hdhEnews issue: September 23, 2016

Integration process picks up speed to create new hospital corporation
Setting Hotel Dieu Hospital’s strategic priorities for 2016-2017
Where no scope has gone before:  new equipment opens up diagnostic frontier
Not-your-typical band shows the other side of the fence in mental health
Getting hip to the best seating for patients in busy orthopedics clinic
New pediatric eye specialist joins expanding Ophthalmology Department
Hospital staff lace up for patient comfort and care

Integration process picks up speed to create new hospital corporation

“This is the next logical step in an evolving partnership,” says Dr. David Pichora, HDH CEO and future CEO of the new academic health sciences centre.  “We’ll have one structure and one budget in place to create new strategies and investments to improve care and the system.”   As an example, he highlights the need for a chronic disease management strategy to keep patients out of hospital.  A prohibitively costly investment for Hotel Dieu, the strategy would work better—by reducing pressures and costs at KGH—in an integrated organization that can allocate resources where they are needed to improve care and benefit the system.

“It’s about being able to use our collective resources to better identify and seize opportunities to transform the patient experience,” says Dr. Pichora.

In the past few months, the hospitals have been working closely together to move the voluntary integration process forward.  The first step was the creation of a Joint Steering Committee that consists of four representatives from each Board, the CEOs and Chiefs of Staff from both hospitals and the Dean of the Faculty of Health Sciences at Queen’s University.  The committee will oversee key legal and financial processes and guide the preparation of the integration package that must be submitted to the South East LHIN and Ministry of Health and Long-Term Care.

The Joint Steering Committee is supported by a Transition Team—co-chaired by Dr. David Pichora and Jim Flett, interim CEO at KGH—that will create a comprehensive Transition Plan.  The team also includes Patient Experience Advisors from both hospitals.  Its key tasks include communication, engagement, change management and business plans, risk mitigation and document preparation.  And supporting everyone is a project manager to help organize and prioritize all integration work.

The hospitals’ spirit of innovation recently caught the attention of the Ontario Hospital Association. This summer it sent a team to Kingston to interview the Board Chairs for a video that features stories of how hospitals are finding new ways to transform the health system and serve patients better. Scheduled to be shown as part of the Health Achieve conference in Toronto in November, the video is now available for viewing at www.oha.com/OHATV.

The fall months will bring engagement opportunities for patients, families and hospital staff to talk about how integration is unfolding and how it will benefit our community.  Dr. Pichora started this important conversation with a presentation to the Kingston Chamber of Commerce on September 13, and he and Jim Flett have teamed up to talk with hospital staff and physicians at town hall sessions at both sites. 

“As anyone familiar with health care in Kingston will know, this isn’t the first time our two hospitals have considered joining forces but this time the conditions were right for us to integrate,” says Jim Flett.

“Our two hospitals already have a long history of sharing programs, services and people,” says Dr. Pichora, “and this integration is all about taking this close collaboration to the next level to serve our patients and families even better.  To get there, we’ll need to hear from everyone to ensure we’re creating an academic health sciences centre that will make everyone proud.”

Photo:  (L) Jim Flett, KGH interim CEO, and (R) Dr. David Pichora, HDH CEO, speak with HDH staff about the progress of hospital integration.

Where no scope has gone before:  new equipment opens up diagnostic frontier

With its sheer length and complex looping the small bowel poses a big challenge when being investigated for disease, but now patients in our region have access to a breakthrough diagnostic technique—previously available only in Toronto or Ottawa—that lets physicians visualize more of the small bowel than ever before.

For the first time, gastroenterologists at Hotel Dieu Hospital can evaluate the small bowel through single balloon enteroscopy, a procedure performed with a long flexible endoscope that has an overtube with a balloon attached at the tip.  By alternately inflating and deflating the balloon, the physician can advance the lighted endoscope deep into the small intestine—well beyond the reach of a traditional endoscope—and more easily negotiate the bowel’s sharp turns along the way.

“In the past, we might suspect a problem such as a bleeding blood vessel in the small intestine but we couldn’t diagnose or treat it unless we performed invasive surgery or sent the patient to Toronto for the balloon procedure,” says Dr. Lawrence Hookey, Medical Director of the Endoscopy Unit at Hotel Dieu.

“It was frustrating for the physician because we just couldn’t get at the blood vessel and it was frustrating for the patient because of significant wait times for the procedure. Four in five patients opted to live with their condition—which then necessitated regular blood transfusions here—because they were unable to make the trip to Toronto.  That’s why the small balloon enteroscope has been on our equipment wish list for the last five to seven years.”

That wish turned into a reality this summer thanks to the generosity of Ron Irvine—one of Dr. Hookey’s patients—and Volunteer Services to Hotel Dieu Hospital. 

Intestinal hemorrhaging had landed Ron in Toronto for the small balloon procedure, a journey and stay he made with lots of family support.  Afterwards, determined that other patients avoid the “nuisance” of that trip, he approached Dr. Hookey and the University Hospitals Kingston Foundation about donating $20,000 towards the purchase of our region’s first single balloon enteroscope.  At the same time, Volunteer Services had a chunk of funding available—$46,251, as it turns out—that helped to complete the purchase of the endoscopy equipment.

