A publication for Staff and Physicians of IH

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The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: IHAcommunications@interiorhealth.ca Deadline for submissions to the Summer 2015 @InteriorHealth magazine is June 12. Editors: Amanda Fisher, Breanna Pickett Designers: Breanna Pickett, Kara Visinski, Tracy Watson IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Megan Kavanagh, Breanna Pickett, Erin Toews, Tracy Watson

Every person matters

Hats off to the first graduates of the Southern Medical Program.

A message from Susan Brown, VP Acute Services.

Helping caregivers manage responsive behaviours.

Featuring David Kelsey, Lifeline Program Manager and Daybreak.

Making the MOST of a difficult conversation – talk early, talk often.

New multi-sensory room provides therapeutic environment.

Preparing for October’s Employee Engagement Survey.

Award winning photo in the national Clean Shots Photo Contest. Story p. 18.

Snapshots of our staff in action and trending health-care videos.

Staff-submitted photos of the places that make up the IH region.

At Interior Health, we want to set

new standards of excellence in the delivery of health services in B.C. and

to also promote healthy lifestyles and provide needed health services in a

timely, caring, and efficient manner.

To achieve this, we are guided by the

following strategic goals:

Goal 1

Goal 2

Goal 3

Goal 4

The articles featured in the @IH newsletter are great examples of how

we’re achieving our goals …

and realizing our vision and mission.

Susan Brown, Vice President Acute Services

W hen you think of acute, you may think of the here and now: quick, immediate, and even high intensity.

Certainly, the Acute Services portfolio in Interior Health covers the immediate and urgent needs of the people who come to our emergency departments and inpatient units in the hospitals across the health authority. Our acute staff do tremendous and, in many cases, life-saving work in supporting a variety of patients with injuries or illnesses. Acute Services also includes three important program areas – renal, tertiary mental health, and cardiac services, all of which provide invaluable care that saves lives and helps patients have a better quality of life in the future. The IH Surgical Network sits in Acute

Services as well – supporting physicians and employees as they perform countless procedures each day that make a difference in the lives of our patients and their families. A wide range of physicians and staff support acute services. One of the things I’m most proud of is how well everyone is working together. A great example was the recent teamwork around Ebola preparedness. It was a complex undertaking that touched every part of the system and I think our response was excellent. It was really exciting watching the whole team come together to do work that will serve us well for all emerging pathogens that come into Canada in the future. Watching the system evolve and grow is very rewarding. Growing systems require growing infrastructure, and Acute Services is excited to see major investments in our acute facilities including the new Interior Heart and Surgical Centre in Kelowna, the RIH Clinical Services Building in Kamloops, and major investments in Penticton, Cranbrook, and other parts of our region. Our portfolio is not just about the important work at hand. We also provide support behind the scenes through the

Professional Practice Office (PPO). The PPO connects with the Ministry and other health authorities and guides our regulated professionals’ work by ensuring IH is up-to-date and following new legislation, best practices, and new policies through an ethical lens. The PPO is an excellent resource for our teams on any questions that come up in the day-to-day work and in meeting our longer-term service needs. While much of the work is in the present, Acute Services is also focused on the future. We oversee the logistical needs of the Southern Medical Program in supporting the next generation of physicians. Having this education within IH creates great opportunities for recruiting these physicians back to the area when their education is complete. This collaboration has boosted the medical libraries in IH, generated additional research opportunities, and led to creative work around simulation programs that support additional training for current staff and physicians, as well as the UBC students. I love the variety and challenges that come with our work and I’m equally excited about all the efforts that have gone in to ensure our physicians are leading this work alongside Interior Health. Our team is becoming more and more integrated across all areas and that is essential for the patients we serve every day. Our geography in Interior Health will always be a challenge, so it’s important to do the best with the resources we have, work together and recognize the value of all the services we provide. I hear fantastic stories about how we’ve changed people’s lives and we can’t forget that. My own approach to health care has not changed since I was a front-line nurse – do the best for every patient you can. Keeping the patient at the centre keeps everyone on course and I believe that has become everyone’s focus in Acute Services.

“

A room with coloured lights, celestial wall projections,

and a collection of musical sounds seems reminiscent of a disco, but for many residents and clients it offers

a therapeutic space and improved wellbeing.

