Care, close to home

by: Sharon Pierson, vice president community medicine and population health  and Dr. Barry Lumb, physician in chief

 

On average each year, there are 630,000 visits across Hamilton Health Sciences’ ambulatory services. The patients who visit our clinics range from infants to seniors, and may need our help for a short-term illness or injury, while others will require support throughout their lifetime.

Our job is to enable these individuals to continue to live in their chosen community, close to family and friends, and where they are most comfortable. Ideally, they should also be empowered to manage their own care, and receive care when they need it.

That is why we’re rethinking the way ambulatory services are provided at HHS and in the regions of Hamilton and West Niagara today and in the future. Together with our health and community partners, and with input from our patients, families, staff, physicians and communities, we’re undertaking a review of ambulatory services at HHS and in our community.

Our job is to enable these individuals to continue to live in their chosen community…

We believe that there are ways to improve the delivery of outpatient services in the next several years, as well as the longer 20-year horizon as part of hospital redevelopment through Our Healthy Future.

In the short-term, our goal is to ensure a consistent and high quality experience for all outpatients. With over 170 clinics across our hospital, we know that there is lots of variability in, for example, how appointments are scheduled, clinic processes and wait times. We also know that there are best practices throughout existing clinics that can be applied more broadly to improve the patient experience. We’ll start making some of these improvements in the next few years.

Over the next 10 and 20 years, we’re committed to creating a model that takes into account demographic changes such as an aging population, new technologies, and the need to preserve precious hospital resources for the sickest patients. This model will: increase points of care through collaboration with community partners; enhance the use of technology to enable things like virtual connections for instant and real time access to hospital expertise; and be more integrated with primary care (family doctors, community clinics, etc.) to support a seamless health care journey.

By providing patients with more access to care in a well-designed and coordinated service model that is tailored to meet their unique needs, we can ensure better health outcomes, a better experience and, at the same time, reduce our community’s reliance on costly hospital infrastructure.

Faces of HHS – Dr. Julie Timko

Dr. Julie Timko is a family and emergency physician (CCFP-EM) at West Lincoln Memorial Hospital (WLMH).  She has been at WLMH for 9 years.

Favourite colour: blue/book: A favourite book is impossible to choose – there are too many good ones!/vacation spot: Disney World – I love seeing my kids having so much fun and it’s the “Happiest Place on Earth”!/music: country/food: Thai food and my mom’s traditional goulash/holiday: Christmas time (when I’m not working)

Tell us about your first day at Hamilton Health Sciences (HHS).
My first day as a staff physician at HHS was terrifying – probably similar to most other newly graduated physicians! I felt like an imposter and that someone would arrive to tell me it was all a joke and I wasn’t a “real doctor” after all. However, the medical staff at WLMH is an amazing and collegial community. I felt supported and like a member of a bigger team, rather than a doctor working alone. My first case was a life-threatening one, and the outcome, thankfully, was good, so that gave me a confidence boost.

What made you enter your field of work?
I entered medicine because I enjoy mental challenges and because I truly love to interact with and support others through difficult times. I liked almost every area of medicine I experienced in medical school, so I chose family medicine in a community hospital. This field in this kind of environment allows me to keep doing the many things I love to do – obstetrics, emergency, palliative care, teaching and family medicine.

What do you love most about your job?
I love so many things about my job. I am very blessed! I get a lot of joy in witnessing my patients becoming parents – it’s like I get to witness not just their baby’s birth, but the birth of two new adults too! And though it’s often quite stressful, I get a lot of satisfaction out of working with our Emergency Department (ED) team on tough but ultimately successful cases.

I wish patients knew just how much I think about them and worry about them.

Describe one of your most challenging days at work.
My most challenging day at work was the day I lost a young patient, one whom I knew well and whose family I knew well. It was devastating and is a situation I still think about every day.

It is also always a very challenging and difficult day for me and probably for any physician, when we have to give bad news. I find it especially challenging in family medicine, when I have sometimes known the patients and their family members for years. My heart hurts along with them.

What is one thing you wish patients/colleagues knew about you?
I wish patients knew just how much I think about them and worry about them. This is not just a job for me – I don’t and can’t just leave it at work when I walk out the door – my patients are in my mind and heart a lot of the time. Especially my family medicine patients. They have all become people I care about very very much.

