

August/September – Closure of 30 beds at various sites.

September – Conversion of the ER at Douglas Memorial Site (Fort Erie) to a 24/7 Urgent Care Centre, treating a wide range of non-emergency ailments for adults and children.

September/October – Conversion of Acute beds at Douglas Memorial Site, Port Colborne Site and Niagara-on-the-Lake Site to mainly Complex Continuing Care beds.

In Year 2 – 2010, the following changes are occurring:

Development of Master Program and Master Plan for Greater Niagara General Site.

February – Move of Niagara Diabetes Centre from Ontario Street Site to Welland Site. This administrative centre provides clinic bookings for all six locations of the Niagara Diabetes Centre. It also houses physician specialist clinics and sees patients with special needs, such as pregnant women and children.

Spring/Summer – Further detailed planning to expand Dialysis services to Niagara Falls.

May – Opening of 10 Acute Stroke beds at Greater Niagara General Site. A specialized healthcare team will provide inpatient care in a dedicated area to patients recovering from stroke. This is a first for Niagara and enhances the Regional Stroke Program now located at the Niagara Falls site.

May – (To be confirmed) Closure of 39 inpatient beds at various sites.

Renovation of larger treatment space for Port Colborne Site’s Urgent Care Centre on main floor (date dependent upon approval of plans by Ministry of Health and Long-Term Care).

“Change is always difficult and there has been a lot of emotion in the community regarding the changes,” Bala says. “With the approval and support of the Local Health Integration Network, it is our goal to work collaboratively with all of our internal and external stakeholders. Our goal is for our hospital system to provide healthcare to Niagara that is both high quality and sustainable.”  «

The CSP, approved by the board in November 2009, is an action call for a healthier population, improved ways of working together for better health outcomes, and best practice organization and distribution of clinical programs.

This plan is a roadmap for health improvement and will guide the planning, integration and funding priorities in our LHIN over the next three years and beyond. The CSP is also an important piece of the LHIN’s Integrated Health Service Plan, approved in December 2009.

“The Clinical Services Plan is a roadmap for change and a call for action – it signals that change is coming and that tough decisions will be made,” says CSP Steering Committee Chair Rick Woodcock. “It outlines what needs to be different in three key theme areas – interprofessional care, clinical program integration, community-based health service capacity – and highlights the importance of e-health as a common enabler.”

Interprofessional care is a team-based approach to care throughout the LHIN where different healthcare providers – nurses, social workers, family doctors, pharmacists and dietitians – provide care together as a virtual team, connected electronically but in different locations.

Clinical program integration involves linking services currently provided in different organizations on a program basis, such as cardiac care, maternity and rehabilitation. This will mean that all aspects of care delivery are connected and co-ordinated following common standards and practices. All residents in the HNHB LHIN, regardless of where they live, will have equal access to services organized and working together as a system.

Community-based health service capacity involves a number of key initiatives:

• Better co-ordination of community-based services
• Better matching of services to clients’ needs
• More focus on health promotion and disease prevention
• Improved access to transportation services
• Expanded diabetes education centres and foot care services
• Focus on falls prevention

Key to each of these themes is e-health, and goals around this are as follows:

• All hospitals in the LHIN have access to a central electronic database that houses diagnostic images
• Two electronic portals – one to link healthcare providers and another for patients to access personal health information
• Electronic tool for Community Care Access Centre (CCAC) to connect clients to services

The benefits for residents are multi-fold, in that patients will only have to tell their health history once, there will be access to primary care when it’s needed, patients will undergo a test only once because all providers will have access to the results, and there will be local access to disease prevention and wellness services.   «

In this issue of Roundup… (Download PDF or browse links below)

