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INTOUCHJANUARY 2015

Taking two for the teamBy Kate Manicom

Social worker Leanna McCarney, CCAC coordinator Khadra Mohamed and case manager Linda Lo plan a Trauma Neurosurgery patient’s transition from the hospital to home. (Photo by Yuri Markarov, Medical Media Centre)

Like most units at St. Michael’s, Trauma and Neurosurgery on 9 Cardinal Carter has a lot to cover during its daily and weekly rounds. Many of its patients have complex injuries and illnesses and most require continued care after they leave the hospital.

What sets these rounds apart is that in addition to nurse practitioners, social workers and case managers, they are attended by the same two CCAC coordinators every week, Khadra Mohamed and Katherine Chow.

Mohamed and Chow attend bullet

rounds on 9 CC twice every week as well as weekly ALC rounds. The result is improved communication and understanding between the unit and CCAC and a faster transition for patients who are ready to recover at home or elsewhere in the community.

“We had a patient who was admitted after a violent attack,” said Ingrid Kuran, a social worker on 9 CC. “His injuries left him with behavioural issues that would have made any placement challenging. Because Khadra and Katherine were aware of all aspects of his treatment needs,

Of the 677 severely injured patients seen by the St. Michael’s trauma team in 2013, 180 of them, or 26.5 per cent, had a positive blood alcohol level.

Each one of them – no matter what the alcohol level was—had an alcohol screening intervention from a social worker.

“There is a clear link between alcohol use – and not necessarily alcoholism – and injury,” said Laurie DeOliveira, a Trauma and Neurosurgery social worker. “In fact, the majority of injuries that include the use of alcohol

By Evelyne Jhung

Continued on page 3 Continued on page 3

How health-care providers are reducing the risk of alcohol use and injury

Happy New Year!

Bob Howard President and CEO

OPEN MIKE with

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Happy New Year! I hope each of you had a happy holiday season and were able to relax, recharge and spend some time with friends and family. I also hope that 2015 is a year full of joy and good health for the entire St. Michael’s family. It’s certainly going to be a busy year – one of the busiest since I arrived here as a resident more than 32 years ago.

Our first priority will be to communicate and implement the new three-year strategic plan. I’m really excited about this plan. It’s a different kind of strategic plan for a different St. Michael’s.

What’s so different about it? A lot – although I have room here to give you only a few highlights. We’ll be sending out links so you can read the entire document.

Our patients are at the centre of this plan. That’s where they’ve always been, ever since the Sisters of St. Joseph founded the hospital in 1892. But it makes a difference when you put it in writing and make it a

centrepiece of your guiding document. It becomes a constant reminder to everyone to think about how they can best engage and treat our patients and it holds us accountable to those patients for delivering high-quality care.

The new plan also has a new vision: world leadership in urban health. That doesn’t mean we’re going to stop doing what we already do, and in many cases do better than anyone else. We’re still going to be an acute care, general hospital with a Level 1 trauma centre. We’re still going to offer specialized services and be a provincial and national resource for many advanced therapies and surgeries. On top of all that, we’re going to put a new emphasis on serving our entire catchment area, which is one of the most diverse in Canada and is changing faster than ever before.

And we have to do all of this without any new money. The province has made that very clear to us. So we’re going to put a heightened emphasis on the final E in SOAPEE: efficiency. We are also going to pay more attention to innovations, which are NOT incremental changes, but are big, bold and sometimes risky new ways of doing things.

One way we’re trying to become more efficient and sustainable is by conducting

an operational review, an objective, third-party assessment of the financial, clinical and operating performance of all areas in the hospital. Perioperative Services, Heart and Vascular and Supply Chain volunteered to go first and we’re expecting some recommendations from Ernst and Young this month.

We’re also about to start construction for St. Michael’s 3.0. We know that the redevelopment project is going to be disruptive to you and our patients, and we’ll do everything we can to mitigate that. We thank you in advance for your patience. This is going to be the biggest physical transformation in the hospital’s history and the result will be a leading-edge facility that will transform patient care and enable everyone who works, studies or volunteers here to do a better job in a more attractive and efficient environment.

Also this spring we’ll be opening our sixth Family Health team sites in Regent Park, making us the biggest academic FHT in Ontario. We’ll have 45,000 patients rostered –that’s the equivalent of the entire population of North Bay, Ont.

I look forward to sharing an exciting year with you.

Follow St. Michael’s on Twitter: @StMikesHospital

Research Patient Care Education

JANUARY 2015 | IN TOUCH | 3

When injured patients with a positive blood alcohol level come to St. Michael’s, a social worker such as Laurie DeOliveira is called in for an alcohol screening intervention. (Photo by Yuri Markarov, Medical Media Centre)

St. Michael’s is an RNAO Best Practice Spotlight Organization

happen to be at a time when a person used a little more than usual or had an episode of binge drinking.”