Also, and it’s a little silly, but sometimes I wish patients knew that I’m a little older than I look! I get a lot of “Wow! You look so young to be a doctor!” which is a lovely compliment (one that I enjoy more and more as the years pass) but I want patients to feel they can trust me too. Luckily I think most patients view us “young” docs as having the most “cutting edge” knowledge, so most of the time my young looks don’t seem to throw patients off too much.

Luckily I think most patients view us “young” docs as having the most “cutting edge” knowledge…

Do you have a best friend or confidant at HHS? Tell us about him/her.
My best friend, Dr. Melissa MacEwen is also a family and emergency physician at the WLMH site. I love working with her. We both have young families, and so we understand and support each other through the difficulty of finding balance between work and family life. Additionally, because our work is similar, we can confide in each other when we face emotional cases and can put our heads together on challenging diagnoses.

What do you wish you had more time for at work?
I wish I had more time at work for learning! There is so much to learn in medicine, especially for a generalist like myself! I love to read, listen to podcasts and attend conferences, but don’t get to do these things as much as I would like! I also always wish there was more time to talk to patients. I try very hard to be giving of my time and my patience, but when there is a backlog of other patients needing to be seen, it is a difficult balance to find.

What are your favourite ways to spend your free time?
My favourite way to spend my free time is with my family – my daughter is 7 and my son is 4 and they are such fun! My husband and I enjoy a lot of laughter at their antics – one cute story of my daughter is when she was five and got new furniture in her room. She had a bedside table for the first time and was listing everything she could put on it – “I’ll put a light and some Kleenex, and my book and maybe some water. Oh! And I’ll put a phone in case the hospital needs me in the middle of the night!” My husband and I love going to the kids’ activities (hockey, swimming and gymnastics are current faves) and like to spend time outside riding our bikes as a family.

It was a pretty amazing experience to tell that young man that he had saved a life….I hope he will carry that badge of honour for the rest of his life.

On my own, my favourite pastimes are playing hockey (something I just learned three years ago) and reading. I hope in the next few years to learn how to fly – my dad was a pilot and my three brothers currently fly my dad’s home-built plane, so I think it’s about time that I joined them.

Tell us about your most gratifying experience at HHS.
Once I had a patient survive a medical emergency with a dismal prognosis, thanks to the quick-thinking and action of a bystander. The patient asked me to share the good news of his survival with the bystander, who was a stranger. It was a pretty amazing experience to tell that young man that he had saved a life. I won’t ever forget the smile that lit up his face and I hope he will carry that badge of honour for the rest of his life.

What are your short and long term career goals?
My short-term career goal is pretty simple – my kids are still very young, so I want to maintain and increase my knowledge, especially in emergency care (where there isn’t a lot of time to research or read in the moment) while protecting my family time. In the long-term, I would love to develop our emergency department’s continuing education. Our team is incredibly cohesive and work very well together, but we are a small centre, so we don’t get a large volume of critical cases. I’d love to build on our team’s capacity and confidence for dealing with the critical and rare cases through simulation and case-based learning.

Improving patient safety: Electronic health record implemented at WLMH

Hamilton Health Sciences’ vision to achieve the best care for all requires us to plan for the continuous improvement of everything we do to meet the evolving needs of patients across all of our hospitals.

At West Lincoln Memorial Hospital, one of the most recent investments to improve the standard of care is the implementation of an electronic health record (e-record).

The hospital already uses electronic health information technology to communicate and report diagnostic tests and lab results. The expansion of the e-record will give staff, midwives and physicians access to more of the information they need to inform care decisions.

This is a significant advance in how we care for patients

It tells the patient story in real-time and patient information is immediately available in an easy-to-read and organized electronic chart. It also makes it possible to standardize documentation processes across all disciplines and clinical areas across HHS, and supports the sharing of information between units and health care providers when patients are being transferred or when a consult is required.

“This is a significant advance in how we care for patients,” says Cindy MacDonald, Director of Community Programs at WLMH. “It will improve access to vital information by members of the healthcare team so that informed decisions can be made about care delivery for each patient. The e-record will also make it possible for staff and physicians across HHS to collaborate in planning care regardless of a patient’s location.”

The implementation of the e-record started in April with patients admitted through the Emergency Department. Over the upcoming weeks, the e-record will be phased in across all programs at WLMH.

Restorative Care Program at St. Peter’s Hospital

The Restorative Care Program at St. Peter’s Hospital (SPH) does a lot with a little.

