2015 Professional Advisory Committee Annual Report of the Health Disciplines
Professional Advisory Committee Report of The Health Disciplines
Overview Professional Advisory Committee Vision: “As leaders in professional practice we are committed to making a difference in people’s lives through collaboration, accountability, and integration of excellence in professional practice that promotes clinical care, education and research across St. Joseph’s Healthcare.”
The mandate of the Professional Advisory Committee (PAC) is to advance and support both discipline specific and interdisciplinary professional practice at St Joseph’s Healthcare Hamilton (SJHH). The PAC is comprised of twenty health professional disciplines and corporate members. The disciplines include regulated professions recognized under the Regulated Health Professions Act and the Social Work and Social Services Work Act, and unregulated professions that meet the requirements of the committee. Each discipline has a Professional Practice Lead. The responsibilities of the Professional Practice Lead (PPL) and PAC are to:
Ensure standards of care, education and research are based on best practices; and meet relevant policy, regulation and legislation; Provide leadership in change processes and ongoing quality improvement; Represent professional practice issues in decision making at SJHH; Enhance the profile of SJHH with external agencies; Support recruitment and retention of excellent professional staff; Contribute to the achievement of the strategic directions for SJHH. Support recruitment and retention of excellent professional staff; Contribute to the achievement of the strategic directions for SJHH.
In 2015, the PAC continued their work focusing on strategic priorities for St. Joseph’s in Hamilton by ensuring a continued alignment of the activities with strategic goals and focusing efforts on corporate projects. This report while highlighting alignment with our strategic priorities, also is highlighting the strength of our interprofessional focus. In collaboration with Human Resources the Professional Practice Leaders/Advisors continue to update generic position descriptions to support hiring. The PAC played a key role in several information service projects, the Digital Order Sets project and ensured Accreditation requirements were integrated into each practice group to support our Accreditation Review. The following PAC report and discipline specific reports are intended to summarize the important and valued contribution of the PAC and the health professional disciplines at St. Joseph’s Healthcare Hamilton and to demonstrate how the work of the PAC supports and is aligned with the strategic priorities of St. Joseph’s in Hamilton. If you have any comments or questions we would be delighted to speak with you. Jane Loncke, Chair, PAC Monica Alderson, Vice-Chair, PAC Helen VandeMark, Vice-Chair, PAC
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
Table of Contents: PAC Achievements
4
Interprofessional Education Report
7
Interprofessional Research Report
11
LEAN Events
20
Health Professionals Excellence in Practice Awards
21
Discipline Reports Addiction Services
25
Audiology
29
Cardio Pulmonary Technology
32
Clinical Nutrition
35
Diagnostic Services
38
Dialysis Technology
41
Medical Laboratory Technology
44
Nursing
49
Occupational Therapy
72
Peer Support
81
Pharmacy
84
Physiotherapy
89
Polysomnography
98
Psychology
101
Respiratory Therapy
114
Social Work
118
Speech-Language Pathology
124
Spiritual Care
129
Therapeutic Recreation
136
Vocational Services
141
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAC
ACHIEVEMENTS
PAGE
4
PAC Achievements Quality and Safety
TOA is defined as an interactive process of transferring client specific information from one caregiver to another or from one team of caregivers to another for the purpose of ensuring the continuity of care and the safety of the client.
Transfer of Accountability Transfer of Accountability (TOA) is a Required Organizational Practice (ROP) from Accreditation Canada. The PAC continued to audit these practices as appropriate within each discipline and reported these outcomes. Hand Hygiene Audit Review and Response PPLs took responsibility for discipline specific results and required actions to improve performance. Health Records Committee Participation This committee went through a transformational process to ensure that it was assisting In the dissemination of information about how coding of the Health Record translates to our funding and encouraged the interprofessional understanding and participation in ensuring fulsome documentation of the patients journey so coding would reflect the intensity of the care required by our patients. Digital Order Sets The digital order sets project is a project intended to transition the ordering process to a digital product to improve patient safety by ensuring legibility. With the inclusion of order sets themselves, integration of best practices will be achieved. The PAC has established a rapid review process to ensure there are no practice gaps in the process. PAC involvement has ensured integration of best practices, communication and adoption. The project moved into general operations with PAC involvement well established. Two Patient Identifiers The PPLs ensured communication about this Accreditation requirement among all disciplines to ensure compliance. Human Resources Core Job Descriptions Projects: The PPLs have been working in collaboration with Human Resources to complete the development of discipline job descriptions that reflect professional requirements and duties. Dissemination of Accreditation Monthly Updates to Professional Groups Interprofessional Policy Development Reported Sexual Assault Accreditation Self Assessment Survey Results related to Patient Safety Culture PPLs reviewed the results of the organizational self assessment related to Patient Safety Culture to determine the interpretation of results and potential initiatives to improve. Home First Refresh Enterprise Risk Management PPLs were subject matter experts for Policy and Procedures, Credentialing and Competencies PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAC
ACHIEVEMENTS
PAGE
5
Change
Leadership Participation in Policies and Procedures Project To fast track policy approvals prior to Accreditation, PPLs led this project to expedite updates.
Document Management Scanning Project The hospital embarked on a document scanning project of current paper health records to ensure that documentation is available electronically. The PAC provided representation to evaluate bids during the RFP process. To prepare for implementation, the project required everyone to submit forms so they could be recognized by the system and indexed properly. To ensure a thorough index of documentation forms were appropriately collected and indexed by Health Records to support the scanning project. The Professional Practice Leaders collected forms and sample records and properly identified their purpose and place in the health record. Practice Leaders ensured forms were updated to meet facility standards.
Patient Link: The PPLs continue to establish the standards of documentation for each discipline to continue to guide outpatient documentation builds.
Community
LEAN Event The professional practice leaders coordinate and support an Annual LEAN event to promote continued development.
PAC Excellence in Practice Awards PAC Members lead and coordinate an awards ceremony celebrating professional practice excellence.
Professional Practice Network of Ontario PAC is a member of the PPNO and participates in provincial scans and queries about professional practice issues or queries.
Welcomes to New Leaders
Website Development The PAC developed a method of creating a space on the hospital website to share professional practice information and updates.
Mental Health Wellness & Engagement Committee Participation
Engagement Survey PPLs provided with discipline specific survey results to stimulate review and conversations about how to improve or maintain engagement.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAC
ACHIEVEMENTS
PAGE
6
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
Interconnection
Integrated Medical Leadership Model for SJHH and NHS PAC participated in the evaluation of this Leadership model and participation in Recruitment and Orientation of the New Chief of Staff
Discharge Checklist Review and Dissemination The Discharge Checklist was reformatted as part of a HNHB LHIN initiative to improve it as a communication tool for family practitioners and patients. The Health Records committee embarked on expanding it to also function as a way to capture the coding information required for coding of the patient’s journey in our programs. The need for this comprehensive coding was rolled out to the PAC and the role of other health professionals to add to the discharge summary enhancing the ‘ richness of the information supporting funding maximization.
Standard of Practice for Transitions across St. Joseph’s in Hamilton – St. Joseph’s Home Care, St. Joseph’s Villa, St. Joseph’s Healthcare Hamilton PAC reviewed, disseminationed and endorsed the Best Practice Adoption for The Standard of Practice for Transitions
PAC Goals 2016: Website Development for PAC and Health Disciplines Continued Educational Events including LEAN events, sponsoring practice knowledge with OHA webcasts, yellow belt lean training, emerging leaders education Continued participation representing professional practice in Clinical Transformations related to Clinical Documentation. The new clinical documentation system touches on many areas of practice that will require PAC expertise from the RFP, to the foundational structure, the build, implementation, change management and maintenance.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
7
Interprofessional Education Subcommittee/Coordinator Achievements
“Clinical Pastoral Education (CPE) is one of the most important courses I have taken during my seminary studies. Thank You for this opportunity to learn about myself and others in an environment that was new to me.”
The Learners Committee created a collaboration site on MyStJoes where all documents are shared to support common frameworks and practices. Affiliation database has transitioned to the collaboration site, with affiliation agreements scanned and archived online for easier access by all coordinators. A working group is meeting to respond to the new Bill 18-expansion of worker definition and rights to unpaid learners. Bill 18 passed on Nov. 20, 2014. It affects the Occupational Health and Safety (OH & S) Act and the Workplace Safety and Insurance Act. The goal of the group is to identify required OH &S training for learners and determine how to deliver and track the training. The orientation handbook that is online is being revised to include content required for Bill 18. Interim measures for disciplines has been reviewed with PPLs until a corporate process is completed. A complete checklist is also being developed and strategies to keep records are being developed. Learner orientation and evaluation surveys were transitioned from previous Vovici software to new FluidSurveys. This transition occurred in Jan. 2015. New links have been posted online. Orientation quizzes are now printable so learners can print them and bring them to their supervisor at the start of placement. Academic Placement Coordinator provided an update to PAC in June and a further information presentation on affiliation agreements in Dec. 2015 Meetings with the research group and the coordinators have occurred to develop a learner algorithm and process path for research learners. A research learner policy is being developed by the Research Institute. Learners who require access to EPIC-electronic documentation system for placement are registering for this via email and receiving the training before or at the beginning of their placement. The Learners Committee completed an Enterprise Risk Management exercise in 2015 for risk management as it relates to learners. Student placement processes were enhanced for nursing students in the mandatory pre-placement completion of e-learning programs for Infection Prevention and Control and Falls Hand hygiene compliance by nursing students has improved. A standardized process for distribution of Security Swipe Cards has also been developed to support student access to controlled areas.
Clinical Placements
SJHH is an Academic Teaching Hospital affiliated with McMaster University and Mohawk College. The PPLs assist in the coordination of learner placements for their disciplines including facilitation the available learning opportunities and pre-placement orientation, ensuring standards are met, and assisting with concerns for learners or preceptors. Across all the health disciplines, SJHH provided clinical learning experiences for learners in 2015. The impact of this facilitation is as follows: PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
INTERPROFESSIONAL EDUCATION
PAGE
8
Total Number of Learners by Discipline 800 700 704
600 500 Number of Learners 400 300 262
200 100
1
5
14
23
34
18
35
7
6
43
15
6
36
1
1
12
26
0
Professional Advisory Committee Disciplines
Total Hours of Clinical Placements
959
2015
Addiction Services
174218
Medical Laboratory Science
1665
830
Medical Radiation Science
35 40 247
Occupational Therapy OTA/PTA 997
Physiotherapy
Pharmacists 1,931
185 761
Pharmacy Technician Psychology Registered Dietitians
205 120 1,080
Respiratory Therapy
Social Work 247
1,649
Social Services Worker
Additional nursing student placements have been facilitated through the expansion of opportunities into increasingly diverse and specialized clinical practice areas (such as the Chest Unit), and further expansion into outpatient and clinic settings. Increasingly, we are also exploring innovative opportunities to enable student placements, such as splitting a group placement between two similar units when that is appropriate, and routinely scheduling group placements on weekend days. Internationally trained nurses enrolled in the BIEN Program were provided with student placement opportunities in increasing numbers throughout 2015. “Absolutely great opportunity to come here. I learned a lot from the RT’s. It was a great facility, wouldn’t change this experience for the world!” PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
9
INTERPROFESSIONAL EDUCATION
Interprofessional Education Our General Internal Medicine Program has a structured interprofessional program that run once annually which include the following: 1. Student Orientation Booklet - This is a reference guide to all of the interdisciplinary team members and their respective roles. It outlines each discipline's scope of practice, role on medicine, when and how to refer, and how to connect on the unit. 2. Case Facilitated Review - Learners come together during a formal meeting time to discuss 2-3 patients within medicine. Students discuss their role with the patients, learn about the other disciplines' roles, explore ethical and legal dilemmas, discuss barriers to communication etc. The purpose is to increase each student's knowledge of other health care disciplines while also working on self-reflection, communication, conflict resolution, shared decision making and trust. Discussion is facilitated by Therapeutics clinician representatives. 3.
Rapid Rounds – Medical learners are introduced to interprofessional case management and presentation during rapid rounds.
Interprofessional On-Line Evaluation Learners are requested to complete an on line evaluation of their placement.
Why did you choose St. Joseph’s for your Clinical Placement?
SJHH is an excellent learning institution with dedicated staff and a safe and supported learning environment for new nurses. I have previously had a nursing placement with the inpatient psych unit at St. Joseph's Hospital in level 2, and it was a very positive learning experience. St. Joseph's Hospital is an environment that is known to be supportive to students and professional learners. The history and culture that still exists in the system. My past experience of a wonderful team and working environment. Long standing history of excellence in patient care and I want to be part of it .St. Joseph's Hospital is an environment that is known to be supportive to students and professional learners. The history and culture that still exists in the system. My past experience of a wonderful team and working environment.“ “From my past experience on being placed with the organization, St. Joseph's workers have a positive approach in terms of a student's learning. The workers are very resourceful and knowledgeable which helps my learning as a student nurse. They are also very accepting and friendly making my placement more enjoyable. “
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
INTERPROFESSIONAL EDUCATION
PAGE
10
Education Subcommittee Goals 2016 Quality & Safety
Update all PAC Education Policies -- Learner, Job Shadow, Clinical Trainee. Continue to work toward standardization of processes related to learner on boarding.
Change
Ensure learner needs are integrated into new Health Information System build and process access and orientation. Continue to advocate for learner access to e-learning opportunities for generic orientation and training. Implementation of Bill 18 Orientation Checklist and Maintenance of Records with ready access if there is concerns for learners.
InterConnection
Ongoing renewal and creation of affiliation agreements
Affiliation Agreements: Ontario Institutions: Other Canadian Institutions: American Institutions:
43 11 6
“St. Joseph's Healthcare Hamilton is a unique place for clinical research, where the academic knowledge directly blends with the community healthcare improvement. i feel it is an excellent environment for me getting my clinical practice in the clinical research field at St. Joseph's, I like the C.A.R.E. commitment to patients and Research HELP. It's really a great learning opportunity to visualize all steps taken in preparing, finalizing, REB submission, conducting, monitoring, analyzing, and reporting the clinical research project. “
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
11
Interprofessional Research Subcommittee Achievements
Development of Award Submission Evaluation Criteria Evaluation of First Submissions Monitoring First Three Projects and Awarded Two Further Projects
The PAC Research Awards The Professional Advisory Committee (PAC) Research Award Program is designed to support health professionals engaging in independent research activities at SJHH. Through the generous support of the SJHH Research Institute, these awards are aimed to foster ongoing research activity conducted by professionals from across the health disciplines, facilitate initial pilot data to support future external research funding applications, and serve as a catalyst to take new research ideas to action. This year, the Research Committee coordinated the review of 9 excellent submissions. All submissions were in the experienced researcher category. Nine submissions were from psychology and one submission was from physiotherapy. No mentor supported new researcher submissions were received. Each submission was reviewed by a PAC member and a researcher from SJHH/ McMaster. The 2015 Research Award winners were:
Dr. Irena Milosevic Evaluation of Exposure Plus Safety Beahviour for Contamination-Related OCD Dr. Matilda Nowakowski A Pilot Study of Cognitive-Behaviour Therapy for Irritable Bowel Syndrome and the Gut Microbiome
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
12
INTERPROFESSIONAL RESEARCH
Discipline Research Participation Discipline
Research Proposal Development
Research Data Collection
Principle Investigator
Research Funding Received
Addiction Services CardioPulmonary Technology Clinical Nutrition Dialysis Technology Medical Laboratory Science Nursing Occupational Therapy Peer Support Pharmacy Physiotherapy Polysomnography Psychology Respiratory Therapy Social Work Spiritual Care Therapeutic Recreation
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
INTERPROFESSIONAL RESEARCH
PAGE
13
Interprofessional Research
PPL: Partnership with Boris Research Centre to promote the integration of research into clinical practice. A publication that highlights the Concurrent Disorder program has been submitted. Womankind: Significant contribution to the Withdrawal Management Standards document that was recently updated and published. Womankind: Research Group looking at Integrated Treatment for Pregnant Women – 2 staff on the advisory panel. CD Out-patient: In partnership with the Boris Research Centre, a battery of screening and assessment tools has been implemented. Ethics approval has been received. The battery will be used for clinical advancement and future research. Build advanced concurrent disorder skills through education and professional development. Relationship with the Boris Centre to increase the opportunities for the integration of research into practice Support for the INSPIRE (Implementing a National Smoking Cessation Program in Respiratory Clinics) Ottawa Model for Smoking Cessation program in Firestone Institute 1 Dietitian advancing PhD work on “The role of amniotic fluid growth factors in fetal overgrowth” Project of painting/disguised door on the ALC unit to reduce agitation, responsive behaviours and exit seeking. We are still gathering data re: it's effectiveness. BRAVE study. Contributed to the proposal for the BRAVE Trial: A pragmatic randomized trial to investigate the effectiveness of BehaviouRal ActiVation group therapy in reducing dEpressive symptoms and improving quality of life in patients with depression. (occupational therapy, psychiatry, social work, psychology, therapeutic recreation, nursing) “Pushing Limits” study. Adventure-Based Therapy ( occupational therapy, therapeutic recreation, psychology, social work) Nordic Walking – continuing to develop this new program “Up and Out” and initiating research study with Anxiety Treatment and Research Centre (in progress) – with therapeutic recreation, psychology, psychiatry Development of Tinetti for Dementia ongoing PAC supported research. Evidence Based Practice Projects: McMaster (Faculty of Health Sciences) to supervise student research activities within the Concurrent Disorders unit with OT leading the 4 students throughout the project titled “A Study of the Concurrent Disorders Unit at St. Joseph’s Hospital (West 5th Campus)” Eight students, research/quality assurance projects in Schizophrenia Services EPVENT2 trial: A randomized controlled trial of ARDS patients comparing two methods of mechanical ventilation. Ongoing assistance with a GE study by performing arterial line insertions in study participants. Start and completion of the SENIOR mechanical ventilation weaning assessment trial Pharmacy residents and pharmacists were lead investigators in the following two research studies: - Evaluating the Short-term Sustainability of Benzodiazepine Receptor Agonist Discontinuation Following Discharge from a General Internal Medicine Program: A Prospective Observational Study - An Evaluation of the Impact of Digital Order Sets on the Quality of VTE Prophylaxis in Hospitalized Medicine Patients The Physiotherapists on MSK are currently involved in a study assessing the benefits of Fascia-iliaca Nerve blocks for THR patients. The Physiotherapy role is to assess mobility POD 0 and POD1 and report results (distance and limiting factors) to the study nurse. The Incentive Spirometry study on Thoracics Completed Juravinski and General ICU bike install meetings (Jan 13/14, 2015; March 26/27, 2015) PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
INTERPROFESSIONAL RESEARCH
PAGE
14
Ongoing collaboration with cardiology at the Hamilton Health Sciences and McMaster University in a multi-centered clinical trial in heart failure patients. Ongoing co-facilitation and data collection of Cool Running Forensic Research Project by multiple OT and TR staff across 6 forensics programs REB # 12-3660 Co-investigator, Project Title: Investigating the mediators of therapeutic effectiveness of a thirteen-week running program in a group of adolescents with depressive disorders REB # 14-042 Co-investigator, Project Title: A pragmatic randomized trial to investigate the effectiveness of Behavioural Activation group therapy in reducing depressive symptoms and improving quality of life in patients with depression (pilot) REB #14-611 Co-investigator, Project Title: A pragmatic randomized trial to investigate the effectiveness of Behavioural Activation group therapy in reducing depressive symptoms and improving quality of life in patients with depression: (main study) REB #14-611 Co-Principal Investigator, Project Title: Pushing Limits – Adventure Based Therapy in Persons with Mood Disorders (ongoing) Motor Vehicle Accident Study - Emergency COPD-Mepo, NIH / CAT, pDCs & IL-33, Optima, Activate, TCZ001, B cell & IL2, Reslizumab Studies Respirology CR0012 Study - Pediatric Gastroenterology Gut Microbiota Study, Motility & Gluten Sensitivity Study- Gastroenterology Protocol SPO994, SP0993 - Neurosurgery HPV in HIV, MK0578-292, CARMA-2, MK-0518-292, MK1439-018, MK1439A-024, AbbVie M14-004, Epic, Positive Brain Health Now Studies- SIS MK-5592-069, BMS Protocol AI443-102 MK-8228-011 Studies- Infectious Diseases PAUSE, Cochicine, Reverse AD Studies, - ThrombosisRASP Study - Arrhythmia Service TIMI 54 Study, SIRS 116 Study, ACCELERATE, COMPASS, TIPS 3, Amgen 20110118, Amgen 20120138, GUIDE-IT, THEMIS, TRICS III Studies, Thrasos, GAUSS Protocol 20120332, Cantos, Tosca-5, Odyssey Studies Cardiology VIPS, Xyntha, T1DM Study, PREPAReS Study, GENA-05, CSL654_3003, Bayer 13400, GENA21b, NN79993895, DU1766-A-U157, FADE, CR-AIR-007 Studies- Hematology & Transfusion Medicine Vision Study, POISE II Study, MANAGE Study - Dr. P. Devereau TrialNet Studies, PCS2, AstraZeneca D3461C00004, BMS IM128-027 Studies, – Pediatrics COIN, EPVent 2 Studies– Critical Care REMIT, Rewind Studies – Endocrinology PKU 015 Studies – Genetics CIHR B-HIP Study, DFC B-HIP Study – Nutrition Services Protocol GE180 Study, CPD-1028 – Nuclear Medicine Fluid Study, HEMO-Tin, GSK BEL115466, Biovision, HOSTTime, Study 416858-CS4 – Nephrology ValenTX Study, ACM CSL830_3002, Peanut Study – General Medicine Family Study, ABC Study, CONCEPTT, AEGEA Vapor Study, ACM Study UL1208 – Obstetrics/Gynecology INOXT and Riluzole Studies - Psychiatry Continued support of clinical internal research studies at the four acute care hospital sites through Clinical Research and Clinical Trials Laboratory. This laboratory also provided complete central laboratory testing for many national and international studies, as well as contracting to provide specialized testing for other research studies. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
INTERPROFESSIONAL RESEARCH
PAGE
15
Prat, S., Losier, B. L., Moulden, H. M., & Chaimowitz, G. A. (in press). Incapacity of the mind secondary to
medication misuse Nowakowski, M.E., McCabe, R.E., Rowa, K., Pellizzari, J., Surette, M., Moayyedi, P., Anglin, R. (in press). The gut
microbiome: Potential innovations for the understanding and treatment of psychopathology. Canadian Psychology. Zhang, Y., Montoya, L., Ebrahim, S., Busse, J.W., Couban, R., McCabe, R.E., Bieling, P., Carrasco-Labra, & Guyatt,
G. (2015). Hypnosis/relaxation therapy for temporomandibular disorders: A systematic review and meta-analysis of randomized controlled trials. Journal of Oral Facial Pain Headache, 29, 115-125. Oremus, C., Oremus, M., McNeely, H.E., Losier, B., Parlar, M., Hasey, G., Hall, G.B.C., King, M.The ECT & Cognition
Systematic Review Team, Lanius, R. & McKinnon, M. (2015). Effects of Electroconvulsive Therapy on Cognitive Functioning in Patients with Depression: Protocol for a Systematic Review and Meta-Analysis, British Medical Journal, BMJ Open 2015;5: e006966. doi:10.1136/bmjopen-2014-006966 Nazarov, A., McNeely, H.E., Kiang, M., Lanius, R. & McKinnon, M. (2015). "Role of morality in the experience of
guilt and shame within the armed forces". Acta Psychiatrica Scandinavica, 1-16. Tobon, J.I., Reid, G.J., Brown, J.B. (2015). Continuity of care in children’s mental health: Parent, youth, and
provider perspectives. Community Mental Health Journal, 51(8), 921-930. DOI 10.1007/s10597-015-9873-5. Reid, G.J., Stewart, S., Zaric, G.S., Carter, J., Neufeld, R.W.J., Tobon, J.I., Barwick, M., & Vingilis, E.R. (2015).
Defining episodes of care in children’s mental health using administrative data. Administration and Policy in Mental Health and Mental Health Services Research, 42(6), 737-747. DOI 10.1007/s10488-014-0609-6 McKinnon, M.C., Palombo, D., Nazarov, A., Kumar, N., Khuu, W., & Levine, B. (2015). Threat of death and
autobiographical memory: A study of the passengers of Flight AT236. Clinical Psychological Science, 3(4):487502. Nazarov, A, Frewen, P., Oremus, C., Schellenberg, G., McKinnon*, M.C., & Lanius, R. (2015). Comprehension of
affective prosody in women with posttraumatic stress disorder related to childhood abuse. Acta Psychiatrica Scandinavica, 131(5):342-9. Nicholson, A., Densmore, M., Frewen, P., Theberge, J., Neufeld, R.W.J., McKinnon, M.C., & Lanius, R. (2015). The
dissociative subtype of posttraumatic stress disorder: Unique resting-state functional connectivity of basolateral and centromedial amygdala complexes. Neuropsychopharmacology, 40(10):2317-26 Williams, M., Becker, S., McKinnon, M.C., Wong, Q., Cudney, L., Steiner, M., Frey, B.N. (2015). Emotional
memory in pregnant women at risk for postpartum depression. Psychiatry Research, 229(3):777-83 Lanius, R., Frewen, P., Tursich, M. & McKinnon, M.C. (2015). Restoring large-scale brain networks in PTSD and
related disorders: A proposal for neuroscientifically-based treatment interventions. European Journal of Psychotraumatology, 27313 - http://dx.doi.org/10.3402/ejpt.v6.27313 Palombo, D., McKinnon, M.C., McIntosh, A., Anderson, A., Todd, R., Levine, B. (2015). The neural correlates of
memory for a life-threatening event: An fMRI study of passengers from flight AT236. Clinical Psychological Science. DOI: 10.1177/2167702615589308 Parlar, M., Frewen, P.A., Oremus, C., Lanius, R.A., McKinnon, M.C. (in press). Dissociative symptoms are
associated with reduced neuropsychological functioning in patients with recurrent depression and a history of trauma exposure. European Journal of Psychotraumatology. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SUBCOMMITTEE REPORTS
PAGE
16
Legislation Subcommittee The Legislation Subcommittee focused discussion this year on the integration and implementation of new legislation as it relates to psychotherapy. The Ontario Government endorsed the need for a new College of Registered Psychotherapists of Ontario and for the recognition of Psychotherapy as a controlled act. The College became a reality this year; however, the act of psychotherapy has not been made a controlled act at this point. Once proclaimed as a controlled act, all disciplines who provide psychotherapy within their current scope, through the registration with the new college or in a new process of delegation will need to be ensuring they are meeting legislated requirements to maintain competency and supervision. Several disciplines including Medicine, Nursing, Occupational Therapy, Psychology and Social Work have this as part of their scope of practice. Other disciplines providing forms of psychotherapy would need to join the College to continue this work once it is proclaimed as a controlled act. Several disciplines which include psychometrists, addictions counsellors, spiritual care, and therapeutic recreation have been consulting with Human Resources about the need to be registered as part of the requirements of certain job descriptions. The Subcommittee has been evaluating all disciplines readiness to adopt new practices related to psychotherapy. The Subcommittee will continue to work towards uniformity of practice and a common understanding across all disciplines as this legislation fully unfolds.
Policy and Procedures Subcommittee In 2015, Members of the Policy and Procedures Subcommittee participated and lead an initiative supporting a streamlined policy updating process to expedite the maintenance and updating of corporate policies. Allergy Skin Prick & Intradermal Testing Policy – policy reviewed and recommended authors review 019-PAC Intro of Clinical Practice Change, New Healthcare Professional, Medical Directive, or Delegation of a Controlled Act 083-Rights Advice Policy – Reviewed and feedback provided to author(s) 104-MED Complimentary Therapy by Privately Employed External Care Providers Protocol – Scan and review of similar healthcare policies completed
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
17
Best Practices Open House St. Joseph’s Healthcare Hamilton’s 9th Annual Best Practices Open House: Best Practices – Research Takes us Forward, was held on February 23, 2015, with approximately 125 people in attendance. The event included both a keynote address and a poster display featuring best practice initiatives currently being implemented across all sites of SJHH. The keynote featured 2 stellar presentations by SJHH staff whose research had been, at least in part, internally funded through a newly developed research funding program designed to increase internal research capacity and support staff in their research activities. The first presentation was by Carrie Bullard, a CNS in the Anxiety Treatment and Research Centre, part of our Mental Health and Addictions Program, and was entitled: Exploring Family Burden in Anxiety Disorders: A Hermeneutic Phenomenological Study. Ms. Bullard presented her findings, which confirmed that the detrimental effects of anxiety disorders are not limited to the individual, but also impact the family of the affected individual. These effects include detrimental impacts to Interpersonal relationships (social and familial), physical and mental health, and financial wellbeing, among others, are compounded by a lack of emotional supports, and can lead to increased social isolation. The need for further research to explore families’ perceptions of how to promote safety and manage risk during transitions to community care, opportunities for earlier identification and intervention, and strategies to improve access to family support programs was highlighted. The second presentation was by Dr. Alison Douglas, an Occupational Therapist in our Seniors Mental Health Behavioural Unit, also within our Mental Health and Addictions Program, and was entitled: Adapting the Tinetti (Balance and Gait) for Persons with Dementia. In this presentation, Dr. Douglas presented her work to modify and test a standardized measure of mobility for use with persons with dementia who may lack the ability to follow instructions. The Tinetti Scale of Balance and Gait was selected for modification as it had established reliability and validity, could be utilized within diverse settings without the need for prohibitively expensive technology, and offered the most promise for use with persons with dementia. The reliability of the modified measure was high, and use of the tool will enable assessment of functional changes in this population to determine the impact of mobilization and least restraint programs. The need for further study to establish the validity of the score for predicting falls risk was also noted. Through both of these presentations, SJHH staff were able to learn about some of the many research activities being undertaken across our organization, and to explore potential opportunities to develop their own potential to conduct research with internal support. Following the keynote, an impressive 60 best practice poster displays highlighted some of the multiple interprofessional best practice initiatives currently in progress across all sites of SJHH. Topics ranged from an overview of our evidence-informed organizational PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
BEST PRACTICES OPEN HOUSE
PAGE
18
approach to pressure ulcer prevention and management to implementation of a c-difficile resource nurse to improve patient monitoring and outcomes, to quarterly results and new learnings in prevention of falls and fall injuries in older adults, to implementing best practice guidelines in diabetic patients with foot ulcers, to implementing best practice guidelines on facilitating client-centred learning, to reducing the risk of catheter-related blood stream infections in hemodialysis patients, to evaluating patients’ and staff perceptions about the care of patients with abuse or trauma experiences, to developing an evidence-based strategy to reduce catheter-associated urinary tract infections, to evaluating patients’, families, and staff experiences with a tobacco initiative in a mental health study, to implementing strategies to reduce pneumonia rates through the introduction of evidence-based oral care procedures, to identify just a few of the many best practice initiatives that were profiled at the event. Event participants declared it an outstanding success, with many identifying the opportunity to hear from our own clinical researchers, and to network with colleagues actively engaged in best practice initiatives, as particular highlights of the event. This annual Best Practices Open House has become a signature event at St. Joseph’s Healthcare Hamilton. It is a welcome opportunity to reflect on and highlight the incredible work that has been done, and to explore additional opportunities for expanding existing work or developing in new directions.
Best Practice Open House Poster Presentations: Akhtar, N. Implementing Collaborative Assessment for Managing Suicidality (CAMS) at the Bridge to Recovery. Alliston, S. Cue-Based Oral Feeding: The Introduction & Progression of Oral Feeding in NICU Special Care Nursery for Preterm Infants. Ambrosini, D., Losier, B. NeuroLaw in Forensic Psychiatry. Andrus, J., Byrnes, B., Dick, R., Fram-Kovar, M., Mounlden, H. Enhancing Quality of Work-Life: You Should Never Stop Having Fun! Barrett, J. Buchanan, M., Chapman. B., Felker, K. Smith, A. M., Stanisz, L. Hand in Hand: Leveraging Nursing Relationships to Optimize Data Quality. Baxter, J., Westover, G., Gojmerac, C. Development of Behavioural Activation Programming in SJHH Seniors Mental Health Service. Bullard, C. Reynolds, J., Szorenyi, J., Swinson, R., McCabe, R. Family Burden and Anxiety Disorders: A Hermeneutic Phenomenological Study. Campbell, M., Frail, J. Growing Gratitude-Positive Psychology for Mental Health Clients. Crowe, A., John, B., Sandhu, S. An Organizational Approach to Pressure Ulcer Prevention & Management. Campbell, B., Fuller, S., Horvath, J., Sanderson, M., Lewis, A., Raymond, H., Filipovic, T. Inpatient to Outpatient and Beyond--Introducing our Warm Hand-Over Model of Care. Daigneault, M., Crispin, D. Engaging Research...Supporting Clinical Practice: A Narrative Journey. DePaul, V.G., Bosch, J., Oczkowski, W., Ferguson, M., Wishart, L. R. Independent Mobility and Physical Activity Training (IMPACT) on a Stroke Rehabilitation Unit: A Pilot Study. Devries,A., Bovard, M. A., Cottrell, L., Maragno, J. Making Clinical Practice Evidence Based. Dick, R., Lee, A., Mahleka, D. Youth Wellness Centre: If You Ask Us, We Will Come. Risk, Legal and Medical Affairs Department. Enterprise Risk Management (ERM) PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
BEST PRACTICES OPEN HOUSE
PAGE
19
Driscoll, D., Furimsky. I., Sanson, T. One Year after DASA Dunn, M. Eyles, P. Listening to Our Clients: Client Satisfaction and Program Evaluation in the Bariatric Program. Evans, C. Ford, P., Ireland, S., MacDonald, A. Howarth, A., Noseworthy, S., Ritchie, S., Dunn, M., Bialachowski, A., Potts, Y. CAUTIon with Catheters: Development of an Evidence-Based Strategy to Reduce Catheter-Associated Urinary Tract Infections. Evans, C., Nieuwstraten, C., Gallina, T., Choi, J., Volman, L., DellaMaestra, N., VanSickle, A. M., Amy Groen, A., Wilson, P., Hastings, M. Supporting Safe Medication Practice through Best Practices: Parenteral Monograph Project Update. Haynes, M. You Can't Smoke Here, But You Can Quit Here. Gaffney, D., Wiseman, B. Vocational Orientation Group. Gardizi, E., Gojmerac, C., King, J. Cognitive Remediation of Memory Difficulties in Mood Disorder. Gatkowski, L., Volman, L., Ireland, S. Shared Core Nursing Competencies for Integrated Clinical Skills: MHAP. Hecker, C., Kilpatrick, S., Steven, J. In the Moment: A Mindfulness Group In the Schizophrenia Outpatient Clinic. Headley, S. Best Practice Guideline Implementation: A Journey on Complex Care for Patients with Foot Ulcers who have Diabetes. Hoogenboom, K., Bialachowski , A., Lee, C. Implementation of a C difficile Resource Nurse to Improve Patient Monitoring & Outcomes. Hudd, L, Eyles, P., Willison, K. APN Role Delineation Survey of NPs & CNS's Working within SJHH. Enhancing Patient Safety through Transfer of Accountability. Ireland, S., Watson, B. & the Falls Steering Committee. Prevention of Falls & Falls Injuries in the Older Adult: Quarterly Results & New Learnings Kirkpatrick, H., Sahr, R. Best Practice Spotlight Organization Since 2006 – Up-Date for 2015. Lee, J. Y., van der Zalm, J., Van Stralen, S., Voigt, P., Wou, L.,. DePaul. V. G. Experiences & Perceptions of Community-Based Occupational Therapists' Regarding their Work with Adults with Morbid Obesity. Martin, M-L. Transitions & The Recovery Process. Martin, M-L., Baldock, D., Pare, L. Relaxation Exercises. Haynes, M. You Can't Smoke Here, But You Can Quit Here. Gaffney, D., Wiseman, B. Vocational Orientation Group. Gardizi, E., Gojmerac, C., King, J. Cognitive Remediation of Memory Difficulties in Mood Disorder. Gatkowski, L., Volman, L., Ireland, S. Shared Core Nursing Competencies for Integrated Clinical Skills: MHAP. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D. Patients’ & Staff Perception about the Care of Patients with Abuse or Trauma Experiences.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
BEST PRACTICES OPEN HOUSE
PAGE
20
Martin, M-L., H. Kirkpatrick. Evaluating Patients’, Families & Staff Experiences with a Tobacco Initiative in a Mental Health Setting. Martin, M-L., Radocaj-Grosvenor, T., Fiona, W., Forchuk, C. The Transitional Discharge Model: Implementation. Maund-Jackson,N., Bialachowski, A., Lee, C. Development of an Outbreak Management Toolkit. Maclennan, M., Legassie, J., Shipley, A., Bertin-McDonald, M., Ball, M., Cheng, A., Anderson, K., Griffin, R. Leading & Transforming Care Using Standardized Digital Order Sets. McLean, L. Photo Voice at the Schizophrenia Outpatient Clinic. McLean, L., & Boric, A. Journaling and Mental Health. McNeely, H., Hasey, G., McKinnon, M., King, J., Losier, B., Gojmerac, C., Lee, E. H., Burnett, D., MacKillop, E., Dool, C., Mosher, M., Bieling, P. Electroconvulsive Therapy (ECT) Mood & Cognition Database. Mills, L. Best Practice Guideline Implementation, Facilitating Client Centred Learning, Incorporating Teach-back Techniques into Everyday Practice in the Independent Home Dialysis Program. Olarte-Godoy, J.,Labuguen, B., Groff, T., Raymond, H., Desimone, A., Devenny, A. Building Capacity: Integrated Care for Clients with Concurrent Disorders. Penko, M., Baxter, J., McConnell, M. Seniors Mental Health Outreach & the Client/Family Experience: Development and Implementation of a Tool to Improve Care Partner Communication. Pennisi, R., Saini, A., McDermott, S. Mindfulness. Prince, M., Hatzoglou, D., Gosse, C., Barrett, L., Ritchie, S., Long, T., Rudkowski, J., DePaul, V. Promotion of mobility activity in hospitalized older adults: Preliminary results of the MOVE ON Plus project at St. Joseph’s Healthcare Hamilton. Oliveira-Picado, C. Forensic program &Concurrent Disorders. Peddle, N., McBride, N, Sutherland, K., Carlisle, E., Bialachowski, A., Lee, C. Reducing the Risk of Catheter Related Blood Stream Infections in Hemodialysis Patients. Peddle, N., McBride, N, Sutherland, K., Carlisle, E., Bialachowski, A., Lee, C. Reducing the Risk of Catheter Related Blood Stream Infections in Hemodialysis Patients. Rehman, Y., Rathbone, M., Parkinson, W., Jiang, S., Bhandari, M., Kumbhare, D. The Association between Chronic Pain & Neurocognitive Test Performances. Reitmeier, M., Martin, M-L., Furimski, I. Family Perceptions about the Care by Families of Forensic Out-patients. Ritchie,S., Greiter, A., Long, T. The GIM New Graduate Nurse Transition Study. Rowa, K., Stead, V., Gavric, D., LeMoult, J., McCabe, R. I Just Can’t Stop Thinking About it!”: Understanding Post-Event Proessing in Social Anxiety Disorder. Ryan, J., Clarkson, D. SOC Collective Kitchen. Ryan, J., Strong, S. SCIS Outpatient Falls Prevention & Management Strategy. Sevenson, C. Transitions in Code Blue/Emergency Response at West 5th Campus. Young, J., Toledo, F., Porter, L., Lopatniuk, A., Crispin, D., Payne, G., Dahl, R., Blinch, G., Landau, L., Page, S., Mann, N., Mansfield, S. A Path through the Seasons of Loss and Grieving: An Overview of Provision of Bereavement Support by the Spiritual Care Department at the Three Sites of SJHH. Wardell, D., Henderson-Dekort, E., Keddy, T., Watson, H., Raymond, H. Mindfulness - A Tool in the Recovery Journey. Wiebe, LA., Messina, K. Developing and Adapting a New Interdisciplinary Forensic Mental Health Orientation Program. Wilson, L. Inspiration Place. Zivanovich, M., Soto, G., Haddock, L. Emergency Disconnect for Home Dialysis: A Nursing Paramedic Collaborative Approach. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
21
Lean Event The PAC has supported the training of PPLs in LEAN Yellow Belt principles. The group has also taken on the goal of encouraging sustainability and creating supportive culture to learn from one another. In September, the PAC hosted the Annual LEAN Event: Hands – On Introduction to Lean Principles 101: This was presented by our Emergency Department Colleagues who have done a tremendous amount of work with their staff and implementing LEAN. Into their everyday practice. This was an interactive afternoon using LEGO and applying the Lean Principles to build airplanes.
