Crocheted wigs on styrofoam heads

WLMH colleagues crochet for cancer

At work, they collect and analyze samples in the lab at West Lincoln Memorial Hospital (WLMH). At home, they ravel and loop yarn into charming garments for kids in cancer treatment. The West Lincoln Memorial Hospital Crochet for Cancer group has woven an incredible bond through their love of crochet and helping kids.

Inspired by an American organization, The Magic Yarn Project, Kim Mischuk, a registered laboratory technologist at WLMH, asked her colleagues if they’d be interested in starting a similar effort. She had six eager volunteers, with more than 100 years of crochet experience between them.

five women standing behind their crocheted wigs

“We’re a very tightly knit group,” Jackie MacCuish, another member of the group, jokes. “Or tightly, crocheted, I should say.”

a young girl in the hospital wearing a while Elsa wig

Using a basic crocheted hat as a base, the women craft everything from beanies to elaborate wigs. Favourites include Elsa from Frozen, Jack Sparrow from Pirates of the Caribbean, and Rapunzel. They try to appeal to both kids and teens, with a wide variety of hats and wigs to choose from. Depending on the complexity of the design, the pieces take anywhere from three to well over five hours to make. Jackie says colleague Svetlana Micovski is by far their most prolific crafter, crocheting the bulk of the complex wigs.

“It’s a wonderful feeling”

The time that goes into each wig is well worth it when they see the joy it brings to a child in cancer treatment. They’ve been lucky to receive a few photos from grateful parents, which they cherish. For children who have lost their hair during cancer treatment, the wigs can be both comforting and uplifting. They bring colour and whimsy during long, hard days.

The group has donated a batch of wigs to McMaster Children’s Hospital, and just sent 25 wigs to Childhood Cancer Canada, a charity that supports children with cancer, and their families. They have even sent wigs as far as Newfoundland. Jackie’s friend in St. John’s requested a wig for her granddaughter, and it was such a hit that they shipped a batch out east for her peers at Janeway Children’s Health and Rehabilitation Centre.

“It’s a wonderful feeling to know we are adding a little bit of joy to these kids’ lives during a difficult time,” says Jackie.

Learn more about WLMH Crochet for Cancer on their Facebook page.




Matthew Bueckert at McMaster Children's Hospital

A lifelong battle with cancer at the age of eight

Eight year old Matthew Bueckert loves Lego, climbing trees, and playing tag and ball hockey. He especially loves when he gets to go to school, which unfortunately, isn’t as often as he’d like. Matthew is battling leukemia.

When Matthew was two and a half, he had terrible unexplained fevers on and off for a month. His pediatrician suspected cancer, and referred him to McMaster Children’s Hospital (MCH) right away.

“My heart sank,” says Valerie Bueckert, Matthew’s mom.

Matthew’s care team at McMaster Children’s Hospital explained to his parents the test results, the disease and treatment options, which included a clinical research trial.

Advancing treatments for childhood cancer

MCH is part of Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium, which includes 11 North American institutions as well as the Children’s Oncology Group, made up of over 200 children’s hospitals from across North America and beyond. As part of these groups, MCH teams works with other hospitals on clinical trials to advance cancer care in children.

“Working with other hospitals allows us to find better treatment options for our patients.”

“Working with other hospitals allows us to find better treatment options for our patients,” says Dr. Uma Athale, Matthew’s oncologist at MCH. “Through another partnership with the Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium a trial was available for patients with the exact leukemia Matthew has. We were offering it to our patients, so we presented it to his parents as an option.”

There are many different types of childhood cancers, and some of them are quite rare. For that reason, each individual hospital doesn’t see enough cases of each type to run a clinical trial alone. With hospitals working together, children can participate clinical trials that otherwise wouldn’t be available to them. This has helped childhood cancer survival rates increase drastically.

Considering a clinical trial

“The idea of a clinical trial was a little scary at first,” says Valerie. “The first thing that came to mind is that I didn’t want my child to be the guinea pig. But, on the other hand, why wouldn’t we want access to a treatment that may be better.”

