RecognizingourAngels

A Message from Kelly Isfan, President and CEO,

Campbellford Memorial Hospital

It was a real honour for me personally to accept the

Small, Rural and Northern Award of Excellence from the Ontario Hospital Association recently on behalf of Campbellford Memorial Hospital. Th is prestigious award recognizes innovation and excellence in the delivery of patient care within a small, rural and/or northern hospital. I am truly proud to be part of the CMH story.

You can’t be a great CEO in the absence of a great hospital team and a supportive community. Th e genuine interest that the “angels” of CMH take in our patients,

and the roll-up-your-sleeves attitude that people who work and volunteer with us bring with them every day is really what makes this hospital so special. We have an award-winning team of physicians and staff . We have made tremendous progress in patient care. We are also continuously improving, and staying on top of the latest best practices and clinical protocols in areas like infection control.

Part of the reason we have the world-class, modern technology that we do is because of the commitment of people from across our

entire region who believe in our hospital. I am grateful for the continued support of the CMH team. Community donors and volunteers are fundamental to our success. Th is award is testament that we are doing the right things for patients to achieve our goal to make our hospital a model of what a rural hospital can be: innovative, warm and striving for excellence. It is with tremendous pride that we are profi ling here just three of the many real angels at CMH who demonstrate their commitment to our patients and our community – both personally and professionally.

Built to Last Thanks to Your Support

Kelly Isfan, CEO Campbellford Memorial Hospital and Peter Johnson, Chair of the Ontario Hospital Association’s (OHA) Board

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For Tammy Philp, the details matter. With 30 years of

providing care as a registered nurse at the hospital, she’s had an active role introducing many changes to improve its patient care and knows that ensuring patients receive quality care is a fundamental part of her role.

Philp, who works at CMH as the Charge Nurse/Unit Coordinator, says she is proud of the care given to patients at Campbellford Memorial Hospital.

“At Campbellford Memorial Hospital, our people go above and beyond to provide the best level of care possible. Our nursing staff is very experienced. We take pride in what we do. We live in this community and this is our second home. When you come to this hospital, I want you to be treated the same way I want my Mom, Dad, Brother or Sister to be treated. We have expectations of care and we all deliver it,” she says.

Tammy Philp, Charge Nurse/Unit Coordinator

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Philp notes that this discipline starts with admission of the patient to the hospital. A few years ago, the hospital introduced a medication reconciliation process that begins when patients are admitted to the hospital either through the Emergency Department, directly to the First Floor or as a transfer from another health care facility.

“The patient meds are checked at all points of care which enables us to ensure the patient receives effective pharmaceutical treatment quickly. Doctors are able to assess and treat the patient quickly, and the patient’s recovery is optimized,” explains Philp.

“Safe drug management is a big part of what we do to protect the health of our patients,” explains Philp, who cites the introduction of Pyxis automatic medication dispensing units two years ago as another improvement in this area. Campbellford Memorial Hospital patients receive over 500,000 doses of medicine each year.

Thanks to donor support for this technology, the hospital has improved the efficiency and safety of dispensing prescriptions, getting patients the

medicine they need quickly and safely. These automatic medication dispensing units also reduce the administrative load on nurses, giving patients more hands-on care.

Safety is built into these medication dispensing units. They can only be accessed by authorized staff, using a ‘bio-medical’ thumbprint and individualized passwords. Ninety percent of the medications used regularly in treatment are stored individually in drawers.

The doctor enters the prescription into the computer. The pharmacist and technicians fill the prescriptions and load the drawers with the necessary medications. The nurses have access to their own patients and only the individual drawer with the appropriate medication for that patient opens. An alarm system alerts nurses and pharmacy of any potential errors.

With the hospital caring for a growing population of elderly patients, another patient safety initiative focuses on falls prevention and mobility. Patients are assessed upon admission and specific prevention strategies are identified and

posted at the patient’s bedside to make staff and family aware of any risk. An information sheet is provided to patients and families to assist them in taking steps to prevent falls in the hospital and at home.

The list of initiatives introduced by the hospital to ensure the safety of its patients continues to grow. “Patient safety is part of the culture here. It’s part of my job to ensure what we say we are going to do to ensure the patient’s safety gets done – but this is very much a team effort that includes not only those who care for patients, but also our housekeeping staff and anyone who visits the hospital,”says Philp, adding: “We all want the best outcome for our patients and their families.”