Evidence shows that offering a single brief motivational intervention can reduce the risk of future injury by as much as 50 per cent, so in 2007, St. Michael’s began its intervention program.

The intervention generally takes about 20 minutes and consists of providing information to patients about their blood alcohol level upon arrival at St. Michael’s, a questionnaire and advice from a social worker such as DeOliveira, Ingrid Kuran or Leanna McCarney.

“Trauma units are an ideal location for a teachable moment because the patient’s injuries can help motivate behaviour change,” said DeOliveira. “We have a conversation about alcohol use and the impact it has on their lives – socially, financially and personally. I’ll provide some recommendations about quantities consumed and safer drinking practices.”

Patients who are considered at high risk are offered community resources and encouraged to seek further intervention, such as Alcoholics

Alcohol screening story continued from page 1

Anonymous or referral to the Centre for Addiction and Mental Health.

“Overall, patients are quite willing and interested in both the intervention and the community resources,” said DeOliveira. “The hope is to continue to offer the alcohol intervention with the intention of reducing re-admissions, injuries and risk to

those who use alcohol.”

Not all who come to St. Michael’s trauma unit qualify for the intervention, such as those who have a well-known alcohol dependency or those whose injuries may be too severe to allow for the intervention.

they recommended and referred him to the Behavioural Support Services Program for assessment. Once opened by CCAC, our 9CC team completed the capacity assessments and medical form within days, a process that might have previously taken up to a month was completed within a week.”

Through this collaboration, Mohamed and Chow have also helped St. Michael’s patients who are diagnosed

with brain tumours go home with the support they need while they wait for radiation oncology treatments at Sunnybrook or Princess Margaret Hospitals, instead of waiting at St. Michael’s. Patients can safely stay with their families, and their hospital beds are freed up for a new patient needing trauma or neurosurgery care.

“Because 9 CC has so many people doing so many things, it always seemed like a maze to me,” said Mohamed. “Now we

have a much better understanding of what everyone else is thinking.”

Linda Lo, a case manager on the unit, found the collaboration has not only improved communication between CCAC and 9 CC, it has helped both groups to communicate with patients and their families.

“We’re providing consistent messages now,” said Lo. “We speak with one voice, as a team.”

Two for the team story continued from page 1

9. Have you or someone else been injured as a result of your drinking?

NoYes, but not in the last year.

Yes, during the last year.

Sample question from the alcohol screening intervention questionnaire.

Q & ACorporate Health and Safety Services is involved with many aspects of health, wellness and safety at St. Michael’s including: health assessments, immunizations, mask fit testing, wellness programs, health and safety training, incident follow-up investigations and the return to work program. The team’s focus for 2015 continues to be on promoting a safety culture and work-life balance. One of the people responsible for this is Barry Lam. He is an occupational hygienist who is trained to anticipate,

BARRY LAM, Senior Occupational Hygienist,

Corporate Health and Safety Services

recognize, control and evaluate chemical, biological, physical or ergonomic hazards at the hospital and develop strategies to address them. He has been at St. Michael’s for nine years and here is what he has to say about his role.

Q. Tell us about your job.

My role really is a mix of everything. Some of my responsibilities include facilitating training sessions with front-line staff on how to use patient lifts and personal protective equipment safely; consulting with researchers and staff on their lab space and work area setup; and ensuring the hospital is in compliance with legislation, regulations and standards related to worker health and safety.

Q. What is a typical day like for you?

My day can be all over the map. Recently I conducted an illumination study of the helipad to ensure there is enough lighting for staff to perform maintenance work at night. I also perform routine air monitoring on anesthetic gases used in our operating rooms to verify the concentrations do not exceed the occupational exposure limit. I also ensure the chemical fume hoods in our labs are working properly so that hazardous vapours or fumes are vented properly.

I constantly have my eye out for hazards, even if I’m just casually walking through the halls from one place to another. It’s just part of my nature.

Q. What is one of the most interesting parts of your job?

Watching how our health and safety programs have evolved over the years has been interesting. Things are much different today than they were when I first started. Health, wellness and safety are more embedded into our culture. There is a more coordinated approach to creating functional and safe workspaces in new projects where we take into consideration how someone interacts with their workstation or work environment. For example, looking at minimizing the distance someone has to travel while pushing a stretcher or optimizing storage space to prevent repetitive strains injuries.

Q. What is your new year’s resolution?

I always try to learn something new. This year I would like to enroll in a cooking or language course – haven’t decided yet.

By Heather Brown

(Photo by Yuri Markarov, Medical Media Centre)

INTOUCH JANUARY 2015

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