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OUR SHAREDPURPOSE
October 2019
Learning never stops St. Joe’s first-ever de Souza Nurse Associate (pg. 2)
Colour Days inspiring joyA new program at Providence uniting staff and residents.(pg. 7)
How resusTO is proudly different Another successful year for the St. Michael’s event (pg. 8)
Behind the scenes with Tim A look at the Hallway Talks video series (pg. 3)
What it takes toinnovate (pg. 4)
Making infectionprotection funHow the IPAC Olympics - and chocolate pudding - put a new twist on infection prevention learning. (pg. 4)
OUR SHARED PURPOSE2 OUR SHARED PURPOSE 3
Our Shared Purpose is a monthly newsletter highlighting our people and the ways they are improving care, patient experience and the health of our communities.
Learn more: www.unityhealth.to
The last few years in Mark Kocsis’ life have been busy, to say the
least. Kocsis graduated from Ryerson University’s nursing program in
June 2017, and by November of that year, had begun his career on the
Medicine, Oncology and Palliative Care (6M) unit at St. Joseph’s Health
Centre. All the while, Kocsis was fueling his desire to improve how he
cares for patients and taking the initiative to support
his professional development goals.
“I had a student placement in a hospice, which
was my first exposure to end-of-life care. I discovered
I really like nursing in palliative and oncology. I like
being present with patients and families and focusing
on psychosocial aspects of nursing,” said Kocsis.
His drive to develop his skills in end-of-life
care led him to the de Souza Institute continuing
education program.
The de Souza Institute, headquartered at
University Health Network, offers courses that empower clinicians
to handle every situation in cancer and palliative care. This includes
managing pain and symptoms as well as providing emotional support
to allay people’s anxiety and fear.
To date, more than 10,000 health-care professionals from across
Canada have enrolled in de Souza courses. In 2019, Kocsis became
the first nurse from St. Joseph’s – and one of only 45 nurses in all of
Ontario – to obtain the de Souza Nurse Associate Designation.
“I’ve always been a go-getter and life-long learner. The de Souza
courses have equipped me with the knowledge to provide more
competent and confident care,” said Kocsis.
Kocsis’ colleagues and supervisors rave about Kocsis and see a
bright future for him at St. Joseph’s.
The members of the 6M team describe Kocsis
as someone who is inquisitive, empathetic and
thoughtful, continually seeking out what is best for
the patient experience. They especially appreciate the
time he makes to sit with patients and learn about
their journey and how he takes a holistic approach to
care.
At a recent celebration to honour Kocsis’
achievements, his colleague Paula Larrondo, a social
worker in the Medicine and Seniors Care program,
spoke about watching Kocsis care for her father at St. Joseph’s.
“When my dad was in palliative care here, I had to step back and just
be present as a daughter, as a family member. It gave me a chance to
watch Mark in action from a different vantage point.
“I was so impressed with his nursing skills and his ability to
connect with my family. He’s really intuitive. He’s an absolute gem,”
said Larrondo.
Education program empowers clinicians
working in cancer and palliative care
by Emily Dawson
Mark Kocsis is St. Joe’s first-ever de Souza
Nurse Associate Dr. Rutledge met residents in Juniper and Sumac Houses as they gathered together for activation programming.
M E E T I N G R E S I D E N T S
The video showcases how our programs, like musical entertainment, are essential in building a sense of community for residents
S M I L E S A L L A R O U N D
Dr. Rutledge stopped by several Houses to say hello to staff to thank them for their dedication to creating a better resident experience in their day-to-day work.
M E E T I N G T H E T E A M“ “
BEHIND THE SCENES
Hallway Talks with Tim Last month, Dr. Tim Rutledge, CEO of
Unity Health Toronto, was in the Cardinal
Ambrozic Houses of Providence to film
a new episode in the ‘Hallway Talks with
Tim’ video series. The video, which will be
released in late October, takes a look at
what makes our Houses such a special
long-term care home.
STORY BY EMILY DAWSON
PHOTOS BY KATIE COOPER
The de Souza courses have
equipped me with the knowledge to provide more competent and confident care
MARK KOCSISDE SOUZA NURSE ASSOCIATE
OUR SHARED PURPOSE4 OUR SHARED PURPOSE 5
UV light — sprinkled on top. They rubbed their hands together to mimic
the friction of providing care and then had to remove the gloves without
contaminating themselves. Thomas then used a UV light to see if any
Glo Germ remained.
“When I took the gloves off, I could still see some spots on my arms,”
said Vina Magno, a registered nurse on the unit. “It’s so scary because
normally we can’t see what’s there.”
Many staff members also had Glo Germ on their fingers and hands
because of defects in the gloves.
“People have a mistaken idea that gloves are impermeable and
that’s why they don’t need to be as good about hand hygiene when
wearing them,” said Thomas. “Staff were surprised to see powder on
their hands and the reality is that Glo Germ powder is still bigger than
microorganisms that could get through, which is why it’s so important
that gloves be used in addition to really good hand hygiene.”
