A publication for Staff and Physicians of IH

Transcription

1 A publication for Staff and Physicians of IH

2 A message from Chris Mazurkewich, Interior Health s CEO. Wellness wisdom for work. Violence prevention and safety training for staff and managers. A daughter shares the story of her mom s decision to complete her life on her own terms. Jason Giesbrecht leads the transformation of Primary and Community Care (PCC). Meet John O Fee, new IH Board Chair. Using RPIWs to improve the patient journey. Waitlist audits lay foundation for patient satisfaction. Patients offered online access to their health information. Introducing the Métis Nation, the fifth of eight Nation profiles. Snapshots of our staff in action and trending health-care videos. On the cover: Jason Giesbrecht is Executive Director of Primary and Community Care Transformation for Interior Health. Story page 12.

3 magazine is a monthly publication created by the Communications Department of Interior Health. Past issues can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please IHAcommunications@interiorhealth.ca Deadline for submissions to the February magazine is January 13. Editors: Amanda Fisher, Karen Hurst Designer: Kara Visinski IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Erin Toews, Breanna Traynor, Tracy Watson, Mike Youds Every person matters

4 President & CEO Chris Mazurkewich elcome to 2017! If you are anything like me, you ve probably spent a bit of time over the last while thinking about the new year ahead what to accomplish, where to make changes, and how to make improvements in both our personal and work lives. This has been top of mind for our Senior Executive Team (SET) as we strive to improve our individual and collective functioning. We recently began work on personal and team development exercises that are focused on selfreflection and collaboration, so that we are more aware of the value we each bring to the table and how those attributes contribute to the overall strength of the team. As your CEO, high-functioning teamwork is a theme for me in I mentioned two priority areas of work in my message: ensuring a safe and healthy workplace across IH; and, transforming primary and community care. You ll find articles related to both in this month s magazine, which clearly articulate how a teambased approach is the key to success. From our day-today commitment to keep everyone as safe as possible at work (see p. 6) to the longer-term goal of shifting the health-care system (see p. 12), teamwork is essential. We all need to be pulling in the same direction toward a common vision. Another area I ve been thinking about is a continued and even greater focus on every person matters as well as our IH values of Quality, Integrity, Respect, and Trust. These are important components of our IH culture and speak to how we care for people and for one another, as well as how we work together. I see and hear countless examples of this culture in action from kudos passed on through managers, to the articles and Sensational Staff submissions on our In the Loop website, and also when I visit our sites and meet staff throughout IH. Whether it s quality improvement collaboration on projects like the medical unit digital patient tracking at Kootenay Boundary Regional Hospital, recognition for the great team in IH West that organized and ran last-minute Hepatitis A immunization clinics over the Christmas holidays, or a heartfelt thank you for those working on our overdose response, these are the stories that convey who we are and what we stand for. And we need to continue to share them because it increases connectedness and improves engagement across all areas of Interior Health. In addition to sharing the good work we are doing and seeing, we also want to be more open and transparent in terms of sharing information, discussions, and decisions. In this vein, I have begun to link in regularly with our VP leadership teams, passing on health-care news items and articles of interest, and I am enjoying the interaction it has stimulated. As well, I have committed to sharing our monthly SET meeting packages with these groups and they have an open invite to attend and participate in the meetings for any and all agenda items that are of interest. My intent is for our leaders in IH to be increasingly involved and engaged, and better able to help their own teams all of you understand our strategic direction and help achieve our objectives. Collectively, this is an opportunity to learn from one another and I am also curious to see if over time this transparency contributes to more robust discussions with better and potentially quicker decisionmaking. Here s to the year ahead and to all that we can accomplish as an IH team!

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6 Matt Renfrew and Karen Peterson have been recently certified as site trainers and can now facilitate the violence prevention classroom training required for all high-risk staff. The IH Workplace Health & Safety team is leading an initiative to ensure all employees are adequately trained to manage workplace risks. We don t always know the daily personal, emotional or physical experiences that impact the people under our care, but paying attention to behaviours and possible hazards in and around where we work can help keep us out of harm s way, says Mal Griffin, VP Human Resources. No matter where you work, you can encounter a situation in the workplace that puts your health or safety at risk. To be prepared for these situations, it is vitally important to complete the required training so you can identify potential risks ahead of time and act accordingly.

