BORN TO MOVE St. Joseph's leads the way for those facing mobility challenges with the creation of The Gray Centre for Mobility and Activity - St ...
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A publication of St. Joseph’s Health Care London WINTER 2020 | ISSUE 01 BORN TO MOVE St. Joseph’s leads the way for those facing mobility challenges with the creation of The Gray Centre for Mobility and Activity.
01 ISSUE 03. HEALTH CARE IN HARMONY A publication of St. Joseph’s Health Care London Winter 2020 | Issue 01 08. UNSPOKEN COMPASSION: A VOLUNTEER’S STORY CONTRIBUTORS Fred DeVries Emilly Dubeau 09. FEELING THE FRESH Allison Hansen AIR ON MY FACE Patricia Hoffer Amanda Jackman Melinda Mathes 11. BORN TO MOVE Matthew Overall Dahlia Reich Renee Sweeney 15. PUTTING THE LID ON 08 03. COFFEE SHOP TALK PHOTOGRAPHY Pauline Devilee Brian Hillier 16. THE POWER OF ZERO Brick House Productions Colleen MacDonald My St. Joseph’s magazine is published three times a year. St. Joseph’s welcomes your comments. For online or print publication contact: ComDept@sjhc.london.on.ca Copyright ©2020 by St. Joseph’s Health Care London. The publishers assume no responsibility for any effects from errors or omissions. All material published in My St. Joseph’s magazine is copyright and reproduction is forbidden without the permission of the publishers. 15. 11. CONTACT US PO BOX 5777 268 Grosvenor Street London, ON. N6A 4V2 519 646-6100 www.sjhc.london.on.ca stjosephslondon 17. THE SCOOP ON POOP stjosephslondon 09. 19. THE BEST PERSON FOR THE JOB - HANDS DOWN MY ST. JOSEPH’S IS 20. A NEW START St. Joseph’s Hospital Parkwood Institute 21. DIABETIC SUPPLIES OR GROCERIES? Mount Hope Southwest Centre Centre for for Forensic Long Term Care Mental Health Care 23. DELIVERING ON DISCOVERY Teams, clinics and programs in our 25. EVERY VOICE TELLS A STORY community and beyond. 26. A HEALTHY DOSE OF EXPERT ADVICE 17. 21. 1 01 ISSUE www.sjhc.london.on.ca 2
important role because they see the patient from a different perspective. We are creating connections and delivering care in new ways recognizing that patients are coming to us with more than one chronic disease. Patients tell you how grateful they are that it has all come together for them. For example, care for COPD at St. Joseph’s now includes an opportunity for patients to join a classroom-based education Through a program and a group exercise comprehensive program with rehabilitation trainers. program for The fitness training begins with an people living eight-week intensive phase with lung disease, of sessions held at St. Joseph’s, patients are able ...continued to rediscover joys that had eluded them for years. HEALTH CARE Dave Garton’s once-boisterous life had become so limited he In 2007, a specialist said he needed a heart/lung transplant but that he recognizing the coordinated care he needed and St. Joseph’s Health IN HARMONY contemplated suicide. But he was so ill he didn’t think he would live long wouldn’t survive it. Two years later he had an implantable cardioverter- Care London for bringing it all together. Through the collaborative enough to kill himself, so he made defibrillator inserted to reduce his work of the heart failure, COPD funeral arrangements instead. risk of dying if his heart stopped and diabetes teams at St. Joseph’s The coming together of beating. And in 2018, he had three Hospital, Dave has reclaimed The former entrepreneur and programs and specialties at stents put in to open blocked his life. self-proclaimed workaholic who St. Joseph’s Hospital for patients arteries. “worked hard and played hard,” This coming together of programs with multiple chronic illnesses Dave was in the darkest of places. Finally, Dave was feeling better and professionals of various has Dave Garton singing again. Poorly managed chronic obstructive and was able to do more, but new disciplines is part of a thrust at pulmonary disease (COPD), heart problems emerged and again, he St. Joseph’s Hospital to improve failure and diabetes had converged began slipping. He couldn’t climb quality of life by addressing the to make every breath, every step, more than two steps without sitting multiple needs of each patient. every task a hardship. down. On the way upstairs to his Program silos are coming down and bedroom, he once got stuck on the care pathways are being redesigned Physicians had given up on him, he third step gasping for air, requiring and re-routed in what is called said, “so I gave up too.” paramedics to be called. In one integrated care. Dave’s health plummeted in 2002 month alone, Dave landed in the “It takes teamwork – across after suffering a heart attack. emergency department seven times. programs and specialties – to He owned two businesses at the The burden on his partner-in-life, meet the needs of patients living time – a neon sign manufacturing Wendy, weighed heavily upon him. with chronic conditions,” says business and a coffee shop. He had While Dave’s various health issues Laurie Loveland, nurse practitioner to give up both, kick-starting a were all linked, each problem was with the COPD and Pulmonary deep depression. Anti-depressants being addressed separately. He Rehabilitation Program. “Every Dave Garton of St. Thomas is not only singing again, he feels lucky to be alive. The coming together contributed to massive weight gain, credits a new family doctor for member of the team has an of teams at St. Joseph’s Hospital means his multiple chronic conditions are now in check. accelerating Dave’s spiral. 3 01 ISSUE www.sjhc.london.on.ca 4
followed by a six-month Mona. When patients are provided have enough breath to do before. maintenance phase in partnership with the tools to manage their Stairs are no longer a problem and with the downtown YMCA. During condition, they are better equipped on scenic drives with Wendy, he their time in the exercise program, to stay out of hospital and enjoy can actually get out of the car patients take part in skill building good quality of life. rather than passively watch the sessions with a social worker to world go by. Dave had resorted to spending his better manage the anxiety and Proudly brings you days on the couch watching TV “I can’t believe what they helped stress that often comes with COPD. when he was referred to the COPD me accomplish,” Dave says of Those with heart failure, heart program and offered pulmonary the many teams and individuals disease or diabetes also see those fitness training. “I thought there was involved in his care. “They not only nurses, educators and specialists. no way I could exercise.” made me understand the mechanics “We work together to tease out the of what was happening, they gave Today, he is a healthy weight, back contributing factors to a patient’s me the skills and confidence to do on the golf course, playing guitar condition and gaps in their care,” what I needed to do. I feel lucky and singing – something he didn’t explains Mona Groenewegen- to be alive.” Beukeboom, nurse practitioner with the Heart Failure Clinic. “Appointments are often made on the same day for a patient being DID YOU KNOW... seen in the COPD and Heart Failure 67% clinics, and we will share test results FEATURING: 3 OUT OF 5 David Sheff so that only one test is needed, such as an ECG or blood work.” Canadians aged 20 and older The overall emphasis is on have chronic disease and four self-management, education and out of five people are at risk. self-advocacy so that patients are not passive consumers of health Of all deaths in Canada per care but rather an essential member of their care team, say Laurie and year are caused by four major chronic diseases: cancer, Author of the Best selling Book Beautiful Boy diabetes, cardiovascular and chronic respiratory diseases. A father's harrowing journey through his son's addiction and undiagnosed mental illness. 