In the past year, we focused on the four key priorities set out in our strategic plan: Quality Care, Exceptional Relationships, Outstanding Performance, and Inspired People, underpinned by innovation. Here are just a few of the many highlights of 2016/2017:
Emily represents every patient and family cared for in the past, present or future. She is embodied by a composite of images of staff, physicians, volunteers, patients and families, illustrating we all play a role in Emily’s experience of care. Emily has personalized our Mission and helped influence positive improvements in patient and staff satisfaction. Emily was the topic of two presentations to provincial health leaders and submissions accepted for publication in the Ontario Hospital Association’s Idea Book and the Patient Experience Journal, an international, peer-reviewed publication. Dr. Eric Hoskins, Minister of Health & Long-Term Care cited Emily at a large provincial conference as "an example of how a simple change in attitude can have a profound effect on the quality of care our patients receive."
Patients presenting to Bluewater Health’s Emergency Department with chest pain with no immediate danger of a heart attack have access to a Cardiac Clinic for further testing and consultation. The team of healthcare professionals is specialized in diagnosing and treating heart disease, and has the knowledge, time and equipment to assess patients promptly – often in just one visit.
A baseline has now been established for a custom question on quarterly internal surveys, ‘It is difficult to speak up if I perceive a problem with patient care.’ This sets the stage for an improvement target and action plan. Encouraging staff, professional staff and volunteers to speak up when they have a concern related to patient safety is a crucial part of ingraining patient safety in the organization.
New CT Technology
The Medical Imaging department acquired a Nuclear Medicine Gamma Camera with SPECT and CT imaging ability, the most technologically-advanced machine available. It combines the power of nuclear medicine and CT for a synergistic result known as fusion imaging. The new Nuclear Medicine equipment with its advanced diagnostic CT scanner capabilities can be used as a back-up scanner for our emergency and stroke patients when our primary scanner is down for service, enabling constant access for the patients of Lambton County. Our hospital is only the third in Ontario, and sixth in Canada, where our new primary CT scanner has been deployed. It is the most cutting-edge CT scanner on the market today.
Bluewater Health actively recruits specialists to increase our patients’ access to care. We’ve gained two psychiatrists, a hospitalist, an orthopaedic surgeon, two radiologists, and an emergency physician, in addition to a family physician and a midwife.
A Respectful Moment
The Palliative Care unit introduced a new process to respectfully acknowledge end of life as our deceased patients are transported from the unit to the morgue. Staff now takes a ‘Respectful Moment,’ to stop what they are doing and pause as the patient is brought through. The moment is intended to pay respect to the patient, and acknowledge the work, care and support provided to the patient and family by the staff, physicians and volunteers. Developing the process involved nursing staff, unit helpers, physicians, ward clerks, managers, morgue staff, security, spiritual care and Patient Experience Partners and has received overwhelming support.
Nutrition and Food Services
Changes in food preparation are contributing to patients’ healing through enhanced nutrition. Food and beverage offerings are specially selected because they are high quality, nutritious, fresh, locally-sourced and less processed. More offerings are prepared "from scratch" using our current food delivery system, the Burlodge carts – essentially "ovens on wheels" which cook or bake. The meal selection process has changed to allow more patient involvement in the decisions about their care. Patient choices, along with the physician’s instructions, are used to determine daily meals since food choices that are more suited to patients’ tastes are more likely to be consumed and contribute to better health outcomes.
As part of our continuation and support of the work of Huddle Boards and Key Performance Indicator (KPI) Boards, a new opportunity for learning and cross-sharing at Bluewater Health began. The Executive Team, Performance & Transformation Team and Patient Experience Partners are visiting various teams throughout the hospitals to gain further insight into the frontline experience, continue to build relationships with staff across all levels, increase dialogue, and share innovative ideas.
Mobile Rapid Response
A Critical Care Outreach team was formed to provide mobile rapid response to assist any patient in distress across the hospital. A team goes out from the ICU to assess patients to avoid escalating patient care situations.
Bluewater Health is part of a national movement called Choosing Wisely focused on encouraging physicians and patients to discuss the appropriateness of tests and treatments that may not be supported by evidence and/or could cause unnecessary harm. We look at specific issues such as reducing unnecessary lab tests and blood transfusions. Monthly evidence-based Choosing Wisely tips are shared with physicians and the public via Bluewater Health’s social media. Four simple questions that start the discussion are: Do I really need this test, treatment or procedure? What are the downsides? Are there simpler, safer options? What happens if I do nothing? We encourage our patients to ask questions and talk to physicians, so they are better informed and a partner in their care.
Real Time Location Service (RTLS)
Bluewater Health installed its Bluetooth low-energy wireless technology to track medical equipment and monitor temperature and humidity. The project saw nearly 1200 pieces of medical equipment tagged. More than 60 temperature sensors monitor refrigeration in Food Services, Pharmacy and the Lab and over 10 monitor humidity in our MDR and OR areas. The system encompasses both the Sarnia and Petrolia hospitals. The installation is profiled in the conference publication for the Healthcare Information and Management Systems Society’s (HIMSS) annual conference held in Orlando in February.
Community Integrated Master Planning with the Town of Petrolia
Petrolia Town Council supported the Master Planning project involving Charlotte Eleanor Englehart Hospital (CEEH) of Bluewater Health. Many productive meetings have occurred between hospital and town staff, community members and our consultants. The analysis to date has centred on volumes, historical growth in the Petrolia catchment area and on population projections which shape the dialogue for the future. The involvement of the Town of Petrolia in this process is unique and provides a springboard for future opportunities around our Petrolia hospital. Bluewater Health has received approval for a capital grant of $7.5M from the Ministry of Health and Long-Term Care towards the rural health capital redevelopment project. This grant endorses Bluewater Health’s Master Planning process and enables the hospital to carry out some initial infrastructure and life-safety improvements.