7 To ensure the safety of our workplaces across Interior Health, a priority focus is for: all staff and managers to be trained in violence prevention; each site to have a violence prevention risk assessment; managers to be trained in occupational health and safety for supervisors; incidents to be immediately reported and investigated; and, corrective actions to be implemented in a timely manner. All IH employees are categorized into one of three risk levels: low, medium, or high. The high-risk category includes all those who work in residential care, mental health and substance use, and emergency departments. Residential, MHSU, and ED are categorized as high-risk due to the varying states of resident, patient, and client wellbeing. Matt Renfrew, Assistant Manager at Overlander Residential Care in Kamloops, and his colleague Karen Peterson, Clinical Practice Educator for Residential Initiatives in IH West, agree that residential care can be categorized as high-risk due to the high numbers of workplace injuries and the increased frequency of behaviours and psychological symptoms of dementia. The cumulative effects from degenerative brain failure, increasing dependency on caregivers, plus many other losses suffered as a result of a resident s illness, can cause frustration, fear, distrust, and/or a decreased ability to communicate their needs, says Karen. And this can contribute to responsive behaviours, which are often unintentional. Matt adds, Multiple residents living in the same room can also pose a challenge, as it can cause frustrations, confusion, and aggression. Courtney Mosley is a member of the Brief Intervention Services and Walk in Counselling teams at the Community Health and Services Centre in Kelowna, where she provides mental health and substance use services. She says that not knowing someone s mental health history is a factor that contributes to her work being categorized as high-risk. We have an open door policy and people come to us for help with mental illness, suicide prevention, relationship crisis, and substance use management, says Courtney. People are not often coming to see us on their best days, so there can be some volatility. Kelly Chapman, Director of Health Services in acute care for the North Okanagan, says one of the high-risk areas in any hospital is the Emergency Department. Emergency is an area that receives patients who are in a state of crisis and seeking immediate medical attention. In those situations, there is always potential risk. Frontline health-care providers can receive verbal threats, physical threats, and/or actual injury. Matt, Karen, and Courtney have all taken violence prevention training and are also site trainers. They can facilitate the violence prevention classroom requirement for high-risk staff. Kelly is also a site trainer and is co-chair of the Joint Occupational Health and Safety Committee (JOHSC). All staff, whether low, medium, or high-risk, have a role in ensuring a safe and healthy workplace across IH, says Mal. I encourage everyone to immediately go to i-learn and check their Development Record to ensure they have the required training. Stay tuned to IHintheLoop.ca as we explore staff stories about their incident experiences and what they have done to ensure their safety, and the safety of others, now and into the future.

8 Working together to ensure a safe and healthy work environment Violence Prevention training for everyone Violence Prevention Risk Assessments at every site Emergency Procedures know your role during a code white Workplace Incident know the immediate reporting steps Occupational Health & Safety training for all executives, directors, managers, and in-charge staff

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10 Patient and family STORY Cari (L) and her sister Lori (R) with their mom, Alice Taylor, during her last week. Alice s Great Demise A daughter s experience with Medical Assistance in Dying Cari Taylor is the second daughter of Alice Taylor. This is her story. O ur mom, Alice Taylor, called her ending her Great Demise and we referred to it that way for as long as I can remember, but this is neither the beginning nor the ending of the story. Our family talked about death and dying pretty openly. Over the years, Mom lost her parents, a daughter, her brother, her in-laws, many friends, and then her husband. Mom told us that she was not afraid of death. She would say: How can I be afraid of death because that would mean my mom and dad, little Melanie, Al (husband), and everyone else had all gone to a terrible place, and I could not let myself believe that.