2000 2020 The rates of cardiovascular diseases and chronic respiratory Presented by Clintar Landscape Management diseases have increased since Now a major 2000, reflecting that more motion picture Canadians are living with those starring diseases every year. Steve Carell. FRIDAY, May 8, 2020 RBC PLACE LONDON 87% 58% Main Event 7-9 am | Panel Discussion 9-10 am $85 per person | $850 for a table of 10 Although seniors are living Of disability in Of annual longer and are healthier than the Canadian health care previous generations, with increasing age their potential population is caused spending goes toward Purchase Your Tickets Today to experience multiple chronic by chronic chronic conditions increases. disease. disease care. 519 646-6085 or sjhc.london.on.ca A COMMON GOAL TITLE SPONSOR PRESENTING SPONSOR PRIVATE RECEPTION SPONSOR PREMIER SPONSORS At St. Joseph’s Health Care London, the broad range of outpatient programs for chronic disease have a common goal – to provide and coordinate care in new ways focused on each person’s multiple, complex continuing needs and individual goals. MAJOR SPONSOR LEAD SPONSORS 5
WELCOME TO UNSPOKEN COMPASSION: MY ST. JOSEPH’S A VOLUNTEER’S STORY For everyone who receives care or works within our walls, women who are on their own breast The unique, specially-designed St. Joseph’s Health Care London holds unique meaning. care journey and pays gratitude for Norton and Lucille Wolf Breast A diverse family of programs and services in various the care she received. Care Centre is the main hub of settings across the city and region, St. Joseph’s is, quite the program. The centre was made simply, one of Canada’s most innovative health care “I was fortunate to be at a possible through the generosity of organizations. From our facilities within London, to facility with such state-of the-art the Bernard & Norton Wolf Family outreach teams in the community and region, and a clinic technology and an incredible team Foundation and support from in Toronto, St. Joseph’s touches the lives of people from of professionals,” says Patricia. St. Joseph’s Health Care Foundation. all walks of life. “They knew what you were feeling and had a way of making you feel Patricia volunteers to let women I am proud to introduce this first edition of My St. Joseph’s, like there was a light at the end of know they are not alone. in which we share compelling stories of care, compassion, the tunnel. It’s an incredible team innovation, discovery, dignity, community giving and “I walk through the door every to be a part of.” spirit. These are stories of impact, excellence and week and I feel so grateful to be inspiration that shed light on who we are, what we do, A recent breast cancer survivor, Patricia here,” says Patricia of the Breast and our enduring legacy of care – body, mind and spirit. Mowry, 76, volunteers with St. Joseph’s “I want women to know Care Program. “As women, I truly Breast Care Program as a way to show her But don’t take my word for it. Visit us within the pages gratitude for the care she received and to help that they are not alone.” believe that sometimes it’s the other women who are on their own journey. unspoken compassion and the of My St. Joseph’s and see the impact for yourself. —PATRICIA MOWRY, shared experience we can offer VOLUNTEER AT ST.JOSEPH’S DR. GILLIAN KERNAGHAN BREAST CANCER PROGRAM one another that greatly contributes PRESIDENT AND CEO to our healing and recovery.” ST. JOSEPH’S HEALTH CARE LONDON For the past three months, St. Joseph’s Breast Care Program Patricia Mowry has been a calming brings together a breast care team presence for many women who of surgeons, radiologists, medical 1 walk nervously through the door radiation technologists, advanced of St. Joseph’s Health Care practice nurses, nurse navigators, For more information London’s Breast Care Program. St. Joseph’s provides exceptional care, earning Patricia provides them with a gown, spiritual care providers, social workers and others in a setting that on volunteering at St. Joseph’s, visit: the complete confidence of those we serve. Care helps administer paper work and, nurtures and supports seamless, www.sjhc.london.on.ca more often than not, simply holds innovative care for patients focused their hand. on individualized care needs. “Sometimes I don’t say anything,” says Patricia. “Sometimes it’s just matters here. a shared look of compassion and understanding.” Patricia is a St. Joseph’s volunteer. While she doesn’t always disclose, the 76-year-old knows all too well what many women are feeling when they arrive for their appointments. As a recent breast cancer survivor, A leader in fecal microbial transplantation for treatment of C. difficile, St. Joseph’s she’s been there. is paving the way in innovative and life-saving treatment for those with this debilitating and challenging infectious disease. Read full story on page 17. A year ago, after an annual mammogram recommended by her doctor, Patricia was told she had sjhc.london.on.ca a small tumour in her breast. With a history of early-onset breast cancer in her immediate family, she underwent a lumpectomy at St. Joseph’s Hospital followed by several weeks of radiation therapy at the London Regional Cancer Program. Dr. Michael Silverman Now cancer free, she volunteers Providing comfort, helping with gowns and administering paper work are just some of the tasks Medical Director, Infectious Diseases Care Program, St. Joseph’s Health Care London Scientist, Lawson Health Research Institute weekly to provide support for other Patricia performs while volunteering with St. Joseph’s Breast Care Program. 01 ISSUE www.sjhc.london.on.ca 01 ISSUE www.sjhc.london.on.ca 8
