A clinical leader for a hospital's developmental pediatrics and rehabilitation program stands in portrait.

Introducing… a clinical leader in developmental pediatrics and rehabilitation

Lindsay Bray is a clinical leader for Hamilton Health Sciences’ (HHS) developmental pediatrics and rehabilitation (DPR) program. She supports the children’s developmental rehabilitation program and the technology access clinic. Lindsay is based at Ron Joyce Children’s Health Centre and has been with HHS for 17 years.

What do you do?

I support a team of extremely dedicated and innovative staff. We serve children with neurological disorders who have physical and/or developmental disabilities that result in functional limitations.

Our technology access team assists both children and adults with written and/or spoken augmentative communication needs.

Who inspires you?

I am inspired by my grandfather, James Belaire, who taught me to work hard, solve problems creatively, celebrate the accomplishments of others and give back to our community. At times in his life, he was isolated and afraid. As a result, he took every opportunity to ensure others felt supported and cared for. My grandfather was a creative, out-of-the-box thinker who could make anything.

I am inspired by my grandfather who taught me to solve problems creatively and celebrate the accomplishments of others.

He used his talents to create a monument for Remembrance Day with plaques for every man in his company who lost their lives. He once anonymously left a gift for each child on his street on Christmas Eve. As his friends and neighbours passed away, he did yard work for their widows.

After he passed away, I found an award he received from the City of Toronto for being a good neighbour. It was tucked away, and I suspect that no one else had ever seen it.

What is your most gratifying experience working at HHS?

Last year, I was approached by a parent from DPR. She told me Halloween is a particularly difficult holiday for her family to celebrate due to their mobility issues. Overhearing our chat, another mother said her child actually hopes to be in the hospital for Halloween as they saw the outpouring of support our sites provide.

This year, a combined effort between our program and the families we serve helped launch an accessible trick or treat event at Eastgate Mall in Hamilton. Our staff, families, friends and the community rallied and donated more than 10,000 treats for the kids. Our recreation therapist as well as community volunteers were on site to support our families. I’ve heard from more than one child it was the best Halloween ever. It was gratifying to see our families empowered to advocate for their Halloween needs.

I have been most surprised by how my team supports me in the same way it supports our patients and families.

What’s one thing people would be surprised to learn about your role?

I’m still new in my role, and my learning curve has been incredible. I thought I would be in a role supporting our front-line staff so they could focus their energy on their clinical roles.

I have been most surprised by how my team supports me in the same way it supports our patients and families. I’ve stumbled, misspoken, delivered hard messages and been truly challenged. My colleagues enthusiastically embrace new endeavours by volunteering their time and resources.

As an example, we won the MacKids Walk and Wheel’s first staff fundraising challenge earlier this year. We also partner with the community and create inclusive groups for all of Ron Joyce Children’s Health Centre. And, when our cheer squad debuted at a recent Hamilton Tiger-Cats game in brutal weather, our staff cheered loudly from the stands. It’s been an incredible journey being part of this team.


A Chief Medical Information Officer stands in portrait

Introducing…our Chief Medical Information Officer

Dr. Rob Lloyd is the Chief Medical Information Officer (CMIO) for Hamilton Health Sciences’ (HHS) Health Information Technology Service (HITS). Rob has been with HHS for 19 years in several roles including as an intensivist in the pediatric critical care unit at McMaster Children’s Hospital. He then served as medical director and division head for this unit before joining HITS.

What do you do?

I represent our clinicians’ needs to our informatics and IT staff, who build and customize our systems. To help with rollout of IT programs and services, I need to engage and educate clinicians as well. I think of myself as a translator between clinicians and IT because they each speak different languages. For instance, in IT, the word ‘business’ refers to the work the IT system supports, namely, the bedside care clinicians provide. But to a clinician, ‘business’ refers to non-clinical things that support bedside care, like IT.

In addition, I provide physician leadership and oversight to the eHealth office, which administers new technology initiatives such as ClinicalConnect. And, to ensure the sustainability of our sites, I advise hospital leadership on our growing computer and electronic needs.

“Motivation in this role is a lot different than motivation at the bedside.”

What keeps you motivated at work?

Motivation in this role is a lot different than motivation at the bedside. With direct patient care, you get immediate payoff, every day. The patient is right there in front of you, responding to your care and it’s immediately gratifying.