This multi-sensory room, referred to as a “Snoezelen room,”

is designed to sooth and calm agitated behaviour and improve social interaction by stimulating the senses.

The most recent Snoezelen room in Interior Health was completed

in December 2014 at Columbia View Lodge in Trail. It features glowing bubble tubes, coloured light sprays, mild aromatherapy,

soft music, tactile beads and other tools that stimulate sight, smell,

hearing, and touch.

“We use the Snoezelen room on a daily basis for preventing and calming unsettled behavioural symptoms that are associated with

dementia,” says Margot Wright, Recreation Therapist at Columbia

View Lodge.

“We have also found it useful in stimulating positive responses with those who are withdrawn and isolating from social contact.”

For resident Ed Podmorow, it provides a calming and relaxing space.

“It’s nice. It keeps his mind going,” says Ed’s wife, Polly, who visits him several times a week. “Even today, he smiled. He enjoys it in

there – I can certainly see that.”

The Snoezelen equipment is adjustable so health-care providers can

select the amount and type of stimuli to suit each resident’s needs.

“

The Snoezelen room really provides alternatives

for entertainment and distracts residents during

difficult episodes.

Bastion Place, Salmon Arm

Columbia View Lodge, Trail

Dr. F.W. Green Memorial Home, Cranbrook

Gateby Care Centre, Vernon

Hillside Centre, Kamloops

Kelowna General Hospital, Kelowna

Noric House, Vernon

Parkview Place, Enderby

Pleasant Valley Manor, Armstrong

Bastion Place, Salmon Arm

Kimberley Special Care Home, Kimberley

Kelowna General Hospital, Kelowna

Hillside Centre, Kamloops

Minto House, Nakusp

Parkview Place, Enderby

Slocan Community Health Centre, New Denver

“I have spent time in the Snoezelen room and found it to be a wonderful addition that all the residents at Columbia View Lodge can benefit from,” says Dr. Elizabeth McCoid, who provides

care for the majority of patients in the special-care unit.

“We try to avoid the use of medications to treat agitated behaviours; the Snoezelen room really

provides alternatives for entertainment and distracts residents during difficult episodes.”

There are a number Snoezelen rooms in use at both residential and acute sites across Interior Health. Some sites offer portable carts with Snoezelen equipment, allowing staff to bring the therapy directly

to residents and clients, or set up group sessions in various locations.

Resident Ed Podmorrow sits in the Snoezelen room at

Columbia View Lodge.

T he man was normally quite gentle. He rarely gave caregivers at his residential care facility any trouble – until recently, when it was time to help him dress. Then, he began to strike out at his

caregiver, which put both of their safety at risk. Why was he behaving this way? The care team stopped and asked three simple questions – What changed? Why did it change? What can we do to help? They learned that he was having increased pain in the morning, which made it difficult to bear the movements associated with getting dressed. They plotted a new course of action, adjusted his care plan to ensure his pain was alleviated, and the morning dressing routine became less challenging. This man could represent any number of residents, patients or clients who are cared for by Interior Health employees each day, either in residential care, hospitals or through mental health and substance use programs. It’s for these people that the P.I.E.C.E.S.™ (Physical, Intellectual, Emotional, Capabilities, Environment, Social)

education initiative was developed, and why it is currently rolling out across Interior Health. P.I.E.C.E.S.™ is a made-in-Canada clinical support framework for those who work with older adults with complex physical, cognitive, mental health, and behavioural challenges. It involves bringing together members of the interdisciplinary care team and applying a framework that can be used to address risk and develop a person- and family-centred plan for individuals, to ensure quality and safety of care. It supports the provision of best practice, enhances interprofessional collaboration, and helps reduce workplace health and safety issues. “It’s a way of understanding the behaviour of people who have dementia or complex physical or mental illnesses,” says Bette Jo Tunks, a Clinical Practice Educator with Tertiary Mental Health Services (TMHS) who is based at Hillside Centre in Kamloops. “Behaviour always has meaning. What we call ’aggressive behaviour’ is a meaningful expression once we find the possible root of it. Patients who exhibit behaviour such as hitting are often responding to something else, such as pain, a sense of

Participants in a P.I.E.C.E.S.™ training session piece together

a matching game featuring the 3Ds – Dementia, Delirium, and Depression.