Patient Safety WalkArounds
Risk Management would like to thank those of you who participated in the most recent round of Patient Safety Leadership WalkArounds. Once again, Senior Team members enjoyed meeting many of you and hearing your success stories… » cont’dRoundup Bouquet
Else Marie Regier, RN, in the Intensive Care Unit at Greater Niagara General Site, flew to Haiti Feb. 3 with the Flight of Angels organization to provide care there. She worked with the Mission… » cont’dAccreditation surveyors provide positive feedback
After a busy five days in Niagara in early February, the five surveyors with Accreditation Canada provided feedback to a gathering of NHS staff, physicians and board members, and the early results are overwhelmingly positive… » cont’dWait no more for ER wait time data
Reducing Emergency Room wait times is a top priority for the Ministry of Health and Long-Term Care. A key factor is to have accurate data, so targets can be measured and hospitals can make improvements… » cont’dNews Briefs
Nursing Awards deadline March 26; Second Look Nook – gently used items; United for Families Campaign wraps up… » cont’dCongratulations To …
Linda Howe, RN, in the Telemetry unit at St. Catharines General Site, who volunteered for 10 days at the Winter Olympics, using her vacation time and staying with her son, who lives in Whistler… » cont’d

Niagara’s new centre of excellence is being modelled after the Hamilton General Hospital’s Heart Investigation Unit.

The prevalence of chronic health conditions in Niagara directly impacts the care and services we require in order to build a better future for our family and loved ones.

As our population’s health needs grow and change, our services must as well.

For example, each year in excess of 1,900 Niagara residents travel outside of the region for specialized cardiac care because we currently do not have access to these specialized services within our geographical area.

With a significant aging population in Niagara, this demand will continue to increase.

To address this surge, when the new health complex in St. Catharines opens its doors in 2013, Niagara will be home to its very own Heart Investigation Unit – meaning that we will have timely access to specialized cardiac services in our own region.

In planning for the new healthcare facility, we are preparing today for the reality we are going to face five, ten, to 25 years from now.

The Heart Investigation Unit, to provide cardiac catheterization services, is being developed from both an operational and capital perspective to provide flexibility in terms of increased numbers of patients and the type of services being provided.

Cardiac catheterization is a minimally invasive procedure whereby healthcare practitioners are able to view how the heart and blood vessels are working so that they can evaluate individual patient needs for other procedures.

“What’s exciting about bringing in a new service at the time of constructing a new centre of excellence is that it allows us to not only look at the physical space provided within the building, but at essentially creating a new program,” says NHS Vice President of Patient Services Sue Matthews. “From there we can look at linkages with other community-based programs and focus on providing a full continuum of care which we have not been able to do for patients in Niagara suffering from cardiac disease.”

In discussion with Hamilton Health Sciences and our Local Health Integration Network, the NHS continues to discuss what service would be most appropriate for the region within the new facility – often discussed as diagnostic (identifying or assessing the level of disease) versus interventional (treatment).

These discussions focus on best practice, human resource requirements and a collaborative approach to cardiac care. The end result is improved service and access to care.

“In preparation for providing these services to our own patients, we have partnered with Hamilton Health Science’s cardiac program to facilitate the planning for this new service based on their expertise,” adds Matthews.

Armed with the capacity to provide this service, the benefit of this new program will be seen in state-of-the-art infrastructure and recruitment of high quality professionals.

Its outcomes to our patients and loved ones will be measured in lives saved.

“In building the new health complex, the opportunity we have before us is not only about infrastructure – the actual bricks and mortar of the new building,” says NHS Chief Planning and Development Officer Gloria Kain, “but about transforming the services we provide.”

The addition of these required programs and services will change the face of healthcare in Niagara and will address the chronic disease conditions we have been battling for years.

For our family and loved ones, this means longer and healthier lives. «

Great weather and a great cause brought out the crowds for the 2009 Annual 5k Run/Walk for the General.

A few of the 60 participants at the 2009 Spin for the General who enjoyed a great day of community fundraising spirit and exercise.

Cardiovascular diseases of the circulatory system, including the heart and blood vessels, are the leading cause of death in adult Canadian men and women. The most common type is heart disease.

Heart disease can happen to anyone. In the majority of cases, we can minimize our risk of heart disease through lifestyle factors such as healthy eating, avoiding stress, refraining from smoking and getting enough exercise. Exercise is a very important factor because people who are physically inactive have twice the risk of having heart disease and a stroke. Even after a heart attack, physical activity is important because it reduces the risk of having another one and it improves the chances of survival.

The St. Catharines General Hospital Foundation has two great events planned to allow you to enjoy a great day of exercise while raising money to purchase medical equipment for the treatment of cardiovascular diseases.

The 7th annual Spin for the General takes place April 17 at The Club at White Oaks. Participants take part in one of five 45-minute classes. Over the years, this Spin event has raised over $65,000 for new medical equipment.