This role, however, is very much about delayed gratification. The rewards are far reaching and broad in scope, but they take a much longer time and require a lot more work to realize. And sometimes, they don’t. But the prospect of making a difference on such a large scale, and setting the stage for improvements that will continue to evolve for years to come, that’s very exciting to me. It’s the reason I do the job.

What made you enter your field of work?

As an intensivist, I was surrounded by numbers and data from so many different sources. Most of the job is about continually assessing multiple factors at the same time. I always liken it to the green digital rain in “The Matrix” with all the numbers cascading down the screen.

I got interested in the computer’s ability to combine all of this and analyze it for us, starting with an electronic flow sheet. This morphed into a more general interest in electronic workflow and how these systems can take on some of the more mundane work for us. Ultimately, that will help prevent us from making mistakes and improve the quality of care we deliver.

I realized we are just at the beginning of a revolution and I wanted to be part of it. I also enjoy listening, communicating and building consensus among colleagues, which is a large part of the job.

“I got interested in the computer’s ability to combine all of this and analyze it for us.”

Tell us about your most gratifying experience at HHS.

I have lots of powerful memories from the PICU, but in this CMIO role, I would have to say it’s been order sets. Order sets are related orders, such as tests and treatments, which a doctor can place with a few keystrokes or mouse clicks. Combining these into a set allows users to issue prepackaged groups of orders that apply to a certain diagnosis or a particular period of time. It saves time and standardizes care. In terms of bringing evidence and best practice to the bedside, I think this is the most impactful things we’ve ever done on a broad scale. It’s knowledge translation in action.

We’ve achieved a lot of consensus and standardization of care. The sets became a powerful tool for quality improvement at HHS. We currently have over 520 sets, with continuous upgrades and improvement happening every day. I’m quite proud of this work.

It will be even more exciting when we can start using them in a computerized provider order entry system, a way for medical instructions to be entered electronically. We can then take advantage of electronic checking and cross-referencing with our integrated decision support team to prevent us from making errors.

A MRI technologist stands in portrait

Introducing… a MRI technologist

Naya Zaiyouna is a senior MRI technologist based at McMaster Children’s Hospital. She has been with Hamilton Health Sciences for 15 years.

What do you do?

As a senior in the area, I have a few roles. I prepare patients for their MRI scans. Preparation involves a full MRI safety screening and initiating IVs when required. I also scan patients and work closely with radiologists to triage any inpatient requests.

I am responsible for the workflow of the day, providing data that ensures we achieve ministry guidelines. MRI safety is a big part of my job. I provide MRI safety training to any hospital staff that may visit our department.

What do you love most about your job?

I enjoy working with children. There are challenging aspects with pediatric patients and MRI. The scanner is sensitive to motion and noisy, and the process can be long.

This can be a bit challenging when you have a child who is scared just to go into the MRI room. Because of these circumstances, I developed specific skills to work with our young patients so they ultimately leave happy and proud of their accomplishment.

Who inspires you?

My mother is my greatest inspiration. I saw her face her own personal challenges, which she always saw as opportunities to make a difference. She taught me to always see the positive in all people and in all situations. I apply those values every day.

As stressful as some days may be, I accept the challenge and work through it by either resolving it on my own or reaching out to my team. I also make time to celebrate the achievements.

What is the biggest challenge in your role?

My biggest challenge is to ensure all the patients (inpatients and outpatients) complete their scans within the correct time frame. We have one scanner and it can be hard to manage several requests.

The good news is I have a great group of colleagues and we work together daily to solve any problems.

A library technician stands in portrait

Introducing… a library technician

Sandy Culley is a library technician with staff library services in the clinical practice and education department at Hamilton Health Sciences (HHS). She has been with HHS for 22 years and is based at Juravinski Hospital and Cancer Centre.

What do you do?

I provide access to high-quality information to our staff, doctors and learners in support of best practices for patient care, education and research.

I help people focus on what’s most relevant to them. Then, I help them use the appropriate resources to retrieve that information. Our team provides database search instruction, document retrieval and runs mediated literature searches. We ensure our electronic resources are easily accessible and manage HHS’ library collection.

What do you love most about your job?

I love the multifaceted and collaborative nature of my job. Though my library colleagues and I are not on the front lines, we work behind the scenes to support the different health care teams across HHS.

“We make it easier to get quality health information and move evidence-based practice forward.”