11 In July 2016, Mom decided to enact the newly created legislation of Medical Assistance in Dying (MAiD). The discussions started many years before, but, officially, the process began in October My older sister Lori and I asked Mom s family doctor to make a house call to her residential care facility. He met with the three of us and Mom told him of her intention. She asked whether he would help her once the Canadian legislation passed. My sister and I fully supported her right to make this choice. He agreed to assist. So in late July my mom chose to leave this planet. She got to pick the date, the time, whether she was sitting up or lying down, the people who would be with her, and, weirdly, even what outfit she would wear. She was not afraid, she was calm. She was a star in the face of what could have been a very grave and terrible time. Lori and I and our spouses held her hands, talked to her, and loved her right until the very second she closed her eyes forever. My mom had multiple sclerosis and suffered with this slowly debilitating disease for more than 30 years. She was a vibrant, family-oriented, loving mom looking forward to a travelling retirement when her symptoms first kicked in. She was in her early 50s when the decline began. She had to quit her job. She went from being a walking person to using a cane, to a walker, to a wheelchair with control buttons and, finally, to a wheelchair in which she had to be pushed. Through the years, she lost all control of her body from the neck down. In the end, she couldn t change the channel on the TV, operate her electronic book reader, or hold a pencil to play her beloved Sudoku. She couldn t feed herself, blow her nose, or even scratch an itch. Her quality of life, her independence, was gone. Yet, she was brilliantly spirited, with no cognitive decline. She had a smile for everyone, a piece of wisdom to share, a bit of history to enlighten us all as to what life had been like in the early days. She loved her family and we loved her. Nonetheless, she was done. Like going to a party and knowing when it is time to go home, this remarkable 82-year-old said her time to leave had come. So how do you wrestle with it? Let s face it there is no good day for your mom to die. However, through this journey, I discovered a beautiful thing. If you truly love someone, you want more for them than you want for yourself. I might have wanted her to stay and battle on, but that was for me. More than that, I wanted her to go, for her. So I was relieved when she passed away because that was for her. I still miss her dearly, but that is for me. Today, when I tell people how my mom died I watch their faces. Some are shocked, some are horrified, some are excitedly happy, and some are blank because they really don t know how to respond. This is all so new. I believe wholeheartedly in MAiD. Selfishly, because I also want that choice as I grow older. Realistically, because I have had the privilege to be a part of it with my mom. I ve had to deal with the strange feelings, the grieving in advance, helping others to understand, and the best part the chance to have amazing closure and say everything that needed to be said. Both my sister and I have been part of something bigger than us and we count ourselves as very lucky. We are happy to be mentors of how MAiD can truly be wonderful. We are so proud of our mom and all our family and friends. We took an amazing journey together and, while some days were really, really hard (and still are); we supported unconditionally Mom s right to complete her life, in her own terms. We believe our dad would have been proud of her too. The memory of the light and sheer joy in Mom s face can never be taken from us. For so many years, MS ruled, but, in the end, she took back control of her own life and she ruled. They say the right to choose is both a privilege and a burden. And yes, it is! Learn more about MAiD Visit the MAiD web page for staff on InsideNet Access MAiD resources for physicians and for patients and families on our public website the MAiD Care Coordination Committee Call toll free

12 Ashley, Jason, Ali, Kyle and Niki Giesbrecht, L-R, embrace the outdoors whether they are at home in the mountains around Cranbrook or on an international adventure. Here they are in Top of the World Provincial Park in the Kootenay range of the Rocky Mountains.

13 M any things define the person leading the transformation of a strong and integrated Primary and Community Care (PCC) health system for Interior Health. Jason Giesbrecht is an athlete, a family man, an adventurer, a person with an enormous social conscience, and an incredibly hard worker. Those attributes are an integral part of his personality whether he is on the job or at play. Consider his description of why he a boy raised on the Saskatchewan prairies loves to sail. Navigating the obstacles of the wind, tide, and wave direction is an intellectual challenge and it s green. I could sail for days on less than five gallons of diesel. Steering Interior Health around what might appear to be insurmountable obstacles will also be required of him in his role to establish viable health services that will help shift patient care from acute hospital settings to homes, community clinics or primary care offices. Despite the unfortunate fact there are only 24 hours in every day and some of it must be used for sleep, Jason has an amazingly full life outside of work. One of my passions involves traveling to Central America. Over the years, it has been very valuable to travel there with my family as we attempt to teach our children about the world and how many people live on less than $2 a day. We ve learned that some of the happiest people on the planet have no earthly possessions. His other passion and his wife and children are part of all his passions is fitness whether that is running, triathlons, mountain biking, or skiing. Wife Niki, who is also a physiotherapist; eldest daughter, Ali, 16; and 14-year-old twins Kyle and Ashley, continue to live in Cranbrook although much of Jason s current work is taking him across Interior Health. We just love the Kootenay lifestyle, which is laid back but also provides easy access to the outdoors that we enjoy so much. His work and education history has positioned him well for the task at hand. Jason has held numerous senior leadership positions in health care, as well as had 10 years of experience on the frontline as a physiotherapist. Education has also been a major interest, with BAs in both arts (psychology) and science (physical therapy), as well as a master s degree in physical therapy and a graduate certificate in health system leadership. He is currently an adjunct professor in the Faculty of Medicine at UBC where he teaches a course on transformational leadership in the master of rehabilitation science program. His teaching background won t come as a surprise to anyone who has heard Jason speak. His natural ability to explain a complex issue will be an asset as he outlines to internal and external stakeholders the value of the system change that is occurring globally and is in progress within our Interior Health communities. Jason captures concepts for planning a strong primary and community care system for Interior Health on a well-covered whiteboard. Here is our conversation with Jason Giesbrecht about what his new adventure in health care is all about. What is Primary and Community Care Transformation? The transformation of primary and community care is an initiative aimed at providing quality primary health care that meets the changing needs of patients and populations through the creation of an integrated and well-coordinated system of team-based primary and community care throughout Interior Health. The health needs of specific patient populations in each of IH s 20 geographical service areas will help define the type of services required. Primary care practices, which provide the first point of contact for patients needing health care, and primary care services provided by IH will link to specialized services to ensure patients have ready access to care.