activities sit in the bike and enjoy nice to see the families and children the ride,” says Brittany. “Their faces in the park, and sit by the water light up, they smile…it brings back and watch people fish,” he says. great memories.” “I also like to bike around the neighbourhood and look at all the Mount Hope’s Cycling Without houses. When I’m out, I feel happy Age program is made possible and relaxed.” through the generosity of donors to St. Joseph’s Health Care Foundation, who contributed 1 to the cycle purchase. 1 For Glen, the bike is more than a To see more stories “When I’m out, I feel comfortable ride. of donor impact, visit: happy and relaxed.” “I get to go to Gibbons Park where sjhcfoundation.org —GLEN MARSH, RESIDENT AT MOUNT HOPE CENTRE I can be around all sorts of nature, FOR LONG TERM CARE water, trees and animals. It’s also a resident at St. Joseph’s Mount which can lead to isolation and “When I’m taking Glen or other “FEELING THE Hope Centre for Long Term Care loneliness,” says Bernice Haasen, residents out for a ride, I see how FRESH AIR ON (Mount Hope). “I also like this bike because I don’t Coordinator of Therapeutic Recreation at Mount Hope. being outdoors and enjoying the view brings a sense of freedom, a MY FACE” have to do any work like pedaling,” he laughs. “I just get to sit back and “Offering them the chance to go on a bike ride gets them outdoors feeling of relaxation,” says Brittany. “They feel special, especially to see life beyond Mount Hope, when families and kids see them enjoy the ride.” and to enjoy the city’s parks and and wave, and sometimes stop to Cycling around the city brings His ride is part of Cycling Without neighbourhoods. And it really talk. It’s a whole different type of joy to residents of Mount Hope Age, a new program at Mount brings a lot of joy to their day.” experience because it connects our Centre for Long Term Care. Hope offering recreational residents with the community.” What’s Glen’s favourite part of being mobility to older adults on a on the trishaw cycle? Since launching in spring 2019, uniquely engineered cycle pedaled the program has rapidly become When Glen Marsh straps on his by therapeutic recreation staff. “Getting to be outside in the a favourite among Mount Hope helmet and settles onto his bike Founded in Denmark, Cycling sunshine, feeling the fresh air on my residents. Time slots fill quickly, seat, he never has to pedal. Without Age is a grassroots face,” he says. even by those who normally keep He leaves that to someone else. movement that’s available in more His bike rides are powered by to themselves. than 30 countries. “It’s so fun to be on a bike again Brittany Tiseo, a Mount Hope staff Glen Marsh, a resident at St. Joseph’s Mount Hope Centre for Long Term Care, enjoys a leisurely “It’s so great to see residents because it reminds me of when “Many of our residents experience member who pedals him wherever spin with therapeutic recreation aide, Brittany Tiseo. The activity is part of a new Cycling Without who are often reluctant to do Age program at the facility. I was a little boy,” says Glen, a loss of mobility and independence, he wants to go. 9 01 ISSUE www.sjhc.london.on.ca 10
COVER STORY BORN TO MOVE FACES OF MOBILITY When we move, we feel better neurological and musculoskeletal about ourselves physically and conditions. mentally. Most of us are mobile The more we can do to get people through much of our lives, but when moving again, the better off our mobility is limited, it can affect they will be in terms of mental us in numerous ways. It may harm and physical health – and in our quality of life, lead to social participating in what’s important isolation and depression, affect our to them. ability to work and participate in the community, and place a burden on our family and caregivers. Q: WHAT DOES THE FUTURE OF MOBILITY LOOK LIKE? Q: WHEN THINKING ABOUT A: We’ve come a long way in MOBILITY LOSS, WE MAY how we treat people who’ve lost PICTURE SOMEONE WITH A mobility. What we’re doing today BROKEN LEG OR AN OLDER in rehabilitation and treatment ADULT USING A WALKER. Dr. Tim Doherty, Chair/Chief of Physical at Parkwood Institute wouldn’t WHAT WAYS DO PEOPLE LOSE Medicine and Rehabilitation at St. Joseph’s MOBILITY? have been possible 20 years ago. Looking ahead, with development For most of us, we took our first A: It can come in multiple ways. of The Gray Centre for Mobility steps before we turned a year old. Sometimes it’s through a sudden and Activity, we are bringing On tiny unsteady feet, we explored incident, such as a tragic accident, together a diverse group of medical the world around us, experiencing concussion, fall, spinal cord injury professionals, researchers and the wonder of independence. or stroke. Other times, mobility industry experts to develop, test and Chris MacGregor receives therapy from the Stroke Rehabilitation Program at St. Joseph’s Parkwood Institute. However, as we age and move into loss is gradual as people deal deliver new treatments, new ways adulthood, our lack of mobility with frailty, dementia, mental of rehabilitating people. This kind Each person’s experience with of 23 years. “It was the worst day since his stroke in 2018, literally might slow us down. illness, diabetes, stroke, arthritis, of coordinated approach will help mobility loss tells a unique story. of my life. I didn’t know if he was and figuratively. Parkinson’s disease, and muscular unlock innovative solutions – ideas Here, three individuals shed light going to make it. Everything was Dr. Tim Doherty treats people who sclerosis. on what it’s like to be immobile He walks to the end of the laneway we may not have considered yet – taken away by the stroke. It was have mobility loss. A renowned and to take the next step. three times a day by himself, says that get people moving again. awful to see him lose his mobility.” expert in physical medicine and Connie. And while his speech is rehabilitation and lead physiatrist Q: WHAT IS BEING DONE TO To regain movement and build slow, it’s coming. at St. Joseph’s Health Care London’s HELP PEOPLE IMPROVE MOBILITY activity into his life, Chris AND REGAIN INDEPENDENCE? EVERYTHING Seeing mobility stripped from Parkwood Institute, he sees received therapy from the Stroke WAS TAKEN AWAY her husband and then witnessing firsthand how movement and A: At St. Joseph’s Parkwood Rehabilitation Program at it gradually return, she remains activity affect one’s health. We Institute, we are leading in many CHRIS MACGREGOR St. Joseph’s Health Care London’s hopeful and optimistic. asked Dr. Doherty about mobility. areas of mobility, including the use FARMER, 52 Parkwood Institute. His care team PARKHILL, ONT. of technology to assess and treat developed a personalized treatment “Yes, life is going to be different but individuals. For instance, people plan, which included therapies we are going to work hard and we’re Q: WHY IS MOBILITY AN A farmer. A hard worker. with a spinal cord injury can use a tailored specifically to Chris. going to get it to the best it can be.” IMPORTANT PART OF OUR An independent man. robotic system that might help them For example, movements needed HEALTH? walk again. This would describe Chris to change a tractor tire – A: We were born to move. Mobility MacGregor, until he experienced a something familiar to a farmer “Without your mobility is how we get around in the world, People are receiving better stroke at age 50. like Chris – were part of his assessments thanks to our you don’t have a lot. allowing us to do all the things we rehabilitation program. researchers who are exploring what “It took everything on his right Mobility is everything.” need to do as people. factors affect mobility in aging, side. It took his speech. He could do With grit and determination, nothing,” says Connie, his wife Chris has made great strides — CONNIE MACGREGOR 11 01 ISSUE www.sjhc.london.on.ca 12