Learning to See Waste Elimination of Waste Through Continuous Improvement (CI) Thinking Distinguishing Value Added Steps from Non-Value Added Steps THE GOAL OF LEAN To Improve Process, Outcomes and Increase Satisfaction Among Customers and Workers
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
22
Health Professionals Excellence in Practice Awards The PAC Health Professionals Excellence in Practice Awards and Reception are designed to celebrate the work of the professionals and teams represented by the PAC. This year there were 37 nominations for awards and we had submissions in 9 of 10 categories. Each submission was evaluated by a blinded selection committee with a standardized evaluative tool. The nomination itself is an honor and expression of the incredible work done by individuals and teams across the organization. The event was held on November 2, 2015 and Dr. D. Higgins and Mr. P. Tice Chair of the St. Joseph’s Hamilton Joint Board of Governors addressed the audience.
Individual Clinical Practice Award Nominees: Mary Ann Ferguson Kamila Gemin Dr. Sandra McNally Dr. Joseph Pellizzari Yolaine Roberge Teresa Valla Carolyn Vanderkooy Heather Wilson
Pharmacy Therapeutic Recreation Psychology Psychology Peer Support Nursing Physiotherapy Physiotherapy
Individual Clinical Practice Award Yolaine Roberge (left) receiving award from Fiona Wilson PPL of Peer Support
Individual Teaching Award Individual Teaching Award Dr. Jelena King (left) receiving Award from Dr. Randi McCabe Practice Leader for Psychology
Nominees: Tuan Dinh Amanda Holding Dr. Jelena King
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
Pharmacy Occupational Therapy Pschology
2015
PAGE
23
Health Professionals Excellence in Practice Awards Individual Innovation in Professional Practice Award Nominees: Dr. Lisa Burckell Dr. Brenda Key Dr. Bruno Losier Valerie Thornton
Psychology Psychology Psychology Social Work Individual Innovation in Professional Practice Award Dr. Brenda Key (right) receiving Award from Dr. Peter Bieling Clinical Director.
Individual Research Award Nominees: Dr. Sherl Green Dr. Stephanie McDermid Vaz Dr. Heather Moulden Dr. Karen Rowa Christine Wallace
Psychology Psychology Psychology Psychology Pharmacy
Excellence in Research Award Dr. Karen Rowa (right) receiving Award from Practice Leader for Psychology Dr. Randi McCabe
Individual Leadership Award Nominees: Diana Hatzoglou Catherine Kovacich Dr. Mini Mamak Mary-Lou Martin Magda McCaughhan Dr. Heather McNeely Candace Rutherford Dr. Juliana Tobon
Physiotherapy Social Work Psychology Nursing Physiotherapy Psychology Medical Laboratory Technology Psychology Individual Leadership Award Magda McCaughan (right) receiving Award from Michelle Kho Clinical Researcher in Physiotherapy PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
24
Health Professionals Excellence in Practice Awards Champion of Professional Practice Award Champion of Professional Practice Award Carmine Nieustraten,Director of Pharmacy (right) receiving Award from Larisa Volman
Team Clinical Practice Award Nominees: Harbour East: Medicine, Nursing Speech Language Pathology Adult Team: Speech Language Pathology Team Clinical Practice Award Speech Language Pathology Adult Team Heather Connors, Shruti Balagopal, Stephen Fraser, Becky Hedges, Kristen Maliphant, Jodi Micucci, Bonnie Reaburn-Jones, Christina Senchuk, & Anthony Wood presented by Linda Hollingham (right)
Team Innovation in Professional Practice Award Nominees: Eating Disorders Team: Nursing, Clinical Nutrition, PsychologyMaternal Child Education Project Team: Nursing, Social Work Medicine Communication Boards Implementation Team: Medicine, Nursing, Occupational Therapy, Physiotherapy, Social Work, Speech Language Pathology
Team Innovation in Professional Practice Award Eating Disorders Team Laura Davis, Lisa DiFronzo, Amrita Ghai, Michele Laliberte, Emma Pote, Stacey Tweed & Anne Williams receiving award from Program Manager, Debbie Bang (left)
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
25
Health Professionals Excellence in Practice Awards Team Teaching Award Nominees: Anti-Stigma Conference Planning Committee: Medical Radiation Technology, Medicine, Nursing, Occupational Therapy, Peer Support, Social Work Physiotherapy Respiratory Team: Physiotherapy
Team Teaching Award Physiotherapy Respiratory Team Receiving Award from Bev Cole Professional Practice Leader Daana Ajami, Laura Camposilvan, Sarah Couch, Kay Churchill, Kelly Fraser, Theresa Hills-Kezman, Michelle Kho, Magda McCaughan, Christina Murphy, Kristy Obrovac, Wendy Perry
Team Leadership Award Nominees:
Cleghorn Early Intervention Team: Clinical Nutrition. Nursing, Occupational Therapy, Psychology, Therapeutic Recreation, Parenteral Drug Therapy Monographs Steering and Approval Committee: Nursing, Pharmacy
Team Leadership Award Early Intervention for Psychosis Program Dr. Suzanne Archie, Raelene Carbon, Emily Cole, Alessandra Czepita, Paula Dawson, Jennifer Gill, Kyle Harber, Heather Hobbs, Jean McNiven, Julie McClemont, Dr. Stephanie McDermid Vaz, Dr. Natasja Menezes, Emily Muizelaar, Alan Sage, Stacey Sestric, Kelly Tanner, Elizabeth Ward, Patricia Wilson & Beth Weatherston
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
26
Addiction Services Professional Practice Leader (West 5th, Charlton): Holly Raymond Number of Members of Discipline The Scope of Practice for Addiction Workers is based on behavioral and technical competencies outlined by the Canadian Centre on Substance Abuse. These competencies ] include : screening and assessment, crisis intervention, community referrals, counseling , understanding concurrent disorders, out-reach and trauma specific care.
Addiction Attendants 54 Community Support Addiction Specialist 6
Clinical Practice Achievements Quality & Safety
M1 - Evaluation of “Red, Yellow, Green” which is a process for managing illicit substances within the hospital setting. A working group is currently adapting this protocol for hospital wide use.
Womankind and MASH - Implemented a revised Transfer of Accountability protocol, and Bedside Safety checks to align with the Mental Health and Addiction program
M1 and Out-Patient - Use of measures, HONOS and BSCQ, to track outcomes and evaluate and modify current programming.
Womankind - Completed program evaluation of the “Yoga Fit Warrior” program
Change
Addiction Workers have specialized knowledge and skill in supporting clients and families in understanding their substance use in a holistic context and exploring the possibility of
change.
MASH - Utilizing a LEAN process involving clients, front-line staff and Management. A process for transitioning clients between programs was developed and implemented. Concurrent Disorders Out-Patient: To decrease barriers and increase access a “Steps” group protocol was developed and implemented. Clients in any stage of change can access this open group without having to complete the formalized screening and assessment. M1: To provide a Motivational Enhancement based program framework, the “Alive” group protocol was developed. This protocol is utilized in morning and wrap up groups to provide clients with a structure for exploring their values and goals.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
ADDICTIONS
PAGE
27
Community
Womankind - Ongoing partnership in which Womankind staff provide direct service onsite at Good Shepherd Notre Dame shelter. To date 123 youth workers have been provided with addiction training.
M1 - Partnered with Mission Services to support program transformation to become Concurrent Capable. A publication outing the partnership has been submitted.
In partnership with other disciplines in the Concurrent Disorder Programs, Addiction Workers have developed and implemented a monthly family education night that can be attended by anyone.
Interconnection
PPL - Involved in an initiative to build concurrent capacity across the LHIN.
Brantford ACT team: Pilot site for “Screening and Assessment tool.” The goal is for this tool to be implemented across the Mental Health and Addiction program.
Tracie Groff (Addiction Attendant) seconded to Capacity Building team to provide orientation and training to new team members.
Candice Brimner (Addiction Attendant) has coordinated AA, NA (Narcotics Anonymous and CA (Cocaine Anonymous) groups on the West 5th site.
Academic Pursuits Formal Teaching:
PPL - Motivational Interviewing lecture - Medical Residents McMaster University.
PPL - Facilitated 20+ presentations on Concurrent Disorders.
Womankind - Partnership with Life Sciences - Neurology of Disease Course, McMaster University. The students will be developing approaches to “Relapse Prevention.”
Womankind - 100 hours of teaching courses in the Child Youth Worker Community Program
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
ADDICTIONS
PAGE
28
Internal Teaching:
MASH, Womankind: 25 staff completed CD Foundation Course.
Womankind: 10 staff trained in Withdrawal Management Core Knowledge.
CD inpatient: Staff have received training on Acceptance and Commitment therapy in preparation for developing future programming based on this evidence based modality.
Scholarly Pursuits Research:
PPL: Partnership with Boris Research Centre to promote the integration of research into clinical practice. A publication that highlights the Concurrent Disorder program has been submitted.
Womankind: Significant contribution to the Withdrawal Management Standards document that was recently updated and published.
Womankind: Research Group looking at Integrated Treatment for Pregnant Women – 2 staff on the advisory panel.
CD Out-patient: In partnership with the Boris Research Centre, a battery of screening and assessment tools has been implemented. Ethics approval has been received. The battery will be used for clinical advancement and future research.
PPL working with partnership with McMaster University students to evaluate the impact of addiction education (classroom and modules) on clinical practice.
Continuing Education:
Leadership PPL/Capacity Building team: leading concurrent visioning in medicine. Leadership of the Recovery Breakfast which brought together 465 + people to celebrate recovery. 20+ placements throughout the hospital providing exposure to addictions/concurrent disorders. Leadership to staff at East Region Mental Heath towards the goal of increasing mental health capacity.
PPL: Completed certificate in
“Knowledge Translation” 3 Addiction workers enrolled in BSW
program 7 staff completed DBT training 12 staff completed trauma based train-
ing 10 staff completed anti-stigma training Womankind: 7 staff completed
“Transition to Independence Process “ which is evidence based for working with youth 1 addiction worker registered with the College of Psychotherapy
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
ADDICTIONS
PAGE
29
External Committees: Human Service Justice Hospital Shelter working group Complex Care System Planning table Human Service Justice Committee Concurrent Disorders Mohawk College Womankind Advisory Council
External Presentations:
Introduction to Concurrent Disorders - Psychology Residents, St. Joseph’s Healthcare Hamilton Strategies working with clients using Crystal Meth Value Based Behavior Change Motivational Interviewing Introduction to Screening and Assessment
Discipline Goals 2016 Quality & Safety
Process for Environmental Scans at Womankind and Mash Review of “Red, Yellow, Green” protocol on M1 Revising of TOA process at Womankind and Mash
Change
Review of position descriptions across sites Implementation of Screening and Assessment tool at Brantford Withdrawal Management Review of screening and assessment tools across sites
Community
The coordination of an Addiction Awareness event that involved representation from across the community The coordination of the Recovery Breakfast The coordination of a community response to the increase in crystal meth use
Research & Education
Build advanced concurrent disorder skills through education and professional development. Relationship with the Boris Centre to increase the opportunities for the integration of research into practice Publication highlighting Concurrent Disorder program
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
30
Audiology Professional Practice Advisor/Leader (Charlton): Linda Hollingham Number of Members of Discipline Audiologists 4.0 Communication Disorders Assistant 1.0
Clinical Practice Achievements Scope of Practice: “The practice of audiology is the assessment of auditory function and the treatment and prevention of auditory dysfunction to develop, maintain, rehabilitate or augment auditory and communicative functions.” 1991,c.. 19, s.3 (1). .
Quality & Safety
Hand hygiene target met based upon Patient Satisfaction results (2015) Hospital and departmental policies for infection control updated. Disposable headphone covers for hearing testing/one time use insert phones. Microphone addition to audiometer Maintain minimal falls incidents by anticipating falls risk and putting plans in place to prevent them. Positive Patient satisfaction scores Two patient Identifiers target met Wheel Chair transport Battery containment process updated to comply with new battery policy.
Change
Video email instructions forwarded to patients post hearing aid fittings
Community
Wellness Opportunities (e.g. massage, yoga) Three time winner of Readers Choice Spectator award Chosen as the Regional Centre for the new Roger FM system Three time staff recipient of the Grateful Patient Award
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
AUDIOLOGY
PAGE
31
Interconnection
Transfer of Accountability Seamless referrals made to community services (e.eg. infant hearing ,Canadian Hearing Society (CHS) Elderly Home Visit Program, Schools) Innovative ways of servicing people in the community Participation in community based presentations (e.g. Canadian Hard of Hearing Association (CHHA)). Convenient pick-up and drop-off of hearing aids
Academic Pursuits Internal Teaching
Presentation to the Laryngectomy voice group
Clinical Teaching
Clinical appointment with University of Western Ontario The mentoring/supervision of Ear, Nose, Throat residence; Medical clerks; audiology interns from University placements; high school job shadow; from various facilities
External Committees
Continuing Education:
Hamilton Regional Speech-Language Pathology and Audiology Committee (HRSLAC)
External Presentations
Presentation on Roger FM system to the Canadian Hard of Hearing Association (CHHA).
Ongoing educational opportunities to stay current in all areas, especially in the area of hearing aid technology Cerumen management training Regional Roger FM Centre Training Annual E-Learning requirements Annual individualized learning goals linked to our regulated college Annual Quality Council Update and Education retreat
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
AUDIOLOGY
PAGE
32
Discipline Goals Quality & Safety
Maintain minimal falls incidents by anticipating falls risk and putting plans in place to prevent them. One time use disposable ear tips for Impedance testing. Sustain use of two patient identifiers for each patient Sustain hand hygiene rates at the corporate targets
Change
Updating and modifying current clinical forms and report format
Community
Improve accessibility by proposing the addition of a second Audiology booth Redesign space to improve patient flow and attendance numbers
Research & Education
Development of an Audiology pamphlet Ongoing up to date hearing aid technology training
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
33
CardioPulmonary Technology Professional Practice Leader (Charlton): Meridene Haynes CPT(P) Number of Members of Discipline Charlton Scope of Practice: The RCPT (P) performs diagnostic cardiopulmonary tests used for the investigation and evaluation of pulmonary and cardiovascular disorders, providing information relevant to patient´s diagnosis, prognosis and surgical risk, requiring specialized skills to perform the procedures. He/she has extensive knowledge of respiratory disease, respiratory medications, exercise physiology, and possesses strong technical skills.
3.5 FTE
Clinical Practice Achievements Quality & Safety
Upgraded new Pulmonary Function Diagnostic equipment to move to an integrated database Identified patient safety issue as some patients attend for their Walk Test with inappropriate footwear – have treaded socks available for use.
Change
Worked collaboratively with FIRH management to implement a new schedule designed to decrease patient wait times for testing procedures and to increase capacity. The new system required changes in staff start times, decrease in testing time for some procedures, and better utilization of staff resources. Incorporated Minimal Contact Intervention for smoking cessation across the Pulmonary Function Labs and clinical areas and continued partnership for Smokers Helpline fax referrals, as well as increasing available educational and self-help materials for smoking cessation
Community
The RCPT(P) serve as mentors throughout the diagnostic lab community, providing support for questions as they relate to diagnostic testing procedures received from other hospitals and clinics .
Academic Pursuits Clinical Teaching Conestoga and Fanshawe College Respiratory Therapy Program - oversee clinical
placement for all RT students during their Pulmonary Function Rotation Preceptorship programs as requested for external organizations PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
CARDIOPULMONARY TECHNOLOGY
PAGE
34
Internal Teaching Education for residents, fellows, clinical clerks, visiting physicians and technologists/therapists, specifically for
the technical aspect of Respiratory Diagnostic Tests and Procedures Presentation at Hospital Clinical orientation Respirology resident lecture series presentation across Canada
Scholarly Pursuits Research
Support for the INSPIRE (Implementing a National Smoking Cessation Program in Respiratory Clinics) Ottawa Model for Smoking Cessation program in Firestone Institute
Leadership
MoHLTC Tobacco Demonstration Project site that aims to promote smoking cessation for patients and employees Primary Care Asthma Program/ Lung Health in North Hamilton for Asthma and/or COPD education and resources, smoking cessation Mentor for Hamilton FHT Lung Health Program Mentor for LHIN Caring for my COPD program Participation in educational display at SJHH LDAP
External Committees
City of Hamilton Community of Practice for Smoking Cessation Member of MoHLTC Primary Care Asthma Program (PCAP), PCAP Newsletter editor, Member of PCAP Coordinators, PCAP Advisory and Lung Standards and Initiatives Groups
External Presentations
Ontario Lung Association Provider Education Program – Spirometry In’s and Outs/ Spirometry Interpretation, Hamilton Respiratory Health Forum, Toronto
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
CARDIOPULMONARY TECHNOLOGY
PAGE
35
Discipline Goals 2016 Quality & Safety
Continue with the implementation of the upgrade of the Pulmonary Function Equipment within FIRH through replacement of end-of-life equipment and providing computerized access though the ADT system Incorporation of new equipment to upgrade diagnostics in the Exercise Laboratory
Change
Complete the upgrade and integration of equipment in the Pulmonary Function and Exercise Lab Incorporate new system for walk tests (Vyntus) that will be compatible with our existing database
Community
Continue to act as mentors across the community to provide support for technical and patient centered diagnostics
Research & Education
Support research imitatives within the FIRH as requested Clinical Education: 6 Respiratory Therapy Students Student days: 2 week rotations per student, total of 60 days Type of education ie diploma – Respiratory Therapy Ongoing collaboration with FIRH physicians and research staff in supporting research studies currently taking place at FIRH
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
36
Clinical Nutrition Professional Practice Leader (Charlton, King, West 5th): Helen Van deMark, RD Number of Members of Discipline Discipline Name: Clinical Nutrition Charlton King West 5th
15.2 FTE 2.3 FTE 9.6 FTE
Clinical Practice Achievements Quality & Safety
Scope of Practice: Registered Dietitians (RD) are recognized experts in food and nutrition. They translate scientific, medical and nutrition information into practical nutrition care plans in the treatment of acute and chronic illnesses.
Ongoing education and audits of TOA Revision of documentation forms to incorporate FAPIE Revision of thickened fluid patient education material Development of Home Tube Feeding Decision Tree for clinical nutrition staff and learners
Change
Presentation to Pharmacy & Therapeutics Committee on alternative TPN lipid emulsion Revision of General Kidney, Kidney Stone, Kidney Transplant, Sodium and Eating Out, Making Changes and Smoothie educational materials Introduction of Self-Management patient model in Kidney Function Intake Clinic Revision of Mood Disorders CBT and Cooking Skills groups
Community
Nutrition Month Display for staff, learners and volunteers Conducted four Diabetes Group Education sessions open to the public
Interconnection
Member of Skin and Wound Care Committee Member of Kidney Function Program Allied Health Committee Member of Wellness Committee Member of Digital Order Sets Approval Committee PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
CLINICAL NUTRITION
PAGE
37
Eating Disorders with Bariatric Programs collaborate to develop screening for Binge Eating Disorders in clients presenting for bariatric surgery Collaboration with Dietitians in other eating disorder program regarding Binge Eating treatment Member of Ethics committee Member of GIM White Board Implementation committee to enhance patient flow
Academic Pursuits Internal Teaching
Nutrition training for psychology and nursing learners in Eating Disorders program Preceptor for learners from Hamilton Health Sciences, University of Guelph, McGill University, Conestoga College and George Brown College
Formal Teaching
In-services to Hemodialysis Nursing staff Overview of Clinical Nutrition to new nursing hires in Nephrology and Critical Care programs Interdisciplinary education on bariatric surgery and hemodialysis
Clinical Teaching
Renal Nutrition Educational session to Hamilton Health Sciences dietetic interns Annual Kidney Fair for medical learners In-services to medical, nursing and allied health learners in mood disorders on benefits of cooking skills group Nutrition in-services to GIM and Nephrology medical learners
Scholarly Pursuits Research
1 Dietitian advancing PhD work on The role of amniotic fluid growth factors in fetal overgrowth Collaboration with psychology on poster presentation “Do we need to communicate more openly about Weight Management Options with our Patients with BED?” for International Conference of Academy for Eating Disorders Contributing nutrition component for BRAVE study “Behavioural Activation Group Therapy in Reducing Depressive Symptoms and Improving Quality of Life in Patients with Depression
Publications
Co-author of Food and Nutrition Care Process, Medical Nutrition Therapy in Renal Disorders Chapter, Escott, Stump and Raymond 14th Edition (publication pending) PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
CLINICAL NUTRITION
Leadership
Chair of PAC Policy and Procedure subcommittee
Hamilton Health Sciences Dietetic Internship Selection Committee Hamilton Regional Patient Education Committee Ontario Bariatric Network Canadian Obesity Network Diabetes Educator Section of the Canadian Diabetes Association
Discipline Goals 2016
38
Continuing Education:
External Committees
PAGE
1 Dietitian completed Cognitive Behavioural Training Level 1 Course 2 Dietitians attended Dietitians of Canada regional conference 1 Dietitian attended Iron Deficiency and Anemia in Pediatrics 2 Dietitians and 1 Dietetic Assistant completed CPI Recertification 1 Dietitian completed Dietitians of Canada Ontario Family Health Team conference 1 Dietitian completed Motivational Interviewing Training 1 Dietitian completed Online Demos for Dietitians 2 Dietitians attended Anti-Stigma conference 1 Dietitian attended Omega-3-fatty acid workshop 2 Dietitians attended Advancement of Nutrition Support 2 Dietitians attended Renal Nutrition National conference 1 Dietitian attended the Kidney and Urinary conference 2 Dietitians attended ASPEN Nutrition Support Round Table 1 Dietitian attended Educating the Educator conference 1 Dietitian attended Ontario Community Outreach Program for Eating Disorders conference 1 Dietitian attended the 2015 IDF world diabetes conference 6 Dietitians attended Evidenced Based Management of Diabetes Epidemic conference 1 Dietitian completed OSHF Physical Activity Tool Kit
Quality & Safety
Approval and implementation of SMOF TPN Lipids Ongoing audits of compliance and documentation of TOA
Change
Medical Directive for Dietitians to prescribe diets Development of FODMAP diet Revision of restricted and lactose free diets
Community
Update clinical nutrition page of hospital website
Interconnection
Complete Metabolic Initiative in Mood Disorders
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
39
Diagnostic Services Professional Practice Leader (Charlton, King and West 5th Campus) Ahmed Mujaffar Number of Members of Discipline Registered Medical Radiation Technologist Charlton 72 FTE King 9 FTE West 5th 3 FTE Nuclear Medicine/PET Technologist Charlton 12FTE Registered Magnetic Resonance Imaging Technologist Charlton 20 FTE Registered Ultrasound Technologist Charlton 21 FTE King 3 FTE Electro Diagnostic Services Charlton, King and West 5th Campus 18 FTE
Scope of Pratice: “The practice of medical radiation technology is the use of ionizing radiation, electromagnetism and other prescribed forms of energy for the purposes of diagnostic and therapeutic procedures, the evaluation of images and data relating to the procedures and the assessment of an individual before, during and after the procedure.”
Clinical Practice Achievements Quality & Safety
Echocardiography Program is now Accredited Working towards the implementation of an Ultrasound service at the west 5 th Campus. April 1st is the start date for this service Actively working on implementing a Neuro-Diagnostics Clinic in May at the west 5th Campus Current X-Ray service at West 5th will be expanded to 5 days per week from the current 3 days Implementation of MI Reg. Technology to facilitate electronic receipt of exam requests. This will improve turnaround times for scheduling an examination NM Technologists are trained to do Sentinel Node injections for Breast sentinel and melanoma sentinel node studies SJHH I-125 seed program for breast cancer patients is now being used as a model for other centers. We have in-serviced staff from other sites The NM Radiation Safety Officer is now an integrated role city-wide Radiation Safety Technologists are responsible for site specific radiation safety Rollout of Image Quality Audit System across all sites is having a positive impact on patient care As a Regional site for MRI breast biopsies, we have seen an increased in volumes PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
DIAGNOSTIC SERVICES
PAGE
40
Change
Implemented advanced practice for CT technologists for Buscopan injections (IV)is progressing well Ultrasound is currently an Accredited Program with the American College and is the first accredited Ultrasound department in the LIHN Completion of core competency training for 2 MRT’s in “Advance Practice in GI Fluoroscopy Procedures” including Barium Enemas Developed a regional assessment unit for OBSP at the Charlton site Post Breast Biopsy patients are now seeing a Surgeon in 5 days at a DI Breast Clinic to discuss treatment options Mammography Technologists are now functioning in the role of Navigator for OBSP patients Utilization of an electronic patient satisfaction survey in Diagnostic imaging Establishment of an ultrasound service within the emergency department. This includes a radiologist in ER Monday to Friday to assist ER physicians with appropriateness for ordering all DI examinations.
Academic Pursuits Clinical Education
Continuing Education:
The use of GE on-line TIP education has increased over the Support students for clinical training in last year for technologists in all areas including Nuclear Radiology, Ultrasound and Diagnostic Medicine Cardiology at McMaster University The Canadian Medical Radiation Technologist of Ontario Support students for MRI clinical offers certificate courses taken by staff to enhance their training through the Michener Institute degree. These courses are necessary for technologists who of Technology, BCIT, Red River, NAIT and want to advance their skills so they can work in Computed Cambrian College Tomography or Mammography. PET program rotation for Nuclear The American Registry of Diagnostic Medical Sonographer Medicine students from Michener offers certificate course to help sonographers prepare for Institute new registry exams Host Echocardiography student for training from Mohawk College
Internal Education
Hosted an Administrative Assistant Day - for external/internal physician offices to help them better understand the diagnostic booking and referral processes Hold weekly breast rounds with Pathology and Surgery Radiation safety training for in house departments as well as research departments MRI Safety Training offered quarterly for non-MRI staff including Fire, Police, Housekeeping, Maintenance Organize and present citywide MRI lectures each month for Technologists, Radiologists, Fellows and Residents Monthly General Radiology rounds Weekly Ultrasound rounds
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
DIAGNOSTIC SERVICES
PAGE
41
Scholarly Pursuits Research
Diagnostic Services is currently involved in many research studies. These studies include both clinical and industry sponsored research. The modality breakdown is as follows: Ultrasound -9 studies. CT - 11 studies MRI - 7 studies General radiology - 15 studies Nuclear Medicine – 5 studies PET – 3 studies
External Activities Committees
Member of Anti Stigma Committee LHIN HNHB Wait Time Work Group Member of LHIN 3&4 Steering DI-r committee CEL member of Mohawk McMaster Medical Radiation Science Undergraduate Advisory Committee and on the Executive of Hamilton Niagara Section of the OAMRT Radiologist Provincial Wait Time Task Force lead for CT & MRI RIS Informatics Specialist working with Ontario Evidence Based Imaging (OEBI)
Discipline Goals for 2016 Patient Safety
Development and utilization of an image Quality Audit for Ultrasound
Change
Working with the LHIN to develop standard requisitions for both CT and MRI Collaborating with HHS to develop joint policies imaging protocols where feasible Currently in the final stages of the Centralization and Standardization of the Interventional Radiology Program (CIRO) at Charlton. This final phase includes the purchase of new equipment and renovations to the existing area. This was the first priority Strategic Initiative for all of Diagnostic Services Integrated City-Wide Steering Committee for PACS technology is working in collaboration with other LHINS to determine best solution for a replacement PACS that will be end of life in 2017 IR and CT Technologists are now “scrubbing-in” for sterile procedures thereby assisting the radiologist and redeploying the assigned nurse to “release time to care” for patients.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
42
Dialysis Technology Professional Practice Leader (Charlton, King, Ohsweken, Brantford): James Bellamy Number of Members of Discipline Charlton King Ohsweken Brantford
Scope of Practice The Nephrology Technologist maintains and services dialysis equipment, provides technical support to patients, nursing, and medical staff, initiates, monitors, and terminates dialysis treatments, functions as a renal perfusionist for kidney transplants.
20 FTE, 11 PTE 14 FTE, 7 PTE 1 FTE 2 FTE, 2 PTE
Clinical Practice Achievements Quality & Safety
Utilizing EMR documentation for acquiring correct supplies for treatments and verification of patient identifiers
Change
Bringing Acute dialysis processes directly into the EMR for complete documentation throughout the continuum of care; all patients, everywhere, real-time
Community
Development of “black box” treatment parameter logging for Home Hemodialysis patients in the community to provide clinicians therapy information between clinic visits
Interconnection
Supporting numerous research activities within the department including application development to assist in tracking and timing of intervals
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
DIALYSIS TECHNOLOGY
PAGE
43
Academic Pursuits Internal Teaching
Take your kids to work day sessions; Charlton Several standing agenda sessions as part of the Nephrology Residents curriculum Orientation to Dialysis sessions for Nursing, Infection Control, Pharmacy, Physicians and other new staff
Formal Teaching
Several standing agenda sessions as part of the Nephrology Residents curriculum
Clinical Teaching
Provide placement for Learners from Durham College Biomedical Engineering Technology program
Scholarly Pursuits Research Hemotin Study, DSALT Study, ISIS Study, DOPPS Study, HOST Study
Publications Z364.5-10 (R2015) - Safe installation and operation of hemodialysis and peritoneal dialysis in a home setting CAN/CSA-ISO 11663:15 - Quality of dialysis fluid for haemodialysis and related therapies CAN/CSA-ISO 13959:15 - Water for haemodialysis and related therapies CAN/CSA-ISO 13958:15 - Concentrates for haemodialysis and related therapies
Leadership
Vice Chair of Canadian Standards Association; Kidney Dialysis
Developing ORN provincial reporting software package with Clinical Computing
Alignment of dialysis services offered at Brantford site
Durham College Biomedical engineering curriculum development focus
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
DIALYSIS TECHNOLOGY
PAGE
44
External Committees
CSA – Canadian Standards Association ORN – Ontario Renal Network Durham College – Biomedical Advisory
External Presentations
Ministry of Finance, taxation changes and medical deductions
Discipline Goals 2016 Quality & Safety
Bridging EMR’s to align patient information, thereby creating a single source of documentation
Change
Increase resource capacity thorough realignment of duties to skillsets
Community
Develop regional plans pertaining to emergency planning for renal services
Interconnection
Facilitate improved access to corporate wound care
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
45
Medical Laboratory Technology Professional Practice Leader (Charlton, King, West 5th): Andrea Tjahja Number of Members of Discipline MLT 397 MLA 111 This includes all Hamilton Regional Laboratory Medicine Program (HRLMP sites: SJHH Charlton, King , W5th, HGH, JHCC, MUMC and WLMH.
Scope of Practice: The practice of medical laboratory technology is the performance of laboratory Investigations on the human body or on specimens taken from the human body and the evaluation of technical sufficiency of the investigations and their results.