The family learned that if a patient enters a clinical trial and they continue to worsen, they are not required to continue and can be switched to the standard of care treatment at any point in time.

Since leukemia can progress rapidly, it was important for Matthew to begin treatment as soon as possible. That meant his parents needed to make a decision quickly. It’s entirely up to the patient and family to select a clinical trial treatment method.

“We could have flipped back and forth on a decision for weeks, but since we only had a couple days we really focused on the facts,” says Valerie. “When it came down to it, the clinical trial wasn’t that much different than the standard of care and it had the possibility to be more effective. So, we went with the trial.”

It’s entirely up to the patient and family to select a clinical trial.

After the 25 month trial, Matthew went into remission at the age of four. He was back to his outgoing self.

Two years later, Matthew’s white blood cell counts started dropping and eventually the fevers returned.

“Matthew was under the watchful eye of McMaster Children’s Hospital, so when the same symptoms started to return we all jumped into action,” says Valerie.

Matthew’s leukemia had officially returned in December of 2017.

Hopeful despite a relapse

“The original clinical trial Matthew took part in provided conventional chemotherapy with slight variations. When he relapsed, we needed to consider a different, more targeted type of treatment,” says Dr. Athale.

There was another clinical trial available to MCH patients as part of the Children’s Oncology Group that included targeted immunotherapy. Immunotherapy works with the immune system to fight off the cancer cells. It is customizable, which made it a good fit for Matthew.

“Because of the immunotherapy component we said yes right away to this trial.”

“Since the last trial was so similar to the standard of care we knew another trial was the best option to go with this time around,” says Valerie. “Because of the immunotherapy component we said yes right away to this trial.”

Matthew is now just over half way through his treatment. When he’s feeling well enough, he goes to school and plays outside no differently than his older siblings and friends.

“For now, no news is good news, because it means nothing concerning has shown up in his test results. Although each day can be different, we’ve been happy to enjoy the good days,” says Valerie.

Thanks to the great support of Matthew’s team at MCH, the whole family is staying positive and hopeful.




a CT scan showing the case of calcium around Herve's heart

Heart excavated from calcium shell

A heart of stone. When Dr. Richard Whitlock looked at Herve Ndikuriyo’s scans, that’s what he saw.

“His heart was basically encased in calcium,” says Dr. Richard Whitlock, a heart surgeon at Hamilton Health Sciences. “On the CT scan, it looked like it was wrapped in bone.”

A bad case of a rare condition

Herve’s is one of the worst cases of constrictive pericarditis Dr. Whitlock has seen in his career. The condition causes calcium deposits to build up in the sac around the heart, often infiltrating the heart muscle itself. Bit by bit, the calcium creates a hard casing around the heart muscle, squelching its ability to beat and pump blood throughout the body.

“They said surgery was the only way to fix it.”

Herve, who came to Canada in 2013 as a refugee from Burundi, had no idea this constrictive armour was the cause behind symptoms he had been experiencing for months. Painful swelling in his legs had forced him to quit his factory job after standing for long periods became unbearable. He found work driving a school bus instead, but the swelling in his legs only continued to get worse.

Herve demonstrates the size of his legs before the procedure

“I knew something was wrong, but I didn’t know what it was,” says Herve.

He went to the hospital, and a chest x-ray revealed the problem. The calcified growth appeared on the scans like a layer of bone.

“They said surgery was the only way to fix it,” recalls Herve.

World class surgery in his own backyard

He was referred to Dr. Whitlock, who takes on specialized and challenging cases. Herve was nervous, but understood the condition was putting a great deal of strain on his heart. His heart was failing, and as a result, blood was backing up into his legs. The swelling had become so bad he had to use his hands to lift his legs in and out of the car.