To that end, she reminds anyone visiting the hospital to use the hand washing stations at the entrance to the hospital, near elevator and in all patient care areas to prevent and control the spread of infection.

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To detect and monitor disease, over 187,000 procedures

were completed last year alone by Campbellford Memorial Hospital’s laboratory. It is the only local lab service in the hospital’s broad catchment area. With people like medical lab technologist Lisa Brown on board, it’s no wonder this laboratory enjoys a ranking among the best in the province.

“All of the work we do here in the lab provides patient lab results to physicians so they have the information they need to diagnose patients

and determine their best treatment,” says Brown. “Eighty per cent of patient decisions are based on lab test results completed here.”

Just two years ago, assessors from Ontario Laboratory Accreditation, a provincial regulator for licensed laboratories, recognized the hospital with a 98% conformance rate after a rigorous review of many standards. Th is score exceeded the provincial average of 94%.

“Th is was a huge win for our hospital and clearly signals the excellent work our laboratory team does to support this hospital and our community,” says Kelly Isfan, CMH President and CEO, “Th ese results demonstrated that as a rural hospital with a focus on excellence, we can set an example for others across the province and take a leadership role in delivering quality health care.”

Th e laboratory team works around the clock, seven days a week, testing, evaluating and reporting results for better patient health. Th e lab is equipped with the latest computerized instrumentation for quick and accurate inpatient and outpatient testing, enabling this skilled team of medical technologists to eff ectively process high numbers of tests in areas such as Chemistry, Hematology, Bacteriology, Immunohematology, Serology, Pathology, and Histology/Cytology.

“Every step of the work we do here is about having a safe outcome for our patients,” says Brown. She notes that patient safety starts with a check of three pieces of patient identifi cation before beginning any test or procedure. Other patient safety measures taken include washing hands between every patient test to prevent the spread of hospital acquired infections, ensuring the information on patients samples is accurately recorded, keeping diagnostic equipment well-maintained and ensuring all laboratory staff keep their qualifi cations and competencies up to date through continuing education.

For Brown, the benefi ts of giving and receiving care in a rural hospital include personal rapport and relationship that develops between patients and staff . Th e fi rst decade of her career was spent at a large hospital in Toronto. For the past 12 years, she’s enjoyed working with her CMH ‘family,’ noting that she is proud of the hospital and values its presence in this rural community and its ability to serve area residents and visitors.

“When you see a patient every day, you get close to them. As part of the CMH team, our lab team has a lot of contact with patients, whether it’s taking blood or running tests in the lab, that we wouldn’t have with a larger hospital,” she explains, adding: “Whether you are in maintenance, housekeeping, the lab or the emergency room -- no matter where you work at the hospital -- we are all focused on ensuring the patient’s stay is a safe one and we appreciate the responsibility we all share in helping our patients get better.”

“Every Step in Hospital’s Laboratory is about Patient Safety”Lisa Brown, Medical Laboratory Technician

5CampbellfordCampbellford MemorialMemorial Hospital FoundationHospital Foundation

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“When two of Canada’s oldest Insurance Companies support healthcare in the communities in which they

do business, this is great news for those communities and in this case, for the patients of Campbellford Memorial Hospital”, says Calvin Newman, President of Newman, Oliver & McCarten.

Newman, Oliver & McCarten have provided over 130 years of continuous service to its clients and as Canada´s oldest property and casualty insurance company, Gore Mutual has been proudly serving Canadians since 1839. Over the past five years, Gore Mutual has donated over $15,000 to the Campbellford Memorial Hospital (CMH) Foundation to support equipment purchases, including the CT Scanner.

Newman, Oliver & McCarten have been supporting the CMH Foundation for over a decade, with corporate donations and event sponsorship totalling over $20,000 and Calvin Newman personally supports the CMH Foundation through its monthly giving program and he notes that “the monthly giving program is an easy way to help our hospital have up-to-date equipment.”

Mr. Newman also says “Having a great partner like Gore Mutual provides extra opportunities to support our first-response hospital and we also believe in the Gore Foundation values that support granting funds to effective, well-managed charities that are in the best interest of our communities.”