Clinical Practice Achievements Quality & Safety Microbiology and Virology Changed from cultural procedures to a more sensitive molecular method (LAMP) for detecting Streptococcus pyogenes (Group A) from throat swabs. Changed from cultural procedures to a more sensitive molecular method (LAMP) for detecting Streptococcus agalactiae (Group B) from vaginal/rectal swabs for prenatal screening. Introduced a new culture medium for detection of ESBL- and CRE-producing bacteria. Introduced a new culture medium for detection of both VanA and VanB strains of VRE. Core Laboratory: Implementation of upgraded software for STA Max Coagulation instrumentation Renovation and reorganization of the physical space and workflow redesign of the HGH core laboratory Increased skill mix duties for MLAs Planning and RFP process for implementation of new hematology analyzers WLMH core laboratory fully integrated as part of HRLMP Receipt of all external microbiology specimens in core laboratory Genetics: Validation of GSL system for karyotyping Implementation of Next Generation Sequencing (NGS) for BRCA 1 and 2 Implementation of EGFR testing for lung cancer Validation of NGS mitochondrial genome testing
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
MEDICAL LABORATORY TECHNOLOGY
PAGE
46
Anatomical Pathology: Continued effort to standardize histology across all sites Review of forensics unit for compliance with Canadian Biosafety Guidelines for handling CJD specimens Validation of HERCEPT biomarker in Immunohistochemistry on Dako Staining Platform Clinical Chemistry and Immunology: Implementation of ICP-MS analyzer for trace metal analysis Transfusion Medicine, Stem Cell and Tissue Typing: Successful relocation of Tissue Typing Laboratory from MUMC to SJHH Implementation of a blood shortage management plan Special Hematology: Validation of Sysmex hematology analyzer Validation of WAM middleware; criteria for slide review and auto verification Implementation of Rivaroxaban activity levels, direct anti Xa inhibitor Quality: Full integration of WLMH into HRLMP Quality Management System including standardization of practices Provision of supervision for Haldimand War Memorial Hospital (HWMH) laboratory Management of the Quality Management System for HWMH Continued training and competency assessment of VHF laboratory response team Gap analysis against version 6.0 IQMH Accreditation requirements Point of Care Testing: Implementation of Gem analyzer in the Operating Room at SJHH for blood gas and electrolyte testing
Change
Relocation of Tissue Typing Laboratory from MUMC to 4th floor Luke Wing Charlton site Expansion of microbiology work to include work from Southlake and Stevenson hospitals
Community 8th annual HRLMP Rapid Fire Showcase attracted over 100 participants from across HRLMP and the HNHB LHIN 2015 National Medical Laboratory Week celebration for HRLMP staff and neighbouring community hospital laboratory staff
Interconnection
Pre-analytical improvements for specimen collection - collaboration with nurse educators at HHS Interprofessional collaboration across HHS and SJHH for ebola preparedness Participation in the HHS annual review for nursing staff at all HHS sites Member of HHS Vascular Access Practice and Education Committee Presenter at clinical nursing orientation at SJHH Members of HHS Chemical Hazard Cluster and Medical and Compressed Gases Cluster committees Member of HHS Biocontainment Preparedness Committee PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
MEDICAL LABORATORY TECHNOLOGY
PAGE
47
Academic Pursuits Internal Teaching
St. Clair College Medical Laboratory Science – 4 students Michener Institute of Applied Sciences (Genetics, Diagnostic Cytology) – 3 clinical placements Mohawk College Bridging Program for Internationally Educated MLTs – 5 clinical placements Mohawk College Medical Laboratory Assistant students – 4 students
Formal Teaching
Monthly presentations at nursing orientation Mohawk Internationally Educated MLT Program Instructors
Clinical Teaching
Clinical education in Anatomic Pathology, Clinical Chemistry, Genetics, Hematology, Microbiology, Transfusion Medicine and Cytopathology (theoretical and practical) Residents, Clinical Fellows Clinical Coordinator, Genetics Technology Program, Michener Institute of Applied Health Sciences Assistant Professor, Department of Medicine, McMaster University Rotation supervisor, Adult Hematology and General Pathology Residency Programs
Scholarly Pursuits Research
Continuing Education
HRLMP supports interprofessional research projects. See interprofessional research section
Publications
Masters of Education Bachelor of Technology Bachelor of Science
HRLMP produced 191 publications and 136 abstracts and posters, of which 20 posters were authored by Medical Laboratory Technologists
Leadership
Participation on HNHB CoLabs Quality Management team Participation on HNHB CoLabs Education team Expansion of regionalized microbiology service to include Southlake and Stevenson hospitals work
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
MEDICAL LABORATORY TECHNOLOGY
PAGE
48
External Committees
Consultants to the External Quality Assurance (EQA) division of the Institute for Quality Management in Healthcare (IQMH) Provincial assessors for IQMH Laboratory Accreditation Program Chair, Clinical Laboratory Managers Association (CLMA) Trillium Chapter Education Committee Member, IQMH Cytology Scientific Committee Member, Medical Laboratory Science Advisory Committee, St. Clair College Member, MLT/MLA Advisory Working Group, College of Medical Laboratory Technologists of Ontario Board of Directors, CSMLS Member, Program Advisory Committee, Division of Laboratory Medicine, Michener Institute POCT Testing Advisor Member, Ontario Regional Blood Coordinating Network Advisory Committee Member, Canadian Society for Transfusion Medicine (CSTM) Standards Committee Member, Golden Horseshoe Education Supporting Transfusionists Vice Chair, IQMH Hematology Scientific Committee Board of Directors, International Society for Laboratory Hematology (ISLH) Secretary, North American Specialized Coagulation Laboratory Association (NASCOLA) Member of Canadian Society for Medical Laboratory Science (CSMLS) exam panel
External Presentations
ECCMID, Copenhagen, WASPLab Automation, Change the Never-ending Journey (April 2015) OSMT Conference – Microbiology Automation: The Times, They are A-changin’ (October 2015) International Symposium on Technological Innovations in Laboratory Hematology – Assembly and evaluation of an inventory of guidelines that are available to support clinical hematology laboratory practice, Oral Presentation, Chicago. International Symposium on Technological Innovations in Laboratory Hematology – Source of the normal donor plasma influences the dilute Russell Viper Venom time cut off values for the investigation of a lupus anticoagulant – One center’s experience. , Oral Presentation, Chicago. ISLH, Implementation of the CellaVision Model (May 2015)
Discipline Goals 2016
Quality & Safety
successful IQMH accreditation peer assessment Increase skill mix duties across several disciplines Validation and clinical implementation of new NGS testing: NGS cancer panel Evaluation of RBC software for CellaVision Centralize body fluid morphology to Malignant Hematology at JHCC Implementation of BioRad Unity quality control software and autoverification in Clinical Chemistry and Immunology Expansion of WASPLab to a wider range of specimen types in microbiology Continued expansion of autoverification of results Improved use of the HRLMP scorecard PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
MEDICAL LABORATORY TECHNOLOGY
PAGE
49
Validation of ALK Biomarker on Dako Staining Platform Validation of IDH-1 antibody on Dako Staining Platform Validation of MSI antibodies on the Dako Staining Platform Standardization of Grossing Dictation by Pathologist’s Assistants Standardization of H&E stain
Change
Continue planning for the consolidation of histology technical services to the SJHH Charlton site
Community
Continue to provide leading edge educational opportunities for HRMLP staff and area hospitals Continued collaboration with external organizations for the provision of education sessions for HRLMP an community partners
Interconnection
Continued collaboration with HHS Vascular Access Practice and Education Team Continued focus on pre-analytical errors – continued work with nurse educators
Research & Education
Continued participation in interprofessional research projects across both HHS and SJHH
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
Nursing Vision: We will make a difference in the lives of those we care for, our organization, and the future of our community, through achievement of excellence in nursing and commitment to a culture of nursing innovation, empowerment, leadership, and accountability.
50
Nursing Chief Nursing Executive: Winnie Doyle Professional Practice Leaders: Cheryl Evans & Larisa Volman Number of Members of Discipline: Charlton FTE: 1243 King FTE: 35 West 5th FTE: 347 Total FTE: 1625
Total RN: 1607 Total RPN: 477 Total Nurses: 2084
Clinical Practice Achievements SJHH nurses have been key contributors to and leaders of multiple nursing, interprofessional, and corporate initiatives to advance clinical practice. We gratefully acknowledge the collaborative interprofessional work that has contributed to these advancements, and present the following as a sampling of this work throughout 2015.
Quality & Safety
Scope of Practice: The practice of nursing is the promotion of health and the assessment of, the provision of care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function. .
We continue our partnership with the Registered Nurses Association of Ontario (RNAO), initiated in 2006, as a Best Practice Spotlight Organization (BPSO), providing provincial leadership in the implementation and evaluation of multiple nursing Best Practice Guidelines (BPGs). This ongoing initiative has included the implementation of multiple clinical and healthy work environment BPGs, and funded research into BPG implementation strategies related to falls prevention. The focus of this work over the past couple of years has been on implementing the following BPGs: Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour (in Acute Mental Health) and Facilitating Client-Centred Learning (in Kidney-Urinary), and planning the implementation of best practices related to the Assessment and Management of Pain BPG. Our ongoing commitment as a BPSO builds upon our capacity for both evidence-informed clinical practice and management decision-making within nursing and contributes to creating and sustaining an evidenceinformed practice culture that benefits patients/families, nurses, and the organization. Implementation of the Facilitating Client-Centred Learning BPG was enabled within the Kidney-Urinary Program through the completion of a successful Advanced Clinical Practice Fellowship and included a focus on the use of teach-back as a key patient education approach, and the L.E.A.R.N.S. model of care delivery. Surveys were conducted with home dialysis patients and staff, and related education concerning best practices PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
51
The following resources were developed for use within hemodialysis and peritoneal dialysis: Learning style assessment tools Patient Education tools Teach-Back documentation tools This work will inform future initiatives, and has been presented internally and at peer-reviewed national and international conferences. In addition, the Diabetes Service has also reviewed their patient education program against the BPG recommendations, and have incorporated a teach-back component into their patient education initiatives. These changes have been very positively evaluated by staff and patients.
Within acute mental health, the Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour BPG is being implemented. This work also builds on a successful ACPF completed within the Psychiatric Emergency Service. This has involved implementation of a care path which incorporates multiple related RNAO BPGs, including Establishing Therapeutic Relationships, Crisis Intervention, and Client-Centred Care. As part of this initiative, education has been provided related to best practice recommendations, skills fairs have been held to support staff in the introduction of crisis plans, and staff surveys have been conducted.
SJHH nurses are increasing our collective capacity to successfully implement and sustain nursing best practices in multiple ways: as Best Practice Champions, through attendance at RNAO BPG Summer Institutes, “Mind the Gap” Skin and Wound, Chronic Disease Management, and Mental Health and Addictions Institutes, participation in Advanced Clinical Practice Fellowships (ACPFs) as fellows, mentors, and application reviewers, and as RNAO BPG development panel members and reviewers.
In 2015, we were successful applicants to an RNAO request for proposals to pilot the implementation of nursing order sets within an electronic documentation system. Nursing order sets help to translate evidence into practice by providing clear, concise, actionable evidence-based intervention statements that can be readily incorporated into nursing clinical practice and support evidence-informed decisionmaking. Through this pilot, we will leverage technology to advance the implementation of the following RNAO BPG’s: Assessment and Management of Diabetic Foot Ulcers in People with Diabetes and Strategies to support Self-Management in Chronic Conditions: Collaboration with Clients. This initiative will occur within outpatient nephrology, beginning in January 2016 and ending in June 2017.
We continue to support our staff nurses to pursue opportunities to advance their practice through RNAO Advanced Clinical Practice Fellowships, and this year we were pleased to support an application from Acute Mental Health to implement the BPG on Person and Family-Centred Care.
The Professionalism in Nursing BPG continues to provide a useful framework for our BPG implementation activities, and has been threaded throughout General Clinical Orientation for all new nursing hires.
We continued our work to implement and sustain the Integrating Smoking Cessation into Daily Practice BPG across SJHH sites. At the West 5th Campus, a 4-year follow-up study of the Implementation of the Smoke Free/Tobacco Initiative was completed, and demonstrated strong support for the initiative from patients and staff. This implementation built upon the Professionalism in Nursing, Integrating Smoking Cessation into Daily Nursing Practice, and Client-Centred Care BPGs.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
52
The Falls Prevention Steering Committee has continued to provide leadership in the implementation of falls prevention best practices, including the following key initiatives launched/endorsed by the committee: Managerial review of all falls occurring within their clinical areas within a 72 hour time-frame in order to monitor performance, implement patient and/or unit-specific falls prevention strategies in real-time, and provide a mechanism to prompt a review of falls prevention standards with staff. Use of a Debriefing Tool following all patient falls at the unit level. This enables identification and implementation of patient and/or unit specific falls prevention strategies in real-time. Use of the SIRST reporting tool that monitors unit performance related to adverse events in real-time. It is readily accessible by all managers and can be used to prompt discussion with point-of-care staff related to general or specific patient safety indicators, including falls. Inclusion of falls risk and incidents as part of unit safety briefings to capture real-time issues, resulting in more effective debriefing, resolution, and prevention. Introduction of an Ambulatory Falls Prevention Policy Introduction of falls risk assessment into electronic documentation within EPIC and RAI Quarterly and monthly review of falls performance data by the Steering Committee, including reviews of fall rates, rates of completion of falls reviews, and data trends. Mandatory completion of the Falls e-Learning Module 2 by clinical staff Monthly falls performance data is also reviewed by managers, who are provided with a summary of their unit's performance specific to falls including: Total number of reported falls on their unit Rate of fall reviews completed relative to the total number of reported falls, Falls rate per 1000 patient days, and Trending data in comparison to previous month’s performance . We continue to collaborate with our clinical partners at HHS in an effort to continuously improve our falls prevention program. This includes crossrepresentation on our respective organizations’ Falls Steering Committees. Unit-based falls assessment and prevention work has included: - Within Senior’s Mental Health, RAI assessment and clinical risk assessment is completed on admission for every patient. Multiple fall prevention strategies have been implemented, including safety huddles, clinical monitoring, low bed position, bed alarms, Falls Strategy cupboard, patient & family engagement, bedside safety board, programs (walking, singing, dancing), and focus on proper footwear. Data demonstrates lower re-admission rates and due to a few repeat fallers, an increase in falls but a reduction in injurious falls. - Geriatric Services developed a digital order set for falls assessment and bone health. The order set includes medication review, rehabilitation, diagnostics, falls prevention & management, and external referrals. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
53
- Across the King Campus, including the Outpatient areas, a review of falls incidents was undertaken, and revealed the majority occurred either inside of the building but not within the clinical areas, or outside of the building. Falls prevention strategies introduced here include falls information and data presented on quality boards, increasing numbers of volunteers, providing an education package sent directly to patients prior to their scheduled visit, ambulatory councils, and regular auditing of progress. Within Urgent Care, a falls risk assessment is completed on all admitted patients.
During National Falls Prevention Month in November, SJHH hosted the inaugural Falls Prevention Conference. This was a collaborative approach to developing city-wide falls prevention strategies, and included representation from SJHH, HHS, Public Health, and St. Joseph’s Home Care. This half-day conference included addresses by multiple experts presenting a variety of falls prevention approaches, and was both well-attended and highly rated by clinicians, who identified concrete learnings they would incorporate into their practice as a direct result of this event.
RNAO has introduced Nursing Quality Indicators for Reporting and Evaluation (NQuIRE), the first international quality improvement initiative of its kind, consisting of a database of quality indicators derived from recommendations within RNAO’s clinical BPGs. In 2015, we began reporting on pressure ulcer prevalence, falls, and breastfeeding rates.
The RNAO BPG: Strategies to Support Self-Management in Chronic Conditions: Collaboration with Clients was implemented within the Kidney-Urinary Program as part of its strategic direction, and included development of patient educational materials for renal transplant recipients related to healthy lifestyle choices and self-monitoring of blood pressure and weight, implementation of the RNAO BPG: End of Life Care During the Last Days and Hours within Nephrology, which included the development of patient education materials and introduction of palliative care best practices, and completion of an ACPF within Home Dialysis, involving implementation of the Facilitating Client-Centred Learning BPG, with a focus on The Woman Abuse BPG provided a foundation for the continued implementation of trauma-informed care approaches and related research into staff and patients’ perceptions of their care pre and post-implementation within the Mental Health and Addiction Program
SJHH nurses participated in bridging the research to practice gap through contributions to the development or review of RNAO Best Practice Guidelines: - Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma: Ann Bartlett - Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD) Nursing Order Set: Ann Bartlett - Practice Education in Nursing: Pat Ford
Throughout our BPSO work, there is an increasing focus on evaluation, sustainability, and outcome data, and we have seen improvements in patient health outcomes in areas of falls, pressure ulcers, breastfeeding, and smoking cessation. Best practices and evaluation activities are routinely incorporated into new organizational initiatives.
In 2015, planning began to support the implementation of the RNAO BPG: Assessment and Management of Pain. The steering committee has reviewed pain assessment criteria contained within accreditation standards, evaluated current state against BPG recommendations, and consulted with peer organizations with experience and expertise in this area. The major focus of BPG implementation will be the introduction of a pain assessment policy, recognizing that accurate pain assessment is a critical step in achieving optimal pain management for all patients. The policy will establish expectations for consistent pain assessment using standardized, validated tools and support the implementation of evidenceinformed nursing best practices regarding pain assessment and management. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
54
The Skin and Wound Care and Enterostomal Therapy nursing team has provided leadership to the Skin and Wound Care Steering Committee in the implementation of pressure ulcer prevention and management best practices, and advanced skin and wound care quality across SJHH in multiple ways through the following activities: - The Skin and Wound Care and Enterostomal Therapy nursing team has provided leadership to the Skin and Wound Care Steering Committee in the implementation of pressure ulcer prevention and management best practices, and advanced skin and wound care quality across SJHH in multiple ways through the following activities: - Development and continued implementation of an organizational pressure ulcer prevention strategy: In collaboration with Quality and Patient Safety, the team has improved the pressure ulcer prevalence audit process in 2015 by establishing a regularly scheduled, evidence-informed, and sustainable process. This new process is designed to engage point-of-care nursing staff, collect reliable data, and provide timely results to staff in all inpatient areas. The process is outlined in the Pressure Ulcer Prevalence Audit Toolkit developed by the team and posted to the SJHH intranet. Highlights of the strategy and outcomes were presented in multiple SJHH and external forums. Over the past year, this process has demonstrated a reduction in pressure ulcer prevalence on Charlton-site inpatient units.
Staff engagement and development of the Wound Care Resource Nurse (WCRN) Team: Point-of-care nurses made a significant contribution to the success of the Pressure Ulcer Prevention Strategy, and other wound care-related initiatives in the past year. The addition of many new WCRNs over the past year, to an organizational total of 38, reflects the enthusiasm that nursing staff have for developing wound care expertise. WCRNs are backfilled by their managers to receive training provided by the Skin and Wound Care team. “Wound Care Blitzes” have been developed, in which brief, 5 minute huddles for staff, on an alternating topic every 2 months, have been developed. Through these forums, WCRNs bring new skin and wound information back to their colleagues, on topics ranging from assessment and management of skin tears to swabbing techniques, and reviews of assessment and management of Stage 1 and 2 pressure ulcers.
Resources and product enablers: As part of our commitment to deliver the best treatment to the right patient at the right time, the Purchasing Department collaborated with the skin and wound care clinical product lead for wound care supplies and WCRNs to trial new dressing, ostomy, continence, and other products. Policy has been created by the team to support the use of these products where needed. Additional education has been provided to support nursing staff in the use of negative pressure wound treatment systems over the past year. The skin and wound team also continues to provide input into the use of appropriate skin care products and surfaces to support skin health and prevent skin breakdown.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
55
Enhanced Recovery After Surgery (ERAS): The Skin and Wound Care Team Enterostomal Therapist represents our hospital on a provincial committee in reviewing the ERAS guidelines. The committee is currently publishing an addendum specific to the colorectal population who require a diversion.
Knowledge Translation: In the past year, the skin and wound care team has been involved in the development of educational resources, including an interactive E-Learning module with a focus on skin breakdown, that is based on RNAO Best Practice Guidelines for pressure ulcer prevention and management and will be available soon. The Skin Health and Wound Management intranet page has been updated, and evidence-based educational information has been provided. A new feature allows staff to post questions in a section titled “Frequently Asked Questions”. All members of the Skin and Wound Care team provide ongoing educational opportunities by engaging staff, patients, and family members in “teachable moments” as they arise during their consultations. Monthly orientation is also provided by the team to all newnursing staff on SJHH skin and wound care principles and best practices. In addition, a new pamphlet has been developed to support the role of patients and families in the prevention of pressure ulcers. Opportunities to enhance skin and wound care expertise at the West 5th site have also been explored, including supporting the attendance of West 5th site nursing staff at the RNAO “Minding the Gap” Skin and Wound Institute. Members of the skin and wound team have helped to advance nursing practice broadly by presenting the successful SJHH Pressure Ulcer Prevention and Management program in multiple external and peer-reviewed forums.
The Digital Order Set Project has provided the Skin and Wound Care Team with the opportunity to contribute to the development of electronic, evidence-informed order sets for Stages 3, 4 and unstageable pressure ulcers, leg ulcers, and diabetic foot ulcers. Evidence-informed protocols for nursing-initiated skin and wound care interventions have been adapted to meet SJHH standards and resources. These include those for the prevention and management of Stage 1 and 2 pressure ulcers and skin tears. Through the development of these order sets and protocols, the skin and wound team has helped to enable evidenceinformed skin and wound practices by nurses and other practitioners across the organization.
The Skin and Wound team provided leadership in ensuring that SJHH met or exceeded all Pressure Ulcer Prevention and Management Required Organizational Practices set by Accreditation Canada in 2015. Policies and procedures have been reviewed and updated and tools have been developed to support these best practices moving forward.
The Department of Nursing lead major initiatives to reduce the incidence of hospital-acquired infections: pneumonia and catheter-associated urinary tract infection. The Hospital-Associated Pneumonia Working Group developed and implemented an evidence-based policy on oral care for patients at risk of aspiration, and ensured the availability of associated signage and supplies required to meet the policy requirements. A series of walkabouts were conducted to ensure staff awareness of the new Oral Care Protocols and to obtain their feedback on the initiative. Audits of oral care practices for patients at risk for aspiration were completed by the members of the working group during the Spring. In the Fall, a tool to help identify indicators for risk of aspiration was developed. Throughout the year, usage data for suction toothbrushes was tracked for all units as a measure of compliance with the new oral care policy. In December, a safety briefing tool developed for nursing huddles in General Internal Medicine was reviewed, which includes Oral Care for patients at risk for Aspiration. Use of this tool will be monitored, and it may serve as a useful model for other areas to follow
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
56
The Catheter-Associated Urinary Tract Infection (CAUTI) Reduction Working Group developed evidence-based policies and order sets for both indwelling and intermittent catheterization and procured inclusive all-in-one catheter kits to support infection prevention and control best practices. These initiatives involved implementing best practices to ensure indwelling catheters are inserted for appropriate evidence-based indications only and are promptly discontinued, with an automatic stop-date 24 hrs post-insertion, unless otherwise ordered or reordered. Audits are being conducted to monitor the implementation in practice, and unitbased data will be shared with key stakeholders as part of these continuous quality improvement initiatives.
Nurses worked with our interprofessional colleagues to develop sepsis risk assessment tools and clinical order sets to improve early recognition, treatment, and outcomes for patients with sepsis.
Nurses were key to planning and implementing the St. Joe’s Early Warning Score System in pilot areas in 2015. Adapted from the United Kingdom’s National Early Warning Score (NEWS), this system standardizes regular assessment and response to acutely ill patients by applying an evidence-based scoring system to patients’ vital signs. The literature supports that the implementation of these measures significantly improves early recognition of physical deterioration, allowing for more rapid and appropriate clinical response and resolution to improve patient outcomes and reduce the incidence of preventable deaths in hospital. This initiative was piloted within the Surgical Program in 2015, and will be evaluated and spread across Surgery and to other clinical areas in the coming year.
In collaboration with our Pharmacy colleagues, nursing co-lead a review of our parenteral monograph processes and structures. This work included consultation with external peer academic health science centres and review of externally available monographs. As a result of this review, the Ottawa Manual was confirmed as the foundational adult parenteral monograph reference for SJHH, an interprofessional Steering Committee, co-chaired by Directors of Nursing and Pharmacy, was formed to oversee the transition to these monographs, and parenteral monograph development and approval processes were streamlined for enhanced sustainability. In 2015, this initiative culminated in the introduction of a full parenteral drug manual, including information re subcutaneous and intramuscular administration routes. This manual provides a comprehensive, standardized, and evidencebased parenteral monographs to support safe nursing medication administration across SJHH. Over 200 monographs were reviewed, updated, and approved, including monographs for 75 medications for which there was no previously existing monograph available as a resource. Monographs include vital information to support safe medication practice, including indications and contraindications/cautions, special status notifications (e.g. high-alert or special access drugs), administration information, minimum monitoring requirements, potential adverse effects, dosage information, and compatibility and stability information. SJHH monographs are now hyperlinked to key supporting documents (policies, medical directives, titration tables, etc.) and have been cross-referenced against infusion pump guardrails, which were also fully updated. In addition, a policy was developed to support practice, and the monographs were made readily accessible through the Point of Care Tools tab on the SJHH intranet homepage. An evaluation of user satisfaction with the monographs is currently being conducted. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
57
Change
Through the staff nurse-lead Releasing Time to Care (RTC) initiative, formal and informal nurse leaders are continuing to support a culture of continuous quality improvement, staff engagement, patient safety, outcome measurement, and operational efficiency and standardization. Nurses are actively engaged in leading change processes at the point-of-care, using quality improvement tools such as huddles, safety crosses, and PDSA cycles to improve both the process and outcomes of care. Safety crosses are being used in many areas to track rates of falls, pressure ulcers, medication incidents, infection, seclusion, elopement, self-harm, and code white. This real-time data is then reviewed with key stakeholders who are best positioned to both analyze the information and identify and implement quality care improvements. Through RTC support structures, quality improvement initiatives are being successfully aligned with other SJHH organizational structures, such as Unit-Based Nursing Practice and Quality Councils to facilitate sustainable improvements.
Nurses across SJHH were supported to work to their full scope of practice through updated job descriptions, policy revisions, implementation of medical directives, and opportunities for professional development through support for attendance at internal and external educational events. In addition, nurses within the Medicine program have been supported in the use of valid and reliable tools to determine appropriate patient assignments based on the College of Nurses of Ontario (CNO) 3-Factor Framework, and the creation of working teams, called patient care collaboratives, of at least three RNs and RPNs who work together to plan and coordinate nursing care delivery that is responsive to evolving patient care needs. This implementation is being evaluated on an ongoing basis to ensure that key quality indicators are met.
Throughout 2015, work continued to integrate and sustain clinical monitoring within the Mental Health and Addictions Program (MHAP) into a daily practice with specific focus on therapeutic engagement with patients. This has included policy development to support practice, use of a peer mentorship model as part of the implementation strategy, and inclusion of clinical monitoring indicators into TOA process within MHAP. This initiative has been formally evaluated through research project in collaboration with McMaster School of Nursing. Outcome measures include rates of seclusion, chemical and physical restraint, falls, Unauthorized Leave of Absence, and clinical monitoring frequency. In addition, staff focus groups have been conducted and patient satisfaction information has been obtained.
Current state re nursing policies and procedures was reviewed, internal and external stakeholders consulted, and best/promising practices related to nursing policy development and management were identified. An overall framework and action plan was developed to revive and sustain an effective nursing policy process and structure moving forward. To date, considerable progress has been made, including: Membership, terms of reference, and committee processes were reviewed and revised as appropriate to achieve the goal of expedient policy review and approval & efficient use of limited committee resources A Policy & Procedure submission form to be completed by the Policy Lead and to be submitted electronically with all policies submitted for review A Policy and Procedure Toolkit was developed, including templates for creating a powerpoint presentation and a Frequently Asked Questions document for rollout
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
58
Unit-based Nursing Practice Councils were key to shaping decision-making re nursing practice at the unit level and implementing important nursing practice advances within many clinical areas. A sampling of their accomplishments includes: Urgent Care: Provided education related to urgent labour and delivery & diabetes management Developed patient education videos streamed in waiting areas to address frequently asked questions, infection prevention and control practices, and information regarding wait times Mother & Baby Unit: Reviewed and revised nursing documentation tools (kardex and flow sheets), updated education pamphlets & TOA sheets, and developed a template for leading team huddles Nephrology: Reviewed and revised nursing documentation tools (kardex, flow sheets, & discharge forms) and infection control signs Revised palliative care flow sheets and developed the “Precious Moments” Palliative Suite information booklet for patients and families Ensured compliance to Accreditation Canada required organizational practices Provided input into digital order sets and initiated the use of whiteboards Seniors Mental Health: Reviewed and revised the nursing flow sheet, which provides a user-friendly and comprehensive overview of clinical care, triggers FAPIE documentation, and will assist with electronic record management and unit-to-unit TOA. It will also help to streamline the process of gathering information prior to patient care conferences and team meetings Implemented a number of fall-reduction strategies, including: Lowering the height of beds Use of crash mats Use of no-skid socks at bed time Frequent gait assessment Built-in clarms Use of top bedrails only Use of safety calendars to identify trends
Intensive Care Unit: Developed and implemented a successful critical care bowel protocol, in collaboration with interprofessional colleagues. The protocol is a nursing-driven algorithm and is triggered upon initiation of oral or enteral feeding or at physician discretion. Developed and implemented a critical care constipation relief regime, in collaboration with interprofessional colleagues. This order set is utilized when the bowel protocol is no longer achieving the desired results. Instituted the ICU Waiting Room Communication Board, which includes several slides containing general ICU information, introduces team members involved in patient care, addresses frequently asked questions, and provides helpful resources in times of crisis. Developed ICU Contact/Business Cards to provide quick reference information to families, and information re how to contact the ICU unit & Manager for patient updates or to address issues or concerns. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
59
A policy review and approval form was developed for use by the committee to ensure the approval process is focused on key requirements: involvement of relevant content experts, including point-of care nurses; consultation with relevant stakeholders (eg. IPAC, Risk, etc.); recent literature and best practice documents cited; activity is within nursing’s scope of practice; cross-referenced and hyperlinked to relevant internal documents (e.g. policies, protocols, parenteral monographs, etc.); legislative requirements referenced if applicable; provision of clear and appropriate direction for nursing practice Increased presence is planned for this committee on the Department of Nursing site of the Intranet, with all applicable documents/tools available there and committee members and meeting dates listed The policy template was revised to be more user-friendly and to include all sites of a Program, reflect the broad categories of regulated health professions who can write orders, and to reflect the CNO expectation of all nurses to refrain from performing any activity for which the requisite knowledge, skill, and ability for safe performance and management of potential outcomes is lacking. In addition, the Nursing Advisory Council provided delegated authority for nursing policy subcommittees within Hemodialysis and Women’s and Infants Programs, under the leadership of the Nursing Professional Practice and Policy Advisor, to review, revise, and approve nursing policies within these areas. To date, over 80 policies have been reviewed as part of this process, and this work is ongoing.
Community
The Nursing Advisory Council (NAC) is a key nursing governance structure at SJHH. Using a shared governance approach, NAC provides an important leadership forum for nurses to advise on key nursing issues, share expertise, help to facilitate change, and engage in collaborative decision-making related to nursing practice, education, and research. An evaluation conducted by NAC members confirmed an increased sense of engagement by members, and alignment of activity with the Council’s vision of advancing quality care outcomes by providing leadership in evidence-informed patient and family-centred care, upholding excellence in nursing professional practice, education, and research, and playing an integral role in enhancing the interprofessional practice environment. Through continued participation in MOHLTC funding initiatives, new nursing graduates were hired and supported through extended mentored orientations. Canadian Nursing Association (CNA) certification continues to be supported and promoted across the support for initial CNA certification . In 2015, Nursing once again co-lead the 9th annual Best Practices Open House, an annual event that has grown out of our RNAO Best Practice Spotlight Organization initiative. With approximately 125 people in attendance, and an impressive 60 posters.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
60
The Nursing Transfer of Accountability (TOA) Steering Committee has continued to provide leadership in breaking down barriers to effective communication to help ensure that transitions in care are seamless, safe, and effective. The TOA process includes three key elements to effectively communicate critical patient information: verbal handover guided by an optional TOA sheet and the patient chart, a bedside safety check completed by two n urses, and documentation. The documentation comprises of date, time, and signature by both practitioners to confirm that a verbal handover and bedside safety check occurred. Specific key initiatives launched/endorsed by the committee in 2015 include: Shift-to-shift TOA is now implemented in all inpatient areas, including the Mental Health & Addictions Program (MHAP), where the process has been adapted to maximize opportunities for technology to improve communication, including an excel spreadsheet on the Smart Board to guide handovers. Implementation of the Unit to Unit TOA has begun in the Medicine and Surgery areas. In addition to the key elements highlighted above (verbal handover, bedside safety check, and documentation), criteria has been developed for escorted and unescorted transfer (i.e. when would a nurse accompany or not accompany the patient and porter during transfer). The goals for 2016 are the expansion of this implementation to all other areas, including MHAP, outpatient clinics, and discharge to the community. TOA is incorporated into the Patient & Safety component of the corporate orientation The MHAP TOA working group lead the roll-out of the unit-to-unit and unit-tocommunity TOA across the Program, and met monthly to review the MHAP data, track progress, and identify and implement process improvements. All inpatient units complete a monthly shift-to-shift TOA audit, which includes chart audits, patient feedback, and discussion with the nurses. Monthly TOA performance data is reviewed at the TOA Steering Committee and at the Quality Councils to monitor progress and identify and implement process improvements as needed. Managers and Directors are provided with a summary of their unit’s performance on TOA including the compliance rate for each indicator. Managers also post the TOA scorecards on their unit Quality Boards. Ongoing areas of focus include (1) ensuring TOA documentation is signed by both nurses at the change of shift, (2) ensuring consistent completion of bedside safety checks, and (3) ensuring consistent audit submissions. Considerable planning has been completed to support the unit to Diagnostic Services and Endoscopy TOA process implementation in 2016. Medications on transfer has been added to the TOA form to allow medications to safely move during the patient transfer from one unit to another to prevent duplicate work, delays in patients receiving needed medications, and also additional costs associated with the same medication being dispensed twice. Work is ongoing to test this approach and monitor progress.
Interconnection We continue to initiate and maintain productive relationships with our community partners to advance nursing at SJHH, including effective collaboration with LHIN-4 provider partners, the Registered Nurses Association of Ontario, our BPSO collaborators, and our local academic partners, McMaster University and Mohawk College. In addition, we have developed highly successful regional and provincial partnerships. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
61
Academic Pursuits Clinical Teaching
29 Masters and PhD-prepared SJHH nurses tutor nursing students through clinical faculty appointments with McMaster University School of Nursing; 3 are currently in progress. SJHH nurses also contribute to student learning through part-time clinical lecturer & faculty roles within local college nursing programs.
Internal Teaching
Nurse Educators support quality practice and the ongoing professional development of nursing staff and interprofessional colleagues by developing, delivering, and evaluating high quality competency-based orientation and continuing education inservices and programs across all SJHH clinical areas and sites. Clinical orientation programs include Clinical Medical-Surgical and Mental Health Orientation, Critical Care Essentials, and competency-based orientations that are specific to each clinical area. Nurse mentors and Nurse Educators contributed significantly to creating a firm foundation for practice for our new nurses by coordinating an outstanding nursing clinical competency-based orientation program. In 2015, the Nursing Education team undertook a review of the general nursing orientation program, and revised the program and content. The resulting program is more streamlined and focused. Content that was redundant or available in alternate formats, such as e-learning, was removed, and a focus on effective communication and learning through case-based scenarios was added. The revised program is appropriately aligned with CNO Standards, nursing best practices, corporate and nursing priorities, and accreditation required organizational practices. A major vascular access initiative has been undertaken, with considerable input from the Nursing Education team, with the goals of supporting nurses to attain and sustain proficiency in consistent implementation of best practices related to vascular access skills. In consultation with point-of-care nurses, Directors and Managers, strategies were implemented to improve competency in IV initiation, venipuncture for blood specimen collection and care and maintenance of central lines. Nurse Educators continue to embrace and advocate for innovation within our dynamic health care environment. Over the past year, many in-services, education sessions, workshops, and eLearning modules have been developed, facilitated, coordinated and delivered across sites. These included supporting the implementation of new equipment and products, and supporting the implementation of multiple best practices, policies and initiatives, as well as required organizational practices associated with accreditation processes. The team continues to encourage CNA certification and has supported this by offering exam-preparation workshops.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
62
The Critical Care Essentials Program was also reviewed and updated this year. Major revisions included: Introduction of vascular access skills sessions (central line insertion, central line maintenance including infection prevention and CVP monitoring, arterial line insertion, maintenance and utilization). Sessions were also revised to reflect active teaching-learning approaches characterized by the introduction of highly interactive teaching-learning situations, and use of case studies as the foundation for problem/issue exploration. There was a significant reduction in the use of didactic approaches centred on the use of powerpoint presentations, and an increased focus on critical thinking and clinical decision-making. 4 simulated mock code scenarios were introduced, with learner hands-on participation. These scenarios build on existing knowledge and curriculum already presented in previous sessions. A CD is provided to new learners well in advance of the CCE session to enable the review of materials prior to the sessions and encourage more active participation and interaction with the content within the program. This initiative has included: Certification of Nurse Educators in venipuncture, PICC bloodwork, and PICC dressing changes to enable sustained and direct just-in-time support to staff nurses when and where it is needed. The development of an IV Team request card database, which allowed a deeper understanding of the nature of the requests to the IV Team. Based on this data, Nurse Educators now have more specific information to better understand the specific learning needs of the nurses within their clinical areas. Development by the IV Team of a nurse observation card which is completed by the IV Nurse to report real time practice issues directly to unit managers and educators to facilitate their immediate follow-up. A successful pilot project was completed involving DCD/CCU and tested an educator model to include process mapping, tools, 1:1 training and focus groups. This successful initiative will provide a proven model to spread these innovations across all clinical areas. This ongoing work has resulted in increased vascular access competency, and nurses collaborating with unit experts to increase their own competency and confidence. This focus on skill improvement and competency enables nurses to deliver better care to patients and reduce incidents and infections. This work to date has also resulted in a significant decrease in the incidence of bacterial infections. In 2015, Lisebeth Gatkowski, Nurse Educator, was the recipient of the prestigious RNAO Leadership in Nursing Education (Staff Development) Award for her ongoing work in implementing nursing best practices.