“Everything just fell into place,” says Dr. Hookey, “and now we can perform a procedure that complements our video capsule endoscopy procedure—which also helps us to image the small intestine—but that lets us see further into the small intestine than ever before.”

He points out that single balloon enteroscopy not only visualizes the small intestine but also allows for therapeutic or treatment procedures such as biopsy, removal of polyps and bleeding therapy.  The procedure has a wide range of applications when it comes to evaluating patients with surgically altered bowel anatomy such as those who have undergone gastric bypass surgery for weight loss.

“The equipment is relatively simple,” he says, “but it translates into a big step forward in what can actually do. And it all started with a single patient and our Volunteers coming together to make one particular patient experience better for others.”

Watch a video that captures the team effort of a patient and hospital volunteers bringing a new level of health care to our community.

Photo:  Teaming up for improved patient care:  (L-R)  Dr. Lawrence Hookey, patient Ron Irvine and President of HDH Volunteer Services Carol Hazell.

Not-your-typical band shows the other side of the fence in mental health

Screen Capture of Video from YouTubeIt’s easy to think you’ve discovered a new indie band when you catch the Beyond the Fence music video—a low-budget and quirky production, with song lyrics about relationships and finding your way in life.  An indie vibe, for sure, but The Fences are not your typical indie band.

The group consists of young adults dealing with mental health issues along with a few Kingston musicians.  Over four months this year, they collaborated as band mates, meeting weekly to play music, brainstorm lyrics and record tunes, all culminating in the July release of The Fences, a professionally-recorded CD featuring two original songs and one re-mix, plus that music video.

“It’s not the usual way things work in the day-to-day world of mental health,” says Kathleen Hunn with a grin. 

Hunn is a case manager in the Heads Up! Early Psychosis Intervention (EPI) Program at Hotel Dieu Hospital, a program that helps people between ages 14 and 35 who are experiencing a first episode of psychosis and whose best chance for recovery is early assessment and treatment that helps to transition them back to a fully functioning and engaged life. 

While Hunn is familiar with recovery activities such as family support groups, mood walks, cooking groups and music therapy, the leap to pulling together a full-fledged band was uncharted territory. 

The Fences has its roots in an earlier EPI Program music group facilitated by Chris Trimmer and Rich Tyo, both local musicians and community mental health workers.  They wanted to kick the original group experience up a notch by creating something tangible.  When they landed funding from the Canada Council for the Arts, the project took off and included several clients from the EPI Program, two case managers and a peer support worker.

“We all have some connection with music, and it’s something that really levels the playing field,” says Trimmer.  “From day one, we were all members of a band, not facilitators and clients, and we all shared a space where there was lots of freedom to explore and express ourselves.”

No one was required to have any musical experience, although Trimmer and Tyo tapped into the local music scene to enlist guest musicians to help with picking chords, playing instruments (including a nifty theremin), writing lyrics, sound recording and creating album art.  The band jammed at the Queen’s Grad Club, laid down tracks in a state-of-the-art recording studio in the Isabel Bader Centre and scored an interview with the Queen’s campus radio station.

Two local videographers were also recruited to film the band’s inaugural video, a collaboration that turned a farmer’s field on Howe Island into the perfect backdrop for Beyond the Fence, a song that speaks powerfully to the stigma of mental illness with references to being “branded” and “stranded,” “waiting for the sun to come around” and looking for friendship “beyond the fence.”

“The lyrics are metaphorical and reflective of their experiences in living with mental illness and the mental health care system,” says Hunn.  “You really hear and feel them in the video.”  Trimmer agrees, describing the lyrics of Beyond the Fence and its companion song Emotional Alchemy as “eloquent” descriptions of everyday reality for people struggling with psychosis.

On July 28, The Fences joined the Heads Up! team for the official launch of their CD and video. 

“It was amazing to watch that video and to see how far these young people had come,” says Hunn.  “Several had been quite ill and struggling, but they made it to the sessions even when they weren’t doing well, and in the video they’re smiling and really engaged.  The whole experience was powerful and you hear something very powerful in their music.”

With rekindled motivation and hope—one member is now drawing every day after years of pushing his art aside—The Fences and their supporters have talked about keeping the group going, maybe opening it up to new members.  It makes sense to Hunn and her colleagues, who are game for activities that keep their clients on a safe and meaningful path to recovery.

“It was pretty cool to see these people having so much fun, doing so well and creatively telling their story,” she says.  “The whole process was fantastic and it creates much hope for more positive experiences like this.  We need more of this kind of programming.”

You can view The Fences video here.  

Getting hip to the best seating for patients in busy orthopedics clinic

Orthopedic patients are sitting a little higher and happier these days thanks to new specializeds seating in the orthopedics clinic that are giving a welcome boost to the quality of the patient experience.

