Workplace violence Enough already - Special Focus: Professional Development + Education - Hospital News
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Special Focus: Professional Development + Education
Inside: From the CEO’s Desk | Evidence Matters | Safe Medication | Long-term Care
www.hospitalnews.com January 2022 Edition
FEATURED
Enough already
Workplace violence
Page 8
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Contents
January 2022 Edition
IN THIS ISSUE:
THE 20TH ANNUAL SUPPLEMENT
William Osler
Health System
goes beyond for its
Development people
+ Education
6
www.hospitalnews.com JANUARY 2022 HOSPITAL NEWS 17
▲ Cover story: ▲ Special Focus:
Enough already: Professional
Workplace Development
violence + Education
8 17
▲ Cultivating ▲ A shortcut to
COLUMNS culture at Halton immunity: Saving
Healthcare lives through early-
Editor’s Note ....................4
stage COVID-19
In brief ..............................6
38 treatment
From the CEO’s desk .....14
Safe medication ............16 5
Evidence matters ...........36
Long Term care ..............37 ▲ Emergency A creative
department tackles reprieve
workplace violence with for healthcare
two new safety tools workers
12 20
The trouble with ‘resiliency’ 610 Applewood Crescent, Suite 401
Vaughan Ontario L4K 0E3
TEL. 905.532.2600|FAX 1.888.546.6189
It’s time to get to the root causes of www.hospitalnews.com
healthcare worker burnout
Editor
Kristie Jones
editor@hospitalnews.com
By Irving Gold Advertising Representatives
Denise Hodgson
ver the last several years, there has been an But these are just band-aid solutions. denise@hospitalnews.com
O increasing recognition that burnout is ris-
ing exponentially among healthcare work-
ers – and there has been a positive shift in
Resiliency toolkits and online resources do nothing to
address the actual causes of healthcare worker burnout
and mental health distress. The root causes are policy-
Publisher
Stefan Dreesen
stefan@hospitalnews.com
the public understanding of burnout and other mental and system-wide and not related to the shortcomings of Accounting Inquiries
health issues in general. Unfortunately, the policy re- healthcare workers themselves. accountingteam@mediaclassified.ca
sponse from governments, healthcare institutions and Among those I represent, Canada’s medical radiation Circulation Inquiries
policy-makers has been woefully inadequate. technologists who administer radiation therapy to can- info@hospitalnews.com
Instead of addressing the root causes of burnout and cer patients, and do the X-rays, nuclear medicine, MRIs, Director of Print Media
mental distress among our healthcare workers, both be- and CT scans that allow doctors to diagnose and provide Lauren Reid-Sachs
fore and as a result of COVID-19, what has been their medical treatment, burnout is rampant. Senior Graphic Designer
response? A proliferation of toolkits and do-it-yourself re- Promoting personal resiliancy is not a solution for in- Johannah Lorenzo
sources developed and directed at healthcare workers that adequate staffing, unreasonable workload expectations,
focus on helping them build their own personal resiliency. or insufficient leave. These are the issues that need to be
On the surface, providing resources to healthcare addressed, and only governments, employers and leaders ADVISORY BOARD
workers to maintain or improve their mental health in the health sector can do it. Barb Mildon,
seems like a laudable goal. Who could argue against de- Healthcare decision-makers at the federal, provin- RN, PHD, CHE
VP Professional Practice & Research & CNE,
livering these resources to a group that is suffering? But cial and institutional levels need to take this issue on Ontario Shores Centre for Mental Health Sciences
it’s the wrong approach at the wrong time, and carries in earnest. Those with power and access to the levers Helen Reilly,
negative consequences. of change must stop hiding behind issues of jurisdiction Publicist
Framing the issue of burnout as a lack of resilience is and their singular focus on cost as justifications for in- Health-Care Communications
a classic example of victim-blaming. It places the caus- action. Jane Adams,
President
es, effects and solutions to the problem squarely in the The pandemic has shown us that when governments Brainstorm Communications & Creations
hands of those suffering from it. face a national crisis, they can collaborate and surmount
Bobbi Greenberg,
Let me be clear; there is absolutely nothing wrong enormous challenges. Canada is emerging from the pan- Health care communications
with providing resiliency training or resources that focus demic injured, but compared to other countries, we have Sarah Quadri Magnotta,
on things like mindfulness, yoga, meditation, breathing fared fairly well. This is due, in large part, to the people Health care communications
exercises, visualization and the plethora of other solu- that are the essence of our healthcare systems. Dr. Cory Ross,
tions on offer. They can all be useful tools for addressing If we continue to turn the car radio up to drown out B.A., MS.C., DC, CSM (OXON), MBA, CHE
the crisis, and I am sure, many healthcare workers use the sound of a malfunctioning engine, we will ultimately Vice President, Academic
George Brown College, Toronto, ON
and appreciate them. pay the price.