Feedback on the IPAC Olympics was overwhelmingly positive
from staff on 4M, so much so that other units have requested a shot at
playing the games, which also included one related to cleaning shared
equipment and another that tracked bacteria growth in microlab plates
before and after practicing hand hygiene. The infection prevention team
is exploring ways to continue this work to engage all staff members who
interact with patients in a way that will hopefully stay with them.
“A lot of the time, we talk in health care about the moments when
you’re supposed to clean your hands but not really the why,” said
Thomas.
“But when you think about what you touched last and what you’re
touching next, it makes a lot more sense why you should stop and make
sure your hands are clean. Maybe next time someone on 4M is taking
their PPE off, they’ll think about the pudding and be aware that just
because they can’t see something that could potentially be harmful, it
doesn’t mean it’s not there.”
It’s not every day that Dianagris Balakrishnan finds herself covered
in pudding at work. But one day this summer, she had so much of it
on her personal protective equipment (PPE) gown and gloves that it
was dripping onto the floor. The pudding had been spread by Cameron
Thomas, an infection prevention practitioner, as part of an education
session at St. Joseph’s Health Centre called the IPAC Olympics.
Balakrishnan’s task was to remove the gown and gloves without getting
any pudding on her skin or clothes underneath.
“It was gross,” the registered practical nurse said, laughing. “But it
was a good reminder that there’s a lot of other stuff we could have on
us when we leave a patient’s room.”
The game was meant to mimic the potential for transmission of
all types of bacteria by nurses and other health care providers. Walking
in and out of different patients’ spaces means providers may be taking
more than they’d like when they leave, potentially spreading something
to other areas of the unit, other patients or themselves. This can be
especially dangerous for patients with a weakened immune system and
during high volume times – like flu season.
The PPE and pudding game was just one of four that was brought
to the hospital’s 4M unit to help engage staff and visually show the
significance of proper infection prevention practices.
“Working in health care means you get the same information over
and over again but the message gets lost because it’s always the same
– clean your hands, clean shared equipment,” said Rosalyn Espiritu, the
unit’s educator. “I heard that other hospitals had tried this interactive
way of providing education and thought it would be impactful here
because it’s new and exciting. People came over curious about why
there was pudding on the table.”
A common issue in health care is that people use gloves for
extended periods of time, often instead of regular hand hygiene. So in
another game, staff members put gloves on and had Glo Germ powder
— a visual tool used in cleaning education which shows up only under
Pudding and powder help staff learn about hand
hygiene and containing the spread of germs
by Amber Daugherty
Making infection protection fun
Dianagris and Elrica recently went through an education session called the IPAC Olympics to get a hands-on understanding of how bacteria can be transmitted on inpatient units. (Photo: Amber Daugherty)
OUR SHARED PURPOSE6 OUR SHARED PURPOSE 7
SHARING MEDICAL IMAGING DATA TO CUT RADIATION DOSESPatients might expect radiation doses for CT scans to be comparable from one hospital to the next, but a team at St. Michael’s Hospital says the dose variance can be startling. The team is collecting and analyzing data from eight hospitals for the Medical Imaging Metadata Repository of Ontario (MIMRO) to help reduce the province’s average radiation dose per scan. Using artificial intelligence to sort the hospitals’ data, the team generated comparative data by facility, scanner and exam to help determine best practices. MIMRO is funded primarily by St. Michael’s and was created by two of its radiologists, Drs. Timothy Dowdell and Bruce Gray.
Radiologist Dr. Bruce Gray and data analyst Lianne Concepcion review data submitted to MIMRO. (Photo: Katie Cooper)
FIRST PROTOCOL DEVELOPED TO MANAGE MASSIVE HEMORRHAGE
A study published in CMAJ Open outlines the design of Ontario’s first Massive Hemorrhage Protocol (MHP), a set of recommendations for hospitals that will enable rapid and coordinated delivery of blood products in a patient who is hemorrhaging. Until now, there hasn’t been one standard protocol for all hospitals to follow when treating massively bleeding patients, said Dr. Jeannie Callum, lead author and transfusion medicine specialist at Sunnybrook Health Sciences Centre. Co-lead author and transfusion medicine physician at St. Michael’s, Dr. Katerina Pavenski, said this new work will bring together the right care team to the right patient with the right resources.
Patients in Canada and the U.S. who underwent one of four low-risk surgical procedures filled opioid prescriptions within a week after discharge at a rate that was nearly seven times higher than patients in Sweden, suggests a new study. The research found that 76 per cent of the U.S. patients and nearly 79 per cent of the Canadian patients filled a prescription for opioids after their surgery versus just 11 per cent of Swedish patients. “Opioids are routinely prescribed for postoperative pain management in many countries; however, the findings suggest the potential to re-evaluate prescribing practices internationally,” says Dr. Karim Ladha, a scientist at the Li Ka Shing Knowledge Institute.
OPIOID PRESCRIPTIONS FILLED: HOW DOES CANADA COMPARE?