A recent quality improvement survey showed that orthopedic patients recovering from hip and knee surgery found the conventional waiting room chairs in our Johnson 7 clinic extremely uncomfortable because they force you to flex your hip or knee when sitting down or getting up.  As someone who has gone through knee surgery, Patient Experience Advisor (PEA) Rita MacDonald knows all about that kind of pain.

“One day I sat beside a man in the clinic who had driven an hour to get to his appointment,” she recalls.  “The drive was painful enough but then he didn’t get any relief at the hospital because it was just too painful to sit in the chairs.  He ended up pacing in the hallway.”

In her PEA role Rita was delighted to work with the hospital’s quality improvement specialist and the program manager in orthopedics to fix the problem by organizing the purchase of specially-designed rehabilitative chairs with a seat height of 24 inches.  That taller seat creates a hip flexion of less than 90 degrees, allowing the patient to sit and stand with minimal stress on the hip joints.

“The timing was right because we were due to replace aging seating in the clinics and had capital funding available,” says program manager Marie Pitcher.  “Luckily, in Rita we had a PEA with firsthand experience of the problem and we consulted with orthopedic staff to make the best chair selection.  Now we have 10 new elevated chairs that do a wonderful of job of keeping our patients stable and comfortable as they wait for their clinic visit.”

And the patient response?  Clinic staff report comments ranging from “great” to “awesome” (the latter, FYI, from a tall patient).  For Rita, it’s all about helping people have a better experience when they come to Hotel Dieu Hospital.

“I think the gentleman I met that day and others like him, who drive such a long way to get here, will be thrilled,” she says.

Photo:  Orthopedics program manager Marie Pitcher (L) and Patient Experience Advisor Rita MacDonald (R) demonstrate the difference between regular seating and new specialized elevated seating that spells greater comfort for patients.

New pediatric eye specialist joins expanding Ophthalmology Department

A warm welcome to pediatric ophthalmologist Dr. Christine Law, the newest full-time member of our department of ophthalmology. No stranger to Hotel Dieu Hospital and Queen’s University, Dr. Law completed her residency here in June 2015, followed by a prestigious one-year fellowship at the Children's Hospital of Philadelphia.

Dr. Christine Law completed her Ophthalmology residency at Queen's University/Hotel Dieu Hospital (HDH) in June 2015, and then completed a prestigious one-year Pediatric Ophthalmology & Strabismus fellowship at Children's Hospital of Philadelphia at University of Pennsylvania.  Commencing September 1, 2016, Dr. Law returned to Queen's University/HDH to begin her full-time practice in Pediatric Ophthalmology and Adult Strabismus, Department of Ophthalmology.

Meeting the special eye care needs of children, the hospital’s current Pediatric Ophthalmology and Adult Strabismus Clinic team is comprised of physician specialists and certified orthoptists who provide precise strabismus evaluation and oversee therapy of pediatric eye conditions.  Adult patients with strabismus are also treated by the pediatric team:

• Dr. Yi Ning J. Strube, Director of Pediatric Ophthalmology and Strabismus Service
• Dr. Christine Law, Pediatric Ophthalmology & Adult Strabismus Surgery
• Lesley MacSween, Sarah Churchill and Sally Elsayegh, Orthoptists
• Debbie Ball, Administrative Assistant.

“With Dr. Law joining us,” says Dr. Strube, “we will be better able to meet the ever increasing demand for pediatric ophthalmology and adult strabismus in our community.”

“We are delighted to have Dr. Law join the Department of Ophthalmology at Queen’s University,” says Dr. Martin ten Hove, Chair, Department of Ophthalmology.

Hospital staff lace up for patient comfort and care

For the second year, Hotel Dieu Hospital teams are gearing up for the We Walk! For Your Comfort and Care event on October 1, a special project of the University Hospitals Kingston Foundation that aims to raise $30,000 for Kingston’s hospitals.

While hospital staff across Hotel Dieu, Kingston General Hospital and Providence Care demonstrate amazing care every day, We Walk! is designed to help them demonstrate that care in a new and different way, says Lori Faggiani, Director of Annual Programs for UHKF.   “We’re in the midst of a major multi-year campaign for our hospitals and want to complement that by showcasing the incredible commitment the staff and families of Kingston’s hospitals,” she says. 

“What better way than to do that while raising funds that directly help support patients in need? These funds help with extra costs such as transportation, equipment or medication not covered through drug benefit plans.”

This year, the hospital has three teams in the field—Team Dynamite, Minds in Motion! and Walkie Talkies.  Hospital staff can sign up in teams (with co-workers, family members, etc.) for the family-friendly event.  Fundraising is pledge-based and funds can be directed to the hospital of choice.  The five-kilometre walk takes place at Lake Ontario Park on October 1, with registration starting at 9 am and the walk getting underway at 9:30 am.  It wraps up with a barbeque lunch and team presentations at noon. Family and team activities will take place throughout the morning.

Looking for more information?  Or eager to support a team? Visit the UHKF website or call 613-549-5452.