During surgery, Dr. Whitlock and his team carefully excavated the calcium that surrounded Herve’s heart. He had to delicately remove each fragment without damaging the heart muscle. Herve was placed on a heart and lung machine operated by a perfusionist so blood could be diverted around his heart while the team worked. Of the many Dr. Whitlock has performed, he had never had to use the heart and lung machine before.

“This was the toughest case of this I’ve done,” says Dr. Whitlock. “It was very challenging to get everything freed up, but we did.”

When Herve was taken off the heart and lung machine, his heart began beating for itself, and Dr. Whitlock could see that it was already stronger.

New heart dreams big

Since his surgery, Herve has continued to regain strength, and his legs have nearly returned to their normal size. He still has a long recovery ahead, but he is eager to get his life back and pursue his dreams.

“I want to go back to school and start a career in health care,” he says. “Seeing everything the staff here do, it’s inspiring.”

Dr. Whitlock is happy Herve is finally able to put his ‘heart of gold’ to use.

Dr. Whitlock and Herve stand together in the hospital




Ron Gardner next to a portrait of his brother, George.

Experiencing world-class cardiac care

A devastating phone call ultimately saved Ron’s life.

Ron Gardner from Burlington was planning a trip to Florida to visit his brother George, who played for the Vancouver Canucks as the team’s first goaltender. Before making the trip, Ron got a phone call informing him that George had died after suffering a massive heart attack.

After the results of George’s autopsy were released, Ron learned that they both suffered from a hereditary and life-threatening heart condition – a bicuspid aortic valve. The risk of the condition being inherited by a family member is as high as 89 per cent, making screening of family members important.

The cardiac journey begins

After a referral from his family doctor, Ron began his journey with the cardiac team at Hamilton General Hospital (HGH). Test results indicated Ron would need open-heart surgery, but he was healthy enough to delay surgery at the time.

“I probably would have died if I’d walked another 100 steps.”

Several months later, Ron was golfing in Vancouver when he dropped to his knees in pain.

“The sensation was like ‘pushing back the darkness’ as I tried desperately to catch my breath,” says Ron. “Upon returning to Hamilton, the cardiac team at HGH told me I probably would have died if I’d walked another 100 steps.”

The rapid progression of Ron’s symptoms meant the time for open-heart surgery had come.

A positive endorsement

One of Ron’s close friends with connections to healthcare systems in Toronto offered to facilitate a transfer to a Toronto hospital. To Ron’s surprise, the friend called back a few hours later with a glowing endorsement of HGH.

“Physicians he contacted in Toronto told him that HGH was one of the best cardiac facilities in Canada. Given a choice, they would want to have open-heart surgery at HGH.”

Within four weeks of his surgery at HGH, Ron was back to work.

Ten years later

A decade after his surgery, Ron continues to praise Dr. Victor Chu, as well as the cardiac and ICU teams at HGH for saving his life.

“I proudly tell people that we have a world-class cardiac program so close to home.”

Funding Innovation

Ron is the president of Funding Innovation, which is a Hamilton Health Sciences Foundation Care4 cause marketing partner. Funding Innovation operates an art easel program at businesses across the region and in Hamilton Health Sciences sites. Please consider bidding on a print when you spot an easel with the Hamilton Health Sciences Foundation logo, as proceeds will support The Foundation.




Up Close: Cogeneration Plant

Six, giant 18 cylinder engines in the cogeneration plant are what keep the lights on and heat circulating at McMaster University Medical Centre. Six engines, and a team of engineers and tradespeople who make sure they stay functional around the clock.

Cogeneration plants recover the “waste heat” that is otherwise discarded in conventional power generation systems. Instead of heating air and water directly with natural gas, the gas is used to power six engines that create electricity. The heat from these engines supplies an intricate system, and transfers energy for water heaters, building heat, and air conditioned cooling.

The net result is cheaper power, even with fluctuating prices for natural gas and electricity supplied from the local grid. 

Juravinski Hospital and Cancer Centre and Hamilton General Hospital also operate cogeneration plants.

In this Up Close series, take a look underground at the machines and engineers that keep the hospital running.