14 An integrated primary and community care system will better meet the needs of patients today and in the future; better manage the impacts of a changing workforce; better realize value for money in our health-care system; and reduce admissions in acute and residential care. How is the new plan for primary and community care different from what we have heard about over the past 12 months? This transformation of the health-care system is advancing more quickly now with additional clarity provided by the Ministry of Health on the required components of the transformation. The desired outcomes have not changed, but the processes necessary to initiate and complete this large-scale change have become more clear. What are the key components of an integrated primary and community care system? The Ministry of Health has developed something called the target community service operating model, otherwise known as the TOM, which describes optimal primary and community care services in B.C. and the players involved. The three key components are: Primary Care Home, which is a network of Patient Medical Home practices closely linked to primary care services offered by the local health authority to provide comprehensive care options for patients. Patient Medical Home, which is an enhanced primary care practice (general practitioner or nurse practitioner) that applies a team-based approach with other health-care professionals to offer a full range of patient-centred primary care services. Specialized Community Services Programs (SCSPs) or specialized services, which provide a full range of services including specialists, such as a psychiatrist or geriatrician, specialized nursing and allied health services (e.g., social workers, physiotherapists, etc.); home and community care services; and assisted living and residential care services. Primary Care Homes are linked to four SCSPs complex medical / frail older adults; moderate to severe mental health and substance use; cancer care; and surgical services to provide accessible, integrated, and well-coordinated services when patient needs exceed the capability of the Primary Care Home to provide services. Who are the key stakeholders? Patients/families, physicians (specialists and family physicians), Ministry of Health, Interior Health, Divisions of Family Practice, Aboriginal partners, community partners, and private health-care providers. What is needed to make this transformation successful? Any successful change must begin with leaders who have a desire to do things differently and the ability to share that vision across the organization. It is important that the reasons for the change are well understood and clearly shared as we shape the future of health care in IH. It won t happen all at once. The shift away from hospital services towards community-based services will be phased over the coming months and will likely span multiple years. Some areas, such as Kamloops, Kelowna and the Kootenay-Boundary, are moving ahead now as proof-of-concept communities, yet the intention is to create this shift across all areas within IH. How will this respond to the demand from patients who need a doctor? Team-based interprofessional care will support existing primary care providers; practice-ready spaces may be developed to allow physicians and NPs to begin to practice immediately without having to buy into an existing practice or manage a business; and the addition of NP-led primary care practices will also increase access to primary care. Where is the new model being implemented first? We have projects happening in Kamloops, Kelowna, and Kootenay Boundary. We expect to be working closely with North and South Okanagan early in Will services look the same in every geographical service area? This widespread change is very much focused on the health needs of the specific patient population in each Geographic Service Area (GSA). Therefore, as the populations differ, so will the approach to primary and community care transformation in each area. For example, in some communities, the most pressing issue is finding a family doctor. In other areas, access to a particular specialized-care program, such as for diabetes, is the key concern. What is the difference between a Primary Care Home and Interior Health s existing primary care sites such as Sparwood, Kimberley, and Kamloops Primary Care Clinic? The Ministry of Health has identified 12 attributes of a Patient Medical Home/Primary Care Home. Across IH we are working with our existing primary care clinics to help them achieve these attributes. Primary Care Homes also offer specific services that identify them as full Primary Care Homes. What role will Aboriginal partners play in this work? Our Aboriginal partners play a key role in this initiative. We know that Aboriginal people may not use primary care services as much as non-aboriginal people, possibly due to the accessibility, acceptability, and availability of services to Aboriginal populations. It is important for IH to collaborate closely with Aboriginal partners to better understand the needs of this population and ensure services are designed to meet their needs.