RNAO Advanced Clinical Practice Fellowship Through Advanced Clinical Practice Fellowships (ACPFs), nurses partner with a recognized nursing expert for a mentored intensive learning experience that develops clinical, leadership, or knowledge transfer expertise & skills within a chosen focus area. The following ACPF was completed in 2015 by Linda Mills:
Incorporating Teach-Back Techniques into Everyday Practice in the Independent Dialysis Program: Implementation of Best Practice Guideline: Facilitating Client-Centred Learning, with a Focus on the LEARNS Model of Care Delivery. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
63
Scholarly Pursuits Research Bowen, J., Campbell, K., Sutherland, S., Brooks, D., Bartlett, A., Qureshi, R., & Goeree, R. Pulmonary Rehabilitation in Ontario: A Cross-Sectional Survey. Health Quality Ontario. Ontario Health Technology Assessment Series. Chaimowitz, G., Furimsky, I., Driscoll, D., Sanson, T. - Implementing the Dynamic Appraisal of Situational Aggression (DASA) on the secure and general forensic units. Crowe, A. Risk factors associated with post-operative complications of wound healing in adult renal transplant patients. Forchuk, C., Martin, M-L., Corring, D., Mustin-Powell, Campbelll, R., McIntosh, L, Sherman, D., Cheung, R., Srivanastave, R., Ouseley, S., Edwards, B., Reiss, J., Mitchell, B. Implementation of the Transitional Discharge Model. Furimsky, I. Utilizing the Essen Climate Evaluation Schema to evaluate the social climate on forensic inpatient units. Holt, K. Fostering hope in persons with mental illness: An interpretive description of nurses’ experiences. Hudd, L., Willison,K. and Eyles, P. Advanced Practice Nursing (APN) Role Delineation Survey of Nurse Practitioners (NP’s) and Clinical Nurse Specialists (CNS’s) Working Within the St. Joseph’s Healthcare (SJHH) System. Kajah, P. Exploring the Relationship between Hope and Self-Management of Chronic Kidney Disease. Kolawole, O., Furimsky, I., Chaimowitz, G. The utility of treatment orders in the restoration of fitness to stand trial: A Canadian study. MacKillop, J. & Bang, D. Outcome Evaluation of the YogaFit Warrior Program at Womankind Addiction Service. McKinnon, M., Simons, S., Oremus, C., & Holt, K. Partnerships in Medication Management (PIMM). Pace, J. Masters Thesis Study: Handover Among Multidisciplines In Obstetrics: A Mixed Methods Study Of Content And Communication Process, McMaster University. June 2015.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
64
A new initiative was undertaken to build nursing research capacity through the development of research at SJHH with the unifying theme of hope. This initiative links to SJHH strategic directions and BPSO® nursing initiatives, and includes research with our partner School of Nursing faculty at McMaster University, funded by The Nursing Advisory Council Nursing Research Award Program. Through organizational funding provided by the SJHH Research Institute and directed through the Nursing Advisory Council, the Nursing Research Program was established with the objective of supporting nurses to engage in independent research activities. Two nursing research projects were supported in 2015: Title: Evaluation of a Collaborative Model for Patient Care Delivery Researchers: Kelly LoPresti, Liz Barrett, Carolyn Gosse, Donna Johnson, Gaya Amirthavasar, Lawrence Mbuagbaw, Julianna Camera Title:
Evaluation of Building Nursing Research Capacity with a Unifying Theme of Hope: The Research Community of Practice Nurse Researchers: Helen Kirkpatrick and Janet Landeen Ritchie, S., Greiter, A. & Long, T. The GIM New Graduate Nurse Transition Study. Bullard, C. Exploring Family Burden in Anxiety Disorders: A Hermeneutic Phenomenological Study. Martin, M-L, Gatkowski, L., Szypula, F. , Wilson, F. & Bang, D. Patients’ and Staff Perceptions about the Care of Patients with Abuse or Trauma Experiences. Martin, M-L., Kirkpatrick, H. & Johnston, J. Evaluating Patient and Staff Experiences with a Tobacco Initiative in a Mental Health Setting Four Years after Implementation. Hudd, L., Willison, K. & and Eyles, P. Advanced Practice Nursing (APN) Role Delineation Survey of Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs) Working within the St. Joseph’s Healthcare Hamilton (SJHH) Alliston S. Are we paying enough attention to the implications of severe skin breakdown in infants being treated for Neonatal Abstinence Syndrome?
Publications
Bartlett, A. (2015). New Inhaled Medications for Chronic Obstructive Pulmonary Disease. The Lung Association Ontario Respiratory Care Society Update. Winter. 31 (1). Bawor,M., Brasch, J., Hutchinson, N., Iordan, E., Sholer, H., Vair, J. et al. Exploring the Determinants of Suicidal Behaviour: Conventional and Emergent Risk (DISCOVER): A Feasibility Study. Pilot & Feasibility Studies. 1 (17). Becker, M.P.E., Christensen, B.K., Cunningham, C.E., Furimsky, I., Rimas, H., Wilson, F., Jeffs, L., Bieling, P.J., Madsen, B., Chen, Y.Y.S., Mielko, S., Zipursky., R.B. (2015). Preferences for Early Intervention Mental Health Services: A Discrete -Choice Conjoint Experiment. Psychiatric Services in Advance. Dennis, R., Garton, S., Hutchinson, N., Iordan, E., Roshanov, P., Sholer, H. et al. Re-examination of Classic Risk Factors for Suicidal Behaviour in the Psychiatric Population. Research Trends. 36(4). 231-240. Eapen, B. R., & Chapman, B. (2015). Mobile Access to ClinicalConnect: A User Feedback Survey on Usability, Productivity, and Quality. JMIR mHealth and uHealth, 3(2). Kaasalainen, S., Willison, K., Wickson-Griffiths, A., & Taniguchi, A. (2015). The evaluation of a national interprofessional palliative care workshop. The Journal of Interprofessional Care. 29(5):494-6. Marticorena , R., Mills, L., Sutherland, K., McBride, N., Kumar, L., Concepcion-Bachynski, J., Rivers, C., Petershifer, E., Hunter, J., Luscombe, R., Donnelly, S. (2015). Development of competencies for the use of bedside ultrasound for assessment and cannulation of hemodialysis vascular access. CANNT Journal, October-December. 25 (4), 28-32. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
65
Membership on External Committees While not an exhaustive list, SJHH nurses contribute to multiple national, provincial, regional, and local external committees, including: Council of Academic Hospitals of Ontario Regional Peritoneal Dialysis Steering Committee Chronic Disease Management Think Tank LHIN Chief Nursing Executive and VP Committees Cardiovascular Assess Devices Patient Education Committee Stroke Education Committee McMaster Committee for Partnerships in Nursing Research McMaster Undergraduate Committee Executive Council Mohawk Continuing Education Advisory Committee McMaster/Mohawk Curriculum Advisory Committee LHIN Foot Care Committee Ontario Stroke Network Board of Directors Mohawk College Foundation Board Mohawk College Alumni Association As raters for the McMaster Online Rating of Evidence (MORE) System MOHLTC Rehab Alliance Committee for Frail Seniors
Regional Committee for the Enhancement of Elder Friendly Environment (CEEFE) McMaster/Mohawk/SJHH/HHS Academic Partnerships Committee Regional Medication Information Committee HHS Nursing Advisory Council Hamilton Diabetes Collaborative
SOON (Southern Ontario Obstetrical and Neonatal Nurses) 2015 COPD Quality Based Procedure Baseline Report Validation Panel - Health Quality Ontario & Ministry of Health and Long-Term Care Caring For MyCOPD Programs HNHB LHIN Expert Panel Member for the Value Demonstrating Initiative on Chronic Obstructive Pulmonary Disease: Pulmonary Rehabilitation - Health Quality Ontario & Ministry of Health and Long-Term Care. Bariatric Surgery Provincial Case Costing Task Force Quality Improvement Project to standardize the data indicators for community based mental health and addiction agencies in Ontario, Canadian Mental Health Association (CMHA) and Addiction and Mental Health Ontario (AMHO) AMHO Leadership Council Community Stakeholder’s Working Group on Drug Induced Psychosis Burlington Community Foundation’s Mental Wellness Alliance’s Co-ordination & Resource Integration task group Burlington Community Foundation Mental Wellness Alliance Leadership Team Advisory Committee for the Drug Treatment Funding Program (DTFP) – a partnership of Addiction and Mental Health Ontario, CAMH, & Pine River Institute Regional Geriatric Program Rehab Care Alliance –Task Group for Frail Seniors / Medically Complex Patients, MOHLTC HHBN -LHIN Assess and Restore Intervention project steering committee & provincial meeting HNHB LHIN Hospice Palliative Care Program, Early Identification Working Group Home Dialysis Interest Group PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
66
International Society of Thrombosis and Hemostasis (ISTH) Thrombosis Canada Ontario Woundcare Interest Group Hamilton Integrated Research Ethics Board Trauma Informed Community Committee Scientific Review Committee, International Association of Forensic Mental Health Services, Manchester, UK. International Association of Forensic Mental Health Services Psychiatric Mental Health Nursing Section, International Association of Forensic Mental Health Services
2015 Nursing Excellence Awards 182 nurses were nominated for Nursing Excellence Awards in 2015, recognizing exemplary achievement across all nursing domains. These nurses represented the best of the profession and SJHH, and highlighted the important contributions of nurses to quality care. The 2015 award recipients were: Award
Award Recipient
Mental Health & Addiction Nursing
Michelle Carrigan
Surgical Nursing
Christine Doucette
Women’s & Infants’ Nursing
Kristy Waddell
Critical Care Nursing
Amy Groen
Emergency/Ambulatory Nursing
Lisa Castaldi
Medical Nursing
Leo Godreault
Preceptorship / Mentorship
Heather Sholer
Star on the Horizon
Jonathan Buma
Nursing Education
Elisa Bolognone
Nursing Research
Neala Hoad
Nursing Leadership
Heather Hobbs
Robertson Memorial Award
Nursing Education Team
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
NURSING
67
Continuing Education: The Canadian Nurses Association (CNA) offers certification in 20 areas of nursing practice. CNA certification is a prestigious, nationally recognized nursing specialty credential for registered nurses. Achieving and maintaining this certification confirms that a nurse meets or exceeds a national standard for expertise within a specialty area of practice, and demonstrates ongoing commitment to continuous learning and professional development. In 2015, through the generous support of the M. Patricia Krukowski Memorial Fund and Toyota Motor Manufacturing Canada Inc., the St. Joseph’s Healthcare Foundation established a fund to support nurses to obtain this credential. This year, the following SJHH nurses achieved Canadian Nurses Association (CNA) national certification:
Name
CNA Certification
Amy Groen
Critical Care Nursing
Andrea Kossakowski
Perinatal Nursing
Anna Janik
Medical-Surgical Nursing
Christine White
Psychiatric Mental Health Nursing
Jennifer Lowe
Psychiatric Mental Health Nursing
Joseph (Saji) Sebastian
Psychiatric Mental Health Nursing
Karen Albert
Psychiatric Mental Health Nursing
Kimberly Jones
Psychiatric Mental Health Nursing
Kristine Wachmann
Critical Care Nursing
Marsha Dinsmore
Psychiatric Mental Health Nursing
Sandra Forster
Gerontological Nursing
Tanya Zodila
Psychiatric Mental Health Nursing
Tarrah Long
Gerontological Nursing
Viji Joseph
Psychiatric Mental Health Nursing
Bojana Vucenic
Psychiatric Mental Health Nursing
External Presentations Bang, D. & Jendzio, A. Trauma-Informed Practice: What does it look and feel like. Aamjiwnaang First Nation, Sarnia, Ontario, February, 2015. Bang, D. & Gatkowski, L. Trauma-Informed Practice Principles. St. Joseph’s Healthcare Hamilton Rounds. Hamilton, Ontario. March, 2015. Bang, D. & Jendzio, A. Trauma-Informed Practice: What does it look and feel like. Alternatives for Youth / Youth Wellness Centre. Hamilton, Ontario. April, 2015. Bang, D. & Jendzio, A. Trauma-Informed Care. Hamilton East Health Link Physicians and Health Professionals. Hamilton, Ontario. June, 2015. Bang, D., Jendzio, A., Ledger, K., Whitson, J. Standardizing Addiction Program Transitions through a LEAN Process. Addictions and Mental Health Ontario Conference. Toronto, Ontario. May, 2015. Bang, D. A.A. as a Resource for Professionals. International Convention Alcoholics Anonymous. Altanta, Georgia. July, 2015. Barrett, J., Chapman, B. and Joyner, M. Utilize a Benefit Framework to Measure Outcomes and Identify Opportunities for Practice and Business Improvements. 4th National Summit on Data Analytics for Healthcare, Toronto, ON. December, 2015. Bartlett, A. Managing Your COPD - Six Nations Chronic Lung Disease Program White Pines Wellness Centre Ohsweken, ON. November, 2015.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
68
Bartlett, A. Drug Delivery Devices: Dos and Don’ts in Respiratory Care - Canadian Network for Respiratory Care National Respiratory Care and Education Conference – Niagara Falls, ON. November, 2015. Bullard, C. & Reynolds, J. Family Burden and Anxiety Disorders: A Hermeneutic Phenomenological Study – final results. Anxiety and Depression Association of America, Miami, Fl. April, 2015. Constantinescu, V. Patient Engagement: Learning With and From One Another; Patients and Providers on the Same Improvement Path. Lunch and Learn Presentation. Health Transformation Quality. Toronto, ON. October 2015. Crowe, A. Wound Care Resource Allocation and Accessibility for All Ontarians-Working Group Update. Canadian Association of Wound Care. Toronto, ON. November, 2015. Crowe. A. Frequently Encountered Integumentary Concerns and Wound Care of Persons Living With Scleroderma. Systemic Sclerosis CME. Hamilton, ON. September, 2015. Crowe. A. Update of Skin/Wound Therapies for Persons with Scleroderma. International Scleroderma Society. Hamilton, ON. September, 2015. Crowe. A. Use of Negative Pressure Therapy with Irrigation. Acelity Panel Discussion. San Antonio, Texas. June, 2015. Crowe, A., John, B., Constantinescu, V. Presenters: John, B. and Constantinescu, V. Patient Safety-Redesigned Pressure Ulcer Prevention and Management Program at SJHH Workshop. Quality Conference 2015, Accreditation Canada. Toronto, ON. April, 2015. Ford, P. Speaker/Session Chair. Health Achieve Conference. November, 2015. Ford , P. Gosse, C. Loncke, J.Gallacher, M. Nasheed, J.Holding, A. Mayens, E. The ARMT Journey. Ontario Gerontological Association annual conference. Toronto, ON. April, 2015. Ford, P., Wojtowicz, E., Pizzacalla, A., Thompson , D. Facilitating Successful Transitions. The Gerontological Nurses Association of Ontario , Hamilton Chapter. Hamilton, ON. June, 2015. John, B. & Constantinescu, V. Sustainable Pressure Ulcer Program. Accreditation Canada Conference. Toronto, ON. March, 2015. Kirkpatrick, H., & Martin, M-L. Evaluating Patient, Staff, & Family Experiences with a Tobacco Initiative 4 Years Later. Canadian Federation of Mental Health Nurses’ Conference. Niagara Falls, ON. October, 2015. Labuguen, B., & Olarte-Godoy, J. Building Capacity in Concurrent Disorders. Canadian Federation of Mental Health Nurses’ Conference. Niagara Falls, ON. October, 2015. Martin, M-L., Wilson, F., & Bang, D. Supporting Culture Shifts in the Creation of TraumaInformed Care Environments. National Conference of the Canadian Federation of Mental Health Nurses: Celebrating Canadian Psychiatric & Mental Health Nursing Achievements. Niagara Falls, October, 2015 . Martin, M-L. Trauma-Informed Care Study. International Association of Forensic Mental Health Services Conference. June, 2015. Martin, M-L. Tobacco Study. International Association of Forensic Mental Health Services Conference. June, 2015. Martin, M-L. A START to Assess Strengths and Risks to Self and Others. National Conference of the Canadian Federation of Mental Health Nurses: Celebrating Canadian Psychiatric & Mental Health Nursing Achievements. Niagara Falls, October, 2015 . PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
69
Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F. Bang, D., Rehman, Y. Perceptions about a Trauma Informed Care Approach in a Mental Health and Addiction Setting. Celebrating Canadian Psychiatric & Mental Health Nursing Achievements, The 2015 Canadian Federation of Mental Health Nurses National Conference, Niagara Falls, Canada, October 21 – 23, 2015. Martin, M-L., Reitmeier, M., Furimski, I. Perceptions of Care by Families of Forensic Out-Patients. Celebrating Canadian Psychiatric & Mental Health Nursing Achievements, The 2015 Canadian Federation of Mental Health Nurses National Conference, Niagara Falls, Canada, October 21 – 23, 2015. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D., Rehman, Y. Trauma Informed Care: The Perceptions of Patients & Staff 4 Years after Implementation. Custody & Caring 14th Biennial International Conference on the Nurse’s Role in the Criminal Justice System, Saskatoon, Canada, October 7-9, 2015. Martin, M-L., Kirkpatrick, H., Johnston, J., Rehman, Y. Four Years after Implementation of a Smoke Free Tobacco Initiative: Patients’, Families’ & Staff Perspectives. Custody & Caring 14th Biennial International Conference on the Nurse’s Role in the Criminal Justice System, Saskatoon, Canada, October 7-9, 2015. Martin, M-L., The Role of the Clinical Nurse Specialist in Canada: Working in Forensics. In Symposium entitled, Forensic Nursing Competencies: Comparing Work in Scotland, Ireland, England and Canada. Risks-Rights-Responsibilities, The 15th Annual Meeting & Conference, International Association of Forensic Mental Health Services, Manchester, UK, June 16 – 18, 2015. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D., Rehman, Y. Perceptions about a Trauma Informed Care Approach. Risks-Rights-Responsibilities, The 15th Annual Meeting & Conference, International Association of Forensic Mental Health Services, Manchester, UK, June 16 – 18, 2015. Martin, M-L., Kirkpatrick, H, Johnston, J., Rehman, Y.. Evaluating Patients’, Staff & Family Experiences with a Tobacco Initiative. Risks-Rights-Responsibilities, The 15th Annual Meeting & Conference, International Association of Forensic Mental Health Services, Manchester, UK, June 16 – 18, 2015. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D., Rehman, Y. Trauma Informed Care: the Perceptions of Patients & Staff 2 Years after Implementation. Daphane Cockwell School of Nursing, Ryerson University, 7th Annual Nursing Research Day: Research Leadership: Leveraging Intervention Research for Better Outcomes, Toronto, Canada, June 9, 2015. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D. , Rehman, Y. Patients’ & Staff Perceptions about the Care of Patients with Abuse/Trauma Experiences. Building Leadership in Nurses Everywhere from the Bedside to the Boardroom, The 28th Annual Research and Leadership Conference, Arthur Labatt Family School of Nursing, Western University and the Iota Omicron Chapter, of Sigma Theta Tau International Honor Society of Nursing, London, Canada, May 1, 2015. Martin, M-L. Teaching Relaxation Techniques: Practice & Evidence. The 9th Annual Risk & Recovery Forensic Conference, St. Joseph’s Healthcare Hamilton & McMaster University, Hamilton, Canada, April 9 – 10, 2015. Martin, M-L., Kirkpatrick, H., Johnston, J., Rehman, Y. Evaluating Patients’, Families’ & Staff Experiences with a Tobacco Initiative in a Mental Health Setting. Poster presentation at The State of the Art Clinical Approaches to Smoking Cessation, 7th Annual Ottawa Conference, University of Ottawa Heart Institute, Ottawa, Canada, January 23 – 24, 2015. Mills, L., How to use teach-back skills in everyday practice to ensure patient understanding. Reaching New Heights. CANNT. Vancouver, BC., October, 2015. Mills, L., Improving health literacy through the use of Facilitating Client Centred Learning, L.E.A.R.N.S. model. RNAO Chronic Disease Management Institute. Toronto, ON. October, 2015. O’Connell, E. & Wiebe, L. Lessons Learned: Creating an Orientation Program for Forensic Mental Health Nurses. 14th Biennial Custody and Caring International Conference on the Nurse’s Role in he Criminal Justice System. Saskatoon, SK. October, 2015. O’Connell, E. and Wiebe, L. Forensic Orientation: Review and Lessons Learned. National Conference of the Canadian Federation of Mental Health Nurses: Celebrating Canadian Psychiatric & Mental Health Nursing Achievements. Niagara Falls, October, 2015 . PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
70
Olarte-Godoy, J. Concurrent Disorders- Building Capacity for Integrated Care- Mental Health Nursing Conference. October, 2015. Pace, J., Gatkowski, L. and Simpson, S. Birthing a Collaborative Approach: Mental Health and Addiction, Maternal Child Nursing and the Woman with a Trauma History. Canadian Domestic Violence Conference. Toronto, ON. June, 2015. Pace, J., Gatkowski, L. and Simpson, S. Birthing a Collaborative Approach: Mental Health and Addiction, Maternal Child Nursing and the Woman with a Trauma History. Canadian Domestic Violence Conference. Toronto, ON. June, 2015. Pace, J., Gatkowski, L. and Simpson, S. Mental Health Addictions and Trauma Histories. National Conference of the Canadian Federation of Mental Health Nurses. Niagara Falls. November. 2015. Reitmeier, M., Martin, M-L., & Furimski, I. Perceptions of Care by Families of Forensic Outpatients. National Conference of the Canadian Federation of Mental Health Nurses: Celebrating Canadian Psychiatric & Mental Health Nursing Achievements. Niagara Falls, October, 2015 . Ritchie, S., & Long, T. Transitioning New Graduate Nurses in General Internal Medcine. Presentation at Nursing Seminars, McMaster University, Hamilton, ON. March, 2015 Sahr, R., Forchuk, C., Sherman, D., Campbell, R., Corring, D., Martin, M-L., Mustin-Powell, J., McIntosh, L., Glover, C., Reiss, J., Srivastava, R. Adopting Research to Improve Care (ARTIC): Implementation of the Transitional Discharge Model (TDM). Advancing Recovery Research: Patients, Partnerships and Peers, Ontario Shores’ 4th Annual Research Day, Whitby, Canada, February 24, 2015. Sardo, L., Bayadinova, J. Nurse Practitioner Role in Anticoagulation Services: The St. Joseph’s Healthcare Experience. Annual McMaster Update in Thromboembolism and Hemostasis, Hamilton, ON. October, 2015. Sardo, L. History of Thrombosis Management in Canada. International Society of Thrombosis and Hemostasis Congress, Toronto, ON. June, 2015. Sardo, L. The Nurse Practitioner’s Role in Venous Thromboembolism with Special Focus on the Cancer Population. Nurse Practitioners Association of Ontario. Webcast. November, 2015. Saunders, H and Melligan, G. Optimizing the collaboration between Detention Centre and Mental Health Services through the use of Community Treatment Orders for mentally ill offenders in Hamilton, Ontario. Provincial Human Service & Justice Coordinating Committee Provincial Conference. Toronto, ON. November, 2015. Volman, L., Landeen, J., Doyle, W., Szypula, F., & Smith, L. Transforming Patient Care through the Clinical Monitoring Process: A Study of Nursing Practice Change. National Conference of the Canadian Federation of Mental Health Nurses: Celebrating Canadian Psychiatric & Mental Health Nursing Achievements. Niagara Falls, October, 2015 . Willison, K., & Winemaker, S. LEAP (Learning Essential Approaches to Palliative and End of Life Care) Workshop for the Hamilton Family Health Team. Sponsored by the Division of Palliative Care. Hamilton, ON. May, 2015. Willison, K., & Winemaker, S. Workshop presentation at McMaster University’s Continuing Health Sciences Education Department in conjunction with the Division of Palliative Care. Managing Care Transitions. Hamilton, ON. June, 2015. Wright, S. & Ford, P. Restraint Reduction with Seniors. Niagara Health System Medicine Grand Rounds. St. Catherines, ON. October, 2015 PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
71
External Poster Presentations Asare-Kwakye, S., Moulton, A. (2015). Advance Care Planning in the Hemodialysis Community: Partnering with Patients and Families. Partnering with Patients and Families Event, St. Joseph’s Healthcare Hamilton, ON. November, 2015. Bang, D. & Jendzio, A. From Push to Pull a LEAN © Project in a Men’s Addiction Service to Improve Transitioning. Issues of Substance 2015: Addiction Matters Conference. Montreal, Quebec. November 2015. (Invited). Bang, D. & Yanke, C. YogaFit Warrior: Findings from an Innovative Program for Women With Substance Use and PTSD. Issues of Substance 2015: Addiction Matters Conference. Montreal, Quebec. November, 2015. (Invited). Burns, G., & Zivanovich, M. Empowering Frontline Nurses to Lead Patient Safety and System-Wide Change. Nursing Leadership Network Conference. Toronto, ON. March, 2015. Court, M., & Gatkowski, L. Meeting the Psychological Needs of Families of Persons with Dementia. Canadian Federation of Mental Health Nurses’ Conference, Niagara Falls, ON. October 2015. Carole Madeley, Ann Bartlett, Dina Brooks, Joe Cafazzo, Cathy Faulds, Andrea Gershon, Judith Glennie, Michael Hillmer, Carley Hay, Anne Hayes, Alan Kaplan, Lorraine LeBlanc, Chris Licskai, Mark Lundie, Kieran McIntyre, Joanne Plaxton, Jake Pringle, Reza Maleki-Yazdi. A Multi Stakeholder Collaboration to Improve Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD) In Ontario: Value Demonstrating Initiative (VDI) On COPD. Canadian Network for Respiratory Care National Respiratory Care & Education Conference. Niagara Falls, ON. November, 2015. Constantinescu, V. Patient Engagement: Learning With and From one Another; Patients and Providers on the Same Improvement Path. 7th Annual University of Toronto Centre for Quality Improvement and Patient Safety (C-QuIPS) Symposium. Toronto, ON. September, 2015. Dawson, P. Keeping things simple: Engaging and educating with a waiting room blackboard! EPION 10th Anniversary Celebration and Conference. Toronto, ON. October, 2015. Gatkowski, L. Integrated Clinical Skills. Canadian Federation of Mental Health Nurses’ Conference, Niagara Falls, ON. October 2015. John, B., Crowe, A. and Constantinescu V. Redesigned Pressure Ulcer Prevention and Management Program at St. Joseph’s Healthcare Hamilton. Quality and Safety Summit-Leveraging Nursing Leadership. Toronto, ON. November, 2015. Martin, M-L. Tobacco Study. Ottawa Heart Institute Smoking Cessation Conference. Ottawa, ON. January, 2015. Martin, M-L., Gatkowski, L., Szypula, F., Wilson, F., Bang, D., Rehman, Y. Patients & Staff Perceptions about the Care of Patients with Abuse/Trauma Experiences. Mechanisms of Risk, Resilience & Treatment Responses, Department of Psychiatry and Behavioural Neurosciences, 27th Annual Research Day, McMaster University, Hamilton, Canada, April 29, 2015. Martin, M-L., Kirkpatrick, H., Johnston, J., Rehman, Y. Evaluating Patient and Staff Experiences with a Tobacco Initiative in a Mental Health Setting 4 Years after Implementation. Mechanisms of Risk, Resilience & Treatment Responses, Department of Psychiatry and Behavioural Neurosciences, 27th Annual Research Day, McMaster University, Hamilton, Canada, April 29, 2015. Mills, L. Advanced Clinical Practice Fellowship: A Career Changing Opportunity. Reaching New Heights. CANNT Conference. Vancouver, BC. October, 2015. Reitmeier, M., Martin, M-L., Furimski, I. Perceptions of Care by Families of Forensic Out-Patients. Mechanisms of Risk, Resilience & Treatment Responses, Department of Psychiatry and Behavioural Neurosciences, 27th Annual Research Day, McMaster University, Hamilton, Canada, April 29, 2015. Sholer, H. The Costly Effects of Horizontal Violence in the Nursing Profession. Nipissing Undergraduate Research Conference. Nipissing University. April, 2015. Sholer, H., Lowe, J., Simons, S., & Oremus, C. The Effects of Horizontal Violence in the Nursing Profession: Protocol for a Systematic Review. McMaster University Department of Psychiatry & Behavioural Neurosciences: 27th Annual Research Day. Mohawk College. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
NURSING
PAGE
72
Leadership: Influential roles in many interprofessional initiatives, through leadership in nursing best practice review, implementation and evaluation as an RNAO BPSO, Releasing Time to Care initiatives, and through leadership in several corporate priority areas, such as parenteral monographs, integrated core clinical competencies, advancing person-centred care, falls prevention, transfer of accountability processes, clinical monitoring, and reduction of pressure ulcers and hospital acquired infections: pneumonia and catheter-associated urinary tract infections, and early identification and management of sepsis.
Discipline Goals 2016 Quality & Safety
BPSO— Implement and Sustain Nursing Best Practices: - Participate in NQuIRE & maintain BPSO designation - BPSO areas of focus: Assessment and Care of Adults at Risk for Suicidal Ideation & Behaviour, Assessment and Management of Foot Ulcers for People with Diabetes, Facilitating Self-Management of Chronic Conditions, and Assessment and Management of Pain - Introduce nursing order sets into the electronic health record as a pilot Initiative Provide Leadership in Identifying and Implementing Best Practices in: Reduction in Hospital Acquired Infections: Pneumonia and UTI Reduction in Patient Falls Policies and Procedures - Review and revise and build structure to sustain policy best practices
Change Enable Nursing Practice that Reflects CNO Standards and Regulatory Requirements Review policies/procedures/processes that impact on nursing practice Continue to provide supports for all nurses to work to the full scope of practice
InterConnection
Transfer of Accountability –Monitor & sustain shift-to-shift processes and Implement and evaluate unit-to-unit processes Supporting Safe Medication Practice — Parenteral monographs: review and sustain and expand medication reconciliation initiatives
Community Recruitment and retention Optimize MOHLTC New Graduate Guarantee funding Standardize nursing clinical orientation processes Continued engagement of point-of-care nursing staff in nursing best practice and
quality improvement initiatives and decision-making at the corporate NAC
Research & Education Promote and support nursing research NAC Research Award Collaborate with external partners to enhance research opportunities & build internal capacity Continue to promote CNA certification and offer nursing professional development opportunities PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
73
Occupational Therapy Professional Practice Leader (Charlton, King, West 5th): Monica Alderson OT Reg.(Ont.) Number of Members of Discipline Occupational Therapists:
Occupational Therapist Assistants:
Charlton King West 5th Charlton West 5th
24.3 FTE 10 FTE 23.5 FTE 4.1 FTE 3.6 FTE
Clinical Practice Achievements Scope of Practice: The practice of Occupational Therapy is the assessment and diagnosis of physical, emotional, social and cognitive capacity and performance, occupational demands and environmental factors and interventions to enable participation in activities of everyday life to promote and optimize health and well being.
Quality & Safety
-
-
-
Falls Prevention Activities: In their role, OTs work closely with team to ensure patients have falls assessment, to ensure appropriate intervention to address falls risk and have equipment needed to facilitate safe mobility across all the units they work on. Participation in the Corporate Falls Prevention Committee, OTs participation in meetings re: falls prevention working group for outpatient mental health clinics at St. Joe’s, falls screening (SIRS) alert on acute mental health with OT follow-up, OT member of the Complex Care Quality subgroup working on falls and the OT is the ongoing falls prevention lead for Waterfall 3. Rehab Falls Committee, an interprofessional team, OT, PT and Nursing now focusing on reducing toileting related falls. Created info sheets for Nursing to assess walker and wheelchair needs for pts when therapy services not available to ensure appropriate mobility aids are being used when accessing bathroom or moving in room. Looking into highlighting slope into shower area to increase awareness when mobilizing in this area. Developed new paging system to identify needs related to toileting "Level 1". Investigating potential sensors or other devices for those at a very high falls risk. OTs participate on Quality and Patient Safety Committees across multiple programs including Complex Care Quality Committee ( subgroup working on pressure ulcers and falls), Rehabilitation, Ambulatory Therapeutics, Forensics, GIM, and Cleghorn Early Intervention for Psychosis. Participation Digital Order Sets Approval Committee Co-facilitated Managing Emotions group at Bridge to Recovery program collaborating with Nursing and Social Work for 14 weeks
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
74
COPM with the Resp Rehab measure in order to use a more client centred outcome measure than strictly the FIM OT running a life skills group on 10 Acute Mental Health which includes topics of sleep hygiene, problem solving, goal setting, self esteem and budgeting. Partnering with Therapeutic Recreation OT have started a weekly cooking/baking group. Volunteer with “Team Unbreakable” Therapy Running Group at Mood Disorders Outpatient Clinic OT developed and runs a Behavioural Activation group at East Region Mental Health Services In Forensics, OT developed a Short Term Apartment Assessment Protocol and used the Transitional Apartment in a limited capacity to complete a functional assessment for one of the patients. OT now assisting with screening the new intakes for Schizophrenia Outpatient Clinic to decrease wait list times and be more efficient in helping clients receive the best care at the right time. Schizophrenia Outpatient Clinic developed and initiated ‘Relaxation Group’ for patients. Development of patient education booklets for extensor tendon repairs to facilitation home program. Rehab Pressure ulcer awareness- review of clients on unit increase risk of developing pressure ulcers minimizing risk of advancing wound stage Development of a stroke care path for Occupational Therapy Halton Seniors Mental Health Outreach new group in collaboration with neuropsychology facilitating a group "Memory and Aging" session Halton Seniors Mental Healht Outreach completed Zarit Burden Inventory completed for all referrals Cleghorn started Volunteer Group Co-facilitation of a new CBT group for psychosis in the Cleghorn program Canadian Work Profile Inventory assessment use implemented with the Cleghorn Program Implementing excel based program to track level of participation, duration and attendance program within Cleghorn Program as an outcome measurement tool Working with our entire team (RN, SW, TR, Psychology, peer support and management, administrative support, psychiatry) to develop admission to inpatient procedures and processes within Cleghorn program. Developed group evaluation with TR, SW, research coordinator and peer support counselor within program OT developed information/promotional pamphlet describing all of the groups available at the Cleghorn program OT, SW, TR, research coordinator and peer support counselor to develop group calendar for waiting room as well as notification emails to clients in the Cleghorn Program Corporate skin and wound committee participation.