If you enjoyed this photo set, have a look at other collections in the Up Close series:

Biomedical Technology

Open Heart Surgery

Prosthetics and Orthotics in Motion

Trauma Team Response




Dr. Sne running a test of the LaparoGuard technology in the operating room

New equipment aims to make surgery safer

Advancements in technology have greatly aided in making many procedures and surgeries safer for patients. This includes laparoscopic surgery, which has become a common approach over the past 40 years for a variety of surgical procedures.

In laparoscopic surgery, a long, slim tool is inserted through small cuts into the abdomen. The tool is equipped with a very small camera and light on the end. Additional instruments are inserted through a similar technique. Images from the camera are fed to a screen, and the surgeon carries out the procedure by watching their movements on the screen. It’s used for many procedures including gall bladder removal, hernia surgery and colon resection.

Dr. Sne testing the LaparoGuard system

There’s still room for improvement

As a minimally invasive surgery, the incisions are much smaller. This reduces the patient’s risk of infection and significantly reduces the hospital length of stay, overall leading to a faster recovery.

Despite the benefits laparoscopic surgery offers, there is still room for improvement. Since surgeons are working within a much smaller space, it can sometimes be tricky to keep their multiple tools within a clearly defined safe zone. This can result in unintentional minor injury to surrounding tissues. The injury is often recognized and treated when it occurs, but if it goes unnoticed it can eventually cause complications.

Finding solutions with technology

To tackle this problem a local medical device company, Mariner Endosurgery, has developed a new device called LaparoGuard. It allows surgeons to identify and create a safe zone that the surgeon must stay within during laparoscopic procedures. If the instruments unintentionally move out of the safe zone, Laparoguard sends an audio and visual signal to the operating team.

After rigorous testing and approvals, the equipment is ready to pilot in a research trial at Hamilton Health Sciences (HHS).

LaparoGuard uses innovative image-enhancing technology, similar to what’s used in a fighter jet.

“We’ve come a long way in terms of the safety and precision of minimally-invasive surgery in recent years,” says Dr. Niv Sne, trauma surgeon at HHS and principal investigator for the LaparoGuard trial. “Still, no surgery is without its risks. This trial may present surgical teams with a more advanced option to conduct laparoscopic procedures with even fewer risks to the patient.”

LaparoGuard uses innovative image-enhancing technology, similar to what’s used in a fighter jet. It’s described by the makers as augmented reality without a headset. LaparoGuard is installed in one operating room at Hamilton General Hospital for the pilot, which begins in the next few weeks.

LaparoGuard tools being used in a test at the Hamilton General Hospital

“We’re excited to be working alongside Dr. Sne and the surgical teams at Hamilton Health Sciences,” says Mitch Wilson, president & chief operating officer of Mariner. “Their extensive experience conducting laparoscopic procedures and their interest in exploring new technology to improve patient safety and surgical precision is invaluable.”

A collaborative team

This collaboration between HHS and Mariner Endosurgery is one of the projects funded by Health Ecosphere, an innovation pipeline program that assists in commercializing health solutions. This, along with a grant from Hamilton Health Sciences Foundation, helped make this trial possible.

“Now we’ll use feedback from HHS surgeons to ensure it’s efficient for the team that’s using it.”

The surgeons at HHS’ Hamilton General Hospital are excited to explore the new technology.

“At this point we’re confident LaparoGuard can help make laparoscopic surgery safer for patients. Now we’ll use feedback from HHS surgeons to ensure it’s efficient for the team that’s using it,” says Mitch. “We’re looking forward to the results.”




Wesley and his grandfather in the pool

RJCHC helps kids Get Wet ‘N Fit in the pool

Swimming is one of 7-year-old Wesley David’s favourite things to do.

Since he was five, he has been participating in triathlons: swimming with his life jacket, cycling on an adapted bicycle, and using his walker for the running portion of the race.

Wesley was diagnosed with a brain tumour at 13 months old. He later had a stroke related to his treatment and has had ongoing physiotherapy ever since.