From locating journal articles for patient care, to running a comprehensive literature search for a quality improvement project, to providing staff instruction on how to navigate the resources on our clinical reference library. Every day is interesting.

It’s quite gratifying to see how our efforts apply to clinical practice and have an impact on decision-making. I am proud to know I make regular contributions by making it easier to get quality health information and move evidence-based practice forward.

What is your biggest challenge?

One of the biggest challenges in the library is to ease information overload. There is so much information published on a daily basis.

For example, every year, half a million citations are added to PubMed, a global database of medical and life sciences references. You can imagine how keeping up-to-date in the literature is a daunting task for anyone involved in health care.

“We aim to provide the right resources at the right time.”

The library services team advises on the most appropriate resources or methods. A point-of-care tool, like DynaMed Plus, provides synthesized, evidence-based information and sends practice changing alerts. Or, we also recommend a customized monthly literature search.

We help find the best option to meet your information needs and keep you current in the literature.

What’s one thing people would be surprised to learn about your role?

It might surprise people to know we borrow and share resources with libraries across North America. This happens thanks to our involvement with the Hamilton and District Health Library Network, which includes McMaster University and St. Joseph’s Healthcare Hamilton. We aim to provide the right resources at the right time.

A medical radiation technologist stands in portrait

Introducing… a medical radiation technologist

Kathie Lock is a senior medical radiation technologist at the CIBC Breast Assessment Centre at Hamilton Health Sciences’ (HHS) Juravinski Hospital and Cancer Centre. She has been with HHS for 30 years.

What do you do?

I work with an extraordinary group of health professionals including radiologists, residents and fellows, surgeons, geneticists, nurses, technologists and clerical staff as well as our wonderful volunteers.

I obtain any relevant medical history for the patient, handle their imaging and present findings to the radiologist for review. We rapidly discuss and determine outcomes and whether further imaging is needed.

We see women and men with breast-related health concerns as well as a large number of screening patients through the Ontario Breast Screening Programs and the Juravinski Cancer Centre. Our centre was designed to streamline the process from symptom to diagnosis and surgery, if needed.

“The patients we work with inspire me daily.”

What do you love most about your job?

What I love most is to work with such a dedicated team. Everyone here understands how important their role is and how vital the imaging is to get a proper diagnosis.

The combined team effort and discussion leads to us providing the best patient care, tailored for each individual patient. Knowing we have the support of all the skilled members of our team keeps us coming back every day.

Who inspires you?

The patients we work with inspire me daily to ensure we provide the imaging and information needed to assist with diagnosis. They guide us with their issues and concerns. Answering their questions and alleviating their fears to the best of our ability is very important.

What is your biggest challenge?

One of the biggest challenges is trying to accommodate all of our patients and their concerns as quickly as we would like. As our centre grows and our patient population expands, we are constantly looking at the most efficient and professional ways to care for them. We evolve as a team, striving to provide best care for all.

A mental health care professional stands in portrait

Introducing… a child and youth mental health nurse

Mike Percival is a registered nurse with Hamilton Health Sciences’ (HHS) child and youth mental health program. He works with patients who are admitted to McMaster Children’s Hospital (MCH) and has been with HHS for two years.

What do you do?

I work with a strong team to provide care for youth with complex mental health concerns. We establish effective therapeutic relationships to assess the risk of patients and manage crisis situations.

What keeps you motivated at work?

My biggest motivation is definitely the support and encouragement I receive from the great group of individuals with whom I work at MCH. Teamwork is very important on the unit, as mental health can be a challenging environment.

Another motivating factor is the opportunity for personal growth and career development. Since I started working here, I have trained in the emergency mental health assessment unit and taken on leadership roles such as a charge nurse.

“Working with youth and adolescents in mental health was a natural extension of my experience working with vulnerable populations.”

What made you enter your field of work?

Prior to nursing, I was involved with research that included direct work with clients. I realized I enjoyed that interaction. Nursing felt like a great career path that also offered an opportunity to interact directly with clients.

Nursing also gives me the opportunity to use my research skills to enhance patient care. Working with youth and adolescents in mental health was a natural extension of my previous experience working with vulnerable populations. I worked with a non-profit community service that provided social and recreational activities for children with special needs.

What do you hope to accomplish while at HHS?

Given the increased recognition of the need for mental health services, I hope to make meaningful contributions to the field through research and innovation.

