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.

Three front-line healthcare workers collaborating over a tablet

CQI: Creating a culture of 13,000 problem solvers

Barb Pollock has been at Hamilton Health Sciences for more than 20 years.

And she’s seen it all.

When the organization began implementing its latest strategic initiative, called Continuous Quality Improvement (CQI), she wondered how successful it would be. Indeed, she’s seen many attempts at change over the years.

“Over a year later, it’s clear it’s changing the way we work on a day-to-day basis,” says Pollock, a physiotherapist at McMaster Children’s Hospital. “We feel like we have more control in decision-making.”

CQI is a new way for HHS staff and physicians to improve care delivery.

It’s a management system created to put power back in the hands of people on the front lines, who are in the best position to solve problems.

It’s clear it’s changing the way we work on a day-to-day basis. We feel like we have more control in decision-making.

Through a set of visual tools like huddle boards and problem-solving templates called A3s, it is designed to standardize processes and give staff more control.

 

 

Amazing improvements happening daily

Achieving incremental changes to improve quality in the patient experience over the long term is one of CQI’s goals.

Improvements made include a tool to track specialty mattress orders and a process to check medication fridges. They are just a couple examples of the hundreds of changes implemented since CQI was first rolled out in 2015.

Since January 2016, there have been 350 improvements—and counting—initiated by front-line staff, ranging from patient safety improvements to enhancing staff communication.

“In the past, I would have said front-line staff were not as involved in making changes,” says Barb. “Now I see HHS as a place where our people actually have a say on real problems happening every day, and actually find a result and solution.”

Since January 2016, there have been 350 improvements—and counting—initiated by front-line staff, ranging from patient safety improvements to enhancing staff communication. A major outcome considering only eight units, a fraction of the entire HHS family of units, have fully implemented CQI.

It amounts to one improvement towards enhancing patient care for every other day. CQI is also helping teams communicate better with each other, which allows for better planning overall.

“We’ve seen more face-to-face interaction with team members and leaders on a daily basis to discuss challenges, allowing us the opportunity to be more proactive,” says Denise Riggs, clinical manager of the emergency department at Hamilton General Hospital. “As a leader, I can be more visible, which has improved my connections within the unit and my team appreciates that level of visibility.”

What’s next for CQI?

Currently, there are 18 active units, both clinical and non-clinical. HHS has set a target of having 40 active units across the organization by 2019, then continue until full implementation of CQI across the entire organization is achieved.

HHS is also tracking the number of front-line staff and physicians who are trained in A3 problem solving methodology, a new metric identified in the strategic plan.

This will help show the workforce’s increasing ability to solve problems at the front line within the CQI management system.

People goal description and drivers

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.

How to stay cool with Dr. Tang

Hot weather isn’t just uncomfortable. If you don’t take care of yourself when the mercury rises, it can be downright dangerous.

Check out these helpful tips on how to stay cool in hot weather from Hamilton General Hospital’s Dr. Jennifer Tang.

Make sure to watch to the end of the video for signs of heat related illness you should look out for!

Visit the nearest emergency department if you feel unwell and experience these signs of heat related illness:
  • dizziness
  • nausea
  • headache
  • fainting
  • breathing problems
  • rapid heartbeat
  • chest pain

 

How to treat a burn with Dr. Chris Sulowski

Even a small burn can become very serious if it gets infected. Follow these steps from Dr. Chris Sulowski, deputy chief of McMaster Children’s Hospital’s Emergency Department to treat your burn the RIGHT way.

 

 

Steps:

  1.  Remove skin from hot surface immediately. If you’ve been burned by hot splashing liquid,  remove any wet clothing immediately.
  2.  Run cool tap water over burn area for at least 20 minutes to stop burning.
  3.  Do NOT apply ice, butter, milk, oil, saliva, Vaseline, or other liquid, ointment or gel onto the burn area.
  4.  Check the burn. If it:
    • appears to be deep
    • is starting to bubble up
    • is causing unmanageable pain
    • is in a particularly sensitive area (face, hands, feet, groin)
    • covers a large area of the body (>5% body surface area)
    • surrounds a body part (like a wrist)

Then a visit to the emergency department is in order. First, cover the burn with a clean cloth.

5. If the burn appears to be minor, cover it with a clean cloth or bandage and visit a doctor within three days.