MY LEGS DON’T WORK LIKE THEY IS MY WHOLE LIFE GOING USED TO. TO CHANGE? LEE THIBEAULT JUNE HAMEL PARA ATHLETE, 31 RETIRED COURT REPORTER, 87 LONDON, ONT. LONDON, ONT. On June 25 2013, Lee Thibeault took June Hamel and her dog, Casey, his motorcycle for a ride. He didn’t had a difference of opinion while make it home. heading out on a walk. He was struck by a hit-and-run “He ran one way and I landed driver. “The accident left me in a on the floor with a broken hip,” wheelchair,” he says. “It was actually says June. pretty scary. I’ve become a prisoner The next day, June underwent to my own body.” hip surgery and, following a Part of Lee’s rehabilitation at hospital stay, came to St. Joseph’s St. Joseph’s Parkwood Institute Parkwood Institute. involved therapy on robotic “When I was lying in a bed knowing equipment that imitates the I’d broken my hip, I started to think, movement of walking. “Oh no, now what? Is my whole life “Just to see that there’s a light at going to change?” the end of the tunnel, life got a little At Parkwood Institute, June’s easier every day,” says Lee, a former rehabilitation team got her professional boxer who was studying exercising so she could get back air craft mechanics before the crash. on her feet. Even though his mobility is not “They were there to help me. what it used to be, Lee remains Lee Thibeault is thankful for his rehabilitation care at St. Joseph’s Parkwood Institute. They were encouraging me and positive, and perhaps philosophical, they gave me spirit,” says June. as he works to take back his “Being mobile keeps my mind independence. going, keeps my body going. I figure “We take it for granted when we’re FACTS ON MOBILITY if I got moving, I would stay moving. $2 on our feet. We were meant to be I just want to be here, and I have to June Hamel exercises with physiotherapist Reuben Smith at St. Joseph’s Parkwood Institute. standing, walking, and moving. move to be here.” June underwent hip surgery from a fall, which began her recovery journey. Mobility is the most important thing… My legs don’t work like they used to. But just because I have changed doesn’t mean my life needs 1 IN 5 to change. And I feel that’s what billion MOVING MOBILITY FORWARD Parkwood Institute has done for me.” As the country’s population ages and rates of chronic diseases rise, more Canadians will experience mobility challenges, and Annual cost to the Canadian Seniors have difficulty rising will see their work and family life disrupted. At the same time, health care system for from a chair or walking pressure on the health care system will surge. slips and falls. two blocks. St. Joseph’s Health Care London is taking aim at these looming challenges with the creation of The Gray Centre for Mobility and Activity. Located at Parkwood Institute, the centre will expand and advance the medical, research and community work already happening to improve mobility in patients. It will also make 1 IN 4 EVERY 30 MINUTES Parkwood Institute a national hub for rehabilitative care and treatment where scientists, clinicians and community partners Local couple Bill and Lynne Gray made an historic investment in 2019 that will open Will be 65 years or older Someone in Canada has will collaborate on new solutions to treat and care for people by 2030. a stroke. The Gray Centre for Mobility & Activity with loss of mobility and activity. at Parkwood Institute to promote people’s capacity to remain mobile and in good health The centre’s work is being made possible through a throughout their lives. Lee Thibeault walks on a treadmill during a 30,000 CANADIANS $7.5 million gift to St. Joseph’s Health Care Foundation by Bill and Lynne Gray. Locomotor Training session in a rehabilitation Fracture a hip annually. gym at St. Joseph’s Parkwood Institute. 13 01 ISSUE www.sjhc.london.on.ca 14
PUTTING robotics, Dr. Pautler is a highly- respected leader who has keenly “If an abnormality is found or a PSA test is concerning, they get THE LID ON followed the debate over the years. referred to the Prostate Diagnostic Assessment Program at St. Joseph’s “Canada has come to the COFFEE decision that not screening is Hospital,” says Dr. Pautler. “If their risk is low, the care SHOP TALK a grave mistake.” team and patient may decide to observe. If there is cancer requiring NOTHING TO SHY AWAY FROM Prostate screening happens in two treatment, patients may undergo steps starting with a PSA blood test, radiation or surgery. It’s through Urologist Dr. Stephen Pautler those interventions where the explains Dr. Pautler. PSA is made clears the air on prostate risk of incontinence or erectile by the prostate and high levels of screening misconceptions dysfunction happens, but in this protein means a higher risk of and urges men to be informed. many cases, function is restored. Their life may depend on it. cancer being present. If it’s not, then there are still The second part is a rectal exam. more options.” “In my experience, men tend to There is much discussion in Poised over a medical model of a build up this little exam. the medical world of cancers, penis in his office at St. Joseph’s Thomas Telfer participated in the Zero Suicide Implementation Advisory Committee as well as a working group to provide support and advice from We are simply looking for lumps like prostate, being treated as a an outpatient perspective. Hospital, Dr. Stephen Pautler quips, and bumps, which is a key ‘disease of aging’, understanding “to screen or not to screen, that’s indicator. The hype men give this the spectrum is broad requiring the question.” Shakespeare he’s not, but a urologist for almost 20 years, is way worse than the exam. Men need to move past it – everything from a watchful eye to tumor removal, says Dr. Pautler. THE POWER “This community funding support is a recognition of the importance “It’s about helping people stay out of crisis and improve their quality Dr. Pautler knows a thing or two about prostate care. because it’s important.” “Some patients are fine with OF ZERO of the initiative,” says Thomas, who was first diagnosed with of life day-to-day,” says Thomas. “The goal of Zero Suicide is zero. In addition to rectal exam dread, monitoring and others want or depression as a young lawyer. That’s the only acceptable number.” “I call it coffee shop talk – where men hear misinformation about need to take immediate action.” men share the worst stories they’ve At the time of his diagnosis, Currently, St. Joseph’s is reaching treatment. heard, leading to misinformation TIME FOR CHANGE As a mental health advocate Thomas associated mental illness out to community partners, offering and dangerous consequences,” “Sometimes surgery or radiation The trouble is men aren’t even with a passion for suicide with weakness and rejected suicide prevention education, says Dr. Pautler. can cause incontinence and erectile taking the first step – they aren’t awareness and prevention, his doctor’s recommendations resources and training on the Zero issues, and that’s what men hear in getting screened – and that has to Thomas Telfer helped shape a for treatment. That attitude Suicide approach, to help support So why is it important to screen for the