Patient rooms are on the small side and that makes it difficult for individuals to maneuver their wheelchairs and walkers around. Also, patient therapy takes place in a converted hallway, which makes privacy a challenge.

“Many years ago, they basically transformed the end of the hallway into useable space by putting a door and walls around it,” says Sarah Ferguson, an Occupational Therapist and Physiotherapist Assistant. This can make patients feel like they are put on display while they are trying to get better. It can be embarrassing.

“It would be great to have as much space and equipment as we can to help the patients meet their goals.”

This program, along with the other three programs located at SPH, is slated for relocation to the re-built Juravinski Hospital as part of Hamilton Health Sciences’ 20 year Our Healthy Future vision. With custom-built space and a new configuration, patients will be able to receive more direct therapy in better surroundings. This could significantly reduce their length of stay.

“It is much easier to show someone how to put cans on a shelf in a kitchen setting than it is to ask them to imagine putting cans on a shelf.”

Staff are already getting excited about the future space which would include social areas, communal dining and more storage.

Patients will get better faster in a home-like setting because their brains will be able to make the connections they are used to making at home. “Think of any object you use day to day and we want two here in our program,” says Ferguson. “Look around your house. That is what we need to encourage people to get back to their own homes. It is much easier to show someone how to put cans on a shelf in a kitchen setting than it is to ask them to imagine putting cans on a shelf.”

Brenda St. Amant, clinical manager of Restorative Care, agrees. “We always set goals because that is what rehab is all about. It would be great to have as much space and equipment as we can to help the patients meet their goals. I am so proud of what we do with what we have – in our space. Everyone is proud.”

To read more about the Our Healthy Future vision, click here.

BLOG: Our fast-growing Children’s Hospital will need a new home

McMaster Children’s Hospital, emergency department, childrens healthcare, mcmaster university medical centre, hamilton ontario, community, hamilton general hospital, our healthy future, dr. peter fitzgerald

Imagining a new hospital in a new location

By Dr. Peter Fitzgerald, President, McMaster Children’s Hospital

As any parent knows, kids grow up fast. One  minute you’re snapping them into a onesie and the next, they’re asking for the car keys.

I often get the same feeling about our McMaster Children’s Hospital. It seems like yesterday we were celebrating an official designation as Ontario’s newest children’s hospital; now, our 30th anniversary is only a year away. And talk about growing before your eyes: We are the fastest-growing of any children’s hospital in the province and are now second only to the Hospital for Sick Children in size (for number of patients and level of acuity).

During the last five years at our Children’s Hospital, we’ve seen an overall 25 per cent growth in inpatient activity, with a particular growth spurt in the Emergency Department (ED), where the number of visits ballooned by 120 per cent. The McMaster Children’s Hospital ED is now the busiest in our HHS family of hospitals.

As busy as we are today, we’re also thinking ahead to how we’ll serve the next generation of children and youth. Over the last two years we’ve been working on a long-range plan for all of Hamilton Health Sciences, called Our Healthy Future. The plan forecasts the services we’ll provide, and the facilities we’ll need, over the next 20 years.

“It seems like yesterday we were celebrating an official designation as Ontario’s newest children’s hospital; now, our 30th anniversary is only a year away.”

We have a bold and exciting vision for McMaster Children’s Hospital. Over the next 20 years we will see an increase of 1.2 million children in Canada, which equals the current population of Manitoba! So we know the growth we’ve seen will continue as the population of Hamilton and surrounding areas continues to rise. Although our services are by no means limited to inpatient care, let’s look at our projected bed counts as a simple example of predicted growth: today we have 161 Children’s Hospital beds and in 20 years we expect to need 231.

So, when we look down the road, we envision a new facility that is designed specifically for the needs of children and their families, and including women’s health services such as our high-risk obstetrics program. We see this new facility being located adjacent to the Hamilton General Hospital campus.

McMaster Children’s Hospital, emergency department, childrens healthcare, mcmaster university medical centre, hamilton ontario, community, hamilton general hospital, our healthy future, dr. peter fitzgeraldThere are many reasons why this location would be ideal – expectant mothers who need acute care services will have them immediately at hand, while children and their parents will benefit from close proximity to our beautiful new Ron Joyce Children’s Health Centre, with its extensive list of outpatient programs for children and youth with special needs.