His physiotherapist at Ron Joyce Children’s Health Centre (RJCHC) heard about his hobby and suggested he get involved with a new program called Get Wet ‘n Fit.

Wesley and his grandfather in the pool

Get Wet ‘n Fit is a community-based pool program for clients of RJCHC with diagnoses including but not limited to muscular dystrophy and cerebral palsy. The six-week program was held in partnership with the City of Hamilton at Westmount Recreation Centre.

The program was initiated by physiotherapists KC Chavez and Janet Mannen and occupational therapist Brooke Wardrope in the Developmental Pediatrics and Rehabilitation (DPR) program at RJCHC and supported by volunteers. Volunteers allow more children to access these programs by providing one to one support in the water.

“Overall, there is a mutual benefit as volunteering not only enriches our services, but provides meaningful experiences for those who give back,” said Brooke.

Morgan Lewandowski was one of the volunteers who expressed gratitude for being able to participate in the program. She said, “It made me happy to see all of the children having so much fun as well as getting so much exercise. This was one of the most impactful experiences I have had so far and I am beyond lucky to have been a part of it.”

Card that Morgan gave to the program organizer
Volunteers like Morgan enriched the program and were provided with a meaningful experience.

During the program, children worked through their treatment plans as well as group exercises like stretching, range of motion exercises, and some cardiovascular conditioning.

“Each child had individualized goals to progress through which were developed based on their functional levels. A balance challenge was conducted in the first and last sessions to assess stability and strength against challenging variable currents,” said Brooke.

“Group activities provided an opportunity for children to interact with each other and develop peer relationships.”

Wesley’s grandpa Lark can attest to the benefits of the program. He was often in the water with his grandson, while grandma came to watch.

Wesley in the pool with his grandfather

“The program got the kids excited and that excitement promotes exercise. That exercise is the therapy they are looking for,” said grandpa.

Since starting the program, Wesley’s balance has improved as well as movement in his legs. Plus, he gets more physical exercise with the assistance of the water.

Wesley’s grandma Connie said it was wonderful to watch Wesley in the pool because he was able to walk, run, splash, and play without the use of his wheelchair or walker.

“It looked like there were no limitations. He was like any other 7-year-old.”

Although the program has completed until the next session dates are released, grandma and grandpa still take Wesley to Westmount Recreation Centre’s “family swim” to make use of the location’s accessible features.

Wesley gets to spend quality time with his grandparents while getting the added benefit of physiotherapy – all the while enjoying one of his favourite activities. It’s a win-win.




Marilynne Adair crochets a scarf

Stroke survivor crochets for her health, and her community

A former Hamilton Health Sciences patient is turning her passion into productivity. Marilynne Adair’s crochet hobby has become a way for her to improve hand strength after a stroke, and give back to the community.

She experienced a stroke seven years ago. It caused serious weakness in her right arm. An avid crocheter, she set a rehabilitation goal of regaining her ability to crochet. To get even stitches, a crocheter must hold the yarn and needles with consistent tension. Practicing this skill helped Marilynn rebuild the strength and agility in her arm.

A reason for her rehab

When she learned about a project at Hamilton General Hospital (HGH) that provides warm, winter accessories to people in need, her hobby went into overdrive. HGH’s Mitten Fence is located in the hospital’s front courtyard. Donations of hats, mittens, and scarves are collected in bins around the hospital campus. They are then hung on the fence to be taken by people in need.

“Since we started this initiative three years ago, we’ve distributed hundreds of items to people in our community,” says Ann Higgins, senior consultant on improvement, innovation and alignment at HGH. “As an anchor organization in a high-needs area, we know how important it is to care for our neighbours beyond their medical needs. This is just one small way that we’re able to do that.”

“Anybody can benefit from it”

When asked about her crochet skills, Marilynne confidently shares that she is just as good as before her stroke. “Maybe even better,” she says. “I’m doing much more of it now.”