coffee shops. Truthfully, there change, says Dr. Pautler. new approach to patient care. changed after his most recent other organizations as partners in prostate cancer? “One in seven men is so much more to the picture,” Today, the Zero Suicide initiative hospitalization. “I was tired of suicide prevention. will have prostate cancer in their “It’s really about being informed. says Dr. Pautler. at St. Joseph’s Health Care hiding my illness,” he says. lifetime, so men should stay on top It would also be helpful if London is fully-funded thanks of it,” he urges. MANY TREATMENT OPTIONS men would put a lid on the Thomas decided the only way to to community support. The care team looks at family misconceptions and instead spread reduce the stigma and help others FLAWED STUDY was to talk about his struggles. history, lumps, the PSA and use the word about the reality of Despite such staggering rates, the In 2016, St. Joseph’s became the first He began by inviting friends and BY THE NUMBERS clinical formulas to calculate prostate screening – how it’s really number of men being screened is health care organization in Canada work colleagues to visit him in cancer risk for men. not bad, it’s important, and it can decreasing. to adopt Zero Suicide, a system- hospital. Today, he uses his 671 NEW PATIENTS save a life.” “It’s a bit complex, but a study came wide initiative that aims to prevent platform as a professor to share have received a lifetime suicide in the health care system by his experiences with students suicide risk assessment out from the United States saying providing people with the help and and colleagues. since 2018. screening doesn’t save lives, and a Canadian panel recommended protection they need – before they 61 AGENCIES Thomas’ work as a mental health against screening based on this reach a crisis point. in the region have advocate led to his involvement work,” explains Dr. Pautler. Today, the initiative is fully-funded with Zero Suicide. expressed interest in the by generous donations made Zero Suicide initiative. A second study from Europe As a member of the implementation back-tracked on the original through St. Joseph’s Health Care 24 HOURS OR LESS, committee, he was able to share findings, saying screening does Foundation, which brings the goal upon discharge: his story as well as the experiences reduce mortality. of reducing the number of deaths by individuals receive of many patients he has met suicide to zero one step closer. a follow up call from “Sadly, the ‘screening doesn’t in hospital. care staff. help’ language infiltrated doctor’s That’s exciting news for Thomas This vital input helped shape the offices. Now we are stuck with false Telfer. As a survivor of two suicide 7 DAYS OR LESS, new wrap-around approach to information we need to combat,” attempts, Thomas participated in upon discharge: suicide-prevention that is already individuals receive a says Dr. Pautler. the Zero Suicide Implementation making a difference in the lives scheduled outpatient Advisory Committee as well as Southwest Regional Surgical of all patients receiving inpatient appointment. a working group to advise and Oncology lead at Cancer Care and outpatient mental health support the project from an Ontario and a pioneer in surgical Urologist Dr. Stephen Pautler consults with a patient at St. Joseph’s Hospital care at St. Joseph’s. outpatient perspective. 15 01 ISSUE www.sjhc.london.on.ca 16
THE SCOOP ON POOP Like blood transfusions, fecal transplants save lives. Don’t flush away an opportunity to donate. It’s inevitable that any conversation with Dr. Michael Silverman loops around to poop. Few get as excited at the mention of this bodily byproduct, and few are as well versed on the topic. Dr. Silverman, Director of St. Joseph’s Health Care London’s Infectious Diseases Care Program and a scientist at Lawson Health Research Institute, is, in fact, a Canadian poop pioneer. Fecal transplant capsules being prepared in lab. In 2003, long before poop was a hot topic in health care, Dr. Silverman was treating an of the infection. And so began his YOU CAN HELP: DON’T FLUSH 80-year-old patient who had pursuit of poop to treat disease. AWAY A CHANCE TO SAVE A LIFE been hospitalized repeatedly with At St. Joseph’s Hospital, Just like blood transfusions, Clostridium difficile (C. difficile) Dr. Silverman has been able to fecal transplants save lives, says infection –the major cause of advance his work in FMT, efforts Dr. Michael Silverman, Medical antibiotic-associated diarrhea that recently earned his team the Director of St. Joseph’s Infectious that often strikes the elderly. Sandra Letton Quality Award Diseases Care Program. She had borrowed money against presented by St. Joseph’s for But transplants need donors. her house to afford the medication outstanding contributions Dr. Silverman urges people to get and could no longer tolerate the toward improvement in quality past the “ick factor”, be screened burden of this debilitating and life- patient care. and donate. One stool can threatening infection – physically transplant three to four people. and financially. She begged him to Seema Nair Parvathy, Research Coordinator at Lawson Health Research Institute, Since 2015, the team has prepares fecal transplant capsules. And donors can give as often as find a solution. successfully administered more they poop. than 150 FMTs for C. difficile Dr. Silverman had just read a Treating C. difficile with antibiotics patients from across Southern new Scandinavian report about also kills even more of the helpful Ontario. Working in partnership an alternative treatment that normal gut bacteria, and when these with research coordinator 1 addressed the cause of the disease, antibiotics are stopped the SeemaNair Parvathy (PhD), the its prevention and recurrence - fecal C. difficile returns. This can happen outpatient Infectious Diseases Care To find out more about microbial transplantation (FMT), over and over again, making Program at St. Joseph’s Hospital has eligibility and how to otherwise known as a treating relapsing C. difficile a donate, call: become the first clinic in Ontario poop transplant. huge challenge. to offer FMT by capsule instead of 519 646-6100, ext. 61726 by enema, and only the second in Most cases of C. difficile occur With FMT, donated stools from Canada to do so. in individuals who are taking a healthy person are diluted with antibiotics and some acquire it saline, filtered to a clear liquid, The hope is to expand treatment while hospitalized. Antibiotics and introduced by enema into the using FMT to other diseases such can destroy the normal bacteria person with C. difficile. It works a non-alcoholic fatty liver disease, found in the gut, causing C. difficile by replacing the normal healthy multiple sclerosis, melanoma bacteria to overgrow. When this gut bacteria. and atherosclerosis. occurs, the C. difficile bacteria Dr. Michael Silverman, Medical Director of the Infectious Diseases Care Program at St. Joseph’s The 80-year-old woman was produce toxins, which can damage Hospital, Chair/Chief of Infectious Diseases in London, and a scientist at Lawson Health Dr. Silverman’s first FMT patient. the bowel and cause diarrhea and Research Institute, is a Canadian pioneer in fecal transplants. It worked. The woman was cured other complications. 17 01 ISSUE www.sjhc.london.on.ca 18