15 th Annual BC Health Care Awards Call for nominations Recognize someone who deserves to get noticed The BC Health Care Awards recognize excellence and innovation in our province s health care community. Awards are for projects that improve health care delivery and for individuals who inspire those around them. Top Innovation Affi liate Top Innovation Health Authority Workplace Health Innovation Collaborative Solutions Health Care Hero (eight winners!) Learn more & nominate online at BCHealthCareAwards.ca Nomination deadline: 5 p.m., Friday, February 24, 2017 BCHealthCareAwards.ca Twitter.com/BCHealthAwards Facebook.com/BCHealthCareAwards YouTube.com/BCHealthCareAwards PRESENTED BY

16 John O Fee is the new Chair of Interior Health s Board of Directors. C omplex issues associated with decision-making in the world of health care don t worry the new chair of Interior Health s Board of Directors. John O Fee has been dealing with thorny topics since he stepped out of law school in his 20s, both in the legal arena and then as a politician first on the school board and then as a city councillor in the city where he grew up, Kamloops. He s also no stranger to the role of chair, having been head of the school board, hospital board, airport authority, and municipal audit committee. My style as Interior Health s Board Chair will likely be a little less hands-on than previous chairs. I will seek to delegate

17 more to board members, says John, during a recent interview in his faculty office at Thompson Rivers University. A lecturer in the School of Business and Economics as well as the School of Law, John has a full complement of classes. However, that doesn t mean his work as board chair will suffer. It s my nature to be busy and, as a lawyer, I learned quickly how to cut through paperwork like a scythe and get to the heart of what we need to know. John is already aware of the priority areas for health care across B.C. He previously served on the board of the Provincial Health Services Authority and follows health issues through academic articles and media. We have lots of challenges with the seniors population, both in terms of delivering appropriate services and the health-care costs associated with those. We have to rise up and meet them. He knows that primary care models also have to adapt to a changing workforce, such as young family physicians who are no longer interested in traditional business models with their own buildings or long-term leases. They want to show up and go to work, which is why practice-ready clinics such as one being built on the North Shore of Kamloops will help attract primary care providers. John has some innovative thoughts about how online technology may be the answer to improving attachment for patients to primary care. He won t hesitate to share them with leadership in IH either. Senior leadership will soon learn that John is full of ideas and opinions about making the system better and living up to the IH slogan Every person matters. That is just a brilliant motto for the health authority, he says. He s also aware that everyone thinks he or she has the magic bullet for health care, including his own family doctor who has filled his ear on the best way forward. I m an approachable person who is a listener and I m open to hearing all kinds of ideas. Pragmatic is another word for John. He analyzes situations and leaves the drama alone. However, he also has compassion for the vulnerable people that the health-care system must care about, even when some others in society may not. Supervised consumption services and other resources for people who use drugs is simply a no-brainer solution for John. He wants lives saved and he wants to go further and see what can be done to get people with substance use issues stabilized and ready for treatment. My conservative-thinking friends might argue that drug use is their choice, but the same can be argued for lifelong smokers who get lung cancer. It s their choice so we won t give them health care? And what about the kid who breaks his leg on the BMX track? That was his choice, too, so we shouldn t treat him? Aboriginal health is another priority for John, who also has experience with First Nations governance, serving as chief executive officer of the Tk'emlups te Secwepemc (Kamloops Indian Band). We know Aboriginal populations have poorer health outcomes and lower life expectancies. We need to work with Aboriginal partners, along with the First Nations Health Authority, to understand their unique concerns and respond in a respectful, intelligent way to improve the system for their needs. John took over as board chair on Jan. 1, It s a new role that he is looking forward to tackling and one he believes carries great responsibility. So while he may not be at every event in person, he will always know what s taking place and why Interior Health is involved.