Interconnection
TOA audit results forms being used by all practice areas at Charlton campus Accessibility Committee participation ensuring standards are met across the organization. Home First Re-fresh committee Cleghorn OTs met with Mohawk Accessible Learning Services team to build a relationship, explain what our program offers and improve referral process.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
75
Change
Dual Diagnosis Program: OT developing a DBT-based group for individuals with mild intellectual developmental disabilities. Dual Diagnosis Program— Supporting the Promotion of Activated Research and Knowledge (SPARK) project for Transitional Aged Youth with the Mental Health Commission facilitated by OT. SMART (Seniors Mobile Assess and Restore Team on GIM including Social Work and Physiotherapy implementing expanded programming with assistants and weekend Occupational Therapy. OT dynamically modifying the Rehab Screening- working with physio, NP, rehab manager, and psychiatrist in constant review of screening process, criteria, education to units, development/editing of alogrithim for hip fracture etc. Outpatient Mood Disorders have developed a new outpatient group with a dietician that focuses on healthy eating/cooking skills. Rehab Teach Back Project- ensuring client understanding of educational materials presented Developing the occupational therapy role for Harbour East 1 a new unit for Seniors Mental Health with mood disorders. Development of the occupational therapy role at the Youth Wellness Center, a new addition. Development of the occupational therapy role in the Anxiety Research and Treatment Center. OT’s working on the Clinical Informatics Team working alongside a large interdisciplinary team as applications Specialists for the Clinical Transformation Project. OT and PT working to establish a link with Geriatricians for patients in day therapy. Working with Day therapy team (Social Work, OT, PT) to revamp education classes to make them more generic and a more interprofessional focus on exercise classes not just PT to improve flow through the program. General Internal Medicine Program: Patient Communication Board Committee; PatientCentered Care Committee Electronic system for wheelchair sign out operational and process maps implemented. FAPIE inservice to OT to support change over in documentation framework.
Community
OT Retreat: To celebration Occupational Therapy Month, the OTs from all campuses were invited to participate in a day retreat. The topics included a review of changes and directions in Healthcare affecting OT, Health Services Funding Reform, Your OT Career — Assess It, Adapt It, Own It. Additional postings on the new OT MyCollaboration Site OT participated on the Planning Committee for the first Anti Stigma Conference at our West 5th Campus. OT Representation on the Quality of Worklife Committee on Forensics OTs are Co-Chairs of the Forensic Newsletter Committee. More clinical collaboration across practice areas and sites to support one another in where expertise more concentrated at another campus. Hosted the McMaster Preceptor Workshop at our West 5th campus for community preceptors. Hosted education sessions for all OTs at St. Joseph’s outline the new McMaster OT model for their program
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
76
Academic Pursuits Formal Teaching: McMaster University, Faculty of Health Sciences: Seven Professional Associates to the Institute of Applies Health Studies, School of Occupational Therapy, McMaster University. Lecturer (Adjunct), Faculty of Health Sciences, McMaster Universiy Associate Clinical Professor (part-time), School of Rehabilitation Science, Faculty of Health Sciences, McMaster University Several OT’s have participated in the Admission Interview Process Lecturer, Facilitation and Teaching sessions provided: Group Process and Content Functional Assessment/ADL Assessment Skills Lab, Self-Management of Chronic Conditions Professional Reasoning & Skills (PRS) course, Leisure Assessment and Intervention Assessing and Addressing Affective Function Examiner, PREP, Clinical Interviewing (Evaluated Interview & Practical Exam At SOC myself, rec, nursing and social work did a presentation to Mohawk college students back in March on schizophrenia and treatment as related to each discipline. Assisted in transfers lab, physical assessment lab, hand physical assessment, splinting lab and contributed to McMaster IADL session Problem based tutorial leadership by seven therapists Act as resource to McMaster students who are seeking clinical input for PBTcase scenarios related to early intervention for psychosis and hand therapy. Mohawk College Occupational Therapist Assistant Program Mohawk OTA Splinting Integration workshop lecture. Developmental Dual Diagnosis Outpatient Clinic to students at Mohawk Inquiry Course tasked with the researching of underrepresented populations at the post-secondary level within our community (lowincome persons, newcomers to Canada, Aboriginal peoples, and those with physical and intellectual exceptionalities) Everest College PSW students--role of OT and session on body mechanics during functional transfers Medication training in partnership with an RN for public health education session for RCF home operators.
Internal Teaching:
Collaborative posters at all three campuses focusing on OT role in transitions. Forensic Fair poster on the OT role in Forensics which highlighted Assessments, Interventions, Outcomes, and client lead initiatives. Forensics OT completed training for the use of the Hoyer lift and safe transfer training for all staff. "OT and Discharge Planning" education session for the GIM residents Orientation GIM Residents Poster presentations for nursing week and knowledge café on groups Collective Kitchen, 1:1 smoking cessation and Schizophrenia Falls Prevention Strategies PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
77
Falls Prevention Poster shared at the Falls Prevention Workshop GPA recharge to allied health, GPA for RN/RPN on rehab & CC, GPA for PSWs at St. Joseph's Homecare. St Joseph's healthcare Best Practice Open House Poster presentations: - Seniors Mental Health Outreach & the Client/Family Experience: Development and Implementation of an Interprofessional Tool to Improve Care Partner Communication - Experiences and perceptions of Community-Based Occupational Therapists Regarding Their Work with Adults with Morbid Obesity (J.Lee) Complex Care Positive psychology rollout acute mental health inservices to Charlton units Provided 4 hour Concurrent Disorders Educational Workshops for interdisciplinary staff across SJHH Provided ongoing Lunch & Learns and specialized training for Concurrent Disorders unit leads/champions staff across Mental Health And Addiction Program (Intro to Concurrent Disorders, Stages of Change, Motivational Interviewing, Screening and Assessment, & Harm Reduction and Advocacy). provided joint in-service with physio to nursing staff on nephrology, urology and renal transplant to review transfer techniques, use of mechanical lifts, placement of slings. OT as part of an interdisciplinary team to provide training and support on the new Patient Document Management (PDM) application to various units/programs and professionals across Charlton and West 5th. Involved in educating nurses, nursing students and allied health re: appropriate use of waffle over lays. Educational Rounds (Mood Disorders “Urban Poling” with Recreation Therapy
Clinical Teaching
provide shadowing opportunities to co-op students and students of other disciplines Therapeutic Recreation on Mood Disorders, kidney-urinary Nursing students education re: OT and role in kidney/urinary program and Cleghorn program Gerontology students from MAC shadowing role of OT kidney urinary MAC PT students shadowing OT interventions kidney urinary Co-facilitates case based teaching sessions together with social work and PT directed at medical students in the kidney/urinary program biweekly 10 new nursing hires on CC, orientation Continuing Education: session to OT services on program and review of ceiling lift use, policies and practice DBT Introductory training — 3 (hands-on practice as needed), brief 2-day Mental Health First Aid Training through orientation to floor lifts used on complex the “Beyond the Silence” research project at St. Joseph’s Healthcare Hamilton — 3 care DBT Group Faciliation —- 1 2 nursing student groups – orientation PGAP (progressive goal attainment program), session to OT services on CC, patient seating ADP authorizer (ongoing) X 3 and positioning in wheelchair and safe use of Emerging Leaders 3-day workshop, wheelchairs. Certificate in Project Leadership from the University of Waterloo LEAN Yellow Belt — 3 White Belt — 4 PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
78
OT mentor in the CAOT Momentum Mentorship program from Winter-Summer 2015. This program aims to pair up recent graduates of occupational therapy programs, internationally educated occupational therapists, occupational therapists re-entering the workforce and occupational therapists transitioning into new roles (“mentees”) with seasoned occupational therapists that can share professional experience and help younger or less experienced occupational therapists with a career development path (“mentors”). Orientation to OT Role for Medical Students on CTU provided job shadowing opportunities to coop students, Mohawk students, OT students seeking particular clinical exposures, McMaster students other programs and Brock University Job Shadow Opportunities to OTAs looking for refresh to return to practice 1/2 day shadow 2 Mac students re ICU role to assist with research project IPE sessions facilitated on Rehab (January, April, December 2014) with OT, OTA, co-operative students, nursing and physiotherapy students
Scholarly Pursuits Research
Project of painting/disguised door on the ALC unit to reduce agitation, responsive behaviours and exit seeking. We are still gathering data re: it's effectiveness. Co-investigator: BRAVE study. Contributed to the proposal for the BRAVE Trial: A pragmatic randomized trial to investigate the effectiveness of BehaviouRal ActiVation group therapy in reducing dEpressive symptoms and improving quality of life in patients with depression. (with psychiatry, social work, psychology, therapeutic recreation, nursing) Co-investigator: “Pushing Limits” study. Adventure-Based Therapy (with therapeutic recreation, psychology, social work) Nordic Walking – continuing to develop this new program “Up and Out” and initiating research study with Anxiety Treatment and Research Centre (in progress) – with therapeutic recreation, psychology, psychiatry Development of Tinetti for Dementia ongoing PAC supported research. Evidence Based Practice Projects: McMaster (Faculty of Health Sciences) to supervise student research activities within the Concurrent Disorders unit with OT leading the 4 students throughout the project titled “A Study of the Concurrent Disorders Unit at St. Joseph’s Hospital (West 5th Campus)” Eight students, research/quality assurance projects in Schizophrenia Services Supervisor of OT research project Mindfulness Meditation for Healthcare Workers in LTC on Self-Reported Stress ongoing Use of Daily Activity Schedules as a Tool to Reduce Responsive Behaviours in Adult Day Programs project completed and rolling out to practice.
Publications
Celebrating OT month article regarding OT Events at St. Joseph’s was published in OT weekly CAOT OT Now with a facebook page link.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
79
External Committees
MacHand membership to enhance research and education related to specialty hand services McMaster OT/PT Program Clinical Advisory Group to enhance and increase placements. McMaster OT Education Committee Hamilton Hand Interest Group GPA Advisory Committee — co-chair & member Rehabilitative Care Alliance: Outpatient/Ambulatory Advisory Group Co-Chair, Self-Management Support Community of Practice, West 5th Campus, St Joseph’s Healthcare Hamilton Expert Panel Member, Integrating Rehabilitation Principles into Interdisciplinary Self-Management – A Health Strategy for Chronic Disease & Aging, Funded by Health Research Foundation Invited Reviewer, OSOT Research Grants Program Co –chaired the Local Hamilton Network of Specialized Care for Dual Diagnosis OSOT Psychotherapy Committee member, and contributor/reviewer for CBT subsection OSOT Hospital Sector Committee Chair
External Presentations
Continue to provide mental health training for Hamilton Police Service through recruit training, Victim Services as well as the 2 courses of Crisis Intervention Team training (40 hour mental health training program for police). CIT also provided for Niagara Regional Police Service (2 courses), Brantford Police Service, Halton Regional Police Service (2 courses) and Norfolk OPP. Presentions included the HSJCC conference in Toronto. As part of MCRRT, media exposure included a spot on Canada's AM with Police Chief Glenn DeCaire. "Occupational Therapy Approaches To The Management of Osteoporosis" for Osteoporosis Canada: Burlington Support Group Attended and participated as an exhibitor (with a booth) at the “What’s Next Conference “ Workshop on Mindfulness to address self-care for front-line workers as requested by Community Vocational Service Workers. “Creating Spaces for Client’s Self-Management”. Psychiatry Grand Rounds Presentation, St Joseph’s Healthcare Hamilton. “A new approach to an old problem: An integrated rehabilitation unit for challenging behaviours” (poster), Dept of Psychiatry & Behavioural Neurosciences, McMaster University, Annual Research Day, Hamilton, OT, Nursing and Psychology “Self-Management – The Work of Recovery”, 2nd Annual Schizophrenia Professional Development Day, West 5th Campus, St Joseph’s Healthcare Hamilton. "Experiences and perceptions of Community-Based Occupational Therapists Regarding Their Work with Adults with Morbid Obesity". poste presentation at the 4th Obesity Summit in Toronto
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
80
OTED TALK– as part of Interprofessional Mental Health and Addictions Rounds in October 2015. OTs presented brief powerful lectures about how OTs help people navigate through life cycle and stages from childhood to older adulthood. Health and Aging Society (McMaster) networking night to be available to students interested in pursuing a career in OT Health Achieve Conference in November - "From an Assess and Restore Mobile Team (ARMT) to SMART". Intimacy in Long Term Care Workshop and etoolkit in 3 Burlington LTCHs facilitated by OT in Halton Senior Mental Health services Presenting to students and staff at Mohawk College re: psychosis as part of their mental health in motion series Interview regarding the Cleghorn program on Talk 1010. Early Psychosis Intervention Ontario Network: Poster: Windows to recovery (photo voice), Poster: Waiting Room Blackboard (low tech education) Educational booth facilitation explaining Cleghorn and Windows to Recovery photos at 9th Annual Recovery Breakfast Cleghorn OTs presented to the HWDSB Teachers as part of Mental Health Summit “Understanding Psychosis and Role of Occupational Therapy” OT assister interprofessional team to develop a promotional video for Cleghorn that was presented at our 10th anniversary Open House and OT/RN created a formal timeline of the Program Windows to Recovery poster presentation on display at Anti-Stigma Conference Adapting the Tinetti (Balance and Gait) for Persons with Dementia at the Alzheimer’s Association International Conference
Leadership:
Chair of PAC for 9 months and Interim Director of Therapeutics for 6 months Co-Chair Quality Council Ambulatory Therapeutics Health Professionals Excellence in Practice Awards Leader Dual Diagnosis — OT created online template for all of our intake assessments and created a structure for waitlist and intake in order to track data on our program and provide a system for screening referrals Chair of Program Committee for Mood Disorders Program Co-Chair Accreditation Team Complex Care & Chair Accreditation Team Ambulatory Therapeutics Member Digital Order Sets Steering Committee Therapeutic Seniors Education Committee Co-Chair Lunch and Learning Sessions Leadership developing the outpatient’s direct admission/code white protocol for West 5th Leader of IPE sessions facilitated on Rehab and Medicine Forensics OT is the temporary facilitator of the Tablet Committee. Leader of the Bariatric Advisory Council for Complex Care SOC lead in a consistent TOA form to be used by all outpatients within the service. Cleghorn OT’s initiated a working group at Cleghorn to better understand current supportive employment and education resources both in the community and within SJHC. Co-lead on the "Positive psychology education working group" for acute mental health Coordinated the training for the new Mobile Crisis Rapid Response Teams in Hamilton, Brantford and Halton. Management of Cleghorn Programs Assumed the position of Senior Mental Health Worker for COAST Hamilton/Mobile Crisis Rapid Response Team (MCRRT) for Hamilton PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
OCCUPATIONAL THERAPY
PAGE
81
Discipline Goals 2016 Quality & Safety
Determine methodology for introducing skill mix services to appropriate populations Integrate stroke care path for Occupational Therapy
Change
Review documentation formats used for reports at West 5th campus and determine methodology for ensuring documentation standards are met on this campus. Investigate value to implementing enhanced Occupational Therapy services in the Emergency Room to frontload services and get started earlier.
InterConnection
Develop enhanced collaborative relationships with the CCAC
Community
Continue to populate MyCollaboration with shared information to assist all OT and OTAs
Research & Education
Participation in appropriate Occupational Therapy research to enhance understanding of the value of Occupational Therapy services.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
82
Peer Support Professional Practice Leader ( West 5th): Fiona Wilson Number of Members of Discipline West 5th
Scope of Practice: Peer Support is a social/ emotional support, often coupled with instrumental support that is based on mutuality. Formalized peer support is provided by trained individuals who have the lived experience of mental illness and/or addiction. Family peer support is provided by those with lived experience as a family member of someone with mental illness/addiction. Founded on the principles and values of respect, shared responsibility, hope,, empowerment and the belief in everyone's ability for recovery. Evidence shows that peer support can be a significant adjunct or complement to clinical care.
13.5
Clinical Practice Achievements Quality & Safety
Completed review of the Mental Health Commission of Canada’s Peer Support Practice Guidelines Person Served Debriefing following Seclusion or Restraint of patient in MHAP rolled out to all MHAP inpatient units. Ongoing Initiated capacity building for trained trainers in SAFE TALK (suicide prevention) within practice group.
Change
Ongoing review of applicability of Peer Support Certification and Accreditation standards for practice Partnership with Mission Services of Hamilton to provide peer support groups in the Code Red Community. Ongoing since September 2015 Development of Community of Practice for ACT Team Peer Support workers – via Brant ACT PPS Development of Hamilton Based Peer Support Community of Practice in partnership with Mental Health Rights Coalition and Good Shepherd HOMES program.
Community
Ongoing partnership with Good Shepherd Homes Program in providing weekly Dual Recovery Anonymous groups onsite at West 5th Campus. Partner is Consumer Survivor Network Initiative Network of the HNHB LHIN.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PEER SUPPORT
PAGE
83
Academic Pursuits Internal Teaching
Clinical Orientation provided on Peer Support—2 Practice Group members Assistant Professor, Dept. of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University.—PPL General orientation, Anti-Stigma Training – PPL
Formal Teaching
PPL runs coordinates and runs workshops for Psychiatry Residents PPL is ProComp Instructor, 1st year Medical Students, Degroot School of Medicine, Faculty of Health Sciences, McMaster University PPS presents to Mohawk College, Social Service Worker Students, role of Peer Support
Scholarly Pursuits Publications Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment Mackenzie P. E. Becker, Bruce K. Christensen, Charles E. Cunningham, Ivana Furimsky, Heather Rimas, Fiona Wilson, Lisa Jeffs, Peter J. Bieling, Victoria Madsen, Yvonne Y. S. Chen, Stephanie Mielko, Robert B. Zipursky Psychiatric Services February 2016, Vol. 67, No. 2, pp. 184 - 191
Continuing Education:
6 PPS completed Level 1 WRAP certification 3 PPS completed Level 1 SAFE Talk certification
Leadership
PPL Co-Lead, Corporate Anti-Stigma Campaign
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PEER SUPPORT
PAGE
84
External Committees
Consumer Survivor Initiative Network of HNHB LHIN Peer Support Accreditation Certification Canada – PPL Chair, Certification Committee; PPS member Addictions Working Group Psychosocial Rehabilitation Canada, Board of Directors Wellington Psychiatric Outreach Program, Board of Directors Mental Health Rights Coalition , Board of Directors Brant Haldimand-Norfolk Peer Network (Chair) Vice-President and Finance Committee board member for HOPE (Helping Ourselves Though Peer Support and Employment) in Brant County City of Brantford Mental Health Strategy Committee Hamilton Peer Support Community of Practice
External Presentations
In partnership with Good Shepherd HOMES program presented to CORE Collaborative Learning workshop on Recovery Oriented Care.
Discipline Goals 2016 Quality & Safety
Building capacity to provide Wellness Recovery Action Plan support via training of all peer support staff in level 1 and 2 – certification acquired for all staff. Audit / Gap analysis of practice following completion of review of national standards of practice
Change
Certification for Peer Support Providers via Peer Support Accreditation and Certification Canada
Research & Education
Build research capacity of peer support group via education and mentoring.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
85
Pharmacy Professional Practice Leader, Interim (Charlton, King, West 5th): Vida Stankus, RPh, BScPhm, ACPR, PharmD, BCPS Number of Members of Discipline Pharmacists/Pharmacotherapy Specialists Charlton 23/9 FTE King/Retail 2 FTE th West 5 7 FTE Technicians/Assistants: Charlton 41/1 FTE King/Retail 5 FTE th West 5 7 /2 FTE Managers 4 FTE Director 1 FTE
Scope of Practice: Custody, compounding , dispensing and prescribing of drugs (as specified in the regulations) -provision of health care aids and devices -provision of information and education related to above -promotion of health, prevention and treatment of disease, disorders and dysfunctions through monitoring and management of medication therapy -administering, by injection or inhalation, a substance specified in the regulations -performing a procedure on tissue below the dermis .
Clinical Practice Achievements Quality & Safety
Pharmacists Managed Anticoagulation Clinic Antibiotic Stewardship program, rounds in ICU, nephrology/renal transplant and teaching teams of Medicine Day 3 antimicrobial reviews by pharmacists Utilization of electronic BPMH documentation. Printing of eBPMH at the end of the discharge prescription Pharmacists involved in the development of digital order sets Pharmacists in retail pharmacy working within their expanded scope of practice – administering flu shots, extending and adapting prescriptions, renewing prescriptions, providing smoking cessation counselling Assistants all registered as Regulated Pharmacy Technicians with the Ontario College of Pharmacists Roll-out of High Alert Medication policy Pharmacist nominated for the 2015 Health Professionals Award of Excellence for Individual Clinical Practice Updated Narcotics, Controlled and Targeted Substances policy
Change
Implementation of Digital Order sets Planning started for re-design of sterile compounding room at Charlton campus Successful move of non-hazardous sterile compounding to temporary location Improvements to technician rotations Expansion of medication reconciliation completion at west 5 th campus Development of Hazardous Drug Policy PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHARMACY
PAGE
86
Community
Monthly staff birthday celebrations Staff of the month recognition Staff children’s Christmas party Sponsor a family at Christmas time
Interconnection
Pharmacists members of the Parenteral Drug Therapy Monographs Steering and Approval Committee nominated for the 2015 Health Professionals Excellence in Practice award in the category of Team Leadership Updated medication safety module for clinical orientation
Academic Pursuits Internal Teaching
Pharmacy Residents (two) for 2014-2015 successfully completed the one year program. Two current pharmacy residents have completed one-third of their residency year Training for Pharmacy students from University of Waterloo and from University of Toronto Provided pharmacy technician student placements (Mohawk College and Sheridan College) Provided co-op work terms for 6 University of Waterloo pharmacy students and work term for 1 University of Toronto student. Students completed a variety of projects, worked in distribution and were trained in direct patient care activities by pharmacists. Pharmacists (seven) acting as preceptors for various rotations for two SJHH pharmacy residents
Formal Teaching
Provided nephrology, renal transplant, and psychiatry clinical rotations for HHS pharmacy residents. Pharmacists continue to routinely provide education (formal and informal) to nursing staff, clinical clerks, medical residents, and physicians throughout the hospital. Topics included: orientation for medical residents/clinical clerks in nephrology, antibiotic therapy for Infectious Disease residents, orientation for medical residents, orientation presentation for ICU nurses and participate in General Orientation for medical residents Pharmacists are involved in annual nursing re-certification programs Monthly presentation on medication safety at clinical orientation for new nursing staff
Clinical Teaching
Teaching appointments: Seven pharmacists are Adjunct Clinical Assistant Professors (University of Waterloo or University of Toronto) McMaster MBA student completed her project “Dialysis/Transplant Retail Pharmacy Business Case” in conjunction with the Outpatient Pharmacy staff Three high school co-op students completed 4-month credit course in the Outpatient Pharmacy Pharmacist manned a Kidney Function Program booth for a half day conference for medical students. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHARMACY
PAGE
87
Pharmacists preceptors for patient care rotations for PharmD students, seven APPE students from University of Toronto at Charlton and three PREP students at Charlton and four PREP students at West 5th from University of Waterloo Pharmacist preceptor for six co-op students from University of Waterloo and one University of Toronto student One pharmacist participated as a Pharmacy Mentor in the University of Toronto’s Pharmacy Mentorship Program
Scholarly Pursuits Research:
Pharmacy residents and pharmacists were lead investigators in the following two research studies: Evaluating the Short-term Sustainability of Benzodiazepine Receptor Agonist Discontinuation Following Discharge from a General Internal Medicine Program: A Prospective Observational Study An Evaluation of the Impact of Digital Order Sets on the Quality of VTE Prophylaxis in Hospitalized Medicine Patients
Publications:
Wright A, Vaillancourt R, Bussières JF, Lebel D, Wong E, Mancini D, Sarakbi D. Best of both worlds: a comparison of Canadian and International best practices for hospital pharmacy services. Can J Hosp Pharm. 2015 Jan-Feb;68(1):48-53 Wright A, Lovering S, Battistella M. Deprescribing: Is there a role in hemodialysis? CANNT Journal. 2015 Jan-Mar;25(1):21-5 Wright A, Diebold J, Otal J, Stoneman C, Wong J, Wallace C, Duffett M. The Effect of Melatonin on Benzodiazepine Discontinuation and Sleep Quality in Adults Attempting to Discontinue Benzodiazepines: A Systematic Review and Meta-Analysis. Drugs Aging. 2015 Dec;32(12):1009-18 Pharmacist reviewer for “The Patient - Patient-Centered Outcomes Research Pharmacist reviewer for the Canadian Journal of Infectious Diseases and Medical Microbiology Pharmacist contributed to Ontario Bariatric Network (OBN) Passport Workbook
Continuing Education:
Assistants successfully completed training and examinations to register with the Ontario College of Pharmacists as Regulated Technicians One pharmacist successfully completed the program for qualification as a Certified Diabetes Educator Two pharmacists successfully completed PharmD program
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHARMACY
PAGE
88
Leadership
Creation and implementation of electronic BPMH documentation Implementation of Acudose –Automated Dispensing Cabinet on Labour and Delivery nursing unit Completion of baseline Ontario College of Pharmacists hospital assessment at all three campuses Change in dispensing of corticosteroid injections for King Campus Specialty Clinics from inpatient pharmacy to retail pharmacy at the King Campus Management of drug inventory supply at SJHH during ongoing significant drug shortages Pharmacist co-organizer of the Annual PAC LEAN event Co-chair of SJHH Pharmacy and Therapeutics Committee Co-chair of SJHH Medication Management Quality and Patient Safety Council Establishment of the Pharmacy Quality Council to facilitate ongoing quality improvement initiatives Implementation of policies and procedures to comply with medication management standards of Accreditation Canada Participation in successful hospital accreditation with exemplary status Initiation of sterile compounding facility redevelopment Implementation of new parenteral drug therapy monographs Development and review of Hospital Policies and Procedures e.g. Hazardous Drug Policy and Narcotic, Controlled and Targeted Substances Policy Review of Medical Directives e.g. Physician Assistant, Surgery Participation in digital order set roll-out
External Committees
LHIN 4 – Medication Reconciliation Working Group LHIN 4 – Hospital Pharmacy Director Committee Medbuy Group Pharmacy and Therapeutics Committee at HHS HHS Antimicrobial Sub-Committee Hamilton Infection Prevention and Control Committee Admission panel member for University of Waterloo School of Pharmacy Chief Examiner for the Hamilton OSPE (pharmacy technician) and OSCE examinations with the PharmacyExamining Board of Canada Drug and Alcohol Abuse Committee Community of Practice Regional Committee for Smoking Cessation TEACH Community of Practice Committee Renal Pharmacists Network DUE Ontario Pharmacists Group Canadian Society of Hospital Pharmacists (CSHP) Drug Information, Psychiatric Pharmacists and Infectious Disease Specialty Networks CSHP Ontario Branch Awards Committee, Chair CSHP National Awards, assessor CSHP Practice Standards Steering Committee CSHP Canadian Hospital Pharmacy Residency Surveyor Group CSHP Award Appraiser PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHARMACY
PAGE
89
Golden Horseshoe CSP Residency Night Poster Review Group OSCE Pharmacists Exam Assessors OSPE Pharmacy Technician Exam Assessors Sheridan College Pharmacy Technician Program Advisory Committee
External Presentations
Pharmacist presented poster titled Patient Self-reported Adherence to and Perceptions towards Immunosuppressive Medications at the Outpatient Renal Transplant Clinic at the BANFF-CST Joint Scientific Meeting Pharmacy residents presentation of research projects at the Southwestern Ontario Pharmacy residency Night, London, ON: Evaluating the Short-term Sustainability of Benzodiazepine Receptor Agonist Discontinuation Following Discharge from a General Internal Medicine Program: A Prospective Observational Study and An Evaluation of the Impact of Digital Order Sets on the Quality of VTE Prophylaxis in Hospitalized Medicine Patients Pharmacist a panel speaker and presenter of the topic Medications and Falls: A Prescription for Prevention at the Hamilton Falls Prevention: We all have a Role to Play. What’s yours? Event sponsored by SJHH, HHS, Hamilton Public Health and St. Joseph’s Home Care. Pharmacist presented Diabetes Management in Chronic Kidney Disease at half day Nephrology Conference for family physicians and nurse practitioners.
Discipline Goals 2016 Quality & Safety
Continue to work toward Ontario College of Pharmacists Accreditation Criteria for Hospital Pharmacy Improve quality and safety of pharmacy processes through the work of the Pharmacy Quality Council Explore opportunities for further integration of clinical pharmacists into ambulatory clinics Pharmacists and pharmacy technicians working to their full scope of practices
Change
Transition management during construction of new sterile compounding room Redesign of Sterile compounding room at Charlton Redesign of workflows in the sterile compounding room
Community
Social events organized by the pharmacy social group
Interconnection
Participate in Clinical Transformation Project/Electronic Medical record implementation
Research & Education
Completion of two research projects by pharmacy residents and pharmacists PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
90
Physiotherapy Professional Practice Leader (Charlton, West 5th): Beverley Cole PT, BScPT, MSc, MBA Number of Members of Discipline Physiotherapists:
Charlton West 5th Physiotherapy Assistants: Charlton West 5th
Scope of Practice: The practice of physiotherapy is the assessment of neuromuscular, musculoskeletal and cardio respiratory systems, the diagnosis of diseases or disorders associated with physical dysfunction, injury or pain and the treatment, rehabilitation and prevention or relief of physical dysfunction, injury or pain to develop, maintain, rehabilitate or augment function and promote mobility.
26.1 FTE 1.0 FTE 9.6 FTE 1.0 FTE
Clinical Practice Achievements Quality & Safety
Created, reviewed and updated assessment and treatment forms that have been approved through the corporate forms committee. Actively involved in falls prevention education and debriefing on various units including rehab, nephrology and medicine. Continued to review roles & skill mix with all PTs and PTAs attending a College of Physiotherapists Webinar on PTs and PTAs working together. Physiotherapy staff has provided in-services to staff on safe lifting, transfer and mobilization techniques. Reviewed processes to support and encourage department staff to attend and participate in Unit Safety Huddles. The PT Audit committee continues yearly audits to ensure that documentation standards are being met. Reflective practice audits and Transfer of Accountability is completed by the Physiotherapists and the Rehabilitation Assistants. Monthly Safety checks are performed in all areas as well as regular inventory checks. Physiotherapy staff is active members on all quality councils across the organization. Actively involved in patient communication board sustainability projects to promote ongoing use of patient communication boards in order to improve patient engagement. Created a mobility algorithm to enhance quality of care provided to respiratory patients on weekends Working collaboratively with the Thoracics team to create videos for a post-operative app that patients can access at home.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
91
Change
In response to the Stroke Network provincial initiative, the physiotherapy department has implemented the process for tracking Rehab Stroke Therapy Intensity. The physiotherapy department continues to participate in education forums aimed at maximizing the therapy intensity received by patients with stroke. Transition to targeted 2 day LOS for elective TJR patients. From Oct to Dec 2015, 67% of patients were discharged on or before POD2 and 84% on or before POD3. 3% of patients were transferred to in- patient Rehab. With the restructuring of units on the 7th floor of Mary Grace, consistency and quality of care was maintained as 13 Urology Beds were moved. The Day Therapy program amalgamated with the Chronic Disease management program as a strategy to help reduce wait times and improve efficiency. Staff positions in ICU and medicine have been reallocated to improve coverage across areas, enhance patient care and improve efficiency.
Community
For National Physiotherapy Month, the department presented, in conjunction with McMaster University Physical Medicine and Rehabilitation Grand Rounds, Bronze Medal Paralympians at the Sochi Games 2014. Brad Bowden and Adam Dixon spoke about their road to becoming Elite Athletes. The physiotherapists working in respiratory areas helped re-develop the Unit 3 (cardiorespiratory) curriculum of the McMaster University Physiotherapy program. The Physiotherapy Department maintains strong links with the ICC program. The Physiotherapists met in the fall to establish consistent exercise sheets to be used for the total joint patients’ home programs. M McCaughan continues to be the Hamilton District Ontario Physiotherapy Association President. In her role she networks with PTs throughout the district and Ontario – sharing information, presentation ideas, presentor information. This has also been a great opportunity to share information about the research going on in PT at St. Joseph’s Healthcare – including the CYCLE project. This project was highlighted in March 2015 at OPA InterACTION and was recently highlighted in Physiotherapy Today – leading to phone calls from PTs from different provinces asking about more information.
Interconnection
Weekend coverage teams have been revised to accommodate coverage for the SMART initiative MSK and Rehabilitation teams continue to collaborate on the Fractured Hip Initiative to try to ensure QBP standards are being met and the patients are transitioning appropriately from acute care to the next level of care. The physiotherapy department maintains strong links with the CCAC and other community partners to facilitate safe discharges and seamless transitions to the community Stroke Inservice – working on with SLP/OT to present to new Medical Residents During National Physiotherapy Month host an inter professional Pot Luck Lunch and education session PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
92
Academic Pursuits Internal Teaching
Resident orientation in ICU and medicine to the role of physiotherapy on these unitsIn-bed cycling Introduction in the ICU Outcome measures in the CYCLE Pilot RCT Orientation off new staff (including RNs, RPNs, PSWs, students from all disciplines, new grads) on all units across the organization to the role of physiotherapy and importance of mobility and mobilization techniques. Physiotherapists present the topic of mobility and mobilization techniques for Volunteer Services orientation as well as SAVE volunteer orientation approximately three times per year or as needed Physiotherapy staff support “Bring Your Kids to Work Day” by providing interactive sessions for the students in the Physiotherapy department and on Rehabilitation Units Physiotherapy staff provide job shadowing experiences to co-op students on all units Participated in the Celebrate Research Event at St. Joe’s Concurrent Disorders biweekly Pain Management Group Cycling video (involved in filming) from Paris to Ancaster Bike Race Falls Prevention Education sessions– for all staff and patients on various units GPA Session Recharge – Allied Health GPA teaching St. Joseph’s Homecare – PSW’s Hip & Knee Pre-op Class – weekly Injury Prevention for Cool Runnings – Forensic running group Injury Prevention for Team Un Breakable (adult and youth groups) – outpatient mood disorders Injury Prevention for Urban Poling Group – outpatient mood disorders IPE – Inter professional Educational Facilitator for the School of Medicine and School of Rehabilitation Science at McMaster University McMaster Occupational Therapy Students – General Orientation & Education of OTA Role Move On – education of Staff & Volunteers Orientation – to new students Physio/ OTP/PTA Orientation to new staff in the department Poster Presentation – on Rehab Falls Prevention program at Hamilton Falls Prevention Symposium Pre-op Hip & Knee Classes Schizophrenia Units – different topics related to fitness/exercise
Clinical Teaching:
The Physiotherapy Department supervised 35 McMaster University MSc PT students from Units 1 through 6. In addition we were clinical preceptors for 4 Physiotherapy Assistant students from Mohawk College and 1 from Niagara College. The Physiotherapy department strives to create a learning environment for each student that both challenges the student as well as helps them experience a variety of different clinical situations.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
Formal Teaching
PHYSIOTHERAPY
PAGE
93
Canadian Integrated Movement Behaviour Guidelines for Children and Youth Development and Consensus Meeting – Methodological Consulting CYCLE Pilot RCT – In-bed cycling teaching and outcome measure training – London Health Sciences Hospital, Hamilton General, The Juravinksi Hospital, St. Michael’s Hospital Toronto, Ottawa General Hospital and Toronto General Invited Lecture – Technology Evaluation in the Elderly Network Conference – E-CYCLE – A pilot RCT of early in-bed cycling in mechanically ventilated patients Johns Hopkins University, Department of Physical Medicine and Rehabilitation – Adjunct Assistant Professor, Part-time McMaster University, School of Rehabilitation Science – Assistant Clinical Professors (adjunct) , Assistant Professor, Associate Clinical Professor , Clinical Instructors McMaster University, School of Rehabilitation Science Problem Based Learning Tutors, Clinical Skills Lab Tutors, Inter professional Education Tutors, OSCE Evaluators, Admission Interviewers
Scholarly Pursuits Research
The Physiotherapists on MSK are currently involved in a study assessing the benefits of Fascia-iliaca Nerve blocks for THR patients. The Physio role is to assess mobility POD 0 and POD1 and report results (distance and limiting factors) to the study nurse. The Incentive Spirometry study on Thoracics is led by Dr. Hanna – we are in the middle of the project at this time. Respiratory Weekend – addition of a Mobility Algorithm. We are ending data collection at the end of March 2016. Preliminary data shows that it is feasible to add mobility when it is specifically targeting respiratory improvement. Arm cycling training with St. Joseph’s Healthcare PTs March 26 2015 Completed Juravinski and General ICU bike install meetings (Jan 13/14, 2015; March 26/27, 2015) Abstract presented at 2015 Ontario Physiotherapy Association Meeting – TryCYCLE: The First Session of early in-bed cycling in mechanically ventilated patients. Authors: Magda McCaughan MSc (PT), Alexander Molloy BSc, Daana Ajami MSc (PT), Laura Camposilvan BSc, Christina Murphy MSc (PT), France Clarke RRT, Melissa Shears, Deborah Cook MD, MSc, Michelle Kho PT, PhD Opened enrollment to CYCLE Pilot RCT at St Joseph’s Healthcare, March 9 ,2015 Recruitment presentation/meeting for CYCLE pilot RCT with St. Joseph’s Healthcare PTs, March 5, 2015 Abstract presented at 2015 Society of Critical Care Medicine meeting – TryCYCLE: Preliminary results of early in-bed cycling with mechanically ventilated patients Authors: Michelle E Kho, Alexander J Molloy, Magda McCaughan, Daana Ajami, Christina Murphy, Laura Camposilvan, France Clarke, and Deborah Cook Students supported in Research Meghan Barker, Jennifer Noad, and Theodora Nasopoulos. Supervisors: Vince DePaul, Kara Patterson (U of T) Knowledge, practices and perceptions of Canadian physiotherapists regarding the application of motor learning principles in neurorehabilitation – a survey study Kate Benson, Alexandra Shimmell and Devonna Truong Supervisors: Magen Dunkley, Vince DePaul. Exploring the content and stability of mobility-related goals identified by older adult inpatients on a rehabilitation unit: a pilot study PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
94
Research Funding
2013 – 2016 (funded) Hamilton Health Sciences Research Strategic Initiatives Amount: $127 378.00 Project: “Reducing the Burden of Stroke Research Program - Grant Operating” Principal Investigators: Hart R Co-investigators: Healey J; Bosch J, Leong D; Pare D; Dokainish H; Pogue J; DePaul VG; Wishart L; Ferguson M; O'Donnell M; Sharma M; Connolly S; Nesathurai S; Oczkowski W Description: An interdisciplinary research program exploring activity- based stroke rehabilitation interventions as well as stroke prevention interventions. Status: Data collection completed. Analysis and write up in progress.