To date, she has donated more than 60 items to the mitten fence, an accomplishment she didn’t think possible in her early recovery. Jennifer Robinson, who was Marilynne’s physiotherapist at HHS’ Regional Rehabilitation Centre after her stroke, and is now clinical manager of the Stroke Rehabilitation Program, is proud to see her doing so well.

“She really set her mind to achieving this, and it’s wonderful to see her skill benefit people in need,” Jennifer says.

Still seeking donations

Donations of clean, new or gently used items are always needed. Donation bins are located outside the gift shop in Hamilton General Hospital, and the lobbies of the Regional Rehab Center, David Braley Research Institute, and Ron Joyce Children’s Centre.

Marilynne encourages people to give. “Anybody can benefit from it. It makes me feel good.”




blurred photo of a patient in a wheelchair

Optimizing patient flow to improve outcomes

Patient flow is a complex, behind-the-scenes dance that happens at hospitals.

You need the right people, in the right place, at the right time. For patient flow to function best, patients need to be placed with the most appropriate clinical team in the most appropriate area of the hospital. This improves efficiency and ensures patients get the expert care they need.

Optimizing patient flow

A project at Hamilton General Hospital and Juravinski Hospital and Cancer Centre is looking at how we can do this better, focusing on general internal medicine (GIM) patients. GIM patients commonly include people with pneumonia, diabetes, heart issues, and chronic obstructive pulmonary disorder (COPD) to name a few. It is the largest group of adult patients at Hamilton Health Sciences (HHS).

When admitted through the emergency department, patients are assigned to a doctor, and a room. Each doctor works on a specific team, and that team of doctors and staff is assigned a location within the hospital. The crux of the project is simple: place patients assigned to the same doctor in the same area of the hospital. The intent of geographically locating patients based on their care team is to enable better communication between staff, patients, and families, and to reduce the number of clinical units doctors must visit each day to see their patients. But in a large system with many factors at play, this is a highly complex undertaking.

Many steps on the way to success

To tackle such a challenging task, the GIM group and clinical teams started by taking stock of current processes across all the different units where they care for patients. This gave them a better sense of what needed to change, and established a baseline so they could track their results.

They’ve updated their procedures to make it easier for each doctor’s patients to be grouped together, using strategies like standardized communication rounds. Grouping each team’s patients together more consistently results in a number of benefits. It creates opportunities for impromptu discussions among care teams, and makes families more comfortable approaching doctors with questions. It also improves learning for medical students and residents, since they have more opportunities to communicate with families and colleagues.

The project is still in early stages. The team is tracking several different measurements to gauge success, including percentage of patients grouped together, length of patient stay, and patient and staff satisfaction.


Strategy in Action story contest graphicThis story was selected as a winner in our Strategy in Action contest, which asks teams across Hamilton Health Sciences to share how they are putting our strategy into practice.

This initiative supports Operational Excellence, one of four strategic directions identified in Hamilton Health Sciences’ Strategic Plan. Operational Excellence is about aligning strategy, systems, tools, and culture to continuously improve value for patients and families.

 




A nurse checks a patient's blood pressure

Making room for more patients in Oncology Day Services

Oncology Day Services (ODS) is a bustling unit at Juravinski Hospital and Cancer Centre. They care for cancer patients who aren’t currently hospitalized, but need ongoing support such as chemotherapy, blood transfusions, and IV therapies. In recent years, they have begun to see even more patients, and offer even more procedures. To meet increased demand, they are using creative strategies to build capacity and accommodate more same-day appointments.

“We have a really engaged group of staff, and they were eager to get involved,” says Susan Duong, clinical leader of ODS. “Staff shared ideas for how we could improve our workflow to see patients in a timelier manner.”

Finding creative ways to reduce backlog

ODS uses Hamilton Health Sciences’ Continuous Quality Improvement (CQI) system to address issues and identify opportunities for improvement. The system encourages bottom up solutions by giving frontline staff the tools they need to make change. Using the CQI tools, ODS staff set out to improve the number of patients they can accommodate in same-day appointments.