P.I.E.C.E.S.™ facilitators Bette Jo Tunks, Clinical Practice Educator, and Karin Schmidt, Occupational Therapist.

insecurity or threat, or a loss of control. “As health-care providers, our natural instinct is to try to fix it. P.I.E.C.E.S.™ says slow down – back up and give it more thought. We may not know enough yet to fix it.” Put the pieces of the puzzle together first, if you will, says Mona Hazel, Regional Manager, Residential Clinical Practice and Support. P.I.E.C.E.S.™ is not unlike other initiatives that have been implemented in Interior Health, such as 48/6 and InterRAI. All are based on a framework of assessment. Mona says P.I.E.C.E.S.™ can be boiled down to three basic questions: What has changed? What are the possible causes associated with the change? What actions will you take to address the causes? “The questions help us discover the facts of a situation, and not rely on hearsay or stories,” says Mona, who is also based in Kamloops. “It’s a simple framework, but it helps nurses, allied health, and the whole team in a structured way to assess the cause of behaviour and identify possible actions and interventions to minimize what happens to that person.” P.I.E.C.E.S.™ was introduced to Interior Health as a pilot project in March 2012, when Tertiary Mental Health Services purchased a license to provide a train-the-trainers session to a select group of interdisciplinary individuals in Kamloops spanning TMHS, residential care, community mental health, acute care and Thompson Rivers University.

Shortly thereafter, and separate from the TMHS initiative, provincial best-practice guidelines were established in residential care for managing and accommodating responsive behaviours (better known as the Behavioural and Psychological Symptoms of Dementia, or BPSD). Through this, education programs were adopted to support best-practice guidelines – and P.I.E.C.E.S.™ was chosen as one of the initiatives. Today, P.I.E.C.E.S.™ has been embedded into daily care planning throughout TMHS, and there is a concentrated focus on training caregivers in residential care – not just for IH staff, but also for contracted partners. One of its greatest proponents in IH is Dr. Carol Ward, a geriatric psychiatrist who sits on the Provincial Tertiary Geriatric Psychiatry P.I.E.C.E.S.™ Project Steering Committee. Those who have received P.I.E.C.E.S.™ training have reported that its use has promoted enhanced communication, improved care planning, and led to better collaboration and teamwork between caregivers. As a result, patient or resident issues have been addressed more quickly and efficiently, resulting in better-quality patient care. “P.I.E.C.E.S.™ is just a different way of systematically viewing a client and developing a plan of care,” Bette Jo says. “It’s that interdisciplinary team focus, from the nursing staff to the housekeeper to Plant Services – whoever might have that information. The P.I.E.C.E.S.™ framework helps health-care providers speak the same language.”

Maureen Detwiller (L) and Judy Nicol show off the new most posters for IH.

I t’s not something most of us want to think about,

let alone talk about, but many people recognize the importance of telling their loved ones and their

health-care team their wishes for end-of-life care.

Having a voice in decisions about future health care is

important and, thanks to work done provincially on Advance Care Planning and 48/6 Plans of Care, the public,

clinicians, and physicians are getting more comfortable with these discussions.

And now there’s even more to discuss. On June 1, an

initiative called MOST, or “Medical Orders for Scope of

Treatment,” was introduced across the health authority. MOST is a physician order that outlines what medical care

best fits an individual based on their wishes and current health status.

MOST provides direction to the health-care team on levels of resuscitation, critical care, and/or medical interventions

to minimize unnecessary or unwanted medical treatment.

The Professional Practice Office’s Judy Nicol and Maureen Detwiller have been leading the roll out

of MOST, which replaces existing resuscitation orders.

“This will mean a single form and a standard process for

all care settings within Interior Health,” says Maureen.

“After an individual discusses their wishes with their family,

it’s important to also share those with their health-care team, so appropriate plans and treatment options can

be discussed. The result of those discussions will be

the physician filling out a MOST form, which is viewable in Meditech.”

That information follows the individual through the

health-care system, no matter what setting they’re

receiving care in.

“This sets Interior Health apart from other health organizations in Canada,” says Judy.

She recently lost her father in Alberta and experienced

first-hand the challenge of not having all members of

the health-care team on the same page.