18 Renee Narcisse of Chase (R), a member of the Patient Voices Network, provides the most valuable perspective that of the patient using the health-care process under review. change from a powerful perspective Using RPIWs to improve the patient journey S ometimes the best-laid plans in health care aren t actually the best plans at all. They re good plans, to be sure but they could be even better by addressing inefficiencies or preventing mistakes from occurring. The people impacted most by those inefficiencies or mistakes are the patients the customer, if you will. Those who often know best how to fix things are the front-line care staff those who interact with our patients on a day-to-day basis. That, in a nutshell, is the premise behind a Rapid Process Improvement Workshop (RPIW). An RPIW is a five-day workshop that focuses on a particular process from the patient perspective, and empowers the people who do the work to eliminate waste, reduce the burden of work, and create a better journey for the patient. There is more buy-in from staff for change when they help design it, says Shannon Smith, Supervisor of Patient Registration at Royal Inland Hospital in Kamloops. Shannon and her staff have participated in several RPIWs at RIH over the past few years because the patient journey often starts at patient registration. She has found it helps to ask front-line employees what they think. Not only does it get them interested and involved in the process under review, but they also care about the outcome and are more likely to bring their co-workers on board as well. Everybody shares different ideas. They find it interesting I have heard staff say this is fun and that s great to hear. You want it to be a positive experience for people, Shannon says. And they bring great ideas things you would never think of because you aren t doing the job on a day-to-day basis. They re the ones actually doing the work.

19 RPIWs are a tool used in Lean, which is a systematic approach to identifying and eliminating waste or non-value-added activities in a process through continuous improvement. Sometimes, waste is obvious and can be eliminated quickly. Other times, waste is easily identified but is necessary for the process, usually for safety requirements. The key to Lean is identifying non-value-added activity from the perspective of the patient, says Renee Caillier, Leader of IH s Lean Promotion Office. the most important voice at the table might have been that of Renee Narcisse of Chase, who is a member of the Patient Voices Network. Renee s perspective was fresh and articulate; it made us pause and rethink how we do some things which we previously had not questioned, said Angela Hapke, RIH project manager and participant in the session. Renee s input reminded us that even though we are experts in the field, that expertise inhibits us from seeing things for the first time a perspective which is invaluable. And that s why including the patients themselves is an integral part of an RPIW. Above all else, our patients are our customers. They are the reason we are here, Renee says. Each department and program within our hospitals provides a unique and necessary service to our patients. Each one may have their own wait lists, specialized care team, and processes by which the patients receive services. But to many of our patients, their experience doesn t stop in one department and start in another. Their experience continues with them as they pass through many doors, many departments, and many systems put in place by different people. It is one journey; their journey. Take, for example, a recent RPIW at RIH s new Clinical Services Building (CSB), which is home to nine different outpatient clinics on Level 2 alone. All of those clinics had slightly different processes for checking in patients, and the patient charts were created elsewhere, at RIH s Admitting department. They were handled multiple times and walked over to the new building each day. On top of that, signage in the new CSB that made sense from a theoretical perspective when the building was designed was actually quite confusing to patients and staff once put into practice. Renee Caillier, Leader of IH s Lean Promotion Office (standing right), walks staff through process mapping during a recent Rapid Process Improvement Workshop at Royal Inland Hospital. A multidisciplinary team that included administrators, managers, and front-line staff, led by Lean Certification cohorts Tracey Rannie, Lesley McLeod, and Sue Gardner- Clark and supported by Renee, gathered to walk through the process and devise ways to make it more streamlined and less wasteful from a time and steps perspective. But Renee, herself, believes there will be positive changes from her RPIW experience: I liked how we all worked well together, listened, and validated each other. There was a respect there for all. The results of the RIH CSB workshop are still under discussion through follow-up check-in meetings. One change that has already occurred, says Shannon, is in how charts are packaged. Before, both the evening shift and night shift would handle the paperwork. Now, it is sorted differently and only the night shift receives a final slate reducing the potential for mixups and missing paperwork. That wouldn t have ikely happened had it not been for the collaborative nature of the RPIW that involved both patient registration and outpatient clinic staff receiving the charts, says Renee Caillier. What I love about the RPIW and other Lean improvement methods is all the staff who touch the piece of the patient journey under improvement. They learn about what other departments and disciplines do, and how their work impacts the patient experience and safety from one point to another, she says. Sometimes, the seemingly small things get in the way of being able to provide services we want to for our patients in a timely manner. When everyone (including the patients) comes together to solve problems, with a focus on improving the process and respecting people, great things happen. To learn more, visit InsideNet > Projects & Initiatives > Lean in IH.