“Many of the patients we care for are quite sick,” says Karen Robinson, clinical manager of ODS. “By making room for additional same-day appointments, we avoid backlog in the emergency department. We’re also able to reduce the need for overnight hospital admissions.”

When a patient is able to get a same-day appointment in ODS, they can go straight to the unit for their care, rather than waiting to be admitted through the emergency department (ED). This reduces overcrowding in the ED. Additionally, it creates a more pleasant experience for the patient.

“We wanted to find solutions that would last”

At the outset of their project, ODS set a goal of adding five additional same-day appointments to their schedule each day. In order to achieve this goal, they assessed their current processes to find room for improvement.

“We thought about the problem strategically,” says Susan. “We wanted to find solutions that would last, so we tackled the problem one step at a time.”

Saving time and finding space

The team zeroed in on two main ways to add capacity: finding new and creative uses for space, and implementing time-saving technology.

To create new clinical space, the team converted underused office space into exam rooms. They also created a new protocol where patients return to the waiting room while they await blood work results. This frees up valuable space for other patients to be treated.

A nurse presses a button on his communication device

They harnessed the power of technology to work more efficiently by purchasing five new portable workstations, along with a set of hands-free communication devices that function like sophisticated walkie talkies. Thanks to the new technology, less time is spent sourcing and inputting information.

Feedback helps improvements stick

The team has been tracking their progress by integrating additional feedback from staff to refine the changes they’ve made. This feedback loop is a core part of solving problems in the CQI system, and helps ensure improvements stick. So far, both staff and patients have responded positively to the changes.

“We’ve had really good uptake,” says Susan. “People are using the technology and the new protocols. This is allowing us to treat people faster, and make time and space for more appointments.”

The project is still young, and the team sees lots of opportunity for further improvement. They’re proud of how far they’ve come in the past year. Most of all, they’re glad to know they are improving patients’ lives every day.


Strategy in Action story contest graphic

This story was selected as a winner in our Strategy in Action contest, which asks teams across Hamilton Health Sciences to share how they are putting our strategy into practice.

This initiative supports Operational Excellence, one of four strategic directions identified in Hamilton Health Sciences’ Strategic Plan. Operational Excellence is about aligning strategy, systems, tools, and culture to continuously improve value for patients and families.




A doctor intubates a mannequin while two nurses assist

Pediatric simulation prepares staff for pint-sized patients

The emergency department at Hamilton General Hospital (HGH) doesn’t often see very sick pediatric patients. Generally, children are brought to McMaster Children’s Hospital (MCH), which is specifically designed as a Children’s only emergency department. Sometimes, very sick or badly injured children are brought to HGH because they need immediate help, and MCH is too far to go.

“Sick pediatric patients aren’t common here,” says Dr. Kyla Caners, an emergency doctor at Hamilton Health Sciences, who is based at HGH. “This was highlighted as an area where we could be a little bit more efficient, and our staff wanted to feel more comfortable managing these patients.”

Practicing on pediatric mannequins

The team decided to use simulation training to identify small inefficiencies in the way they handle emergencies with children. Participants gather around a child-size mannequin and are briefed on the “patient’s” symptoms and condition. They begin patient care, and the simulation leader updates them with new information along the way. To make the experience authentic, they use real-life scenarios and the mannequin is attached to monitors that track its vital signs. Afterward, they debrief and identify issues and possible fixes.

“We like to make these scenarios as real as possible.”

“We like to make these scenarios as real as possible,” says Kyle Glover, an education and development clinician in the HGH emergency department. “They really work well to reveal problems in our systems and setups. So where equipment is stored, barriers around how patients are moved around the department, how our transfer of accountability is given.”

Watch the video to learn more about this initiative

Using CQI tools to track progress

The team uses Hamilton Health Sciences Continuous Quality Improvement (CQI) system to strategize around these improvements, and track their progress. They are able to test-drive potential solutions before implementing them by running another simulation. If the changes are successful, they roll them out across the department. If they’re not, they tweak the solution until it works.