2015 (submitted) St. Joseph’s Healthcare Hamilton, Professional Advisory Committee 2015 2016 Allied Health Professional Research Award TITLE: Use of near-field communication and smart phone technology to quantify therapist-patient interactions in an inpatient environment: a pilot study Vince DePaul Co-principal Investigator with Bashir Versi. Acting as a Research Mentor to Mr. Bashir Versi, MSc PT Amount requested: $ 9031.25 Grant period: 1 year Status: in review
Kho ME, Costigan FA. I SURVIVE: Validation of Key Physical Functional Outcome Measures in ICU Survivors Across the Recovery Trajectory. Interprofessional Research Award Program. St. Joseph’s Healthcare, Hamilton, ON. $10,000.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
95
Publications Published Papers: Burns KEA, Kho ME. How to read and review a survey: a guide for readers and peer reviewers. Canadian Medical Association Journal. Published online February 17, 2015. doi: 10.1503/cmaj. 140545. PubMed PMID:25691790.
Truong AD*, Kho ME*, Brower RG, Feldman DR, Colantuoni E. Needham DM. Effects of Neuromuscular Electrical Stimulation (NMES) on Cytokines in Peripheral Blood for Healthy Participants: A prospective. Single-Binded Study. Submitted to: Clinical Physiology and Functional Imaging. *=co-first authors
Kho ME Section Editor, Current Physical Medicine and Rehabilitation Reports. Outcome Measurement in Rehabilitation. Volume 3, Issue 4 (September 2015)
Karen EA Burns, Jessica TY Wong, Leena Rizvi, Lori Hand, Deborah J Cook, Peter Dodek, Sangeeta Mehta, Michelle E Kho, Francois Lamontagne, Jan O Friedrich, Andrew J Seely, Laurent Brochard, Eddy Fan, Christine Leger, Fatma Rajwani, Julia Lee, Kevin Thorpe and Maureen O Meade. Parallel Pilot Trials of Screening Frequency for Liberation from Mechanical Ventilation the RELEASE Trial and SENIOR Trial Protocols. J Clin Trials 2015, 5:4.
Richardson J, DePaul V, Officer A, Wilkins S, Letts L, Bosch J, Wishart L. Development and evaluation of Self-management and Task-oriented Approach to Rehabilitation Training (START) in the home: Case report. Phys Ther 2015;95:934-943. doi: 10.2522/ptj.20130617.
Submitted Papers: Unger J, McCaugan M, Molloy AJ, Cole B, Kho ME. Technology in Rehabilitation: In-bed cycling as a tool for rehabilitation in the intensive care unit. Physiotherapy Practice. 2016. In press.
Chaput, Jean-Philippe; Poitras, Veronica; Gray, Casey; Carson, Valerie; Gruber, Reut; Olds, Timothy; Weiss, Shelly; Connor Gorber, Sarah; Kho, Michelle; Sampson, Margaret; Belanger, Kevin; Eryuzlu, Sheniz; Callender, Laura; Tremblay, Mark. Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Submitted to Applied Physiology, Nutrition, and Metabolism. Manuscript ID: apnm-2015-0627.
Saunders, Travis; Gray, Casey; Poitras, Veronica; Chaput, Jean-Philippe; Janssen, Ian; Katzmarzyk, Peter; Olds, Timothy; Connor Gorber, Sarah; Kho, Michelle; Sampson, Margaret; Tremblay, Mark; Carson, Valerie. Combinations of physical activity, sedentary behavior and sleep: relationships with health indicators in school-aged children and youth. Submitted to Applied Physiology, Nutrition, and Metabolism. Manuscript ID: apnm-2015-0626
Carson, Valerie; Hunter, Stephen; Kuzik, Nicholas; Gray, Casey; Poitras, Veronica; Chaput, Jean-Philippe; Saunders, Travis; Katzmarzyk, Peter; Okely, Tony; Connor Gorber, Sarah; Kho, Michelle; Sampson, Margaret; Lee, Helena; Tremblay, Mark. Systematic review of sedentary behavior and health indicators in school-aged children and youth: an update. Submitted to Applied Physiology, Nutrition, and Metabolism. Manuscript ID: apnm-2015-0630
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
96
Poitras, Veronica; Gray, Casey; Borghese, Michael; Carson, Valerie; Chaput, JeanPhilippe; Janssen, Ian; Katzmarzyk, Peter; Pate, Russell R.; Connor Gorber, Sarah; Kho, Michelle; Sampson, Margaret; Tremblay, Mark. Systematic review of the relationships between objectively-measured physical activity and health indicators in school-aged children and youth. Submitted to Applied Physiology, Nutrition, and Metabolism. Manuscript ID: apnm-2015-0663 Michelle E Kho, Alexander J Molloy, France Clarke, Daana Ajami, Magda McCaughan, Kristy Obrovac, Christina Murphy, Laura Camposilvan, Margaret S Herridge, Karen KY Koo, Jill Rudkowski, Andrew JE Seeley, Jennifer M Zanni, Marina Mourtzakis, Thomas Piraino, Deborah J Cook and the Canadian Critical Care Trials Group. TryCYCLE: A prospective study of the safety and feasibility of early in-bed cycling in mechanically ventilated patients. Submitted to Chest. Manuscript ID: CHEST-15-2541. Minor revisions submitted December 11, 2015 Doehring KA, Dorno S, Pakenham C, Versi B, DePaul VG. Knowledge, attitudes, and current practices of Canadian physiotherapists in the management and prevention of diabetes Physiotherapy Canada - Accepted ID: 3514 Levac D, Glegg SMN, Sveistrup H, Colquhoun H, Miller P, Finestone H, DePaul V, Harris J, Velikonja D. Promoting therapists’ use of motor learning strategies within virtual reality-based stroke rehabilitation Submitted to: Disability and Rehabilitation: Assistive Technology In review Levac D, Glegg SMN, Sveistrup H, Colquhoun H, Miller P, Finestone H, DePaul V, Harris J, Velikonja D. A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation Submitted to: BMC Health Services Research November 2015 Resubmitted to: PLOS ONE January 2016 Michelle E Kho, Alexander J Molloy, France Clarke, Daana Ajami, Magda McCaughan, Kristy Obrovac, Christina Murphy, Laura Camposilvan, Margaret S Herridge, Karen KY Koo, Jill Rudkowski Andrew JE Seely Jennifer M Zanni, Marina Mourtzakis, Thomas Piraino, Deborah J Cook, and the Canadian Critical Care Trials Group. TryCYCLE: A prospective study of the safety and feasibility of early in-bed cycling in mechanically ventilated patients. Submitted to Chest. Manuscript ID: CHEST-15-2541. Minor revisions submitted December 11, 2015.
Continuing Education:
3rd International Conference on Alzheimer’s Disease & Dementia – speaker CBT Certification in Treatment of Anxiety & Depression Exploring the COPD Quality-Based Procedures Clinical Pathway – Clinical Education Session IDEAS Advanced Quality Improvement Project Submission Inter professional Care of Critically Ill Adults – from ICU to Community (Lecturer & Organizing Committee) Introductory Project Management Course , McMaster University Introductory Quality Improvement Program McMaster Pain Management Program Mental Health First Aid Shoulder Complex Part 1 & 2 PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
97
Leadership
President of the Hamilton District Ontario Physiotherapy Association M Kho and M McCaughan developed a new emerging role placement– a scientist-clinician role. This year the Respiratory Physiotherapy Team made an exceptional effort and helped rewrite McMaster University’s Unit 3 Physiotherapy program (cardiorespiratory) as well as assisting in the majority of the Labs related to Cardiorespiratory Function. The physiotherapy staff working in respiratory areas won the PAC Team Leadership Award. The physiotherapy department is committed to helping students be the best they can be in a critical and highly acute environment. Placements on acute and critical care units that are offered are very challenging and so the team works closely with the school ensuring that students meet the standards that are expected in such an environment. Students are offered training in manual physiotherapy techniques, an opportunity to meet surgical patients pre-operatively, observe surgeries and follow the patient post-operatively as well. The team has also worked very closely with the McMaster University Physiotherapy Program giving feedback and recommendations for program improvement especially in a clinical setting. This past year, the team had an opportunity to work directly with the McMaster Physiotherapy program to re-develop the Cardiorespiratory Clinical Labs. A physiotherapist provides leadership and acts as resources on the Corporate Falls Committee Physiotherapy staff led the Falls tracking & debriefing on the Nephrology Unit. Physiotherapy staff is leaders in mobility and have designed and presented many in-services on lifting, transferring and mobility techniques for all staff, volunteers and new grads across the organization.
External Committees
Members of the Rehabilitative Care Alliance for System Evaluation task and Advisory Groups, QBP Hip Fracture Task Group, QBP Total Joint Replacement Task group Regional Rehabilitation Network The Assess and Restore Working group. Hospital Liaison for the Ontario Physiotherapy Association’s (OPA) Hospital Advisory Committee Examiners for the Canadian Alliance of PT regulators Auditors for the Ontario College of Physiotherapists 2015 Canadian Institutes of Health Research Knowledge Synthesis Competition, Phase 1 Grant Reviewer CPA Acupuncture Division: Research and Education Rep, Executive Advisory Board Member for APAPT-M Study Archives of Physical Med & Rehab – Peer Review of Manuscript & paper College of Physiotherapists of Ontario – Partners Network College of Physiotherapists – Quality Management Program assessor Hamilton District OPA Education Committee – member LHIP PT Leaders Group Ontario Respiratory Care Society – member OPA Hamilton District – Education Committee – President, secretary, treasurer, member Saint Elizabeth Rehab – Stand Up! Coordinator & instructor
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PHYSIOTHERAPY
PAGE
98
External Presentations
Ontario Physiotherapy Association InterACTION – poster presentation on TryCYCLE: the first session. American Critical Care Society Conference – poster presentation on TryCYCLE: feasibility and safety. DePaul VG, Chow F, Thomas K, Chan P, Azuma L, Poon V, Mansfield A, Patterson KK. Self-assessment of gait symmetry in individuals with unilateral stroke: A pilot study. P1-R-94. World Congress of the International Society of Posture and Gait, Seville, Spain, Jun 28 - Jul 2, 2015. DePaul VG, Campos C, Sivakumaran S, Knorr S, Mansfield A, Patterson KK. Validation of Actigraph GT3X activity monitor in individuals with recent stroke. P1-A-2. World Congress of the International Society of Posture and Gait, Seville, Spain, Jun 28 - Jul 2, 2015. Kho, M. ICU Rehab – Timing it Right. Critical Care Canada Forum. Toronto, ON. Kho, M .Rehab in the ICU. Critical Care Department Rounds. St. Michael’s Hospital. Toronto, ON
Discipline Goals 2016 Quality & Safety
To complete falls debriefing tools on our patients who have had falls within 48 hours of the incident To attend safety huddles on all units where possible Continue to meet fractured hip QBP standards including the mobility 7days a week and timely transfer to Rehab. Continue to clearly define hip restrictions or no hip restrictions on the hemi-arthroplasty and the anterior approach total hip arthroplasty patients. To review process and protocols with surgeons and residents to establish consistency on the digital order sets.
Change
To align the organization of the GIM physiotherapy staff with the new structure of GIM to improve efficiency of care and improve communication between all staff by the end of 2016 To integrate the role of physiotherapy on 7 Mary Grace as Urology and MSK amalgamate
Community
To continue to be involved with the McMaster University Physiotherapy program by offering student placements, participating in clinical labs and problem based tutorials as well as OSCEs .
Interconnection
To continue the fractured hip collaboration between 7 Mary Grace and 8 Rehab to ensure timely and safe transfer of appropriate patients to the Rehab Unit as a “Hip Pull”. To support the use of the medical check list.
Research & Education
To complete enrolment in the 60 patient, 7-centre CYCLE Pilot RCT To participate in a pilot study of a tailored home balance exercise program for reducing falls in older adults with COPD PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
99
Polysomnography Professional Practice Leader (Charlton Site Only): Mary Basalygo B.Sc., RPSGT Number of Members of Discipline Polysomnographic Technologist Charlton 8 FTE : 2 FULL TIME 10 PART TIME
Scope of Practice. The sleep technologist working under the supervision of a licensed sleep physician is specially trained to perform polysomnography and other tests to diagnose and treat sleep disorders in patients from children to adults. Sleep disorders include breathing disorders, movement disorders and parasomnias. The procedures include application, monitoring and analyzing specific physiological variables during sleep and wakefulness.
Clinical Practice Achievements Quality & Safety
Ongoing review of referrals to identify and allocate available resources for patients with special care needs. This includes considerations such as age, gender, mobility, communication, comprehension, and vision. A dedicated effort to focus on individual patient needs from pediatric to adult to maximize safety, quality and efficiency for both the patient and the technologist. Ongoing review and standardization of processes for the collection of data and the use of ancillary devices. This includes review of application procedures and site durations. Review and update of informational forms for patients undergoing day time sleep and wakefulness assessments. Ongoing review and standardization of protocols for continuous and bi-level PAP therapy. Staff had the opportunity to attend the Canadian Sleep Society Meeting which was held in Toronto from September 25-27, 2015 to update skills and knowledge.
Change
Staff scheduling changes to attempt to further balance skill levels associated with patient assessment , data review and report preparation. Review of documentation criteria both during acquisition and report generation
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
POLYSOMNOGRAPHY
PAGE
100
External Presentations:
Sleep program informational display in the lobby for staff, visitors during Sleep Technologist Appreciation Week – last week in October.
Participated in the Arcelor-Mittal Dofasco Health Fair in November which was attended by 2,400 employees and family. Interactive game and informational display with an emphasis on sleep hygiene and sleep disorders.
Discipline Goals 2016 Quality & Safety
To review maintenance and care of existing equipment resources to prolong usage and quality of recorded signals. To further review urgent referrals and develop strategies to better align available resources to streamline completion of reports for physician interpretation.
Change
To relocate the sleep clinic portion of the sleep program from the first floor Firestone clinic location to the 4th floor sleep lab location and identify and implement strategies to maximize usage, and improve efficiencies in process both in areas of clerical administration and technical resources.
Community
To continue to be available as a resource to the community and community activities
Research & Education
Ongoing collaboration with cardiology at the Hamilton Health Sciences and McMaster University in multi-centered clinical trial in heart failure patients. To identify further research opportunities.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
101
Psychology Professional Practice Leader (Charlton, West 5th): Dr. Randi McCabe Number of Members of Discipline Psychologist Psychometrist Postdoctoral Fellow Psychology Resident
22 5 3 6
FTE 2 PT FTE 5 PT FTE 5 PT FTE
Scope of Practice: “The practice of psychology is the assessment of behavioral and mental conditions, the diagnosis of neuropsychological disorders and dysfunctions and psychotic, neurotic and personality disorders and dysfunctions and the prevention and treatment of behavioral and mental disorders and dysfunctions and the maintenance and enhancement of physical, intellectual, emotional, social and interpersonal functioning.” Psychology Act 1991, c. 38, s. 3.
Clinical Practice Achievements Quality & Safety Psychology staff took an active role on Quality Councils in various programs
including Mood and Anxiety Disorders, Forensics, General Psychiatry and Addiction, and Schizophrenia and Community Integration Services. The Policy Committee within the Dialectical Behaviour Therapy (DBT) Program has been working on ways to manage the waitlist as effectively as possible through identification of barriers within the program and the larger system that affect waitlist management and consultation with the hospital ethicist to address ethical concerns regarding resource use with a high-risk, high-needs clientele. Psychology staff were active in developing innovative evidence-based assessment and treatments methods to improve patient care and safety including a new semi-structured interview for DSM-5: The Diagnostic Assessment and Research Tool (DART); a Transdiagnostic Behaviour Therapy group for individuals with mood and anxiety disorders; and the Behavioural Activation Program for Older Adults with Depression (funded by the Regional Geriatric Program - Specialized Geriatric Services Grants for Quality Improvement). A Psychology staff member received the “Individual Innovation in Professional Practice Award of Excellence” from the Professional Advisory Committee, for work introducing mindfulness programs in the mood and anxiety disorders programs and more broadly for staff at SJHH. Psychology staff completed Crisis Prevention Intervention (CPI) training. Two psychology staff became registered with the new College of Registered Psychotherapists.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
POLYSOMNOGRAPHY
PAGE
102
Community
Sleep program informational display in the lobby for staff, visitors during Sleep Technologist Appreciation Week – last week in October.
Participated in the Arcelor-Mittal Dofasco Health Fair in November which was attended by 2,400 employees and family. Interactive game and informational display with an emphasis on sleep hygiene and sleep disorders.
Interconnection
Continue to maintain a shared network drive for specifically for sleep education accessible to sleep technologists, physicians and clinical scholars.
Academic Pursuits Internal Teaching
The sleep lab serves as a visit site for respiratory therapy students from the Mitchener institute and Fanshawe College. Prepared a presentation on sleep hygiene and sleep disorders for St. Joseph’s Employee Wellness Program
Clinical Teaching
Education and review of the technical aspects of polysomnography for residents within the respiratory program. Videoconference of monthly clinical and research rounds from Toronto as part of the half day clinical scholar curriculum. These events are accredited group learning activities as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.
Presentation and review of the technical aspects of polysomnography within the clinical scholar program in sleep medicine.
Research
Ongoing collaboration with cardiology at the Hamilton Health Sciences and McMaster University in a multi-centered clinical trial in heart failure patients.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
103
Change Across the discipline, psychology staff was active in the development, implementation, and
evaluation of clinical innovations in a range of programs including a 6-week cognitive behavioural therapy group intervention for insomnia (CBT-i) tailored to patients with mood disorders, an 8week psychoeducation group for prenatal and perinatal women with bipolar disorder, a new CBT group for chronic pain, the Sexual Behaviours Clinic in the Forensic Program, and the Working Towards Recovery Skills (WORK) Group for inpatients with schizophrenia. The DBT Program is conducting a clinical trial to pilot the use of a combined DBT/ Cognitive Processing Therapy (CPT) intervention for individuals with co-occurring borderline personality disorder (BPD) and post traumatic stress disorder (PTSD). The preliminary results have been very encouraging with clients experiencing significant reductions in PTSD symptoms and improving their overall quality of life. Psychologists have been a major force in the development of a new partnership between SJHH, the Department of Psychiatry and Behavioural Neurosciences (DPBN) and the Department of Psychology, Neuroscience and Behaviour at McMaster University to develop a Clinical Psychology Graduate Training Program that will deliver state-of-the art clinical training to psychology graduate students through the SJHH Mental Health and Addiction Program (MHAP) using an innovative training model that builds on the strengths of the SJHH program and that will ensure that future psychologists are equipped with the depth and breadth of training to provide care in a way that has never been done before. Psychology staff are leaders in the development of Transition Age Youth Programming across various program in the MHAP including the Eating Disorders Program and the Anxiety Treatment and Research Clinic.
Community Psychology staff planned a community event for the Canadian Association for Cognitive and
Behavioural Therapy (CACBT) conference in Hamilton “Barriers to accessing evidence psychotherapy, stakeholder dissemination events at CACBT meeting”. Staff applied for and received funds to support this community forum on access to therapy through a Canadian Institutes of Health Research (CIHR) dissemination grant. Psychology staff gave numerous presentations and training workshops to stakeholders in the community to increase capacity, develop professional competency, and increase public awareness on a range of topics. For example, psychology staff presented to members of the Hamilton Police Force (stress management); Mood Menders support group (strategies for anxiety), provided consultation to Lakeridge Health regarding implementation of a manualized program, and staffed a booth at the Bell Let’s Talk Day at Mohawk College. Psychology staff in the Forensic Program organized a public screening of “Out of Mind, Out of Sight” to raise awareness and encourage dialogue with the community. Staff engaged in both research and clinical services partnerships with various community services and agencies such as the AIDS Network of Hamilton, Veteran’s Affairs Canada, and the Hoarding Coalition. A psychology staff member was integral in the formation of a research partnership between SJHH, McMaster and Homewood Research Institute. Psychology staff used the Ontario Telehealth Network (OTN) to provide training and clinical consultation to community and regional partners (e.g., consultation on problematic hoarding to a series of sites in the Wellington-Guelph region). St. Joe’s DBT Program has partnered with West Lincoln to support a LHIN-wide initiative to develop DBT capacity within the LHIN. Four trainings were hosted during 2015. In addition to hosting the trainings, the DBT Program provides on-going support to the new programs to address implementation issues. The first meeting of the DBT Network of Hamilton was held in November 2015. This was the first formal meeting of DBT providers in various settings who work with different populations and ages in the Hamilton area. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
104
Interconnection Psychology staff were active collaborators with other disciplines to examine important research
questions utilizing an interdisciplinary approach. Examples of projects include evaluating the impact of the redevelopment of the west 5th campus, assessing the efficacy of cognitive mediation interventions for various disorders including schizophrenia and post-traumatic stress disorder, implementation of mindfulness for health care staff, and a Radical Collaboration Day to promote interprofessional research collaboration in the Forensic Program. These collaborations have led to successful grant submissions and numerous publications. Psychology staff in the Forensic Program was involved in organizing a number of conferences including a 1day multidisciplinary conference for 90 registrants entitled Media and social engagement around sexual offenders and their management for the Leverhulme Trust Conference for International Knowledge Exchange Network, Hamilton, Ontario and the Annual Risk and Recovery Conference. Psychology staff was also active in various interprofessional clinical projects to enhance both patient care and interprofessional competencies involving partnerships between psychology, psychiatry, gastroenterology, social work, nursing, occupational therapy, physiotherapy, and medicine. For example, psychology staff members are part of a new partnership with psychology and sleep medicine/respirology to provide a psychological intervention group for insomnia. This collaboration has led to a number of grant submissions. In addition, a partnership between psychology staff, the Department of Gastroenterology and the DPBN at McMaster University developed to enhance patient care and research on bowel disorders led to successful grant submissions and a novel psychological treatment intervention for individuals with bowel disease. Psychology staff was involved in various interdisciplinary committees including the Anti-Stigma Initiative for the West 5th Campus, and the Mental Health, Wellness and Employee Engagement committee. Psychology staff hold membership in various national and international associations including the American Psychological Association (APA), Anxiety Disorders Association of America, APA Division 12 Society for Clinical Psychology, Association for the Treatment of Sexual Abusers, Canadian Institute for Obsessive Compulsive Disorders, Canadian Psychological Association, Canadian Association of Cognitive and Behavioural Therapies, International Association for Forensic Mental Health Service, and the Ontario Psychological Association.
Academic Pursuits Internal Teaching The majority of psychology staff has academic appointments in the DPBN, McMaster University. In addition,
various psychology staff has academic affiliations and appointments with a number of institutions including the Department of Psychology and Behavioural Sciences at McMaster University, Ryerson University, University of Waterloo, University of Regina, University of Toronto, York University, and the University of Buffalo, SUNY. Psychology staff presented at SJHH Mental Health rounds and highlighted Psychology Month with presentations throughout the month of February that were very well attended. All psychology staff was active in providing didactic teaching and clinical supervision to trainees in the SJHH Psychology Residency Program. Psychology staff provided clinical supervision and education to mental health clinicians in the provision of DBT and phone coaching. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
105
Formal Teaching
Psychology staff presented at various McMaster University academic Grand Rounds including the Department of Psychiatry and Behavioural Neurosciences, the Department of Family Medicine, the Department of Gastroenterology, and the Department of Medicine. Psychology staff was actively involved in providing both didactic teaching and clinical supervision in the Faculty of Health Sciences, McMaster University (Clinical Behavioural Sciences Program, Bachelor of Health Sciences Program), the Psychiatry Residency Program, the Undergraduate Medical Education Program (Psychiatry Clerkship), and the newly established Research and Clinical Graduate Training Program. Psychology staff was engaged in formal teaching in the Neuroscience Graduate Program at McMaster University and Mohawk College (Law and Forensics). Psychology staff was also engaged in formal supervision roles (both primary and secondary) for the College of Psychologists of Ontario
Clinical Teaching:
Psychology staff was involved in a wide range of other educational endeavours involving learners from: i) psychology (research supervision of McMaster psychology undergraduates), ii) neuroscience (research supervision of McMaster neuroscience graduate students), iii) health sciences, iv) medical undergraduates, and v) clinical supervision of McMaster psychiatry residents. Psychology staff developed new courses for the Clinical Behavioural Sciences Program at McMaster including a 12- week course in Mindfulness Based Cognitive Therapy for Mental Health Clinicians. The Clinical Psychology Residency Program received 120 applications from across North America for six spots (5 general stream and 1 neuropsychology stream). We interviewed 50 candidates and matched within our top 10 ranked applicants. The current six residents are from Lakehead University, Queen’s University, and Ryerson University. The Psychology Practicum Program received 47 applications in 2015 from across Canada. Seventeen placements were assigned (up from 11 in 2014) throughout the MHAP offering training in a wide range of clinical programs including Anxiety, DBT, Mood Disorders, Neuropsychology, Eating Disorders, Health, Youth Wellness, and Forensics for learners from Ryerson University (7), McMaster University (4), University of Waterloo (2), York University (2), and University of Toronto (2).
Recognition Two psychology staff were elected Fellow status in the Canadian Psychological Association
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
106
Publications: Psychology staff contributed to 70 publications in 2015 (staff names are in bold below): Milosevic, I., & McCabe, R.E. (2015). Phobias: The psychology of irrational fear, an encyclopedia. Santa Barbara,
CA: ABC-CLIO Molls, S., Key, B.L., Frolic, A. (2015). Investing in compassion: Exploring mindfulness as a strategy to enhance
interpersonal relationships in healthcare practice. Journal of Hospital Administration, 4(6), 31-36. Green, S., Key, B.L., McCabe, R.E. (2015). Cognitive-behavioral, behavioral, and mindfulness-based therapies for
menopausal depression: A review. Maturitas. 80(1), 37-47. Key, B.L., & Bieling, P. (2015). Beyond DSM Diagnosis: The Pros and Cons of Cognitive Case Formulation. In
D. Clark, The Research and Practice of Cognitive Behavioral Assessment. Guilford Press. Key, B.L., & Davey, C. (2015). Applied Relaxation. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology
of irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L. (2015). DSM-5. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of irrational fear, an
encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L., & Davey, C. (2015). Introceptive Exposure. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The
psychology of irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L., & Yip, J. (2015). Hypnosis. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of irrational
fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L. (2015). Obsessive Compulsive Disorder. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrationalear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L., & Yip, J. (2015). Perceived Control. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L., & Yip, J. (2015). Impairment Related to Phobias. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The
psychology of irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L. (2015). Post-Traumatic Stress Disorder. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L., & Yip, J. (2015). Psychoeducation. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Key, B.L. (2015). Suicide. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of irrational fear, an
encyclopedia. Santa Barbara, CA: ABC-CLIO. Rowa, K. (2015). Phobia and anxiety definitions. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology
of irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Nowakowski, M.E., Rowa, K., Antony, M.M., McCabe, R. (in press). Changes in anxiety sensitivity following group
cognitive-behavior therapy for social anxiety disorder and panic disorder. Cognitive Therapy and Research.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
107
Scholarly Pursuits Research:
Psychology staff members were principal investigator or co-investigator on several new peer-reviewed grants from the Professional Advisory Committee, SJHH ($10,000), DPBN, McMaster ($7,500) , Ontario Mental Health Foundation (OMHF; $138,598: 2015-2017); Hamilton Academic Health Sciences Organization Innovation Grant $192,942 ; 2015-2017, CIHR ($193,350: 2015-2018; $700,184:20152019;$ 332,994: 2015-2018), Technology Evaluation in the Elderly Network (TVN) Catalyst Research Program Grant ($99,988: 2015-2017); Ontario Thoracic Society Grant ($31,350: 2015), Bickell Foundation Medical Research Grant ($65,000: 2015-2017); Social Sciences and Humanities Research Council (SSHRC; $140,102: 2015-2018), and the Natural Sciences and Engineering Research Council ($24,402: 2015). A number of additional grant proposals were submitted and are currently under review, for example, with the Ontario Mental Health Foundation and CIHR. Psychology staff continue to be actively involved as principal investigator or co-investigator on many ongoing studies funded by the Leverhume Trust (£ 52,444) and CIHR ($100,000; 2014-2015; $100,000; 2014-2015; $120,805: 2014-2017; $299,160; 2013-2016; $495,102: 2014-2017; $399,818; 2009-2015). Psychology staff was active in supervising graduate students in the MiNDS Program and the Department of Psychology, Neuroscience and Behaviour at McMaster University. Psychology staff sat on various dissertation and graduate committees for the MiNDS program at McMaster University and Ryerson University. Psychology staff sat on editorial boards for six scientific journals including the Archives of Women’s Mental Health, Cognitive Behavioral Practice, Psicologia Conductual (Behavioral Psychology), Cognitive Behaviour Therapy, Behaviour Research and Therapy, and the Journal of Child Sex Abuse. Psychology staff served as editorial consultants for numerous scientific journals including Assessment, Archives of Women’s Mental Health, Behavioural and Cognitive Psychotherapy, Biological Psychiatry, Canadian Journal of Criminology and Criminal Justice, Clinical Psychology and Psychotherapy, Cognitive Behaviour Therapy, Cognitive and Behavioural Practice, Cognitive Therapy and Research, Depression and Anxiety, Ethnicity and Inequality in Health and Social Care, International Journal of Forensic Mental Health, International Journal of Offender Therapy and Comparative Criminology, International Journal of Psychology and Counseling, Journal of Affective Disorders, Journal of Child Sexual Abuse, Journal of Anxiety Disorders, Journal of Clinical Psychology, Journal of Obsessive Compulsive and Related Disorders, Journal of Psychosomatic Research, Journal of Sex Research, Menopause: The Journal of the North American Menopause Society, Psychological Assessment, Psychiatry and Clinical Neurosciences, Schizophrenia Bulletin, Sexual Abuse: A Journal of Research and Treatment, Surgery for Obesity and Related Disorders, Trauma, Violence, and Abuse, Women’s Studies International Forum.
Continuing Education:
Psychology staff completed certification in DBT therapy by the Treatment Implementation Collaborative. Psychology staff was certified in cognitive behaviour therapy by the Canadian Association of Cognitive and Behavioural Therapies. A psychology staff member was certified as a local trainer for the GAIN-I Lite (Global Appraisal of Individual Needs (GAIN), Chestnut Health Systems, Normal, IL, USA.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
108
Moscovitch, D.A., Waechter, S., Bielak, T., Rowa, K., & McCabe, R.E. (2015). Out of the shadows and into the spotlight: Social blunders fuel fear of self-exposure in social anxiety disorder. Journal of Anxiety Disorders, 34, 2432.
Moscovitch, D.A., Rowa, K., Paulitzky, J.R., Antony, M.M., & McCabe, R.E. (2015, April). What if I appear boring, anxious, or unattractive? Validation and treatment sensitivity of the Negative Self Portrayal Scale in clinical . Cognitive Therapy and Research, 39, 178-192
Rowa, K., Paulitzki, J.R., Ierullo, M.D., Chiang, B., Antony, M.M., McCabe, R.E., & Moscovitch, D.A. (2015, May). A false sense of security: Safety behaviors erode objective speech performance in individuals with social anxiety disorder. Behavior Therapy, 46, 304-314.
Gros, D. F., Farmer, A. S., McCabe, R. E., & Antony, M. M. (2015, March). Psychometric evaluation of the Multidimensional Assessment of Social Anxiety before and after cognitive behavioral therapy for social anxiety disorder. Journal of Psychopathology and Behavioral Assessment, 37, 144-152.
McCabe, R.E., Hood, H., & Antony, M.M. (2015). Anxiety disorders: Social and specific phobias. In A. Tasman, J. Kay, J.A. Lieberman, M.B. First, and M. Maj (Eds.), Psychiatry fourth edition, pp. 1019-1056. Chichester, UK: John Wiley & Sons, Ltd.
Farrell, N., Milosevic, I., & McCabe, R.E. (2015). Group cognitive behavioural therapy for adolescents with anxiety disorders (Transtornos de ansiedade em grupos de adolsescentes). In C. Beatriz Neufeld (Ed.), Terapia cognitivo-comportamental em grupos para crianças e adolescentes. Porto Alegre, Brazil: Grupo A.
McCabe, R.E., Farrell, N. (in press). Specific phobia: Treatment. In A.E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, CA: Sage Publications.
Nowakowski, M., & McCabe, R.E. (in press). Panic disorder: treatment. In A.E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, CA: Sage Publications.
Merrifield, C. & McCabe, R.E. (in press). Specific phobia. In A.E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, CA: Sage Publications.
Milosevic, I., & McCabe, R.E. (2015, January). Agoraphobia. In R. Cautin & S. Lilienfeld (Eds.), The Encyclopedia of Clinical Psychology. Wiley-Blackwell.
Merrifield, C., & McCabe, R.E. (in press). Specific phobia. In Amy E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, CA: Sage Publications.
Merrifield, C., & McCabe, R.E. (in press). Cognitive behavioral group therapy. In Amy E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology.
Merrifield, C., & McCabe, R.E. (in press). Alcohol-induced anxiety disorder. In Amy E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology.
Ahern, C., McKinnon, M.C., Bieling, P.J., McNeely, H.E., & Langstaff, K. (2016). Overcoming the challenges inherent in conducting design research in mental health settings: Lessons from St. Joseph’s Healthcare Hamilton’s pre and post occupancy evaluation. Health Environments Research & Design Journal, 9(2), 119-129.
Ahern, C., Bieling, P., McKinnon, M.C., McNeely, H., Langstaff, K. (in press). A Recovery-Oriented Care Approach: Weighing the Pros and Cons of a Newly-Built Mental Health Facility. Journal of Psychosocial Nursing & Mental Health Services.’