20 Melody Cutler (L), OR booking clerk in Summerland, and Meghan Hatcher, IH project lead for Surgical Initiatives, are part of the team working to track patients on their surgical journey within IH.

21 Waitlist audits lay foundation for patient satisfaction M elody Cutler is an operating room booking clerk at the Summerland Health Centre. She spends her days immersed in the numbers that have become a commonplace language of surgical health care procedure dates, wait times, and surgical targets. It can become an endless stream of data, not easily understood unless you know its context: that every number represents a real patient who is waiting for an elective surgical procedure. Those numbers that Melody spends her days tracking? They re crucial contributions to the success of IH s Surgical Services strategy and the satisfaction of those patients. You really have to keep on top of it, or you can have patients falling through the cracks, says Melody. And that s why people like Melody and the work they do are so important, says Meghan Hatcher, Interior Health s project lead for Surgical Initiatives. Clear data is the foundation to build upon and leverage once you have it, you can more accurately make decisions and better inform patients, says Meghan. It starts with a goal in this case, it s a mandate from the Ministry of Health to have no more than five per cent of patients waiting greater than 40 weeks for appropriately scheduled elective surgery by March 31, To meet this goal, IH needed to know how many patients would potentially go beyond the 40-week waittime target. So, in November, IH Surgical Services launched a waitlist audit of all patients currently waiting longer than 40 weeks for surgery to ensure they were still ready, willing, and able to have their procedures. Booking clerks like Melody contacted every long-waiting patient on their lists to determine if they were, for example, on multiple waitlists for the same procedure, or if their surgery had been completed elsewhere and they no longer required a procedure. Likewise, if they no longer wished to have surgery, if their clinical condition made surgery no longer possible, or if the patient was deceased. There were quite a few who didn t want to have surgery any more, but forgot to tell their doctors, Melody says. The audit also tracked patients who had declined surgery dates because they were unavailable for more than a year, or if patients were unable to be reached, and all avenues for contacting them were exhausted. We regularly conduct audits, Meghan says. By focusing on patients waiting greater than 40 weeks, this gives us a baseline across the health authority for the new target a place to get started for categorizing all patients appropriately, with a booked date or unavailable dates. Now, says Meghan, IH has a better understanding where the pressure points and the strains on the system lie, and where services are most impacted. It isn t always what you think, she adds. The assumption has been that the longest waits are for hip and knee replacements and for cataracts. By doing the audit, we learned that the strains might be in neurosurgery or ear, nose, and throat because each site has different pressures based on their specific challenges, she says. This helps us inform our next steps, our next decisions, and how we may reach our goals in the future. And they ll do it again in February. Gathering the data is an ongoing collaboration between leadership, surgeons, and staff, Meghan says. It starts with the booking office, but it s also the responsibility of the surgeons, the OR managers, and the health-care administrators. The goal with the audits, says Ben Rhebergen, IH s Network Director for Surgical Services, is to not only ascertain availability, but also to be able to provide information on a patient s expected wait time both of which are pieces of the Ministry s surgical policy. In that respect, the waitlist audit is an engagement tool. By regularly doing the audits, you can see where the patients are in their journeys you increase communication and transparency with patients, says Ben. You re reaching out to them to help them better understand their journey, and to let them know that we haven t forgotten about them which is sometimes how patients can feel if they ve waited a long time for their procedure. We re also gaining valuable information about their readiness for surgery, which allows us to more accurately schedule patients for their procedures, and to plan our resources for the future. There are a lot of moving parts, but it all starts with talking with the patient. And that s what our waitlist audits allow us to do.