THE BEST PERSON FOR THE JOB – HANDS DOWN A NEW START Expertise in hand therapy and a Occupational therapy builds “handy” Indian accent created confidence and independence the perfect formula for teaching for residents of St. Joseph’s in South Asia. Steele Street Rehabilitation Program. During a recent trip to India Dylan leans over to grab another and Sri Lanka, occupational onion for chopping on his cutting therapist Shrikant Chinchalkar, board. He’s making soup – a routine On their road to recovery, residents at St. Joseph’s Steele Street are learning about themselves, a renowned leader in hand therapy task for most, but for Dylan, a former their talents and abilities - including some impressive skills in the kitchen. From left are, at St. Joseph’s Health Care London, resident of St. Joseph’s Health Care John, occupational therapist assistant Angela Miles, and Dylan. challenged old practices and shared London’s Steele Street Rehabilitation his vast knowledge in treating Program, it means much more. the week, not on weekends,” says “Routine and structure are an hand fractures and other injuries. It’s a new start. program coordinator Terri-Lynn important part of the therapy,” Shrikant, a long-time hand By his side is occupational therapist Timmermans. “This new role, explains Angela. “We can now therapist at the Roth|McFarlane assistant (OT assistant), Angela and the many skills Angela offers, offer our residents occupational Hand and Upper Limb Centre Hand therapist Shrikant Chinchalker explains the controlled movement program to a patient in the Miles. Her role at the Steele Street has positively impacted those we therapy outside of traditional who couldn’t sit still in retirement, Roth McFarlane Hand and Upper Limb Centre. residence allows individuals, like serve here.” business hours when they are not is contributing to the organization’s Dylan, to receive occupational at work or at school.” At Steele Street, located in academic mission by teaching therapy seven days a week. Angela recovery and additional surgeries. “They do exceptional work in St. Thomas, individuals with With 20 years of health care abroad. follows treatment plans developed If therapy is started at the right time India and Sri Lanka. I was there complex and persistent mental experience, Angela is always eager by Steele Street’s occupational Travelling to India for the past it helps to minimize recovery time, to enhance the practice of hand illness receive care and to make a difference. She helps therapist who also provides care eight years, Shrikant is no stranger the need for additional therapies.” therapy as best I could. We know rehabilitation therapy for up to residents with meal planning, daily within the residence. Trading off to the medical needs of developing early movement is key as it results two years. A team of professionals chores, cooking, scheduling and Shrikant is also helping to bridge 12-hour shifts, the duo provide countries. In India, he met with in less scar tissue formation and with expertise in occupational socializing with others. As many of the communication gap between consistency in the support available orthopedic and plastic surgeons, better healing and mobility.” therapy, nursing, psychiatry and the residents have spent prolonged disciplines. for all nine residents living in residents, fellows and medical therapeutic recreation provide periods of time in hospital, the When asked about the response the home. students to discuss wound healing “Sometimes the surgeons don’t services and treatment in a therapy gives them a renewed sense to his coaching in Sri Lanka, and decision-making for hand talk to the hand therapists and “Prior to the addition of an residential setting, helping residents of independence and valuable Shrikant humbly states, “It was therapy, including the right timing vice versa. Breaking down silos OT assistant to our care team, to learn the tools and skills they’ll community living skills. good.” So good he was invited back for casting and when to begin is important so we can all share occupational therapy at Steele need to live independently in the in 2020. “Sticking to a routine and learning hand therapy. information that benefits patients.” Street was only offered during community. how to cook and stay on a budget “In the past, the practice of keeping At the request of the Education has been helpful,” says Dylan, who a cast on for three to six weeks was Committee of the International “Often surgeons felt the recently secured a new job and typical,” explains Shrikant. Federation of Societies for Hand moved into his own apartment after stiffer the injury was held Therapy, Shrikant also imparted his living at Steele Street for a year. Starting with a controlled knowledge in Sri Lanka but jokingly in place, the better. But movement program, patients are based on knowledge of declares the invitation wasn’t just benefitting from wearing a cast for wound healing, we know “It’s rewarding to see all about his expertise. only three to seven days and then the residents work together wearing a splint while progressing “It proves challenging in Asia when there is a better way.” and achieve their goal of into therapy. teachers are from Australia or the United Kingdom. The accents pose — SHRIKANT CHINCHALKER, independent living. I’m OCCUPATIONAL THERAPIST “This early hand rehabilitation a problem. I think I was chosen excited for the opportunity helps the break to heal better,” to use my skills in such a not only because of my experience says Shrikant. unique mental health care but because of my Indian accent,” “Having a patient in a cast for up he smiles. Through talks and setting.” to six weeks can pose problems for clinics in both countries, hand therapists as they struggle Shrikant shared his wisdom with — ANGELA MILES, Occupational therapist assistant Angela Miles helps Dylan, a former resident at St. Joseph’s OCCUPATIONAL THERAPIST with stiffness. It results in a slower eager-to-learn clinicians. Steele Street in St. Thomas, plan his meals for the week while staying on budget. ASSISTANT 19 01 ISSUE www.sjhc.london.on.ca 20