Gavric, D. (2015). Phobia Types. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of irrational
fear. Santa Barbara, CA: Greenwood.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
109
Birnie, K.A., Chambers, C., Taddio, A., McMurtry, C.M., Noel, M., Pillai Ridell, R., Shah, V., and the HELPinKids&Adults Team (including Antony, M.M.) (2015). Psychological interventions for vaccine injections in children and adolescents: Systematic review of randomized and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S72 – S89.
Boerner, K.E., Birnie, K.A., Chambers, C., Taddio, A., McMurtry, C.M., Noel, M., Shah, V., Pillai Ridell, R., and the
HELPinKids&Adults Team (including Antony, M.M.) (2015). Simple psychological interventions for reducing pain from common needle procedures in adults: Systematic review of randomized and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S90 – S98. Fairbrother, N., Young, A.H., Janssen, P., Antony, M.M., & Tucker, E. (2015). Depression and anxiety during the
perinatal period. BMC Psychiatry, 15:206. DOI 10.1186/s12888-015-0526-6 Gallo, K.P., Comer, J.S., Barlow, D.H., Clarke, R.N., & Antony, M.M. (2015). Direct-to-consumer marketing of
psychological treatments: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83, 994998. Hara, K.M., Westra, H.A., Aviram, A., Button, M.L., Constantino, M.J., & Antony, M.M. (2015). Therapist awareness
of client resistance in cognitive-behavioural therapy for generalized anxiety disorder. Cognitive Behaviour Therapy, 44, 162-174. Hood, H.K., & Antony, M.M. (2015). Perfectionism-related OCD in an adult. In E.A. Storch & A.B. Lewin (Eds.),
Clinical handbook of obsessive-compulsive and related disorders: A case-based approach to treating pediatric and adult populations (pp. 85-97). New York, NY: Springer. Hood, H.K., & Antony, M.M. (2015). Phobia, specific. In I. Milosevic & R.E. McCabe (Eds.), Phobias: The
psychology of irrational fear (pp. 280-284). Santa Barbara, CA: Greenwood. Hood, H.K., & Antony, M.M. (2015). Phobias, prevalence of. In I. Milosevic & R.E. McCabe (Eds.), Phobias: The
psychology of irrational fear (pp. 311-313). Santa Barbara, CA: Greenwood. Kocovski, N.L., Fleming, J.E., Hawley, L.L., Ho, M.H.R., & Antony, M.M. (2015). Mindfulness and acceptance-based
group therapy and traditional cognitive behavioral group therapy for social anxiety disorder: Mechanisms of change. Behaviour Research and Therapy, 70, 11-22. McCabe-Bennett, H.E., & Antony, M.M. (2015). Phobias, diagnosis of. In I. Milosevic & R.E. McCabe (Eds.), Phobi-
as: The psychology of irrational fear (pp. 293-296). Santa Barbara, CA: Greenwood. McMurtry, C.M., Noel, M., Taddio, A., Antony, M.M., Asmundson, G.J.G., Pillai Ridell, R., Chambers, C., Shah, V.,
and the HELPinKids&Adults Team (2015). Interventions for individuals with high levels of needle fear: Systematic review of randomized controlled trials and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S109S123. McMurtry, C.M., Pillai Ridell, R., Taddio, A., Racine, N., Asmundson, G.J.G., Noel, M., Chambers, C., Shah, V., and
the HELPinKids&Adults Team (including Antony, M.M.) (2015). Far from "just a poke": Common painful needle procedures and the development of needle fear. Clinical Journal of Pain, 31, S3 – S11. Noel, M., Taddio, A., McMurtry, C.M., Chambers, C., Pillai Ridell, R., Shah, V., and the HELPinKids&Adults Team
(including Antony, M.M.) (2015). HelpinKids&Adults knowledge synthesis of the management of vaccination pain and high levels of needle fear: Limitations of the evidence and recommendations for future research. Clinical Journal of Pain, 31, S124-S131. Nowakowski, M.E., & Antony, M.M. (2015). Anxiety and related disorders. In I. Milosevic & R.E. McCabe (Eds.),
Phobias: The psychology of irrational fear (pp. 19-23). Santa Barbara, CA: Greenwood. Nowakowski, M.E., & Antony, M.M. (2015). Phobias, assessment of. In I. Milosevic & R.E. McCabe (Eds.),
Phobias: The psychology of irrational fear (pp. 287-289). Santa Barbara, CA: Greenwood.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
110
Shah, V., Taddio, A., McMurtry, C.M., Halperin, S.A., Noel, M., Pillai Ridell, R., Chambers, C., and the
HELPinKids&Adults Team (including Antony, M.M.) (2015). Pharmacological and combined interventions to reduce vaccine injection pain in children and adults: Systematic review and meta-analysis. Clinical Journal of Pain, 31, S38 – S63. Shikatani, B., Fracalanza, K., & Antony, M.M. (2015). Behavior therapies. In R. Cautin & S.O. Lilienfeld (eds.),
Encyclopedia of clinical psychology. Hoboken, NJ: John Wiley and Sons. Shikatani, B., Nowakowski, M.E., & Antony, M.M. (2015). Illness anxiety disorder/hypochondriasis. In R. Cautin &
S.O. Lilienfeld (eds.), Encyclopedia of clinical psychology. Hoboken, NJ: John Wiley and Sons. Taddio, A., McMurtry, C.M., Shah, V., Pillai Riddell, R., Chambers, C., Noel, M., MacDonald, N.E., Rogers, J.,
Bucci, L., Mousmanis, P., Lang, E., Halperin, S.A., Bowles, S., Halpert, C., Ipp, M., Asmundson, G.J.G., Rieder, M.J., Robson, K., Uleryk, E., Antony, M.M, Dubey, V., Hanrahan, A., Lockett, D., Scott, J., Votta Bleeker E., & HELPinKids & Adults Team (2015). Reducing pain during vaccine injections: Clinical practice guideline. Canadian Medical Association Journal, 187, 975-982. Taddio, A., McMurtry, C.M., Shah, V., Yoon, E.W., Uleryk, E., Pillai Ridell, R., Lang, E., Chambers, C., Noel, M.,
MacDonald, N.E., and the HELPinKids&Adults Team (including Antony, M.M.) (2015). Methodology for knowledge synthesis of the management of vaccination pain and needle fear. Clinical Journal of Pain, 31, S12 – S19. Taddio, A., Shah, V., McMurtry, C.M., MacDonald, N.E., Ipp, M., Pillai Ridell, R., Noel, M., Chambers, C., and the
HELPinKids&Adults Team (including Antony, M.M.) (2015). Procedural and physical interventions for vaccine injections: Systematic review of randomized controlled trials and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S20 – S37. Vorstenbosch, V., Antony, M.M., Monson, C.M., & Rowa, K. (2015). Family accommodation in problem hoarding.
Journal of Obsessive-Compulsive and Related Disorders, 7, 7-15. King, J.P., Gojmerac, C.B., & McNeely, H.E. (2015). Psychological assessment of borderline personality disorder in
geriatric patients. In: A Hategan, J.A. Borgeois, & G.L. Xiong (Eds.), Borderline Personality Disorder in Older Adults: Emphasis on Care in Institutional Settings. New York: Nova Science Publishers. Meusel, L.M., McKinnon, M.C., & Bieling, P. (2015). Geriatric borderline personality disorder in the era of the
DSM-5 and ICD-11. In Hategan, A & Bourgeois, J. (Eds). The Challenge of Geriatric Borderline Personality Disorder in Institutional Settings. Hauppauge, New York: Nova. MacDougall, A., McKinnon, M.C., Herdman, K.A., King, M., & Kiang, M. (2015). The relationship between autobiographical memory and insight in schizophrenia. Psychiatry Research, 226, 392 – 395. Nazarov, A., McNeely, H., Kiang, M., Lanius, R. & McKinnon, M.C. (2015). The relation between morality and
mental health in the North American military forces. Acta Psychiatrica Scandinavica. 2015 Mar 3. doi: 10.1111/ acps.12406. Milosevic, I., Levy, H. C., Alcolado, G. M., & Radomsky, A. S. (2015). The Treatment Acceptability/Adherence Scale:
Moving beyond the assessment of treatment effectiveness. Cognitive Behaviour Therapy, 44, 456–469. Shams, G., Janani, L., Milosevic, I., & Foroughi, E. (2015). Disgust Emotion and Obsessive-Compulsive Symptoms in
an Iranian Clinical Sample. Psychology, 6, 1721-1731. Shams, G., & Milosevic, I. (2015). A comparative study of obsessive beliefs in obsessive-compulsive disorder,
anxiety disorder patients and a normal group. Acta Medica Iranica, 53, 301-310. Gavric, D. (2015). Chronicity. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of irrational
fear. Santa Barbara, CA: Greenwood. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
111
Nowakowski, M.E., Antony, M.M., & Koerner, N. (2015). Modifying interpretation biases: Effects on
symptomatology, behavior, and physiological reactivity in social anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 49, 44-52.
Birnie, K.A., Chambers, C., Taddio, A., McMurtry, C.M., Noel, M., Pillai Ridell, R., Shah, V., and the HELPinKids &Adults Team (including Antony, M.M.) (2015). Psychological interventions for vaccine injections in children and adolescents: Systematic review of randomized and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S72 – S89.
Nowakowski, M.E., & McCabe, R.E. (in press). Panic disorder: Treatment. In A.E. Wenzel (Ed.), The SAGE encyclopedia of abnormal and clinical psychology. Thousand Oaks, CA: SAGE Publications.
Nowakowski, M.E., Atkey, S.K., & Antony, M.M. (2015). Self-help/bibliotherapy. In R. Cautin & S.O. Lilienfeld (eds.),
Encyclopedia of clinical psychology. Hoboken, NJ: John Wiley and Sons. Pillai Ridell, R., Taddio, A., McMurtry, C.M., Chambers, C., Shah, V., Noel, M., and the HELPinKids&Adults Team
(including Antony, M.M.) (2015). Psychological interventions for vaccine injections in young children 0 to 3 years: Systematic review of randomized controlled trials and quasi-randomized controlled trials. Clinical Journal of Pain, 31, S64 – S71. Gavric, D. (2015). Disease-Avoidance Model. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrational fear, an encyclopedia. Santa Barbara, CA: ABC-CLIO. Invited manuscript accepted for publication. Gavric, D. (2015). One-Session Treatment. In I. Milosevic & R. E. McCabe (Eds.), Phobias: The psychology of
irrational fear. Santa Barbara, CA: Greenwood.
Leadership
Psychology staff received numerous awards including the Research in Print Award, Baycrest Centre, Fellow of the Canadian Psychological Association, and the Individual Research Award of Excellence, Professional Advisory Committee Awards of Excellence, St. Joseph’s Healthcare, Hamilton (2015). A psychology staff member is Chair of the LHIN Health Professional Advisory Committee. Psychology staff hold key board positions in Canadian Association of Behavioural and Cognitive Therapies including President, Communication and Advocacy, and Credentialing. A psychology staff is the Conference Chair for the annual meeting of the Canadian Association of Behavioural and Cognitive Therapies. A Psychology staff member was re-appointed Secretary/Treasurer of the Clinical Section of the Canadian Psychological Association. Psychology staff held various leadership positions in the Department of Psychiatry & Behavioural Neurosciences at McMaster University including Academic Head of the Mood Disorders Program, Academic Head of the Anxiety Disorders Program, Associate-Co-Chair of Research, and Director of Continuing Education A psychology staff member is the co-coordinator for Mental Health and Addiction Rounds. A Psychology Staff member is Chair of the Fellowship Committee for the Ontario Mental Health Foundation. A Psychology staff member was a Canadian Psychological Association (CPA) accreditation site visitor for the Ontario CSC Psychology Residency Program. A number of psychology staff completed leadership training in the Department of Psychiatry and Behavioural Neurosciences Leadership Skills Program and Community of Practice.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
112
A psychology staff served as a Reviewer for the Compendium of Psychotherapy Resources for Occupational Therapists in preparation for the College of Occupational Therapists’ application to provide training suitable for registration with the College of Psychotherapists. A psychology staff is an Oral Examiner for the College of Psychologists of Ontario Psychology staff served is a coordinator of a new monthly rounds series in the Seniors Mental Health Program (participants, in particular physicians, may use these rounds to count towards continuing education credits). A psychology staff member participated in the Canadian Institutes of Military and Veteran’s Health Research Knowledge Translation Session. Psychology staff gave numerous community presentations and workshops to groups such as North Hamilton Community Health Centre, Deerview Retirement Home, Parachute Organization Brantford, Coalition on Hoarding Guelph Region, Canadian Police College, Chatham-Kent Police Service, Hamilton Police Service, Halton Healthcare, Hamilton Family Health Team, Human Services Justice Coordination Committee, Royal Victoria Hospital, Joseph Brant Wellness House, and the Canadian Literacy Learning Network. A number of psychology staff gave media appearances for the public relations department of SJHH on topics related to mental health including print interviews (e.g., Hamilton Spectator), online resources (e.g., www.cpa.ca), television interviews (e.g.,CBC, CHCH, Rogers cable), and radio interviews (e.g., CHML Hamilton). Psychology staff collaborated to develop a mentoring curriculum for the Department of Psychiatry and Behavioural Neurosciences (DPBN). This curriculum is currently being tested in a program evaluation study supported by a DPBN Innovation grant. Development of interdisciplinary clinical programs including the interdisciplinary psychoeducation group for inpatients of Schizophrenia and Community Integration Services. Psychology staff were involved in organizing a symposium (Interprofessional Care of Critically Ill Adults: From ICU to Community) that brought together researchers and knowledge users for discussions and presentations on best practices for patient care within an interprofessional environment.
External Committees Psychology staff sat on key committees at (1) SJHH: Chair, Clinical Research Operations Committee, Ethics Committee, Program Quality Safety and Improvement Committees, Research Ethics Board; (2) Department of Psychiatry and Behavioural Neurosciences, McMaster University: Departmental Executive Committee, Education Coordinating Committee, Recruitment Committee; Financial Task Force, Tenure and Promotions Committee. (3) Faculty of Health Sciences, McMaster University: Clinical Behavioural Sciences Program, Program Advisory Committee of the Graduate Program in Neuroscience; (4) Granting Agencies: Behavioral Sciences Review Committee for CIHR, Banting Postdoctoral Fellowships CIHR, external reviewer for the Canada-China Competition of the Canadian Institutes of Health Research, Fellowship Committee for the Ontario Mental Health Foundation, external reviewer for the National Sciences and Engineering Council of Canada (NSERC).; and (5) Various External Agencies and Groups: Canadian Longitudinal Study of Aging Hamilton Working Group Ontario Review Board, and Board of Advisory for the Canadian Critical Incident Association, Sexual Deviance Subgroup of the Evidence-Based Practices in Forensic mental Health Task Group (Ontario Ministry of Health and Long Term Care). PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PSYCHOLOGY
PAGE
113
External Presentations Psychology staff gave numerous presentations at local, national and international conferences or association
meetings, including the American Academy of Addiction Psychiatry, American Psychological Association, Anxiety Disorders Association of America, Association for the Treatment of Sexual Abusers, American Academy of Forensic Sciences, Association for Behavioural and Cognitive Therapies, Canadian Association of Threat Assessment Professionals, Canadian Association of Neuroscience, Canadian Counselling and psychotherapy Association, Canadian Critical Incident Association, Canadian Association of Cognitive and Behavioural Therapies, Canadian Institute of Military and Veteran’s Health Research , Canadian Psychological Association, CREST Women in Science and Engineering Conference, Emergency Management Council, Conference Board of Canada, International Association of Forensic Mental Health Services, International Association of Youth Mental Health Conference International Conference on Eating Disorders, International Congress on Palliative Care, International Society for Traumatic Stress Studies Neurobehavioural Rehabilitation in Acquired Brain Injury, Ontario Respiratory Care Society, Ontario Community Outreach Program for Eating Disorders (OCOPED), Ontario Correctional Nurses Interest Group, Risk and Recovery Conference, and Society of Biological Psychiatry. A psychology staff member was on the board certification in clinical neuropsychology (ABPP) review committee for the American Academy of Clinical Neuropsychology.
Discipline Goals 2016 Quality & Safety
Improve quality and safety standards in assessment and consultation reports across the discipline focusing in three areas: assessment of risk, assessment of substance use, and presentation of recommendations through education of ROPs and development of auditing tools.
Change
Develop new clinical assessment methods and treatment interventions implementing them in a controlled design to determine utility through psychometrically validated measures of treatment response.
Research & Education
Enhance training standards for postdoctoral fellows in the Clinical Neuropsychology Service through the development of post doctoral training curriculum with the intent of applying for accreditation status.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
114
Respiratory Therapy Professional Practice Leader (Charlton): Leslie Brooks Number of Members of Discipline
Scope of Practice: The practice of respiratory therapy is the providing of oxygen therapy, cardio -respiratory equipment monitoring and the assessment and treatment of cardio-respiratory and associated disorders to maintain or restore ventilation Controlled Acts Authorized to RT Performing a prescribed procedure below the dermis (controlled act # 2). Intubation beyond the point of the nasal passages where they normally narrow or beyond the larynx (controlled act # 6ii and iii). Suctioning beyond the point in the nasal passages where they normally narrow or beyond the larynx (controlled act # 6ii and iii). Administering a substance by injection or inhalation (controlled act # 5).
Critical Care: 30.23 FIRH: 8.3 OR: 6.6
Clinical Practice Achievements Quality & Safety
New Non-Invasive Ventilation devices introduced with additional monitoring and alarm features Monthly newsletters highlighting current or future practice issues, safety information, hand hygiene performance, and student updates. Resource website created for staff for mobile accessibility to education materials (handouts, reference guidelines, and education videos)
Change
Firestone Clinic: new data base Sentry Suite; spirometry equipment and Stage 1 Exercise Equipment Aerochamber use within in the SJHH organization: moved equipment to all clean cores; reduced the use of Aerochamber with mask to Emergency Department & Intensive Care Unit
Community
Community Coordinator for Respiratory Therapy continues to give support to patients living in the community that require oxygen, nebulized medication, non-invasive ventilation, and tracheostomy care, with our ongoing Joint Venture with ProResp.
Interconnection
Collaboration between Respiratory Therapy Educator and Intensive Care Unit Nurse Educator for both ICU Nurses and Respiratory Therapy Annual Education Days. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
RESPIRATORY THERAPY
PAGE
115
Academic Pursuits Internal Teaching
Education Sessions provided to Respiratory Therapy, Nursing, Pharmacy, and Physiotherapy students by Best Practice Clinical Educator as well as Respiratory Therapists working in Complex Care, Community Coordination, and Rehabilitation Therapy Best Practice Clinical Educator has status appointments with the Michener Institute of Applied Health Sciences as Clinical Coordinator and with Conestoga College as Clinical Associate Best Practice Clinical Educator has a status appointment in the Department of Anesthesia (Critical Care) for the Faculty of Health Sciences at McMaster University
Formal Teaching
Best Practice Clinical Educator has presented specific training to McMaster medical residents and fellows on Esophageal Pressure Monitoring, Mechanical Ventilation, Asynchrony, Tracheostomy Care, Oxygen Therapy, NIPPV, and Prone Positioning
Clinical Teaching
All Respiratory Therapy staff are Preceptors for bedside clinical teaching of Respiratory Therapy Students as well as educating other Health Professionals throughout the hospital as the need presents itself at the bedside. It is a requirement of the College of Respiratory Therapists of Ontario that Respiratory Therapists provide Education related to their practice.
Scholarly Pursuits Research
EPVENT2 trial: A randomized controlled trial of ARDS patients comparing two methods of mechanical ventilation. Ongoing assistance with a GE study by performing arterial line insertions in study participants. Start and completion of the SENIOR mechanical ventilation weaning assessment trial
Continuing Education
Staff attended an annual education day 4 staff therapists attended the The Canadian Society of Respiratory Therapists Annual Education Conference 1 staff therapist attended the American Association of Respiratory Care Conference In-services provided by: Fisher & Paykel, Drager, and Respironics Ongoing Webinars and Journal Club Presentations offered by The Canadian Society of Respiratory Therapists. Staff re-certification in Neonatal Resuscitation Program PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
RESPIRATORY THERAPY
PAGE
116
Leadership
Continue to monitor and implement the use of NCPAP and BIPAP according to best practice within the organization and generate revenue through the ProResp joint venture. Continue to streamline and increase the utilization of the Pulmonary Function Labs for use and efficiency.
External Committees Members of the RT Professional Practice Committee of Hamilton, the Respiratory Therapy Society of Ontario Acute Care Leadership Committee, the Professional Advisory Committee for Conestoga College, and the Faculty Liaison Committee, Professional Advisory Committee, and Clinical Curriculum Committee for Fanshawe College. Best Practice Educator is a member of the Editorial Board for The Canadian Journal of Respiratory Therapy (the scientific journal of The Canadian Society of Respiratory Therapists, and Respiratory Care Journal (the scientific journal of the American Association of Respiratory Care)
External Presentations Best Practice Clinical Educator was invited to speak at the following events: Manitoba Association of Respiratory Therapists Educational Forum Saskatchewan College of Respiratory Therapists Education Day New Brunswick Newborn Symposium The Canadian Society of Respiratory Therapists Annual Education Conference The American Association of Respiratory Care Annual Education Conference
Discipline Goals 2016 Quality & Safety
Improve and maintain excellence in hand hygiene practice Successfully transition to a new delivery system for inhaled epoprostenol Make adjustments to the current Transfer of Accountability (TOA) method to improve best practice and patient safety Implement Heated Humidified High-Flow Nasal Cannula (HHHFNC) therapy in the NICU as a standard of care option for newborns in respiratory distress. Continue enrollment in EPVENT2 ventilation trial
Change
Implement new modality for Infants in respiratory distress/transition : Optiflow Junior vs SIPAP Implement new Aerochamber device organizationally Implement efficiencies and utilization in the Firestone: Clinic area; & Stage 1 exercise equipment PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
RESPIRATORY THERAPY
PAGE
117
Community
Pro Resp Joint Venture: implement devices clinic (CPAP) in the Sleep Lab for patients who require devices for use at home
Interconnection
Continue working with Nursing and Physiotherapy for providing Education and improving interprofessional collaboration within the hospital.
Research & Education Evaluation of use of the Optiflow Junior
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
118
Social Work Professional Practice Leader (Charlton, King, West 5th): Jimena Silliker, MSW, RSW Number of Members of Discipline Charlton 32 FTE 6 PTE 1 Casual King 7 FTE 1 PTE West 5th 48 FTE 8 PTE
Scope of Practice:
Clinical Practice Achievements The Social Worker – RSW provides quality social work services congruent with the Code of Ethics and Standards of Practice of the Ontario College of Social Workers and Social Service Workers OCSWSSW). The Registered Social Worker provides psychosocial assessment, counselling/ psychotherapy, case management, patient/ family education, supportive counselling, discharge planning, service coordination and consultation according to best practice standards in order to assist patients to achieve optimum recovery and quality of life. This includes maximizing the benefit patients and families receive from their medical and mental health treatments and transitioning to riskreduced, timely discharges. The Registered Social
Clinical Practice Achievements Quality & Safety Quality Team participation on General Internal Medicine, Complex Care, Women’s
and Infant Program, Kidney and Urinary program, Forensics, and the Thoracic Improvement Council Continue to review TAO practice and patient identifiers practice on a regular basis across campuses Co-Lead, Mindfulness Meditation Sessions with patients who have respiratory disease (i.e. CODP; Interstitial Lung Disease): Ongoing collaboration with patient graduate to implement Mindfulness Meditation education and sessions with Respiratory Rehabilitation inpatient/ outpatient Co-Lead, Expanded the monthly Breathing Buddies Support Group by opening program to family members and post lung transplant patients (graduates of the Respiratory Rehab Program). Ongoing development of CBT group for anxiety Co-lead- SMART program steering committee and hospital lead (GIM) Interprofessional Communication Board Committee Member (GIM) (nominated for the Health Professionals Excellence in Practice Award) Unit Champion for “Positive Words” as roll out of Safe Wards initiative. Development of Form G process for at Risk patients with CCAC partners Anti-Stigma Committee, Schizophrenia and Community Integration Service Outpatient Quality and Patient Safety Council Department of Social Work. In partnership with Core Collaborative Hamilton provided two mandatory workshops (1) Anti-Oppressive/Anti-Racism Practice and (2) Recovery for Mental Health. These workshop assisted by providing best practices in person centered care, development of skill to address oppressive behavior and provided the ability to use a recovery perspective to collaborate with and learn from peers
Change
Forensic Quality of Worklife Committee, "Enhancing Quality of Worklife:
You Should Never Stop Having Fun!" Committee participation in the Rethink Respect Anti Stigma Campaign PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SOCIAL WORK
PAGE
119
Community
Peer Case Review and support Group Completed Development of MyCollaboration site Completed review and updated Social Work Documentation Policy, Deceased Patient with No Next of Kin Policy and Elder Abuse Policy and Procedure Completed comprehensive Department of Social Work Orientation and Resources Toolkit Dept of Social Work prepared and delivered mandatory workshop on Social Work Bio Psychosocial Assessments.
Interconnection
Women’s and Infant Program RSW’s plan and implement Moment of Silent Hope Memorial Service for Stillborn and Pregnancy Loss in conjunction with Spiritual Care and McMaster’s RSWs in their maternal child program. Services alternate between SJHH and McMaster Children’s Hospital. RSW with 2 nurse educators, presented a workshop at the National Conference on Domestic Violence in Toronto. The workshop was entitled – “Birthing: a Collaborative Approach between mental health and addiction, maternal child nursing and the woman with a trauma history”. The focus of the workshop was two-fold: 1) to review the staff education sessions we did for our own staff, highlighting the importance of a collaborative approach (using staff as educators, but also involving the patient voice) and 2) work done by staff on approaching the patient without stigma when dealing with mental health and addiction. Member of a collaborative working work group with HNHB CCAC and St. Joseph’s Hospital to reduce ALC designation and ED admissions. In particular, SW leading ALC escalation process. Daily contact between SW manager and CCAC Client Service Manager continue to meet on a regular basis in person and on phone to review potential discharge barriers. CCAC Client Service Manager also in constant contact with Discharge Specialists at Charlton and West 5th sites. SW Manager as site lead for Convalescent Care Program and Transitional Care Bed Program liaise with both programs by attending perspective committees, addressing issues related to transitions, discharge barriers and readmissions. Member and Co lead- Therapeutics Senior Care Education Team continues to present monthly Lunch and Learn Sessions open to all Allied Health and Medical Staff. Some of the topics covered have been Getting Patients to the Right Discharge Program, Compassion Fatigue”, “ Fall and Fraction Prevention, Drug Reaction and Pharmacology in Seniors, Behavioral Support Services and SMART.
Academic Pursuits Formal Teaching Professional Competencies –Longitudinal Facilitator, DeMichael Degroote School of Medicine, Mc Master
University Sessional Instructor for a half-credit graduate level course entitled “Foundations for Advanced Social Work Practice with Individuals”, University of Windsor Sessional Instructor for a half-credit graduate level course entitled “Foundations for Advanced Social Work Practice with Groups”, University of Windsor Instructor for the module ‘Social Supports’ for the e-learn CE course “Mental Health and the Law, Forensic Studies”, Mohawk College
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SOCIAL WORK
120
Faculty Academic appointment in the Department of Family Medicine, Division of palliative care at McMaster University Professional Competencies Tutor, McMaster School of Medicine, Tutor with Division of Palliative Care (TOSCE program) Assistant Practicum Professor – Part-time, Faculty of Social Work, Wilfrid Laurier University Part-Time Instructor, Mohawk College, Introduction to Mental Health and the Law: Forensics Studies, Continuing Education Health Sciences McMaster University Program for Inter-professional Practice, Education and Research Faculty McMaster University Part-time assistant professor, Department of Psychiatry and Behavioral Neurosciences Assistant Professor-Part-time, Department of Psychiatry and Neurosciences Field Instruction: Bachelor and Master Social Work students Continuing Education Examiner of CASPer responses from MD applicants and for MD -Master of Science in Criminology & Criminal Justice students taking the OSCE clinical through the University of Leicester, UK sessions ) and the TOSCE clinical sessions, as Assistant -Certification by the American Board of Forensic Professor , McMaster University, Faculty of Health Sciences Social Workers as a Master Forensic Social Worker (CMFSW) Tutor for Psychodynamic Psychotherapy course , -Completed the undergraduate university course Risk Clinical Behavioral Science program Management & Safety in Health Services, Athabasca Longitudinal facilitator for Professional Competence, University
Internal Teaching
PAGE
-Recertification as a Crisis Prevention Institute (CPI) instructor by completing the course Trauma Informed Care: Instructor Excellence Renewal Training -Continued e-learning modules on hospital leadership through the Institute for Healthcare Improvement -Completed CBT Level III through McMaster Clinical Behaviour Sciences Program -Master degree (x3), McMaster School of Social Work, Windsor University, Dalhousie University - Currently enrolled and training in Behavioral Tech's DBT training - Completed CAMS and GAIN certification - Completed Levels II and III Conversational Certification in French. University of Toronto Continuing Ed. Program
CPI instructor Supervisor for 4th/5th year psychiatry resident doing psychodynamics psychotherapy Facilitator, Presentations to Nursing Staff, presentations to nursing staff of Nephrology on dealing with Challenging Families SW orientation to new dialysis nursing staff, new nurse practitioner in our program and a nursing student Presenter, Family & Friends Information Session – “A Day in the Life……Living with Kidney Disease”. Co-Supervisor, Health Policy Student from Brock University Field Instructor Social Service Student (Mohawk College) Field Instructor for Social Work Students (BSW and MSW), various universities. In-service to Clinical Clerks and Medical Students, Social work role in the K&U Program. Examiner for two full-day sessions of the Multiple Mini Interview (MMI) process for MD applicants at McMaster University (Mar 2015); Examiner for two full-day sessions of the Teaching Objective Structured Clinical Evaluation (TOSCE) for MD students preparing for the Mental Status Examination practical at McMaster University (Nov 2015). SW (Women’s and Infants Program) provide teaching sessions for nursing students on the role of social work within the program, as well as education to working with our client population. Topics reviewed include, mental health, addiction, domestic violence, preterm delivery issues and more. Effective communication is reviewed, including strategies on how to work with the aggressive or volatile patient. A strength based and non-judgmental focus is emphasized. SW Presentation to Midwifery students – a half day to the McMaster University midwifery students together with a woman who delivered a stillborn baby. The focus was on pregnancy loss, including miscarriage, stillbirth and neonatal death. We offered education, information and suggestions on ways to offer support to families who experience the loss of a baby. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SOCIAL WORK
PAGE
121
Presenter, “Perceptions of Care by Families of Forensic Out-Patients” Social Work Week Educational Rounds Presenter, “Advocacy in Real Time: A Social Worker’s Pursuit of a LTC bed for a geriatric Forensic Mental Health Patient” Social Work Week Educational Rounds Teaching Psychology Residents DBT Skills Teaching Psychiatry Residents DBT Skills Kidney Medical fair (once per year) to student physicians Poster Presentation at the 27th Annual Research Day of McMaster’s Department of Psychiatry ‘The Court of Public Opinion: A Study of Online Comments on the Luka Magnotta Trial’ Poster Presentation at the 32nd Annual Conference of the National Organization of Forensic Social Work, ‘The Court of Public Opinion: A Study of Online Comments on the Luka Magnotta Trial’, Arlington. VA
Leadership
Certified Worker Member and OPSEU representative Joint Health & Safety Committee, West 5th Campus Chair, Social Work Peer Support Group Group Facilitator Focus Groups: several patient focus groups with Respiratory Rehabilitation Support Group to assist with program development for Caring for My COPD programs in the local LHIN. Project Lead & Co-Chair, Home First Refresh and Transitional Care Bed Program at St. Joseph’s Hospital Internal Lead Resource Matching and Referral Project Lead, Forensic Dialectical Behaviour Therapy Team Anti-Stigma Conference Planning Committee (lead for Market Place) Co chair- Therapeutics Senior Care Education Team SW manager co lead and facilitated with CCAC Client Service Manager meeting with most West 5th nurse managers to provide a forum for discussion related to collaborative discharge planning Social Workers at Charlton Site partnered in two projects, Health Links and Community Connector Pilot project leading in the delivery of referrals and uptake Social Work continues to lead and implement ALC according to the provincial definition and develop an ALC working plan and ways and opportunities in which our ALC rate can be lowered. Social Workers in acute care have engaged with two pilot projects, Health Links and the Community Care Connector program. Social Workers will review and refer to new programs based on their clinical assessments. these programs. Numerous meetings with respective program leadership have taken place and will continue in order to look at best practice, patient center care and reinforce incremental referrals for each of the programs.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SOCIAL WORK
PAGE
122
External Committees
Program For Faculty Development, Discovering Leadership Resilience Team Department of Psychiatry and Neurosciences , Clinical Behavioral Sciences-Group Studies Area Elected Council Member, Ontario College of Social Workers and Social Service Workers; currently sitting on the Discipline Committee, the Fitness to Practice Committee, and the Governance Committee Member of the Social Work Divisional Council, Wilfrid Laurier University Division of Palliative Care 5 Days in Palliative Care Committee, Palliative Undergrad Teaching committee Vice President, Board of Directors for Artaban Non-Profit Housing Member, Kidney Foundation Board Member of the Ontario Social Work Association –Hamilton Branch. Mohawk College, Concurrent Disorders Program Advisory (member) Lead the Concurrent Disorders “Action” tables across the HNHB LHIN (we have tables that meet in Burlington, Hamilton, Niagara, Brantford, Haldimand-Norfolk monthly) (*this is part of my job, but are newly formed groups that specifically relate to the project and report to the LHIN) Member of the “Niagara Mental health and addiction Charter group” (through Niagara connects) Member of Centre for Addictions & Mental Health (CAMH) LHIN-wide Implementation Committee for Staged Screening and Assessment Prooess McMaster University, School of Psychiatry & Neurosciences, Faculty of Health Sciences, Steering Committee Member for Clinical Behavioural Studies Program McMaster University, Faculty of Health Sciences, Program for Faculty Development, Discovering Resiliency Leadership Team Member Member of LGBTQ committee at Child and Adolescent Services Member, Ontario Renal Network Member, Field Intruction Committee, Mc Master University
External Presentations
Mc Master University, School of Social Work, MSW Research Day PUBLICATION: The court of public opinion: An examination of posted comments by the public about the Luka Magnotta trial of criminal responsibility. Canadian Journal of Criminology and Criminal Justice.
Discipline Goals 2016 Quality & Safety
Social Workers will continue to participate in GPA re/certification program. Social Workers in the Dept of SW will continue to work in the scaling and spreading of the with Health Links Model at the Charlton Site. Social Workers in the Dept of SW will continue to actively participate in the development and spreading of the Home First ReFresh Philosophy and will work with Clinical Infomatics to assist with the trailing and development of HNHB LHIN Home First reporting requirements SW will continue to promote adherence to TOA and proper documentation practices SW will continue to promote and adhere to the (two) patient identifier protocol PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SOCIAL WORK
PAGE
123
Change
Social Workers in the Dept of SW will be actively engaged in the spreading and scaling of the Health Links Model. This is a model of care which is an intensive , integrated model focusing on patient centered goals to address the needs of people living in with complex chronic conditions through a collaborative care plan and more meaningful engagement. Dept of SW will be trialing
Community
Social workers will continue to attend community committees with the aim to enhance relationships and assist with seamless transitions of our patients to the different discharge locations within our community SW (Discharge Specialists) representation continues in the LHIN initiatives: LTCH transitions: Nurse Led Outreach Teams (NLOT), Resource Matching and Referral (RM &R) RSWs have also represented in consultation tables at HBHNCCAC’s Palliative Care Community Engagement/Feedback session, St. Peter’s Hospital- Slow Reactivation Feedback session
Research & Education
The Policy and Procedure subcommittee of the SWPPC will continue to review and amend as necessary policies and procedures to ensure our understanding of best practices is reflective and supported by our policies, procedures and care paths Continue to populate SW MyCollaboration to better standardize practice, link RSW’s across the organization and provide a resource platform. Master’s Dissertation studying on-line comments related to the Luka Magnotta trial, Department of Criminology, University of Leicester Participated in a research study the National Initiative for the Care of the Elderly (NICE) regarding the use of various tools for geriatric patients Execute GPA evaluation research Project (Therapeutics Senior Care Education Team), in partnership with St. Joseph’s Home Care. This research proposal was also submitted to the PAC Interdisciplinary Research Award but will go ahead with or without the funding award from PAC.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
124
Speech Language Pathology Professional Practice Leader (Interim) (West 5th, Charlton) Bonnie Reaburn-Jones, MSc, Reg. CASLPO Number of Members of Discipline Charlton 12.7 FTE West 5th .4 FTE
Scope of Practice: The practice of speech-language pathology is the assessment of speech and language functions and the treatment and prevention of speech and language dysfunctions or disorders to develop, maintain, rehabilitate or augment oral motor or communicative functions
Clinical Practice Achievements Quality & Safety
Implemented the use of two patient identifiers for each patient visit. Documentation of two patient identifiers occurs on first visit with patient/client. Audit of compliance of documentation was 99% across the pediatric and adult Speech Language Pathologists.