“Best of all, we’ll have room to grow and develop.”

Best of all, we’ll have room to grow and develop. Our current location at McMaster University Medical Centre, where we share space with the university, just can’t handle the long term needs we foresee. I’m excited about our vision for the future of our Children’s Hospital and I look forward to sharing more information as planning continues.

We envision a new Children’s Hospital to meet our community’s needs – one designed specifically for kids and their families.

Night owls gather for coffee and conversation

Come for the coffee, stay for the conversation.

That was the premise behind #hhscoffeetalk – a recent recognition and engagement initiative that provided leaders and evening staff from Hamilton Health Sciences (HHS) the opportunity to discuss frontline and corporate initiatives over coffee and cookies.

Collectively, hundreds of staff and physicians participated and provided members of HHS’ executive and management team with insightful feedback about their positions, organizational challenges and opportunities, and about larger strategic projects, such as Our Healthy Future (OHF).

Coffee and cookies Ladies at coffeetalk Rob and gang

The coffee talks were one of a series of staff and community engagement events that have taken place over the last year to help inform HHS’ long-term vision. For more information, visit http://www.ourhealthyfuture.ca.

Staff were provided with handouts which mirrored the information being shared at the daytime town halls, touching on the Strategic Plan, Continuous Quality Improvement – Management System, and OHF. The handouts contained a crossword which staff were encouraged to fill out and share on social media. The shared entries were submitted into a draw and the big winner will be announced shortly.

Thanks to everyone who participated in this initiative. Stay tuned for more events coming in the Fall.

BLOG: A letter to West Niagara from Rob MacIsaac

If anyone ever doubted how strongly West Niagara residents feel about West Lincoln Memorial Hospital (WLMH), our March 3rd community meeting in Grimsby would surely have laid any doubts to rest.

We at Hamilton Health Sciences (HHS) were happy, and not surprised, to see approximately 250 people packing the Livingston Activity Centre for a standing-room-only crowd. I would like to thank everyone who attended that evening. The support that the hospital enjoys from this community is something to be proud of. More importantly, as we plan for the redevelopment of WLMH, the level of engagement from the community is very important.

The purpose of the March 3rd community meeting was to share details about the planning HHS has undertaken for the future of our care in Hamilton and West Niagara.

To re-cap the main points:
• HHS is committed to the redevelopment of WLMH – it is a top priority
• The Ministry of Health and Long-Term Care (MOHLTC) has made it very  clear that we need to create an integrated plan that shows how all HHS’ programs and services will work together. This includes the care we provide at WLMH
• Our vision for WLMH is based on input from many stakeholders, including the communities we serve, our staff, physicians and partners.
• Our plans, once complete,  must be approved by the Hamilton Niagara Haldimand Brant LHIN and the MOHLTC
• We have recommended to the MOHLTC that WLMH be a demonstration site for integrated community care – this is one of the hospital’s major strengths
• We see the future WLMH as a community hub – possibly locating other community health services in the new building

The key programs we’re proposing for a redeveloped WLMH are:
• 24-hour Emergency care
• Maternal & Newborn (low-risk births)
• Community Surgery (an innovative, ambulatory model for same-day surgery for residents of West Niagara and Hamilton)
• Community Medicine: Healthy aging and seniors’ care; specialty clinics (such as general internal medicine, pre-op, geriatrics, mental health); advanced diagnostics (echocardiogram, ultrasound, proposed CT scanner).

There were many questions at the community meeting about hospital beds –  how many and what kind there will be. This is something that is still being discussed by our physicians and staff and we will communicate the outcomes of those discussions as soon as we can.

We think there’s an exciting future ahead for WLMH and we look forward to continuing the conversation as we move forward.

Rob MacIsaac, President and CEO
Hamilton Health Sciences

West Lincoln Memorial Hospital Presentation

On March 3rd, 2016, HHS hosted a community meeting in Grimsby. Approximately 250 people were in attendance to hear about the proposed service for West Lincoln Memorial Hospital. Rob MacIsaac made a presentation and took questions from the audience. Discussion stations were set up for each of the proposed clinical directions plus stations for planning and leadership. Attendees could meet directly with HHS staff and/or share their comments and questions on blank posters set up in each area.

Video: Rob MacIsaac speaks about the vision Our Healthy Future Summit

On March 1st, Hamilton Health Sciences hosted a full-dayOur Healthy Future summit at the Hamilton Convention Centre with community health organizations and local leadership groups.