On May 2, Club Roma will host the 11th Annual 5k Run/Walk for the General. In its 10-year history, over $355,000 has been raised for equipment. Both the Spin and the Run events include a free shirt, brunch or lunch and a chance to win some great prizes.

Many people aren’t aware that the Ministry of Health and Long-Term Care doesn’t provide funding for new and replacement medical equipment. Therefore, we must rely on donations and community participation in our fundraising events to ensure our healthcare professionals have the equipment they need to continue to deliver excellent care.

Join us in these exciting traditions supporting healthcare in our Niagara community. It will be good for your heart and it will do your heart good to know that you are helping ensure our cardiologists have access to state-of-the-art equipment necessary to diagnose and treat cardiovascular disease.

For more information about the events, visit www.scghfoundation.com.  «

This spring, NHS staff, patients and their friends and families are invited to participate in the Cardiac Health Foundation of Canada Walk of Life to raise money to support our cardiac rehabilitation program.

Covering a five-kilometre route, the event will take place in Welland in May — date to be announced. Registration for the Walk of Life is only $10 per person (includes an eco-friendly bag/back pack), and walkers are encouraged to collect pledges from friends, family and co-workers. To obtain a pledge form, or volunteer, contact Steven Walker at 905-378-4647 ext. 63320.

The Niagara Walk of Life is part of a national fundraising initiative through the Cardiac Health Foundation of Canada, hosted by local cardiac rehabilitation programs in cities and towns throughout the country to promote heart health awareness. While this is the first time the NHS cardiac rehab program has participated in the Walk, this year marks the 25th anniversary of this national event that aims to encourage participants of all ages to get active and to educate people about heart disease prevention.

The funds raised locally will support the NHS Cardiovascular Health and Rehabilitation Program. The money will be used to purchase equipment such as blood pressure cuffs, heart rate monitors, lap tops, projectors, and other patient education materials for the program.

Last year, the NHS cardiac program saw over 700 people from Niagara, and numbers are expected to grow in 2010. The program offers services in Welland, Niagara Falls and St. Catharines and sees patients who have experienced heart issues such as bypass surgery, angioplasty, heart attack, heart failure, valve replacement or heart transplant. Rehabilitation strategies include supervised exercise programs, nutrition counselling and help with stress management and smoking cessation–the end goal being to increase fitness level and decrease risk factors.

Do your heart good and join us for the Walk of Life!  «

Niagara Health System Board Member Flo Paladino

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 healthcare needs of the community within the resources that are available.

Niagara Health Now is publishing a series of question-and-answer profiles on individual members of the Board to help our readers get better acquainted with them.

This issue’s profile is of Flo Paladino.

Where were you born?
I was born in Niagara Falls.

Number of years living in Niagara:
I spent a happy childhood in Niagara Falls! I moved when I went to university and then spent 20 years working for the public and broader public sector in Toronto. I returned to Niagara Falls three years ago.

Occupation:
I am currently a director with Global Governance Advisors. GGA is a professional advisory firm that assists boards, executives and investment organizations in maximizing the effectiveness of their executive compensation, board governance, and overall human resources committee mandate.

What were the greatest rewards from your job?
I help organizations develop HR programs that improve the working lives of people. That is my greatest reward. We all spend a good portion of our days at work – let’s make sure that we are motivated and it is time well spent!

What influenced you to become a member of the NHS Board of Trustees?
Nothing is more important to quality of life than health. I moved from a city with world-class hospitals. I wanted everyone in the Niagara region to have access to the same level and quality of healthcare. I’ve always wanted to give back to my community, and the NHS allows me to share my skills and experience.

How many years have you served on the NHS Board?
One year.

What is your greatest achievement or reward as a member of the Board?
While I have only been on the Board a short time, I have valued the time we spent working collaboratively with doctors on revamping the Medical By-laws. This was an issue that the doctors raised in an independent review as being important to them and to patient care. We are close to the end of this process, and I hope we have strengthened the relationship between the Board, management and medical staff.

What is the greatest opportunity for the NHS? What is its greatest challenge?
The greatest opportunity and the greatest challenge for the NHS are to provide quality, integrated healthcare services across
the region.