For example, our unit frequently observes the connection between substance use and mental health. We believe there are many opportunities to improve the care for clients who use substances. I also want to recruit, instruct and retain talented individuals to the field of pediatric mental health.

A neurologist stands in portrait

Introducing… a neurologist

Dr. Barbara Connolly is a neurologist based at Hamilton General Hospital and assistant professor at McMaster University. She has been with Hamilton Health Sciences (HHS) for five years.

She also completed a fellowship in movement disorders at the University of Toronto from 2011-2013 and her neurology residency at McMaster from 2006-2011.

What do you do?

As a neurologist and movement disorders specialist, my practice focuses on evaluating and managing patients with neurological disorders that affect movement. This includes Parkinson’s disease and other causes of tremors, Huntington’s disease and other causes of chorea, dystonia, ataxia, myoclonus and tics.

What do you love most about your job?

I love my job because it is intellectually challenging and diverse. There are regular new developments in the field, which keeps my work interesting and exciting.

It is gratifying for me to address the wide variety of concerns and issues my patients have to help them optimize their quality of life. I tend to treat patients with chronic diseases, so I get to know them and their families over time, which is also very rewarding.

“I treat patients with chronic diseases, so I get to know them and their families over time.”

Who inspires you?

I am inspired by my mentor, Dr. Anthony Lang, a brilliant and world-renowned movement disorders specialist. He continuously maintains his expertise by keeping abreast with new research. He also helps the specialty move forward by participating in international committees and programs. At the patient level, he consistently thinks outside of the box when it comes to figuring out the cause of unusual symptoms.

‘What would Tony do?’ runs through my mind when I face a challenging case. He grew his clinic into a leading movement disorders treatment, research and training facility. I hope to do the same thing here at HHS.

What is the biggest challenge in your role?

The biggest challenge in my clinical role is making sure I can offer the best support possible for my patients, who have chronic and debilitating diseases. There are many disciplines and roles required to provide the best care, not just in the hospital, but in the broader community. By enhancing their quality of life, we can greatly impact symptom control and disease progression.

A clinical research student stands in portrait

Introducing… a clinical research assistant

Samantha Burwell is a student who also works as a clinical research assistant with the perioperative ischemia research team at Hamilton Health Sciences’ (HHS) Juravinski Hospital and with St. Joseph’s Healthcare Hamilton. She spent the last two summers with HHS and now works part time while studying nursing at McMaster University.

What do you do?

My team runs or is involved in many research studies at any given time. Recently, I worked on two studies: the HIP fracture Accelerated surgical Treatment And Care track (HIP ATTACK) trial and the Atrial Fibrillation Occurring Transiently with Stress studies.

As a clinical research assistant, I approach patients and explain the study to see if they want to participate. If so, I help answer their questions and get their consent. I also complete any follow-up appointments they have with us, usually over the phone. All the data I collect is analyzed once the study is over.

“My first day at Hamilton Health Sciences was a terrifying blur but was also exciting. It was my first day ever working in a hospital.”

What do you love most about your job?

I love working as a student in research because there are endless learning opportunities. There is always something new happening.

I meet several patients with different backgrounds and work with talented people every day. My job introduces me to the many different roles that exist throughout the hospital, which enriches my experience overall.

Who inspires you?

Each person working in a hospital makes a difference in patients’ lives. The reason I study nursing is so I can help people and make the same difference my colleagues make.

In my research role, I am part of a great team that could change and improve the life of a patient in the future. Even if it is in a small way, it inspires me to think I am a part of change.

Tell us about your first day at HHS.

My first day at HHS was a terrifying blur but was also exciting. It was my first day ever working in a hospital. I had not started any of my placements at school yet and the most experience I had in health care before this job was the occasional doctor’s appointment.

I got a tour of the hospital (and immediately forgot how to get anywhere) and was introduced to so many people that I couldn’t remember all their names. Each person I met was kind and helpful. Throughout the day, I tagged along with my boss and observed staff members’ daily routine, which included patient encounters.

My first day was really set the tone for a job that I grew to love.

A medical laboratory technologist stands in portrait

Introducing… a medical laboratory technologist

James Pearce is a medical laboratory technologist in the clinical chemistry and immunology laboratory at Hamilton General Hospital. He has been with Hamilton Health Sciences (HHS) for over 30 years.