DIABETIC A SIGNIFICANT STRESS Many patients with type 1 and type SUPPLIES OR 2 diabetes pay out thousands of dollars annually – a significant GROCERIES? stress that adds to the physical and often mental health toll of diabetes, says Rebecca Meehan, DEC registered nurse and educator. For many patients, the “It’s not uncommon for patients to financial toll of diabetes means be faced with choosing between making difficult decisions. recommended care and basic At St. Joseph’s Health Care living expenses.” London, the diabetes care team is helping patients find For example, many of those without the support they need. adequate coverage for test strips used for checking blood glucose levels forego checking, which leads The gap between what people with to poorly managed diabetes and St. Joseph’s endocrinologist Dr. Tamara diabetes need to manage their a higher risk of complications, Spaic often sees the impact of the financial condition and what they can afford toll of diabetes on the lives and health of says Rebecca. is a growing concern for staff and her patients. physicians at St. Joseph’s Diabetes Jason Howard estimates he pays Education Centre (DEC). about $4,000 a year out-of-pocket for diabetes-related essentials. new one daily for insulin injection. A lack of funding for diabetes Both he and his wife are self- And rather than changing the supplies, equipment and employed, which means they can’t lancet each time he pricked his medications essential for evidence- tap into private group insurance finger to draw blood seven to ten based care means diabetes nurses and don’t qualify for most of the times a day, he would use the same and dietitians are spending much government funding programs. lancet for two weeks. While Jason time helping patients navigate now uses a flash glucose monitoring various avenues to secure financial The 47-year-old, who has had to system that can read glucose support. To boost these advocacy scale back his handyman business levels through a painless scan of a efforts, St. Joseph’s recently due to his health, admits to cutting sensor worn on the arm – no finger launched a new service for diabetes corners as a way to ration supplies prick needed - the sensor must be patients. A registered social service and medication, such as using the changed every two weeks at a worker is now available to provide same needle for a week instead of a cost of $100 each. coaching and guidance aimed at helping diabetes patients and their The gap between what people with diabetes need to manage their condition and what they can afford is a growing concern for the diabetes care team families find the resources they at St. Joseph’s Hospital. need for optimal self-care. EVERY 24 HOURS... $75 “The overall goal is to decrease Jason also found a way to stretch management,” she explains. of diabetes management, can be barriers to care,” says Julie Hebert, his insulin use by eating fewer “Yet the cost of these advances expensive. It’s easy to see how the social service worker. “This includes helping people with MORE THAN carbs, which affects how he feels. is not universally covered and hence not readily available to all cost of living with diabetes quickly adds up and how it may discourage TWENTY applications for financial support In St. Joseph’s diabetes clinics, our patients.” some patients from persisting with from various government agencies the team often sees how the their care.” million or advocating for coverage from financial and psychological distress As a chronic illness that affects private insurance companies.” Canadians die of diabetes- associated with diabetes impacts multiple organ systems, diabetes related complications. lives and the health of patients, says management is challenging, endocrinologist Dr. Tamara Spaic. requiring not only good sugar Is spent by the Canadian 480 control but also excellent blood health care system to “We live in the era of great treat diabetes. pressure and cholesterol control, advances in treatment of diabetes. and more, adds. Dr. Spaic. They include medications that significantly improve blood sugar “The number of medications FOURTEEN control and decrease the risk of death and dying, and technological prescribed for diabetes management can quickly exceed Canadians have lower More Canadians are diagnosed advances in blood sugar monitoring five or even 10 medications a day. limb amputation. with this devastating disease. that help patients make informed And we should not forget that a decisions about their diabetes healthy diet, which is a cornerstone 21 01 ISSUE www.sjhc.london.on.ca 22
The R2P team, led by Lawson PRIME members meet regularly scientist, Dalton Wolfe, is to share key findings and identify focused on embedding research issues. This is where clinicians can into clinical care by bringing reflect and refine their practice. together researchers, clinicians, Today, Patrick’s main symptom is administrators and patients in an neuropathic pain below his knees. exciting approach that can quickly About an hour spent sitting is all translate knowledge into care. he can tolerate. When discomfort Parkwood Rehabilitation sets in, physical movement brings Innovations in Mobility relief. Twice a week Patrick travels Enhancement (PRIME) aims to to the Fitness Centre at Parkwood create evidence-based treatment Institute for therapy that is protocols by investigating what continually evolving. combinations of physical or “By integrating research into the occupational therapies are clinical setting, improvements best for what type of patient. in care are made frequently, and Through collaborations with patients are able to benefit from the computer scientists and engineers, research immediately,” says Dalton. researchers hope to identify which “Patients experience more effective activities might be linked with treatment, faster recovery, and the best physiotherapy practices, ultimately, better outcomes.” with the ultimate goal of providing the best possible clinical recommendations. Patrick has experienced the health system from all angles and knows 1 the Rehabilitation Program at Parkwood Institute well. For an in depth His insights make him a valued interview with the PRIME Team, visit: member of the PRIME team. A PRIME Team - Lawson “Ensuring the patient experience Link 2019 on YouTube is embedded in our research is integral to this type of model,” says Dalton. At Parkwood Institute, the Research 2 Practice team brings together researchers, clinicians and patients to improve care for spinal cord injury and acquired brain injury patients. From left are Melissa Fielding, Laura Graham, Calogero Giurleo, patient Patrick Stapleton, Dalton Wolfe, Heather Askes, and Deena Lala. IN THE TOP 10 – YET AGAIN Lawson Health Research Institute is ranked eighth in the country according to the DELIVERING Five years ago, Patrick Stapleton was sitting upright in a chair when has been difficult. During the first year, he was prescribed multiple 2019 edition of Canada’s Top 40 Research Hospitals List by Research Infosource. This strong national position has been maintained by Lawson for the past six ON DISCOVERY his forehead went cold and clammy and his vision suddenly blurred. medications to manage the pain and underwent spinal decompression years. Lawson has also maintained the top ranking for research intensity among the large tier institutions with $612,800 of research spending per researcher. The next thing he remembers is surgery. He now has two titanium “As a hospital-based research institute, our innovation happens where care is waking up on the floor with no rods spanning his T11, T12, L1, L2, delivered,” says Dr. David Hill, Lawson Scientific Director. “Every day, researchers With patients as part of the feeling in his legs. and L3 vertebrae. are working directly with clinicians and patients to improve treatments or create team, new knowledge can entirely new ones. They also find innovative methods of delivering services that “There is no explanation for