More than 70 leaders attended the event, which was praised for being both “bold and transparent.” The purpose of the summit was to share our 20-year clinical vision and gather input from organizations that provide health and social services at the community level. The major themes discussed were: patients as partners, a population health approach, and a new physical service delivery model.

Watch the video above to view Rob MacIsaac’s presentations from the Planning Our Healthy Future Summit.

Gallstones: An unexpected side effect of childhood obesity

Let’s talk about gallstones. When we think of childhood obesity, diabetes and heart disease tend to come to mind. But according to a new study, this lesser-known side effect of childhood obesity is on the rise.

Researchers in London, Ontario discovered that compared to 20 years ago, 62 per cent more patients under age 18 are getting gallstones.

Childhood obesity and gallstones

Because our gallbladder helps us digest fatty foods, living without one means our bodies can’t handle anything greasy. That means no hamburgers, poutine or chicken wings.

The best way to keep your gallbladder healthy and avoid gallstones is to minimize your intake of these foods to begin with and to keep your weight within a healthy range for your height. Your gallbladder will thank you.

 

 

BLOG: Imagining a healthier future at Hamilton Health Sciences

By Rob MacIsaac, President & CEO, Hamilton Health Sciences

 

Hamilton Health Sciences President & CEO Rob MacIsaac

Hamilton Health Sciences President & CEO Rob MacIsaac

I’ve worked in public service for a long time, and I’ve noticed that too often our systems are designed around the needs of the people who run them, not the needs of the people who use them. At Hamilton Health Sciences, we want to change that. We’re reimagining the way our hospital system is designed, based on the needs of the people we serve. This initiative is called Our Healthy Future, and it’s our biggest planning effort in decades.

We’re putting everything on the table for discussion. We are looking at all our services and all our facilities. We want to create a bold vision for the care we’ll provide over the next 20 years. Our planning process began in March 2015 and will wrap up in June 2016. Along the way we’ve asked questions, studied data, analyzed trends and challenged ourselves to imagine a healthier future for the communities we serve.

As part of the process, we talked to hundreds of people who use the health system, and to local health and social service organizations serving people at the community level. Now we have arrived at the point where we’re starting to draw conclusions about the kind of hospital system we need to build and how it should integrate into the broader health system.

We see a future where our patients and their families play a larger role in determining the care they will receive. We envision smooth transitions between one type of care and another so that patients and their families don’t feel overwhelmed, confused or frustrated. We see better communication and stronger collaboration with community partners.

We intend to increasingly invest in better managing and even preventing illness and disease, especially for the community’s most vulnerable populations. Rather than waiting until people show up at the hospital, we will bolster community-based care and wellness programs that help people avoid the need for hospital care. This population health approach is particularly important in Hamilton, which has among the highest rates of urban hospital use of any city in Ontario.

One strong suggestion we’re hearing from community-based health partners, and from the general public, is to expand our services beyond hospital walls, bringing them closer to the people we serve. We see a future where people can receive much of their health care in convenient community locations.

That said, there will always be patients for whom there’s no substitute for the acute care provided at a hospital. Our regional programs for cancer, cardiac care, stroke, trauma and burns are good examples of programs we will enhance and grow. We will also maintain and expand the care provided by our McMaster Children’s Hospital. While these services are located in and serve the people of Hamilton, they also serve a much broader region of some 2.3 million people. People travel from as far as Thunder Bay to receive care from HHS.

These changes go hand-in-hand with our role as one of Canada’s preeminent research and teaching hospitals. We will continue attracting the most talented health-care practitioners to our community to continuously improve our care using the best medical science. Our efforts in research and development will also need to extend to innovations in technology because it will be such an important enabler of our vision.

We think we can supercharge our work in technology innovation through collaborations with the private sector — be it local entrepreneurs or technology companies. And by doing so, we intend to make Hamilton Health Sciences an even more important player in helping power a strong local economy as new businesses spring up to sell our innovations to the world.

We’re not done planning yet, but our vision is starting to take shape. It’s a vision inspired by our workforce, our partners and the communities we serve — and central to it is a health-care system that puts the patient first.

To provide your comment or question about Our Healthy Future, please go to www.ourhealthyfuture.ca

 

This article originally appeared in The Hamilton Spectator.