Research from St. Michael’s has shed light on how a class of medications that help regulate blood sugar for patients with Type 2 diabetes can also protect against heart disease. The findings focus on the effect of a diabetes medication – empagliflozin – on cell repair in blood vessels and resulting risks of heart disease. This medication falls under a category of drugs called SGLT2 inhibitors. The research suggests it regulates circulating cells that play a role in heart health. “Clinical trials have shown that SGLT2 inhibitors may protect patients who have diabetes from heart disease,” says Dr. Subodh Verma, scientist at the Keenan Research Centre for Biomedical Science. “Before our study, it wasn’t clear why.”
DIABETES MEDICATION SHOWS POTENTIAL TO REDUCE HEART DISEASE
New study’s findings point to the differences in preference and culture of patients and providers says Dr. Karim Ladha, scientist at LKSKI. (Photo by Katie Cooper)
A multidisciplinary team at St. Michael’s, led by Dr. Subodh Verma, collaborated with Western University’s Robarts Research Institute on this work.
(Photo by Medical Media)Charmaine Coleman loves working with residents in Sumac House
in the Cardinal Ambrozic Houses of Providence. From their morning
smiles, to the stories and hugs they freely offer, working in one of the
Houses’ two dementia units brings her joy and satisfaction. Over the
years, she has dreamed of building something special to reciprocate
those feelings.
Coleman is a Resident Assistant (RA) who has worked in the
Houses of Providence for 16 years, with seven of them in Sumac
House. At a recent conference, she learned how colour has a positive
effect on residents living with dementia. Bright colours can invite
connection, instil a sense of welcoming, and promote happiness.
In June, Coleman introduced the idea of Colour Days for Juniper
and Sumac Houses. People living, working and visiting in the units are
encouraged to dress in the designated colour of the day, six days a
week.
“I wanted to do something for the residents, and also something that
could bring the staff together as a big team with laughter and fun,”
says Coleman.
The RAs will dress residents in that day’s colours if they have
something in their closet that has even a hint of the right shade.
For residents who are more communicative, RAs show them
possible options and encourage residents to make their own decisions
on what to wear.
“We get residents energized and smiling by dancing and singing
in our matching colours,” says Coleman. “It’s amazing how a little thing
can get people so excited.”
Coleman is equally pleased that family members, personal
caregivers, and volunteers are also getting into the spirit, as are staff
from other units.
“It makes me very emotional, to think that we can touch people
in this way. I’m privileged that after 16 years I was able to finally create
something special for my Houses family.”
“It makes me very emotional, to think that
we can touch people in this way.”
by Emily Dawson
Resident Assistant inspires joy through ‘Colour Days’ The Sumac and Juniper House staff are all smiles as they enthusiastically
embrace Colour Days.
OUR SHARED PURPOSE8
It’s clear that resusTO — a hybrid simulation-resuscitation
conference organized in partnership with St. Michael’s Hospital
— is different.
From branding inspired by a prolific southern California rapper, to
a program that included an escape room simulating being inside an air
ambulance, this year’s resusTO was boldly rejecting the conventions
of medical education conferences.
“ResusTO is different from other conferences in that it’s very
interactive,” said Dr. Christopher Hicks, an emergency physician and
trauma team leader at St. Michael’s and chair of the conference. Dr.
Hicks and Melissa McGowan, the research education co-ordinator for
the St. Michael’s emergency department, collaboratively organized the
conference, which took place on Sept. 10 and 11.
“Our plenary lectures delivered by the faculty are followed by
some sort of hands-on workshop. It gives participants an opportunity
to practice what they’ve learned so that it has more permanence
carrying forward into their practice,” Dr. Hicks said.
Participants from around the world travelled to Toronto for
this year’s conference, the follow up to last year’s highly successful
inaugural event. Dr. Hicks, McGowan and the entire organizing
committee feel gratified by the success and feedback they’ve received
so far, which they credit to the teamwork of St. Michael’s staff.
“They say it takes a village, and to execute an innovative event like
this, it really does,” she said. McGowan acknowledges the contributions
of Emma O’Neil, Andrea Meeson, the Emergency Department and the
team at the Allan Waters Family Simulation Centre – which is accredited
by the Royal College of Physicians and Surgeons of Canada.
The event was also made possible by staff from environmental
services, AV, catering, medical media, clinical equipment, procurement,
telecommunications, print shop, planning, and respiratory therapy and
finally all the volunteers – many of whom took vacation from their day-
to-day job at St. Michael’s to help make it a success.
At its core, resusTO is about challenging health care providers and
inspiring them to think beyond their current practice, said Dr. Hicks.
He believes the conference engages the medical community in a
novel way, which would not be possible without support from hospital
leadership.
“There is a true commitment to medical education and medical
innovation at St. Michael’s.”
“There is a true commitment to medical education
and medical innovation at St. Michael’s”
by Jennifer Stranges
resusTO: Not your typical medical conference
The follow up to last year’s highly successful inaugural event brought in participants from
around the world. (Photo: Yuri Markarov)