Hospital Achievement Award
Trillium Gift of Life Network (TGLN) presented Bluewater Health with a hospital achievement award for our dedication to organ and tissue donation. We earned the Provincial Conversion Rate Award for meeting or exceeding the target set by TGLN. In 2015/2016, 100 per cent of potential donors we referred went on to give the gift of life. Organ donation is a complex process and the conversion rate reflects how well TGLN and Bluewater Health work together to save lives.
Community Collaboration Committee
A committee was formed to integrate work on more effective transitions for patients across the care continuum. The committee includes members from Bluewater Health, ESC LHIN, Canadian Mental Health Association, CCAC, Health Quality Ontario, Rapids Family Health Team, North Lambton Community Health Centre, Vision Nursing Home, Grand Bend Area Community Health Centre, Twin Bridges Nurse Practitioner-Led Clinic, Central Lambton Family Health Team, Lambton Elderly Outreach, and Behavioural Supports Ontario. Work that began in late December resulted in two funding proposals being submitted to the LHIN for Health Links and both were approved and completed.
Increasing Service Access
Hospitals and physicians are only one part of a person’s care journey and we know partnerships outside of our four walls are key. This is never truer perhaps than in mental health and our psychiatrists are undertaking amazing work collaboratively with our community partners, CMHA and St. Clair Child and Youth Services. Together, we’re looking at strategies to increase services to our patients and reduce the need for hospitalization and ER visits.
In support of traditional practices, Bluewater Health included an Indigenous Labour, Birth, Recovery, Postpartum (LBRP) room in its redesigned care delivery model. The local Aamjiwnaang First Nations community donated art for the room which is larger to accommodate families and ceremonies. The hospital is working with the LHIN to secure funding for an Indigenous Patient Navigator.
Expanding Best Practice Work
Bluewater Health has not only sustained implementation of the initial six Best Practice Guidelines (BPGs) but has also completed a further four: Assessment and Management of Pressure Injuries for the Interprofessional Team; Promoting Continence using Prompted Voiding; Developing and Sustaining Interprofessional Health Care; and Self-Management – Patient E-Services. P progress has also been made on more BPGs such as Facilitating Client Centred Learning, Breast Feeding Best Practices for Nurses, least restraints, and Caregiving Strategies for Older Adults with Delirium Dementia and Depression. This work involved pioneering efforts in implementing Nursing Order Sets, a recent initiative of the Registered Nurses’ Association of Ontario (RNAO). Being part of RNAO’s Nursing Peer Leadership Network project puts Bluewater Health on the forefront of this new method for implementing, monitoring and sustaining best practice.
Integrated and Collaborative Mental Health Services
Bluewater Health, Canadian Mental Health Association Lambton Kent Branch (CMHA LK) and Chatham-Kent Health Alliance (CKHA) announced a new and innovative mental health and addictions partnership that puts patients, clients and their families at the centre of care by improving integration of services. The shared goal is to create an integrated mental heath delivery system that provides positive, seamless patient and client experiences across regions and sectors.
Healthy Living Team
The Healthy Living Team’s aim is to instill a culture of well-being within Bluewater Health and to develop initiatives to Care for the People Who Care for Emily. The team focuses on five pillars of healthy living: Recognition, Food for Fuel, Spiritual, Physical, and Mental Wellness. Each pillar has a lead and team members who have identified priorities. Plans are aligned with our strategic goals, most notably the experience of care and caring, and strengthening our culture of kindness
Culture of Kindness
Through a series of focus groups, and a new Employee Council, we are identifying ‘what does kindness look like?’ A total of 27 frontline employees began meeting monthly to shape a process to engage employees, recommend activities and initiatives to strengthen our culture of kindness and collaborate with existing teams and committees. The Nutrition & Food Services and Diabetes & Clinical Nutrition group began making deliveries from its new ‘Random Acts of Kindness Cart.’ Frontline staff created the concept of the cart as a way to strengthen Bluewater Health’s culture by acknowledging acts of kindness, with kindness. Pharmacy has begun rewarding acts of kindness with a ‘Kindness Prescription.’ These are just a few examples of the activities that are underway.
Staff Training and Leadership Development
Investment in staff training continues, both with e-learning and classroom courses, and knowledge-sharing opportunities such as Skills Days. Our first cohort of participants graduated from Lambton College’s Healthcare Management and Leadership Program, and our own internally-developed and facilitated programs: Innovative Management Core and Innovative Management Advanced. Organizational Development also launched new curriculum called Leading in the Middle designed for people currently in roles that assist managers to support their teams (e.g. charge nurses, senior technologists, educators, lead hands, charge techs). These courses require an investment of time in already-busy schedules.
Recognizing and Managing Compassion Fatigue
Most people who choose to enter the healthcare field do so to help others yet U.S. statistics (applicable to Canada) suggest that more than half of providers show serious signs of compassion fatigue, burnout and an overall lack of well-being. We asked, how can we provide exemplary patient experiences, when our providers are in such distress? Bluewater Health participated in a series of workshops (sponsored by the Healthy Living Team) with Françoise Mathieu, renowned Compassion Fatigue Specialist to learn more about compassion fatigue. This and other steps we have taken around our Healthy Living Team, a culture of kindness, and our leadership training, all point us in the right direction.