Sustained use of Transfer of Accountability (TOA) across the pediatric and adult Speech Language Pathologists. Audit revealed 99% compliance. Adult Speech Language Pathologists are members of Quality Councils for General Internal Medicine, Rehab, Complex Care, Ambulatory Therapeutics and Thoracics. Adopted an evidence-based standardized assessment, analysis and reporting protocol for Videofluroscopic Swallowing Studies, the Modified Barium Swallow Impairment Profile (MBSImP) Co- lead and member of the Pneumonia Working group, an interdisciplinary working group addressing the use of oral care for adult patients who are at risk for aspiration
Member of the General Internal Medicine patient bedside board implementation team. The team is supporting the interdisciplinary use of a patient bedside board to improve communication at the bedside.
Advocate for obtaining funding for alternative communication devices for patients on the Head and Neck Unit.
In collaboration with infection control, reviewed and revised infection control protocol, including personal protective equipment, with the head and neck population.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPEECH LANGUAGE PATHOLOGY
PAGE
125
Active member of the Therapeutic Seniors Care Education Team which included identified topics and speakers for monthly Lunch and Learn sessions.
Co-Chair of Day Therapy Initiative which promoted education regarding Day Therapy services to stakeholders Received an overall satisfaction rating of 100% in the Outpatient Speech-Language Pathology Service, as per results on the Ambulatory Therapeutics Patient Satisfaction Survey. Achieved hand hygiene compliance of 93.3% in the outpatient Speech-Language Pathology Service, as per results on the Ambulatory Therapeutics Patient Satisfaction Survey. The pediatric Speech Language Pathology team implemented strategies to improve attendance.
Change
Standardized all adult Speech Language Pathology reports. Standardized the organization and the location of the pediatric outpatient charts to improve accessibility.
Community
Supported building leadership within adult and pediatric Speech Language Pathology teams through annual rotation of team leader and attendance at the Emerging Leaders Program. Participated in the employee engagement survey. Established a journal club for the Adult Speech Language Pathology team
Interconnection
Collaborated with the Early Words Regional team, the Hamilton-Wentworth District School Board and the Hamilton-Wentworth Catholic District School Board to establish an ”intentional transition model for successful transitions” between Early Words, school boards and Community Care Access Centres (CCAC) of Hamilton, Niagara and Haldimand Provided community-based Speech Language Pathology services to target the hard to service population though participation in the Community Support Team and New Choices Participated in the Integration of Rehabilitation Services planning table for the Special Needs Strategy in Hamilton.
Academic Pursuits Formal Teaching
Four learners completed clinical placements (students in Speech-Language Pathology, Communicative Disorders Assistant and Cognitive Linguistic programs as well as a High School CO-OP student) One Speech-Language Pathologist is a part-time professor in the Occupational Therapy Assistant and Physical Therapy Assistant Program at Mohawk McMaster Institute for Applied Teaching
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPEECH LANGUAGE PATHOLOGY
PAGE
126
Internal Teaching
Provided Gentle Persuasive Approach (GPA) refresh sessions to allied health team members. Collaborated on an interdisciplinary poster presentation at “Partnering with Patients and Families Event at SJHH”. Poster was entitled “Improving Communication with Patients and Families: An Interprofessional Approach in General Internal Medicine” Provided orientation and education sessions for staff across various clinical programs and services: Volunteer orientation regarding the role of the Speech-Language Pathologist in communication and dysphagia “Role of the Speech-Language Pathologist” for new hires in General Internal Medicine “Role of the Speech-Language Pathologist, dysphagia and communication” for clinical clerks in nephrology “Role of the Speech-Language Pathologist and dysphagia” for nurses on the Senior Mental Health Unit “Oral care” for Personal Support Workers on the ALC unit
“Different Liquid viscosities and their impact on swallowing” for Personal Support Workers on the ALC unit
Clinical Teaching:
Job shadowing experiences- 5 provided Volunteers-12 university students who required this experience for application to Graduate School in Speech Language Pathology Provided a number of job shadowing opportunities to cooperative education students and therapeutic students while on placements at SJHH Participated in “Take your Kids to Work Day” Education to families in Seniors Mental Health regarding: Swallowing and Communication in Dementia Education to inpatients and outpatients on the Respirology Rehabilitation Program regarding COPD, Pneumonia and Oral Care (8 times per year)
Scholarly Pursuits Research
One Speech Language Pathologist is participating in a student research study regarding service delivery and treatment models to support management of pediatric Speech Language Pathologist waitlist. One Speech Language Pathologist is pursuing research possibilities in the area of maternal mental health and its influence on the child’s speech and language development.
Continuing Education
Emerging Leader’s Program Motor Speech Treatment for Neurodenerative and Neuromuscular Diseases: A Systems Approach PROMPT training Niagara Literacy Conference Auditory Verbal Therapy Education: Interest group and sound intuition workshops Early literacy skill GPA refresh Modified Barium Impairment Profile (MBSImP), standardized assessment protocol for Videofluroscopic Swallow PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPEECH LANGUAGE PATHOLOGY
PAGE
127
Leadership
Co-Chair of Pneumonia working group. Adult and Pediatric Team Leaders participated in Emerging Leaders sessions
External Committees
Hamilton Regional Speech and Audiology Council (HRSLAC) Hamilton Stroke Community Re-Engagement Network Speech-Language Pathology of Ontario Oncology Network (SPOON) Greater Toronto Area Speech-Language Pathology Professional Practice Leaders Group Integrated Rehabilitation Planning for the Hamilton Special Needs Initiative Early Words, The Hamilton Preschool Speech and Language Services: Administrative Management Early Literacy Hamilton Infant Parent Waitlist Management Forms Review Parent Groups Transition to School Planning Infant Hearing Program Committee’
External Presentations
Co-presented at a Spiritual Care conference. “Following Our Surprises” focused on collaboration and the power of community in enhancing communication and quality of life for patients who were primarily non-verbal. Collaborated on an interdisciplinary poster presentation at Stroke Congress as a member of the Hamilton/ Burlington Stroke Community Re-Engagement Network. The title of the poster was “Building a Stronger Community Network Through Language Appropriate Documentation” Facilitator at the Interprofessional education (IPE) day through the McMaster Program for Interprofessional Practice, Education and Research Voice and Voice Disorders, ENT residency program Provided Gentle Persuasive Approach (GPA) sessions to Personal Support Workers from St. Joseph’s Homecare
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPEECH LANGUAGE PATHOLOGY
PAGE
128
Discipline Goals 2016 Quality & Safety
Sustain use of two patient identifiers for each patient/client visit across all Speech Language Pathology services Sustain hand hygiene rates at the corporate targets for the outpatient Speech Language Pathology service Sustain use of MBSImp across all adult Speech Language Pathologists Maintain an accurate and sufficient consignment of voice prostheses to service the laryngectomee population Establish an approach to oral care for patients who are at risk for aspiration in the mental health population
Change
Evaluate the impact of change in the pediatric Speech Language Pathology Discharge and Re-evaluation reports Evaluate the impact of strategies to improve client attendance for the outpatient pediatric SLP service
Interconnection
Standardize the process for obtaining pre-admission swallowing history and transferring swallowing discharge status and discharge swallowing care plans from and to Longterm Care Facilities
Research & Education Educate healthcare team at the West 5th Site regarding swallowing in the Huntington’s population Develop a patient education brochure on Videofluroscopic Swallow Studies Review and update education materials in the area of dysphagia
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
129
Spiritual Care Professional Practice Leader (Charlton, King, West 5th): Gary Payne, R.P., M.Div., Specialist and Certified Teaching Supervisor, Canadian Association for Spiritual Care (CASC) Number of Members of Discipline Professional Spiritual Care Providers and Residents: Charlton 6.25 FTE King 0.5 FTE West 5th 3.0 FTE
Scope of Practice: Spiritual Care and Counselling Specialists seek to improve the quality of life for individuals and groups experiencing spiritual, moral and existential distress related to changes in health, maturation, ability, and life circumstances. They utilize a holistic, relational approach to assess the nature and extent of the concerns; collaboratively develop a plan of care; provide therapeutic interventions to promote, maintain, and restore health and/or palliate illness and injury; and evaluate the implementation of the plan of care to ensure its efficacy and adequacy.
Clinical Practice Achievements Quality & Safety
All Spiritual Care staff successfully completed e-Learning requirements and maintenance (Falls Prevention 1 & 2, AODA, Hand Hygiene, WHMIS, Emergency Preparedness, Prevention of Violence in the Workplace, Basic Occupational Health and Safety Awareness Training). Initiated, engaged and completed 5-S component of LEAN philosophy in Spiritual Care Department offices and education spaces. All staff submitted applications to the College of Registered Psychotherapists of Ontario (CRPO) with five having successfully registered and others awaiting confirmation. One staff successfully completed a Canadian Association for Spiritual Care, Specialist Peer Review.
Change
Initiated and completed one departmental-specific LEAN activity focused on increased efficiency and elimination of waste in human resource time and energy. This activity centered on the creation of an on-line data storage bank for documentation of on-call referrals accessed exclusively by Spiritual Care staff from any location within or external to the hospital.
Community
Ongoing implementation of developed method of actively seeking feedback for quality assurance and improvement related to the quarterly Memorial Service (Patient/(Family) Engagement) PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
130
Interconnection Facilitated and coordinated SJHS Spiritual Care Services Retreat in which all Spiritual Care Practitioners throughout
the System, hospital executive members, program leads, ethicists, physicians and board members consulted and collaborated to achieve Strategic Directions for the discipline moving forward. Initiated Spiritual Care Journal Club as professional development opportunity with focused attention on developing work plans to address strategic goals. Invitation to participate extended to all Spiritual Care Practitioners of each SJHS organization Initiated Harbour Spiritual Centre mural project, a collaborative between Spiritual Care and Art Therapy in which patients engaged in therapeutic exercise of creating, through artistic expression, a mural to adorn this space of spiritual reflection Launched Spiritual Care e-Learning Module available to all existing as well as new hires to SJHH through the SJHH e-Learning studio as a staff or external guest (Health Professional Discipline Priority) WW1 and WW2 Plaque Rededication Ceremony, a collaboration between The Spiritual Care Department, Volunteer Services and Public Affairs. Submitted, received acceptance and displayed poster at first SJHH Partnering with Patients and Families Event, a collaboration with the Patient and Family Advisory Council Continued active engagement of partnership and collaboration with Dr. Deborah Cook, ICU staff and the Palliative Care Consult Team in research pertaining to the 3 Wishes Demonstration Project Collaborated with Public Affairs regarding Blessing of Youth Wellness Centre and coordinated and facilitated the participation of youth to actively contribute to the blessing. Collaboration with Corporate Wellness regarding Spiritual Care presentation, Multitasking and Mindfulness Collaborated with Public Affairs in a Christmas Tree Lighting event involving patients, staff and the general public. Following Our Surprises, Not Letting our Assumptions Get in the Way, a workshop presented in collaboration with SLP and Recreation Therapy Collaborated with the Suicide Prevention Committee to provide a memorial ritual for World Suicide Prevention Day. Initiated and collaborated with Volunteer Services, Human Resources, and Public Affairs to co-ordinate a food drive for `Neighbour to Neighbour’, December 2015. Collaborated with General Internal Medicine Team in CTU-West by providing leadership in the preparation and observance of a ritual/service for the Dedication and Blessing of the Palliative Suite for Palliative Patients on the Clinical Teaching Unit West, Mary Grace Wing.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
131
Academic Pursuits Internal Teaching The Role of Spiritual Care to 3rd year RN students Engaging Research- Supporting Clinical Practice, a Narrative Journey, a collaboration between Spiritual Care, SLP, and Recreation Therapy, presented at Best Practice Spotlight event. th The Role of Spiritual Care to 4 year RN students from McMaster. Introduction to Spiritual Care, an orientation for new nurses in mental health The Role of Spiritual Care in the Hospital Setting, presented to all new staff in Critical Care units The Use of Diagnostic Tools: Psychotherapeutic Assessment of LTC Resident with MS. Communication Skills with Challenging Families to Nephrology, RTU and URO staff. Power Differentials in Providing Family Support to Nephrology staff. Multicultural Issues & Culturally Sensitive Caregiving in Palliative Care to Nephrology, URO and RTU staff. Moral Distress for Nephrology staff
Formal Teaching
Affiliation with Waterloo Lutheran Seminary, (Wilfrid Laurier University) Adjunct Lecturer, Waterloo Lutheran Seminary, (Wilfrid Laurier University) Pastoral Counselling Course, Waterloo Lutheran Seminary, (Wilfrid Laurier University), SJHH, West 5th Campus, September 2014 to April 2015 Post Modern Family Therapy – Waterloo Lutheran Seminary (Wilfrid Laurier University) Qualitative and Quantitative Research Methodologies – Waterloo Lutheran Seminary (Wilfrid Laurier University) Supervised Pastoral Education, St. Josephs Healthcare Hamilton
External Presentations
Grief and the Family, presented to facilitator's group at South Central Bereaved Families of Ontario Pastoral Theology of Caring for Sick, presented at Hamilton Diocese, Permanent Deacons Formation Day Following Our Surprises, Not Letting our Assumptions Get in the Way, a workshop presented in collaboration with SLP and Recreation Therapy Spiritual Care as Compassionate Caring, presented to third year Physiotherapy students at McMaster University Personalizing Death in the ICU: Three Wishes Demonstration Project, presented at the Canadian Association for Spiritual Care 2015 National Conference PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
132
Scholarly Pursuits Research
Three staff received the Canadian Association for Spiritual Care (CASC) Group Research Award - 2015. Three Wishes Research at St. Joseph's under the direction of Dr. Deborah Cook. Initial Research – Development of Research Posters regarding: “How does a First Nations person experience spiritual care in a Canadian hospital?” “What is the experience of mental health in-patients who have received a diagnosis of compulsive buying disorder of walking through the hospital lobby with its retail tables and shops?” “Is there a relationship between Grandiose Religious Delusions (GRDs) and spiritual coping, and if so, what is it?” “What is the experience of ICU nurses after they make a referral to the Spiritual Care Department for the family of a patient who has just died?” “How is the Three Wishes Project experienced by LGBT couples where one of the partners is experiencing end of life in ICU?” One staff/resident, Nigel Bone, received the 2015 Angel Marie O’Connor Award recognizing the Spiritual Care Resident who best integrates clinical work, academics and research Staff member pursuing Doctorate of Ministry received approval for DMin Research Thesis Proposal .
Publications
Published Manuscripts: Cook DJ, Swinton M, Toledo F, Clarke F, Rose T, Hand-Breckenridge T, Boyle A, Woods A, Zytaruk N, Heels-Ansdell D, Sheppard RD. Personalizing Death in the ICU: The Three Wishes Project. Ann Intern Med 2015;163:271-279. doi:10.7326/M15-0502.
Submitted Book Chapters: Breckenridge T, Swinton M, Rose T, Toledo F, Woods A, Boyle A, Cook D. Interprofessional Collaboration in the 3 Wishes Project: Enhancing Spirituality for Dying Patients, their Family Members and their Health Care Professionals. In: Canadian Association of Spiritual Care Counsellors of Canada Yearbook 2015 (in press).
Submitted Abstracts:
Swinton M, Rose T, Woods A, Boyle A, Toledo F, Hand-Breckenridge T, Shears M, Cook D. Spirituality during the Dying Process in the ICU: Findings from the 3 Wishes Project. Crit Care Med 2016 (in press). Swinton M, Rose T, Toledo F, Hand-Breckenridge T, Woods A, Boyle A, Clarke F, Zytaruk N, Saunders L, Shears M, Sheppard RD, Cook D. Interprofessional Collaboration in the ICU: Determinants of Success in the 3 Wishes Project. Can Crit Care Forum Abstract Book 2015, Toronto, ON, October 26, 2015. (in press).
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
133
Leadership
2015 SJHS System-Wide Spiritual Care Services Retreat – Envisioning the Future of Chaplaincy in Catholic Healthcare Organizations / Development of Strategic Directions Collaboration with Hamilton Health Sciences regarding bi-annual Early Pregnancy Loss and Stillbirth Memorial Service Clinical programming entitled, “Life Stories Project”, an inter-professional collaboration with Recreation Therapy Initiation, design and facilitation of Quarterly Memorial Services for families of patients who died at SJHH during 2015 Leadership in individual SJHH Employee Memorial Services Collaboration with research project in ICU, 3 Wishes Demonstration Project whose lead investigator is Dr. Deborah Cook. The overall aim of the entire research project is to improve the quality of the dying experience for patients and their families. Participation in the Multicenter Implementation Study of the 3 Wishes Project involving SJHH ICU and St. Michael’s Hospital, Toronto, ICU. Spiritual Care Awareness Week, October 2015. Initiated engagement of the hospital population with "Enriching our Workplace with a Spirit of Gratitude" through daily reflections provided to every department in the hospital and in-patient units.
External Committees CASC 2015 National Conference – SJHH Spiritual Care Department financially supported this event and our
staff's work was a key part of the conference's success. Many were on the Executive Planning Committee and several accepted leadership roles of various committees such as Public Relations & Marketing, Advertisement, Volunteer Coordination, Social Activities, and Fundraising. Local Faith Group committees and boards Attending local deanery and presbytery meetings Canadian Association for Spiritual Care (CASC) Academic Assessment Committee (for national assessment of academic equivalencies of members for certification purposes) True City Program (ecumenical initiative of Hamilton area churches to provide social aid to local needy residents) Labyrinth Committee, Chair and member Community Spiritual Care Advisory Committee Canadian Association for Spiritual Care Southwest Ontario (CASCSWONT) Executive (Local Region of the CASC) Peer Review Coordinator for the Ontario Southwest Region; Board membership of the Ontario Multifaith Council Membership on the Regional Multifaith Committee Mood Menders Support Group Hamilton Member of the Advisory Board of the St Dymphna Society at St Joseph’s Parish Committee Chairs for the Canadian Association for Spiritual Care 2015 National Conference at the Sheraton Hotel Hamilton Ontario South Central Bereaved Families of Ontario – Professional Advisory Committee Canadian Association for Spiritual Care (CASC) Education Centre Accreditation Committee for London Health Sciences Centre. PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
134
Continuing Education: Four residents/staff earned level 1 Advanced education in Clinical Pastoral Education (CPE), certificates Four residents/staff earned level 2 Advanced education in Clinical Pastoral Education (CPE), certificates Five residents/staff earned level 1 Basic education in Pastoral Counselling Education (PCE), certificates One resident/staff earned level 3 Basic education in Clinical Pastoral Education (CPE), certificate Six residents/staff earned level 2 Basic education in Clinical Pastoral Education (CPE), certificates Eleven learners earned level 1 Basic education in Clinical Pastoral Education (CPE), certificates One learner earned level 3 Provisional Teaching Supervision in Clinical Pastoral Education (CPE), certificate One staff earned level 3 Provisional Teaching Supervision in Clinical Pastoral Education (CPE), certificate Two Resident/Staff completed Graduate Level course in Professional Ethics One Staff completed Suicide Awareness and Prevention training, certificate One staff completed Dialectical Behavioural Therapy skills training One staff completed Introduction to Lean Principles Hands on Workshop Three staff completed Mental Health Commission of Canada’s, Mental Health First Aid Training, certificates One staff completed Mindfulness Communication Course, McMaster, certificate One staff completed Healthcare Issues in Mental Health for GLBTTIQ, Emmanuel College, certificate Gentle Persuasive Approaches to Dementia Care (Recharged) Training Workshop, 2 certificates Affirming an Ethic of Care: Bridging the Gaps at the End of Life, Center for Clinical Ethics Education, certificate Two staff successfully completed College of Registered Psychotherapists of Ontario (CRPO), Jurisprudence Module, certificates Schizophrenia Overview Workshop, 5 certificates Seven staff/residents completed Crisis Prevention Institute (CPI) training, certificates/CPI Blue Cards Therapeutic Seniors Care Education, certificates 10th Educational Conference on Palliative and End of Life Care, Dying Peacefully: Clinical, Emotional, Familial and Spiritual Perspectives, certificate Canadian Association for Spiritual Care, Ontario Southwest Region, Professional Development on Growing in Professional Practice, certificate Hamilton National Fall Prevention Month Event: We all have a role to play: What’s yours? certificate Two staff completed graduate-level course entitled Professional Ethics and the Pastoral Counsellor from WLS Five residents completed graduate-level course, Postmodern Family Therapy, WLU Five residents completed graduate-level course, Qualitative and Quantitative Research Methodologies, WLU
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
SPIRITUAL CARE
PAGE
135
Discipline Goals 2016 Quality & Safety
Ensure compliance of all Spiritual Care staff in regard to E-Learning requirements and maintenance (Falls Prevention 1 & 2, AODA, Hand Hygiene, WHMIS, Emergency Preparedness, Prevention of Violence in the Workplace, Basic Occupational Health and Safety Awareness Training – managers and staff) Complete practical aspects of 5-S component of LEAN philosophy throughout Spiritual Care Department offices and education spaces at Charlton campus by May 2016 Review and update Spiritual Care Department Guidelines and Protocols to reflect current practice .
Change
Initiate, engage and complete LEAN project associated with electronic, discipline-specific, documentation regarding Sacrament of the Sick (Health Professional Discipline Priority) Initiate, engage and complete LEAN project associated with integration of TOA information into on-call electronic documentation system. Complete registration of all permanent Spiritual Care staff with the College of Registered Psychotherapists of Ontario (CRPO)
Community
Initiate and coordinate plan to collaborate with Spiritual Care colleagues throughout the SJHS to support each organization in the development of working plans to address commonly held Spiritual Care Services Strategic Directions
Research & Education
Develop through consultation and collaboration with multidisciplinary team members, an education module focused on Initiating Crucial Conversations Regarding Advance Care Planning (Health Professional Discipline Priority) Canadian Association for Spiritual Care, SJHH Site Accreditation to be completed by end of 2016. Engage research exploring the lived experience of ICU nurses after making a referral to the Spiritual Care Department for the family of a patient who has just died. Progress to date: The protocol has been drafted along with an application to the HiREB. Submission of research application to HiREB prior to March 31, 2016. Research to be conducted once application approved.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
136
Therapeutic Recreation Professional Practice Advisors: Susy Marrone Charlton, Sandra Berzaitis Smith W5th
Scope of Practice: To plan, implement, and evaluate recreation and leisure programs and services relative to the identified needs of patients. Therapeutic Recreation (TR) practice at SJHH is guided by the Leisure Ability Model (Peterson, Gunn, Stumbo). TR utilizes functional intervention, leisure education and recreation participation in a holistic approach to enable persons with physical, cognitive, emotional, spiritual and/ or social limitations to acquire and/or maintain the skills, knowledge and behaviors that will allow them to reach their optimal level of functioning for recreation and leisure. The major functions of a Recreation Therapist are directly related to the adopted Therapeutic Recreation Ontario Standards of Practice and Code of Ethics (TRO). .
Number of Members of Discipline Charlton West 5th
5 F/T, 1 P/T, 1 Sr. TR 26 F/T, 8 P/T, 1 Sr. TR
Clinical Practice Achievements Quality & Safety
CRRC outpatient referral form amended to add further details related to Falls Prevention and Risk of Suicide/Prevention aligned with SJHH Quality and Safety initiatives. TOA audit systems for W5th and Charlton now in place and used monthly for the discipline. Reported to PAC quarterly. TR staff ongoing representatives of services specific Quality Councils and Quality of Work Life Committees. TR contributing and completion of Forensic Program Patient and Family Orientation Brochure Charlton TR PPA on SJHH Hand Hygiene Committee for SJHH with 4 TR staff responsible for unit audits W5th TR PPA member of the SJHH Ethics Committee in liaison with PAC TR staff representative for Occupational Health & Safety Clinical Inspections TR staff representative for Homes for Special Care Ministry Standard Inspection A SAVE “Patient Referral Tool” was created by GIM TR and CTU – W UCC. This tool assists with identifying and communicating potential SAVE patients. The UCC, Charge nurse and nursing staff identify referrals for SAVE during morning huddles.
Change
Completion of TR staff Registry to ensure minimum TR credentials and qualifications are being met and maintained by all SJHH TR staff. 2 staff completed Solution Focused Crisis Intervention Certificates in addition to CPI Nonviolent Crisis Intervention
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
THERAPEUTIC RECREATION
PAGE
137
Community
Multiple TR staff responsible for initiation and involvement in SJHH Foundation and United Way fundraising partnerships, including the United way annual campaign, Curling Bonspiel, Indoor Soccer Tournament and baseball Two Pitch Tournament Multiple TR staff maintain ongoing community partnerships specific to TR programming to ensure safe, quality client interventions transferred to community settings. Examples include the YMCA, St. Peter’s HARRRP, Sherwood Lanes, Good Shepherd, City of Hamilton, Eva Rothwell Community Centre and many more. TR has re-introduced the Pet Visitation program at Charlton Campus in partnership with St. John Ambulance and the Hospitals Volunteer Resources.
Interconnection
W5th Audit system for TR documentation as part of submitted standards to PAC related to Patient Link, currently active and in use, aligned with TR Performance Appraisals across services. TR staff coaching GPA sessions for staff at St. Joseph’s Homecare and recharge sessions for St. Joseph’s Hospital Staff.
Academic Pursuits Internal Teaching
Ongoing affiliation agreements with University of Waterloo totaling 4 Co-op placements in 2015, Georgian College with 1 unpaid TR internship in 2015, Niagara College TR diploma program students totaling 7 placements in 2015, Mohawk Practicum TR students with 18 students supervised in 2015, UW and Brock University CTRS Internships which hosted 2 interns in 2015. TR staff support high school coop students in Complex Care program.
Formal Teaching:
Formal MHAP Rounds in February 2015 hosted by 2 TR staff and 1 Co-op student related to Recreation Therapy and TR Outcome Measures, specifically in relation to a study on Forensic Services.
Clinical Teaching:
College Professor affiliations- 3 W5th TR staff teaching part time Recreation Therapy courses for Mohawk College’s diploma program and 1 W5th TR staff teaching towards TR diploma second year courses for Niagara College. TR staff involved in educating and training SJHH staff in acute care MH related to Positive Psychology
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
THERAPEUTIC RECREATION
PAGE
138
Scholarly Pursuits Research
Ongoing co-facilitation and data collection of Cool Running Forensic Research Project by multiple TR staff across 6 forensics programs TR Staff on Mood Disorders involved in the following specific projects: REB # 12-3660 Co-investigator, Project Title: Investigating the mediators of therapeutic effectiveness of a thirteen-week running program in a group of adolescents with depressive disorders REB # 14-042 Co-investigator, Project Title: A pragmatic randomized trial to investigate the effectiveness of Behavioural Activation group therapy in reducing depressive symptoms and improving quality of life in patients with depression (pilot) REB #14-611 Co-investigator, Project Title: A pragmatic randomized trial to investigate the effectiveness of Behavioural Activation group therapy in reducing depressive symptoms and improving quality of life in patients with depression: (main study) REB #14-611 Co-Principal Investigator, Project Title: Pushing Limits – Adventure Based Therapy in Persons with Mood Disorders (ongoing)
Continuing Education
2 TR staff applying and receiving the Registration Designation with Therapeutic Recreation Ontario. 1 additional staff awaiting approval of submitted application. 2 New staff completed Can-Fit Pro Certified Fitness Training credential for Personal Training Specialist 1 TR Obtained Certified Therapeutic Recreation Specialist credential from the U.S. National Council for Therapeutic Recreation Certification 1 Re-certification in Personal Training and Individual conditioning Instruction 1 Re-certification in Yoga Instruction/Yoga Exercise Specialist via East to West Yoga & Pilates 2 New staff and 4 recertified staff acquiring Community Safety Training Staff acquiring certification to instruct Tabata Bootcamp Physical activity program 2 F/A, CPR Recertification 2 City of Hamilton Food Handlers re-certifications 5 staff re-certified in 2 day CPI Non-violent Crisis Prevention Intervention, 1 Staff providing CPI instruction to SJHH staff and 5 new staff receiving initial CPI certification instruction 8 SJHH TR staff attended the annual Therapeutic Recreation Ontario conference in 2015 with 2 staff providing presentations to the professional delegates in attendance and 1 TR on the conference planning and facilitation committee 3 TR staff attended Annual Forensics Risk and Recovery conference 1 TR staff Completed online certificate program for “Open School” through the Institute for Healthcare Improvement 1 new staff completed Safe TALK training for prevention of suicide as all TR staff have taken as a collective to date 1 new staff completed Motivational Interviewing Certificate 2 staff completed Introduction to CBT and DBT online courses 4 TR staff completed 5 day level 1 DBT training.
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
THERAPEUTIC RECREATION
PAGE
139
Publications TR staff on Mood Disorders involved in publication: A pragmatic pilot randomized trial to investigate the effectiveness of behavioural activation group therapy in reducing depressive symptoms and improving quality of life in patients with depression: the BRAVE pilot trial protocol Pilot and Feasibility Studies20151:39 DOI: 10.1186/s40814-
External Committees
2 TR staff members on executive Board of Directors as Board Members at Large for Therapeutic Recreation Ontario for 2015 TR staff member sat on the TRO Governance and Nominations Committee for 2015 TR Staff member on Core Competencies Committee for Therapeutic Recreation Ontario 2015 TR Staff member on College of Psychotherapy Working Group Committee for Therapeutic Recreation Ontario TR Staff member a Committee representative for Mohawk College’s Professional Advisory Council – renewed for a second 3 year term 3 TR staff members of Hamilton Therapeutic Recreation Group, taking leadership on the committee’s first TR professional development day within the region November 2015
External Presentations
Presentation on W5th Therapeutic Recreation Discipline and TR services at the Schizophrenia Society of Ontario’s Annual Walk of Hope in May 2015 Presentation on Laughter Yoga and TR services at the Hamilton Wentworth Secondary District School Board’s Annual Leadership Conference Organization of a Hamilton Area Therapeutic Recreation Professional Group Wellness and Education Sessions in November 2015 Titles Walk the Talk Guest Lecture for Mohawk College 1st year Community and Public Sector Course November 2015 Hosting A w5th Tour in collaboration with Public Affairs for 80 Niagara College Students in January 2015 Participation in Mohawk College Career and Networking Education Day in February 2015 3 TR staff Presented Grand Rounds in February 2015, hosting internal and external education on outcome measures and research projects in TR Forensics
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
THERAPEUTIC RECREATION
PAGE
140
Discipline Goals 2016 Quality & Safety
Many TR staff indicating that working towards and maintaining “Registered” status with Therapeutic Recreation Ontario remains an active goal for 2016, by accumulating ongoing credentials and points towards the formal certification, or re-certification process.
Interconnection
TR committee formed to address regulation with college of psychotherapy. Committee is working in consultation with TR professional organization, Therapeutic Recreation Ontario.
Research & Education
Many TR staff identified desire to promote and develop research and outcome measurement projects related to TR practice at SJHH
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
PAGE
141
Vocational Services Professional Practice Leader: (West 5th) Dawnna Kazarian Keith Number of Members of Discipline Vocational Counsellors: Vocational Instructors:
14 4
Scope of Practice: Vocational Rehabilitation professionals assist individuals with overcoming barriers to accessing, maintaining or returning to employment or other useful vocational roles. Professionals utilize evidencebased, client-centered processes and services to assist persons with or at risk of functional, psychological, developmental., cognitive and emotional impairments or health conditions.
Clinical Practice Achievements Quality & Safety
CRRC outpatient referral form amended to add further details related to Falls Prevention and Risk of Suicide/Prevention aligned with SJHH Quality and Safety Initiatives
Change
Development of the Working Towards Recovery (WORK) groups on the schizophrenia units Facilitate and transition TARP to Concurrent Disorders Updated note standards for discipline Updated TOA standards for discipline Development and implementation of TOA audit Transition Vocational Assessment from a central program and develop capacity and integration of assessment skills within all Vocational Counsellors roles.
Community
Creation of job development brochure to build working relationships with the employment community while supporting return to work initiatives for clients Creation of vocational counselling brochure to educate patients, families, and staff of programs and services Ongoing co-facilitator of family education night at Mood Disorders Clinic Mood Disorders poster presentation at Hamilton Police Family Information Night PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
VOCATIONAL SERVICES
PAGE
142
Interconnection
Presentation of modules for Out of the Blues group program – Productivity: Work, School & Volunteering Bi-weekly group sessions on MDP Waterfall 1 – “Achieve” sessions focusing on various topics including : return to work, lifelong learning, volunteering, the disclosure dilemma, etc Presentation of Progressive Goal Attainment Program (PGAP) at Mood Disorders Program, as well as at VPC Journal Club, and to clinician at ATRC with future plan to assist in research study
Academic Pursuits Internal Teaching
Counsellor frequently called upon by OTs in ATRC, CPC and Cleghorn for consultation on cases and for information about community resources th Facilitated vocational rehabilitation poster presentations at SJHH West 5 and Charlton campuses Vocational Practice Council Journal Club with a focus of Vocational Best Practices and other vocationally related topics
Clinical Teaching:
Coordinated student intake and placement for York/Seneca students Updated student placement binder Provided vocational assessment education for department staff in completing assessments Vocational counselling mentoring/teaching other allied health staff
Scholarly Pursuits Continuing Education:
Obtained and maintained membership with the Vocational Rehabilitation Association of Canada (VRA) (6) Obtained and maintained Registered Rehabilitation Professional (RRP) designation through VRA (5) Maintained Certified Psychiatric Rehabilitation Practitioner (CPRP) designation (3) One representative maintained CCRC designation Maintained Certified Vocational Professional (CVP) designation through the College of Vocational Rehabilitation Professionals (CVRP) (2) Maintained Masters Certificate Vocational Professional (MCVP) (2) One representative maintained membership with PSR Canada Obtained Progressive Goal Attainment Program certification (1) Received Meritorious Instructor status through the Crisis Prevention Institute (CPI)
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
VOCATIONAL SERVICES
PAGE
143
Leadership
One representative led Vocational Practice Council (VPC) meetings and participated in Professional Advisory Committee (PAC) meeting in absence of PPL as needed One representative participated in information booth at “Marketplace” Two representatives developed and implemented the Tablet Pilot Project for patients on the Forensic units One representative attended the “Building on Hope” PSR/RPS Canada National Conference Two representatives attended the 2015 VR$A Ontario Fall Conference 2 representatives chaired and co-chaired the Security Audit Committee
External Committees
Two Vocational Counsellors sat on EARN committee
External Presentations
Accreditation committees and activities on units to present to accreditors Presentation of a three talks at MHRC on the topic of volunteer work, education/training and competitive employment Presentation to the Board of Governors of Mohawk College
Discipline Goals 2016 Quality & Safety
To build on and improve current TOA process, achieving 100% compliance in 2016 To increase VPC staff membership and professional designations under the Vocational Rehabilitation Association Canada
Community
To produce a brochure outlining the benefits and resources of Vocational Rehabilitation
Interconnection
To present Vocational Rehabilitation at the Mental Health and Addictions Program Rounds in 2016
PROFESSIONAL ADVISORY COMMITTEE REPORT OF THE HEALTH DISCIPLINES
2015