22 Adam Smith (L) and Drew Dawson, clinical information analysts, have been enrolling patients at hospitals throughout the Thompson, Cariboo and Shuswap areas. They will be in the Okanagan next. I nterior Health area residents are the first in B.C. to be offered access to their personal health information online via a new tool called MyHealthPortal. MyHealthPortal provides patients with 24-hour secure online access to their health information via their smart phone, tablet or computer through a portal on the Interior Health website. Features include the ability to view IH lab results, diagnostic imaging reports (such as X-rays, scans, and ultrasound), certain upcoming appointments, recent hospital visit history, and the opportunity to update address and phone number information. Most recently the team was at Royal Inland Hospital in Kamloops to enrol users. More than 700 patients signed up during this three-week period. The team will be in Vernon and Kelowna next as part of MyHealthPortal s phased roll-out. To sign up, patients presented to the project team in person with legal photo identification and their Care Card or B.C. Services Card in order to verify their identity. They were given a login username and password that they use on their own device. Then they simply login to the MyHealthPortal page on IH s web site at MyHealthPortal.

23 I have spent a bit of time with the new portal and I think there are certain important things it accomplishes. The portal gives patients some element of control when it comes to reviewing their lab and diagnostic imaging results, said Dr. Simon Treissman, Chief of Staff, Royal Inland Hospital. This means that in some straight-forward cases, the patient may not need to book an appointment with their family doctor s office specifically to review results. This capability is important today as there is a shortage of family physicians. The portal also helps to reduce the overall review and response time, improving access to care. Okanagan resident and Patient Voices Network volunteer Diane Edlund agrees that MyHealthPortal will help put information into the hands of patients. This will help patients be more proactive in looking after their health an important element of patient empowerment which leads to better health outcomes, she said. For example, having access to information from emergency room visits ensures information flows through transitions in care; this can reduce the need for follow-up emergency visits for test results. MyHealthPortal is currently available to patients who have enrolled at sites in the Shuswap, Cariboo, and Thompson- Nicola areas. To date, more than 4,000 patients have enrolled in MyHealthPortal. The service will eventually be available to all Interior Health facility patients through a phased roll-out schedule. MyHealthPortal is a secure patient health portal. Protecting and safeguarding patients' personal information is among Interior Health s highest priorities. In addition to stringent privacy practices, Interior Health uses a diverse range of technologies and security mechanisms to ensure the safety, confidentiality, and integrity of patient information. For more information visit MyHealthPortal. Janis Novosel, Senior Analyst on the MyHealthPortal project, is excited to see so many patients jumping at the opportunity to access their personal health information online.

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25 This is the fifth in a series of eight profiles of Aboriginal Nations within Interior Health. This month we feature the Métis Nation.

26 Coldstream Submitted by: Sherry Keeley

27 Cranbrook Submitted by: Dianne Dilts Grand Forks Submitted by: Donna Thibeault Kamloops Submitted by: Kim Stone Where We Live & Work... A Spotlight on Our Communities Covering more than 215,000 square kilometres, Interior Health is diverse in nature and composed of vibrant urban centres and unique rural communities. Photos are submitted by employees and posted to the InsideNet. Select photos are featured Submit your photos of the beautiful places that make up our region on InsideNet Spotlight Photos.

28 BC Transplant organ recipients and volunteers were in Trail and other communities in December to bring a festive tin of popcorn and gratitude to IH staff and physicians as part of the annual Operation Popcorn. Hugs for intensive care unit staff at Kootenay Boundary Regional Hospital show how much lifesaving organ transplants mean to patients and their caregivers. Christine Guerin, an RN on Royal Inland Hospital s 3 West unit, is an avid Kamloops Blazers fan and season ticket holder. For the past four years she has happily found herself on shift when the Western Hockey League club has made its annual Teddy Bear visit to the hospital this is her fourth straight year of snagging a photo with the Blazers. The Heart Function Clinic in Kelowna hosted their annual holiday education session for heart failure clients in late December. The session was held at the Community Health and Services Centre in downtown Kelowna and provided lowsodium appetizers and tips to reduce sodium intake during the holiday season. Pictured here are members of the Heart Function Clinic team (L-R): Mary Hicks, Christina Kelly, Pam Luehr, and Candace Dowhaniuk.

29 As part of the new intervention training available at quitnow.ca, Dr. Milan Khara explains a brief intervention using the 5As approach to helping your patients quit smoking. Learn more at Quitnow.ca. Learn about the science behind how sitting less and moving more throughout the day can lead to increased productivity at work. Adding physical activity into your work day will help you feel energized, awake, and even happier. Do you dread winter (be it seasonal affective disorder or the winter blues)? Embrace this Danish concept of living simply, happy, and cozy during winter. To learn more about seasonal affective disorder (SAD), visit

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