Each individual solution may seem small, but together, they can make a big difference to patient care. The simulations have helped the team identify several issues so far, and have also given staff and doctors a chance to polish their pediatric skills.

“This is about both process and practice,” says Dr. Caners. “By trying to identify ways we can improve our process, we are also, by chance, giving our staff time to practice for patients that they may not otherwise see on a regular basis.”

Expanding pediatric simulation

The initiative has expanded to the Main West Urgent Care Centre, and will soon be launching in the emergency department at Juravinski Hospital and Cancer Centre. Monthly simulations will take place at both these locations, in addition to the emergency department at HGH. Ultimately, the team hopes to bring pediatric simulation training to a broad range of units across Hamilton Health Sciences.


Strategy in Action story contest graphicThis story was selected as a winner in our Strategy in Action contest, which asks teams across Hamilton Health Sciences to share how they are putting our strategy into practice.

This initiative supports Operational Excellence, one of four strategic directions identified in Hamilton Health Sciences’ Strategic Plan. Operational Excellence is about aligning strategy, systems, tools, and culture to continuously improve value for patients and families.




Sky rides an adaptive tricycle in a courtyard at McMaster Children's Hospital

Adaptive tricycle makes exercise fun

When 17-year old Sky was diagnosed with cancer, she dreaded the long stay in hospital. She has acute myeloid leukemia, which requires six months of intensive chemotherapy. Between May and December, she spent almost no time at home.

“It was really hard,” Sky says. “I knew there wasn’t anything I could do to change it, so I decided to keep a positive mental attitude.”

Maintaining muscle during cancer treatment

During her stay, Sky worked with a physiotherapist so she could keep as much of her strength as possible. Intense cancer treatment can make physical activity very tiring, and it was often difficult for Sky to get out of bed. Physiotherapist, Mindy Broersma, would take her for regular walks around the hospital to get her moving.

“Sometimes I felt like I was just dragging her out of the room,” says Mindy, joking about Sky’s reluctance. Luckily, during her stay, Sky found a way to exercise that was much more enjoyable for her.

The Hamilton Health Sciences Volunteer Association funded the purchase of a specialized reclining tricycle that can be adapted to suit different needs. Mindy and her colleagues applied for funding because they saw a gap in the tools they were able to use with adolescents and teens.

“We would ride it all around the halls

“We had small trikes for little kids, and stationary bikes, but we needed something that would work in between,” Mindy says.

The adaptive tricycle was just what Sky needed.

Enjoying activity again

“We would ride it all around the halls, and it was fun!” she says. “When I was walking I felt like I could only go for a little while because I got so tired, but I could keep riding that bike for laps and laps.”

Mindy assists Sky on the adaptive tricycle

Mindy says physical activity is proven to be beneficial during cancer treatment, so she and her colleagues try to make it enjoyable for patients. “Research shows that exercise isn’t harmful during chemotherapy and radiation,” she says. “And studies have shown that people in exercise programs have fewer complications, and less chance of relapse.”

Sky is now home and doing well. She says the chance to use the tricycle during her treatment motivated her to exercise, and that kept her strength up.

Mindy is grateful for the Volunteer Association’s support so patients like Sky, and those in other programs can benefit from the adaptive tricycle. “Because it’s not a necessity, it’s not in our typical budget, so this support is so important.”

DID YOU KNOW? All profits from purchases made at Hamilton Health Sciences Volunteer Association (HHSVA) Give Shops, cafes, cafeterias, catering, and parking services are donated to enhance patient care at HHS. The HHSVA is a non-profit organization which operates retail and parking services across the Hamilton Health Sciences (HHS) family of hospitals. Throughout the year, HHSVA supports HHS by purchasing much needed patient care equipment, and providing funding for education and patient care programs. In many cases, traditional funding means do not support these purchases and programs, so the HHSVA’s support is very important.