“His family physician knew what my dad wanted, but the hospital staff didn’t, so the care he received was not in

line with previous decisions made. If there had been a way

to communicate family physician orders with the broader health-care team, like Interior Health can with the MOST

initiative, unwanted or unnecessary treatment could have been avoided.”

Working in the health-care field, Judy and her family

were able to advocate for her father’s wishes, but not

everyone has the knowledge or comfort level to do that. That’s why it’s important to have those discussions in

advance, then documented and shared with loved ones and the health-care team.

For more information, visit InsideNet > Clinical Resources > General Interprofessional Practices > ACP/MOST.

Enhancements to MOST were made

possible thanks to the creation of the

“Dignity Fund” by an anonymous donor

to the Kelowna General Hospital

Foundation.

T he first medical students to be fully educated and trained in the B.C. Interior graduated from the University of British Columbia’s Southern Medical Program (SMP) on May 20, 2015.

UBC Okanagan, in partnership with Interior Health, welcomed the inaugural SMP class in September 2011. Now, as part of the largest medical graduating class in UBC history, 30 new doctors are preparing to enter residency training in family medicine or various specialties for the next two to five years. “On behalf of the Interior Health Board, as well as our physicians and staff, congratulations to the Southern Medical Program’s first graduating class,” says Interior Health Board Chair Erwin Malzer. “We are proud to play an important role in the future of tomorrow’s doctors, and we look forward to building upon our successful partnership with UBC.” Students in the Southern Medical Program completed most of their academic work – lectures, labs, and small-group workshops – at UBC Okanagan, but received their clinical training at various hospitals and clinics throughout Interior

Health. More than half of the SMP’s graduates will pursue training in primary care. One of them, Alexandra Bond, who grew up in Surrey, will head to Vancouver to begin a five-year residency in internal medicine at UBC. “I am extremely grateful to have had the opportunity to complete my medical education with the Southern Medical Program’s inaugural class,” says Alexandra. “The SMP has a supportive learning environment that is cultivated by a team of dedicated administrative staff, talented physicians, an enthusiastic medical community, and incredible classmates. This has made for a truly exceptional experience." The SMP admits 32 students annually and now, four years into the program, more than 800 Interior-based health professionals are involved in teaching medical students and residents in 30 different communities. This July, a new family medicine residency site will open at Kootenay Boundary Regional Hospital in Trail, and training sites in Kamloops and Kelowna will welcome their second round of residents.

Alexandra Bond, SMP Graduate Class of 2015

@IH: What is the Lifeline Program?

Lifeline is the emergency response program for individuals,

such as the elderly or people with chronic diseases, who live independently. They wear a Lifeline pendant and if they have

any trouble they press the pendant and it sends a message to our 24-hour response centre. The individual’s information

is made available and we’re then able to get help for them.

@IH: How many people are currently using the

Lifeline Program? We currently have 2,450 subscribers in the Okanagan.

@IH: How has the program grown over the years?

This is my 25th year as the Lifeline Manager. I began when

I was 30 years old. The program was very small when I

began, we had 75 subscribers. We’ve since expanded over

the years to cover the whole Okanagan. We were acute-care

based when the program started and we were right in the

hospital. With the advent of Community Integrated Health

Services, we became a community program. Our focus is

keeping people independent and in their own home, but we’re

also a tool that’s used by integrated care coordinators and the

discharge folks at the hospital to get people home faster.

@IH: What are some of the biggest changes you’ve seen with the program over the past 25 years?

Definitely the technology. Originally, the buttons that

individuals had to wear were the size of garage door openers.

Now they’re very, very small – the size of a wristwatch.

We have also added a fall system now that detects when

someone falls from a standing position. If they do not get up

within 30 seconds it sends an automatic alarm. The

technology has also greatly improved the service. We now

have the ability to have individuals, like neighbours, added to

contact lists so that we can call the neighbour to check on the

individual rather than going straight to calling an ambulance.

It saves the system a lot of money.

@IH: Has the Lifeline Program always been housed in the Vernon Daybreak building?

No, the hospital auxiliary started the program originally out

of Vernon Jubilee Hospital (VJH). The hospital switchboard

operators used to monitor our calls, but as we got bigger

and bigger we went to centralized monitoring, so now all

of the calls go to Toronto. About 10 years ago we moved

our offices from the hospital to this building.