What do you do?

I analyze patient samples including urine, plasma, whole blood and various other fluids for the presence of hormones, drugs of abuse, therapeutic drugs, metals and other elements, antibodies and various proteins.

What do you love about your job?

Over the years, my role as a technologist has changed. I began my career in the blood bank, now known as transfusion medicine. The most gratifying part of that job was supplying blood products for trauma patients coming in through the emergency department then to the operating room and intensive care unit. I knew then I played a significant role in saving that person’s life.

Later, I worked in hematology where I spent lots of time looking down a microscope at blood smears. Identifying various diseases was quite rewarding. I also collected peripheral blood samples from inpatients. Patients are always top of mind. I tried to make the venipunctures—the collection of blood from a vein—as pain free as possible and hopefully get the patient to smile.

Now that I am in clinical chemistry, working on somewhat more obscure testing, the reward comes from accurately and efficiently completing large numbers of tests.

“I knew then I played a significant role in saving that person’s life.”

Who inspires you?

Several of my colleagues work well into their 60s, sometimes beyond. I’m inspired by their love of lab work.

I used to have the mindset of working only up to my early retirement age. Since I started working in clinical chemistry, I have a regular routine and work with great people every day. Now, I’m part of that group of people who loves their work so much that I hope to be like my older colleagues who work beyond the typical retirement age.

What’s one thing people would be surprised to learn about you?

I’m not trying to blow our own horn, but we have an extremely in depth understanding of medicine. When we have conversations about health and medicine with people outside HHS, the amount of medical knowledge my colleagues and I have amazes them.

What do you hope to accomplish while at HHS?

I hope to finish my career with the proud knowledge I did the best I could. That I helped many patients recover, taught students and possibly motivated others to do the same.

A pediatric radiation therapist stands in portrait smiling.

Introducing… a pediatric radiation therapist

Melanie Carrigan is a pediatric radiation therapist based at Hamilton Health Sciences’ (HHS) Juravinski Cancer Centre (JCC). She has been part of the pediatric team at JCC since its inception in 2010.

What do you do?

My job is to plan all aspects of the radiation and treatment process for children and young patients. I guide our families through the initial stages all the way through treatment and assessment, which includes providing education. Most of our patients come through HHS’ McMaster Children’s Hospital, so my role is also to liaise with the various departments at that site.

What do you love most about your role?

What I love the most is how much I learn every day. My drive to be a life-long learner allows me to provide high quality and compassionate services to patients and their families. I am quite proud of developing a pediatric patient handbook specific to our unique shared care setting. I also helped produce a video that showcases a child’s journey through the pediatric radiation process.

Each child brings a new challenge, which helps me to improve for the next child. I thrive on employing new strategies and using appropriate language geared to children and their families.

“It is a privilege to offer patients knowledge, experience, hope or someone to just simply play with.”

What keeps you motivated?

Working with children, particularly those who are ill or terminal, can be difficult. But, it is humbling and rewarding on a personal level.

I am absolutely driven to assist our families during what is likely to be the most difficult circumstance they will face in their lives. If I can help in any way to streamline the process, I am determined to make it happen.

It is a privilege to offer patients knowledge, experience, hope, a distraction, someone to coordinate appointments between multiple centres, listen to them, offer a shoulder to cry on or just simply play and have fun with them. These kids are so brave and strong, I am in awe of how they cope every day.

What is the biggest challenge in your role?

For someone who cares for patients with cancer, particularly children, managing the emotional effects in a healthy way is a challenge. Ultimately, if they can do this, so can I.

I saw a quote from Rawsi Williams recently about nursing, which resonated with me: “To do what nobody else will do, in a way that nobody else can do, in spite of all we go through.” That’s what it feels like to work in a field focused on childhood cancer.

Some days are unbelievably hard, but some of my best days are here with these amazing, resilient kids.

A healthy workplace coordinator stands in portrait.

Introducing… a healthy workplace coordinator

Melissa Cummings is a healthy workplace coordinator who has been with Hamilton Health Sciences (HHS) for less than a year working on the health, safety and wellness team. She is the key contact for HHS’ Shine wellness program. Everyone in the organization may know her as the person who helps you de-stress with the popular massage clinics.

What do you do?