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

Congratulations To …

Linda Howe, RN, in the Telemetry unit at St. Catharines General Site, who volunteered for 10 days at the Winter Olympics, using her vacation time and staying with her son, who lives in Whistler. Olympic volunteer organizers saw value in Linda’s skills in dealing with large numbers of people, stressful situations and confidentiality. She was selected to volunteer in the Olympic Village as a concierge for the athletes, helping them acclimatize to their new surroundings.  «

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

Wait no more for ER wait time data

Reducing Emergency Room wait times is a top priority for the Ministry of Health and Long-Term Care. A key factor is to have accurate data, so targets can be measured and hospitals can make improvements. To achieve this, the Ministry has mandated a new initiative to reduce the turnaround time that hospitals report ER wait and treatment time data. Until now, the Ministry has asked for completed and coded health records data within 45 days after month-end. Now, the deadline has been reduced to just 10 business days.

“Health Record coding staff has been working feverishly over the past few months to attain the newly-mandated turnaround time, and we are pleased to announce we have succeeded. We have reduced the time for coding and submitting ER wait time/treatment data to the required 10 days,” says Jane Doan, Regional Manager of Coding and Data Quality.

This information is submitted to the Canadian Institute for Health Information and statistics are publicly posted, showing data on ER and Urgent Care departments across the NHS, Local Health Integration Networks and Ontario.

“Not only is this data needed to show wait and treatment times to the public, it assists in decision-making for future planning and resources for ER needs,” Jane explains. “Faster turnaround times also mean the Ministry will be able to post more recent stats.”

Point of Care Tracking

Accurate data is the foundation for evaluating ER workflow and identifying system bottlenecks. Best practice is to capture dates and times at the point of care – meaning physicians, nurses and other health professionals must document into the patient record at the following points of a patient’s experience:

• Triage
• Ambulance arrival and transfer of care
• Physician initial assessment
• Decision to admit, transfer or discharge
• Specialist consultant date/time called
• Clinical Decision Unit in and out
• Patient left

A Team Effort

The work and success of this initiative, called ERNI, is a collaborative effort from the following hospital departments: Health Records; Patient Resources; Decision Support; Information & Communication Technology; and Nursing.

“Health Record professionals want to ensure they accurately reflect the flow of ER patients, but can only do so if staff from these departments are continually involved,” Jane says.

Clinical staff can do your part…

• Understand your role in the process
• Ensure ER times are consistently documented on the ER record
• Capture data at the point of care
• Ensure accurate data is entered into Meditech – reflect dates and times orders written, NOT the time you are entering the data. Data quality at the source is the most effective way to collect valid and reliable data
• Ask your Health Record staff for more information «

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

News Briefs

Nursing Awards deadline March 26

Planning for annual Nursing Week celebrations is underway. This year’s Nursing Week theme from the Canadian Nurses Association is Nursing – You Can’t Live Without It. Nursing Week will be celebrated May 9-15, and our Nursing Week Dinner is booked for Wednesday, May 12, at Club Italia. Please book this in your calendar now! Ticket information will be available soon.

Please recognize your nursing colleagues and nominate them for a nursing award. Access the awards nomination forms on source•net. Deadline for submissions is Friday, March 26. We are also hosting again this year a Nursing Week Breakfast, where we will celebrate our Nursing Awards. Breakfast date and location will be confirmed soon.  «

Second Look Nook – gently used items

Auxiliary members at St. Catharines General Site have begun a new venture in their main floor space near the boardroom, with the opening of the Second Look Nook. Open the first and third Thursday each month, all the profits from the sale of second-hand items are put towards the purchase of hospital equipment.

The Second Look Nook is run by volunteers and depends solely on donations from any and all sources. Convenor Ann Coulter asks staff to be sure to stop by to purchase some quality items with lots of life still in them, or make a donation of items in the Auxiliary room or the Gift Shop.  «

United for Families Campaign wraps up

Co-Chair Bala Kathiresan, left, accepts a $1,000 cheque from Frank Gigliotti, president OPSEU Local 215.

Congratulations to all the winners in the payroll deduction and raffle prize draws in February. As the United for Families campaign comes to an end, the campaign committee thanks all staff for their support of the 2009-10 effort to donate $80,000 to local community agencies through United Way.