@IH: Why is it called Daybreak Building?

Before we got here, this building housed the Daybreak Adult

Care Program, but that program moved to the Gateby Care

Facility. Even though the Daybreak Adult Care Program

moved, they kept the name here.

@IH: Any final words on the Lifeline Program?

At Interior Health, we have a really dedicated group of

employees who care about our subscribers and who really

care about the individuals belonging to the Lifeline program.

I’d like to recognize them, as well as all our volunteers, who

go above and beyond to make this program so successful.

David Kelcey, Lifeline Program Manager

Gathered from 2014-2015 data

19 1989 Year Lifeline began

2,450 Lifeline users in the

Okanagan

7

90 New subscribers

to Lifeline monthly

Lifeline staff

103 Age of oldest

Lifeline user

Lifeline Office (a.k.a. Daybreak), Vernon

Age of youngest

Lifeline user

Kootenay Lake Submitted by: Sjaane Beattie

Submit your photos of the beautiful places that make up IH on the InsideNet.

Covering over 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 in @IH.

Where We Live & Work ... A Spotlight on Our Communities

Barriere Submitted by: Jennifer Maier

Okanagan Lake Submitted by: Michele White

Kelowna Submitted by: Jennifer Treger

Interior Health cleaned up at this year’s national Clean Shots Photo Contest. Not only did IH submit the most photos, Leahh Potyok from Elk Valley Hospital won the grand prize for best photo! Leahh entered her “Share the love for your patients and co-workers by washing your hands” photo and won a free admission to the Infection Prevention and Control Canada 2015 National Education Conference in Victoria.

–

If you’re talking to Dr. Anders Ganstal or Dr. Norm Kienitz at Royal Inland Hospital and they don’t talk back … don’t be offended! Life-sized images of Dr. Kienitz, the Chief of Staff (L), and Dr. Ganstal, the Emergency Department head, (shown here with Carol Laberge, RIH Health Services Administrator) have been captured in cardboard cut-out form, and are now appearing in hallways and waiting rooms to help spread the message of the importance of hand hygiene to public and staff. Proper hand hygiene is one of the most important ways to reduce the spread of infection, and the cardboard cut-outs promote making good hand hygiene a habit.

Behind every great construction project is a great team! With thousands of hours of hard work invested, the Interior Heart & Surgical Centre (IHSC) Project Team has delivered a beautiful state-of-the-art building that opens on Sept. 28, 2015. Proud to show it off, the team invites IH employees and their families to tour the IHSC on June 19 from 4 - 6 p.m. Public tours are on June 20 from 10 a.m. - 2 p.m. The IHSC Project Team is (back L-R): David Fowler, Tish Smith, Niki Horan, Brian Miller, Laura Dalton, Dan Gagne, Jane Gilchrist, Trevor Speed, Sam Campese, (front L-R) Catherine Whittingstall, Trudi Perkes, Doris Langlois, Ev Kroschinsky, and Norma Malanowich. Not pictured: Lisa Braman, Birgit Koster, and Sylvia Weir.

Fraser Health Communications and Public Affairs collaborated with Quality Improvement and Patient Safety, Eagle Ridge Hospital (Port Moody), and clinical nurse educators to develop a touching and effective video that demonstrates how being mindful is our best defence against events that can harm patients. Learn more at BC Patient Safety & Learning System Central, at www.bcpslscentral.ca.

Who on Earth is exposed to the most ionizing radiation? Some places aren't as radioactive as you'd think, like Chernobyl and Fukushima. This video explores nuclear power plants, research reactors, Marie Curie's institute, Einstein's apartment, nuclear medicine areas of hospitals, uranium mines, and nuclear bomb sites. But none are more radioactive than the last one … it’s a real killer. Learn more at Interior Health, Tobacco Reduction Program, www.interiorhealth.ca.

You may remember actress Mara Wilson, who played the young girl in movies like Miracle on 34th Street, Mrs. Doubtfire, and Matilda, but you may not know her life-long experiences with anxiety, obsessive compulsive disorder, and depression. In partnership with Project UROK, Mara shares her story on mental health and how she copes. Project UROK is a non-profit organization dedicated to creating fun, informative, meaningful, and hopeful internet content for those struggling with a wide variety of mental health issues. Learn more at Project UROK, www.projecturok.org.