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“Having worked at several hospitals -- both large and small, urban and rural – and since coming

to CMH, I have not encountered a hospital that does so much to enhance patient safety as we do here,” says Andrea Thomas, Certified Pharmacy Technician at CMH.

CMH encourages its people to pursue a number of professional development opportunities. Andrea is currently is working on becoming a licensed Registered Pharmacy Technician. The Ontario College of Pharmacists has supported the creation of a Regulated Pharmacy Technician (RPhT) who will have much more responsibility and professional accountability which will enhance the changing roles within the pharmacy profession. The new designation will be representative of a licensed professional and the title “pharmacy technician” will become protected by law wherein only those with an RPhT designation will be able to call themselves “pharmacy technicians.”

In her role at CMH, Thomas is responsible for procuring medication, maintaining the hospital’s medication inventory, entering physicians’ orders for medication into the hospital’s system and on occasion,

adjusting the form of drugs so their administration can be tailored to the specific needs of individual patients.

“The pharmacy is an important and necessary partner in a patient’s circle of care,” says Thomas, adding: “We are working together with nurses, physicians, pharmacists and local pharmacies, to ensure that the right patient receives the right drug at the right time in the right strength and form for the right reasons.”

Any medication required during a hospital stay is prescribed by a physician and supplied by hospital personnel. The cycle of medicine or “the path of a pill”, from its arrival at the hospital until it’s ultimately administered to a patient, is a cycle reinforced every step of the way with safety measures and best practices.

It starts with the number and types of medication used by the hospital for patient care. The hospital uses a “closed formulary”, a list of drugs primarily used by the hospital and pre-approved for purchase by the hospital. “If, however, the physician wants an alternative drug used for a particular patient, then they have 24 – 48 hours to purchase the drug and must write “no substitution” on the order. For the safety of that particular patient, we will

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Safe Medication Practices Guide the Work of Campbellford Memorial Hospital’s Pharmacy TeamAndrea Th omas, Pharmacy Technician

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purchase the physician’s drug of choice,” explains Thomas.

“In most cases we are able to get non-formulary medications from local pharmacies or other hospitals in a timely manner. For those items which will take longer to receive, the physician will be promptly notified of the potential delay in therapy and given an approximate arrival time/date. Given this knowledge, the physician may then make a choice whether to continue with his preferred therapy or change his order to a formulary item. Physician’s are very much involved in the decision-making for formulary additions/deletions,” says Thomas.

CMH’s Pharmacy Department packages 10,000 – 20,000 unit drug dose units per month. Explains Thomas: “This hospital is “unit dose”, meaning that each pill is individually packaged as a unit before it is dispersed into in-patient floors and placed into the Pyxis machine. Once the medication is pre-packaged by one pharmacy technician, it is checked again by a different pharmacy technician to ensure that all information related to the medication is correct. Once this step is completed, the medication is filed in the pharmacy stock area.”

Twice a day, a Pyxis refill report is generated in the pharmacy department and the team refills the Pyxis machines to ensure there are sufficient quantities of medication at all times in the in-patient areas. Again this is a two-step process with two individuals present to eliminate any possibility of error related to the quantity of drug or the strength of drug. “One technician picks the drugs and another technician physically places the drug in to the Pyxis machine,” explains Thomas.

“We also document any food or drug interactions that may be present with specific drugs and that are noted with the patient drug information is entered into MEDITECH. The pharmacy advises physicians of any potential for adverse interactions, often noting this information directly on the patient’s chart for the physician to follow-up on,” explains Thomas, adding: “This ensures the information regarding potential medication issues is available to physicians at all times.”

Within the pharmacy, a high risk designation is assigned to certain drugs to ensure extra caution is taken when placing these drugs into the Pyxis machines. As well, nurses

using the Pyxis machine must take extra steps to access these kinds of drugs – eliminating any potential for error.

These are just a few of the steps that define the path of a pill from the time it arrives at CMH to the moment it is given to a patient. Along the way, even the smallest of tasks are centred on ensuring the safety of the patient, according to Thomas. “Based on my experience in other hospitals, I think CMH really goes above and beyond to ensure a safe stay for its patients.”

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