“We came close to achieving our goal, but for the first time, we fell short, raising approximately $72,000,” says Co-Chair Lynne Pollard. “Of that total, $58,600 came from 397 payroll pledges and one-time donations.”

The remainder was raised through various raffles, luncheons, other fundraising events, and OPSEU and SEIU gifts. A sincere thank you goes out to all those who worked on this year’s campaign, including the Site Administrative Assistants and various ticket sellers, who promoted activities at their respective sites.  «

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

Patient Safety WalkArounds

Risk Management would like to thank those of you who participated in the most recent round of Patient Safety Leadership WalkArounds. Once again, Senior Team members enjoyed meeting many of you and hearing your success stories, concerns and challenges. The themes this round were patient identification and falls prevention. We are pleased to report that on all the units visited, patient identification is being tracked as good catches, as per national benchmarking standards. It was gratifying for leaders to confirm that everyone is aware of the NHS Patient Identification Policy and is using the unique identifier’s protocol before any treatment occurs. We are also proud to affirm that everyone is vigilant about falls prevention. Over the next few months, there will be additional information and new benchmarking strategies to further decrease our rates of patient falls.

A recurring concern at all sites is the availability of wheelchairs and their condition, particularly the wheels. Also, there are concerns from staff with the number of old crank beds. These issues have been brought forward to the appropriate leaders and plans are underway to address them. Already, some new wheelchairs have been purchased for Greater Niagara General Site. Stay tuned for an update on more plans in an upcoming issue of Patient Safety Connection.

The Accreditation Canada surveyors were pleased to learn of the success of our WalkArounds and the increased visibility of Senior Team members. Moving forward, they have recommended two areas for improvement. The first is for us to define safety briefings corporately. The second is to reinforce our clients’ role and knowledge in patient safety.

We already demonstrate these in our daily practice, so the next steps are to formally define and reinforce them. Please stay tuned for up and coming initiatives that will assist us in achieving these next important steps. In the meantime, visit the Institute for Healthcare Improvement (IHI) website for more information. The IHI offers a wealth of comprehensive information and tools for healthcare organizations worldwide.

If you have any questions/suggestions, please contact Cindy Ko, Patient Safety Specialist. cindy.ko@niagarahealth.on.ca, ext. 44420.  «

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

Accreditation surveyors provide positive feedback

Accreditation Canada surveyors, from left: Chris Gustavson, Catherine Danbrook, Dr. Orlando de Silva, Sam Kearns, and Sue Carpenter.

After a busy five days in Niagara in early February, the five surveyors with Accreditation Canada provided feedback to a gathering of NHS staff, physicians and board members, and the early results are overwhelmingly positive.

The surveyors told the gathering that the NHS is compliant in more than 95% of the 1,712 criteria that Accreditation Canada uses to evaluate organizations against national standards! This is excellent news and demonstrates the diligent efforts of everyone to make improvements in a wide range of areas since the 2006 survey. Full results are expected in the near future.

Highlights since last survey

Successes: previous recommendations addressed; new hospital development; medication management processes enhanced and implemented; infection prevention & control policies and procedures enhanced; informed consent process; formalized program-level goals and objectives

Opportunities/Challenges: fiscal challenges; work force plans (vacant positions); sensitivity with changes (intense media & community scrutiny)  «

In this Roundup (View PDF or browse links below)

• News Briefs
• Patient Safety WalkArounds
• Congratulations To …
• Roundup Bouquet
• Accreditation surveyors provide positive feedback
• Wait no more for ER wait time data

Roundup Bouquet

Submitted by Submitted by Paul Hesch, Clinical Manager ICU

Else Marie Regier, RN, in the Intensive Care Unit at Greater Niagara General Site, flew to Haiti Feb. 3 with the Flight of Angels organization to provide care there. She worked with the Mission of Hope, north of Port-au-Prince, for approximately two weeks.

Registered nursing is an honoured profession of caring for people in need. Else Marie’s commitment to nursing is additionally demonstrated through her willingness to volunteer to provide assistance to the people in Haiti who are experiencing a monumental crisis as a result of the earthquake.

The Critical Care program thanks Else Marie for reaching out and helping the people of this devastated country. She was in everyone’s prayers as she did amazing work at the Mission of Hope. She put forth a commitment that is unselfish and inspiring.