what The road to recovery following a be quickly translated into drive efficiency and reduce costs.” happened to me,” says Patrick. spinal cord injury (SCI) or acquired rehabilitative care at St. Joseph’s “Many doctors have looked at my brain injury (ABI) can be long and Lawson received $123,790 million in research income in 2018, which represents Parkwood Institute. case, and after ruling everything challenging. Since every patient’s 0.4 per cent in growth from the previous fiscal year. out, their best guess is that I had condition is unique, so too are the a muscle seizure, which broke rehabilitation needs. Optimizing “Our position as a leading research institute is the foundation for brilliant research and worldwide partnerships tackling the most pressing challenges in health care,” my vertebra.” treatment for the individual is the says Dr. Hill. goal of Lawson Health Research Patrick has what is known as an Institute’s Research 2 Practice Lawson Health Research Institute is the research institute of St. Joseph’s Health L1 spinal cord injury. His journey (R2P) program at St. Joseph’s Care London and London Health Sciences Centre. through recovery and treatment Parkwood Institute. 24 23 01 ISSUE www.sjhc.london.on.ca 24
EVERY “Something that stood out was how patient and family caregiver “We can’t quite put our finger on it,” Joan muses, “but you know that VOICE TELLS involvement is being welcomed, not only at a program or project people are well-cared for and that individual voices are valued.” A STORY level, but in active roles up through decision-making and governance For Joan, having the accreditation process include inquiry into the structures,” explains Joan. role of patients and families as She acknowledges that not every partners in care speaks volumes As a patient, Joan Hubert story is a good story, but there is to the authenticity of the work shares what it means to be opportunity to learn as much – at St. Joseph’s. valued as a partner for if not more – from difficulties change at St. Joseph’s “Sharing our stories is how we and challenges. Health Care London. keep compassion and the human Accreditation is an ongoing “It is about how those situations element at the centre of health process of assessing health and social services are heard, respected and taken into care,” says Joan. organizations against As Joan Hubert looked around the consideration that leads to positive standards of excellence. table during a panel discussion at change all around. It truly is a At St. Joseph’s, the St. Joseph’s Parkwood Institute, she partnership,” she says. Accreditation Canada felt a wash of connection and pride. “Every voice is important. surveyors recently evaluated On this particular day, Joan’s story At the conclusion of the survey the organization’s performance process, St. Joseph’s was awarded Each experience is against a total of 1,980 and the stories of other patients and family caregivers were being heard Accreditation Canada’s highest important… and even standards of which 1,973 as part of an Accreditation Canada distinction: Accredited with small changes can (99.6 per cent) were met. cascade into big changes St. Joseph’s, which has already survey that took place this past fall. Joan Hubert is a patient advisor on the Quality Committee of St. Joseph’s Health Care London’s Exemplary Standing. held the highest designation Board of Directors. Following a traumatic car accident in 2016, Joan Hubert spent more than five for you and for others.” These stories were shared to access months as an inpatient at Parkwood Institute. One of the Accreditation Canada given by Accreditation Canada surveyors recognized a ‘secret sauce’ for the past eight years, once strengths and weaknesses in how — JOAN HUBERT, again received “Accredited services are offered and accessed, behind the organization’s success. PATIENT ADVISOR with Exemplary Standing,” and to deepen understanding of all. Having spent time in a shared A strong voice for continuous extending the title to 12 years. the lived experiences of patients room during her recovery, Joan improvement, Joan has recently and families. recalls some of the challenges taken on the role of patient advisor “It was powerful to listen to other that can come with balancing on the Quality Committee of patient and caregiver stories – to everyone’s needs. St. Joseph’s Health Care London’s learn about their journeys and Board of Directors. “The intentions of a policy may involvement with the organization,” be good, but it also needs to work A HEALTHY remarks Joan. “Many have been in practice. Working as partners involved for several years and each made that possible,” Joan says, Across St. Joseph’s, DOSE OF has had a real impact.” During the panel discussion, Joan “As patients and caregivers, we were encouraged to sit together patients and family caregivers are providing EXPERT shared her involvement with the development of a new Family with staff and work through scenarios and solutions.” valuable insight based on their experiences. ADVICE Presence policy, which came Patient and family advisory They are essential into effect across all St. Joseph’s committees at each site of partners impacting sites in June 2019. The policy was St. Joseph’s are another mechanism the following areas: St. Joseph’s DocTalks program SNEAK PEEK AT THE 2020 developed jointly by staff, patients through which individuals share is back by popular demand with DOCTALKS LINEUP and family caregivers through a their voice and lived experience • Patient care an informative and enlightening series of lectures by experts Feb. 4 Dr. Janet Pope Rheumatoid arthritis co-design process that included with the organization. These groups • Organizational a working group and engagement work with staff and physicians to at St. Joseph’s Health Care Mar. 11 Dr. Tom Sheidow Retinal disease and vision loss processes workshops at each site. drive innovation and improvement. London. From today’s most • Education pressing health issues and the May 27 Dr. Viraj Mehta Substance use and mental illness Bringing patient and family Changes to wayfinding to ease and research latest treatment options to July 22 Dr. Collin Clarke Managing chronic pain caregiver voices to the table navigation for patients and family caregivers, the design of new new research findings these provided integral context for the • Environment Nov. 25 Dr. Ken Faber Shoulder surgery and upper limb health lectures are also an opportunity policy, which replaced traditional spaces, furnishing decisions and and design menu selections are just a few to showcase the role of visiting hours. Family caregivers • Quality philanthropy and the difference Attendance is free but advance registration is required. are now welcome based on patient examples of the impact of these improvement donors make in advancing Visit sjhc.london.on.ca for more information and to receive notification wishes, respecting the care needs, committees. patient care. when registration opens for each lecture. well-being, safety and security for • Staff recruitment 25 01 ISSUE www.sjhc.london.on.ca 26
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