I develop programs and create opportunities to promote health and wellness for our HHS employees. These programs may include Shine educational presentations on wellness topics, fitness classes and special events. I also design wellness content for the Shine website and newsletters we send to our employees.

There are two projects where I supervise students including the stretch break program and the healthy cafeteria project. I regularly connect with contracted benefit and service providers, and internal and external wellness stakeholders to develop and deliver programming. Data analysis and reporting are also part of my role. There is always something on the go and every day is different.

It’s wonderful to hear about the positive impact the Shine program has on our people’s health and well-being.

What do you love most about your job?

I love connecting with our people to talk about their personal wellness. Listening to their success stories and their ideas for programming are big benefits of my job. It’s always wonderful to hear about the positive impact the Shine program has on an individual’s health and well-being. We spend a lot of time at work, which makes it the ideal setting to support the wellness of our staff, physicians and residents.

Tell us about your most gratifying experience at HHS.

There are too many to count. I’ve received numerous positive comments from my colleagues via email, at onsite events and phone calls expressing their gratefulness and appreciation for the Shine program. It truly touches my heart. I’m so fortunate to be part of such a caring organization that wants to see others succeed and be well.

I want to help sustain a healthy workplace culture.

What do you hope to accomplish while at HHS?

I’m currently revamping the Shine program to increase engagement so we can sustain a healthy workplace culture. I constantly search for and tweak programming to adhere to best practices and make it more convenient for staff to get involved.

I would love to establish wellness committees at all our sites. More staff should be involved in how we deliver programs that will be the best fit for them and their colleagues.

How do you use social media in your role?

Social media is a great tool that allows me to let staff know about all the wellness opportunities around HHS. You can follow me on Twitter @mmcummings91.

A nurse practitioner stands in portrait

Introducing… a nurse practitioner

Usha Chauhan is a nurse practitioner in the adult digestive disease clinic at Hamilton Health Sciences’ (HHS) McMaster University Medical Centre (MUMC). She has worked at HHS since the late 1970s including some time away to work in the community until her return in 1989.

She trained in the United Kingdom (UK) as a registered nurse and midwife before immigrating to Canada where she furthered her education including a Master of Nursing and an acute care nurse practitioner diploma.

What do you do?

My primary focus is on patients with inflammatory bowel disease (IBD). Since I returned to HHS close to 30 years ago, I worked in gastroenterology as a study coordinator for numerous sponsored and investigator initiated drug trials, including upper and lower functional gastrointestinal disorders and gastric pacemaker studies.

As a nurse practitioner, I see IBD patients in the nurse practitioner-led clinic. I also work with the gastroenterologist to offer phone advice to IBD patients. I also conduct nurse-led research.

What made you enter your field of work?

I wanted to be a nurse since I was very young. In my community, as an Indian in the UK, this job was viewed as a dirty job. My mother supported my decision and encouraged me to pursue my aspirations. She always had an answer to anyone who made any negative comment by saying, ‘who will take care of you when you are sick in the hospital’.

Initially I started in the gastroenterology field because I could work during the daytime. As the years went by, I learned a lot about IBD management and how it affects patients’ lives.

My physician partners give me an opportunity to excel in my role.

What’s one thing people would be surprised to learn about your role?

When I started nursing school at age 18, I was told by a matron I would not enter the registered nurse program. She felt I would not complete the program as I only had a basic secondary school diploma.

I had to achieve an advance level high school diploma in three subjects—English, math and science—within the first six months of starting the program. Since then, I was the only person who graduated from my class with a dual degree. I continued to work hard to earn my master’s degree to allow me to work as nurse practitioner.

Who inspires you?

Firstly, my family. They do not complain when I work long hours, both at the hospital and while at home doing various committee and research work.

Secondly, my physician partners, who encourage me to excel in my role at HHS. They provide an opportunity to be involved at the local level and on a global scale to provide IBD care and to conduct nursing research.

What do you hope to accomplish while at HHS?

To date, I achieved a lot personally and professionally with all the committee work within and outside HHS.

I received two grants, including one from HHS to conduct nursing lead research studies. Four years ago, I played a key role in establishing the Canadian Nurses Inflammatory Bowel Diseases Group.

I also co-authored articles in a peer review journal, an IBD nurse consensus guideline, practice guidelines, as well as presented abstracts as oral and poster presentations locally, nationally and internationally on the work we do at HHS. Recently, I wrote a book chapter on the clinic model in IBD care.