Continued on page 6 ASSOCIATE PARTNERS:
UPCOMING DEADLINES
FEBRUARY 2022 ISSUE MARCH 2022 ISSUE
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4 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.com
EVIDENCE MATTERS The MAB Clinic
team members.
MAB therapy vials.
A shortcut to immunity:
Saving lives through early-stage COVID-19 treatment
By Arden Bagni-Fast UNVACCINATED INDIVIDUALS
try, surgeries are being delayed and
healthcare workers are experiencing
hat images come to mind ARE BURDENING OUR HEALTHCARE SYSTEM, burnout. But Dr. Chagla sees this clin-
W when you think about
treating patients with
COVID-19? Likely pa-
tients on ventilators, family members
AND OTHER PATIENTS WHO NEED OUR
HOSPITALS’ RESOURCES AREN’T ABLE TO
ACCESS THEM
ic as the start of a solution.
“We can save lives, and not just the
patients who come into the clinic, but
those who come to the hospital with
separated from loved ones, over- other life-threatening circumstances.
whelmed staff and overrun hospitals. We are keeping those beds and re-
It’s a disheartening picture, but what to immunity” that clears the virus and The therapy has been approved by the sources available,” says Dr. Chagla. “It’s
if we could avoid those experiences prevents us from getting sick. World Health Organization and the especially important now, as we enter
altogether by treating patients early in Those who are vaccinated already Ontario COVID-19 Science Advisory one of the busiest times for hospitals
their disease progression? Good news: have COVID-19 antibodies stored, so Table. (winter). If we can avoid being at criti-
Healthcare providers at St. Joseph’s the therapy would be ineffective. But For now, Canada has access to this cal capacity, that’s a win for everyone.”
Healthcare Hamilton are doing just patients who have not been vaccinat- therapy delivered through a 30-minute
that in a new pilot program. ed, or whose bodies did not respond intravenous infusion, but Dr. Chagla WEIGHING SAFETY
Dr. Zain Chagla, St. Joe’s Co-Med- appropriately to vaccinations, have anticipates more products for early AND DUTY TO PATIENTS
ical Director of Infection Control, is not built up these antibodies, leaving treatment of COVID-19 will be avail- Initial feedback about the clinic has
leading a team that offers treatment for them vulnerable. able in the future, including those that been overwhelmingly positive. It has
patients with early-stage COVID-19. “There are people who cannot cre- are available by intramuscular injec- also raised important considerations
It’s Ontario’s first dedicated clinic of- ate these antibodies,” says Dr. Chagla. tion or oral capsules. about allocating resources to unvacci-
fering monoclonal antibody (MAB) “Not just those who are unvaccinated, nated patients during a pandemic.
therapy, and will help determine the but vaccinated individuals who are NO SUBSTITUTE “First and foremost, healthcare pro-
feasibility of such a treatment center immune-compromised. They are most FOR VACCINES viders have a duty to treat patients,”
in other locations across the country. likely to be hospitalized with serious Dr. Chagla stresses that getting vac- says Dr. Chagla. “Leaving your bias
complications, but now we can give cinated is still the best line of defense. at the door – whether you’re treat-
JUMPSTART THE them synthetic antibodies to jumpstart However, we have seen unprecedent- ing someone who is vaccine-hesitant
HEALING PROCESS the healing process.” ed levels of misinformation about the or not – is important. We do this in
Antibody treatment isn’t new: MAB therapy can save these pa- COVID vaccine, and various popula- other forms of infectious disease. If
We’ve used it for decades to treat pa- tients’ lives and keep unvaccinated, tions are skeptical of drastic govern- someone with HIV didn’t take the pre-
tients at risk of rabies after being bit- COVID-positive patients out of hospi- ment-mandated health policies due to ventive measures available to them,
ten by a rabid animal. In the case of tals. This allows our strained systems historical mistreatment. Unvaccinated we wouldn’t deny them care. We are
MAB, antibodies latch onto COVID to direct resources to other patients individuals are burdening our health- here to help patients and use the ev-
spike proteins, preventing the virus who need them. Initial studies show care system, and other patients who idence-based tools accessible to care
from invading healthy cells. And they a 71 per cent reduction in hospitaliza- need our hospitals’ resources aren’t for them the best way we can. And in
work fast, giving our body a “shortcut tions and a 70% reduction in death. able to access them: Across the coun- this case, we are saving lives.” ■
H
Arden Bagni-Fast is a Public Affairs Specialist at St. Joseph’s Healthcare Hamilton.t
www.hospitalnews.com JANUARY 2022 HOSPITAL NEWS 5
IN BRIEF
William Osler Health System
goes beyond for its people
tinued demands of the COVID-19 pan- silient teams, Schwartz Rounds are a
By Catalina Guran demic can leave staff feeling tired and live, one-hour, interdisciplinary forum
he last two years have tak- Osler’s respite initiatives, play a vital that aim to create open, honest and
T en a toll on the health care
system and, most of all,
on its people. Although
role in helping staff stay Osler Strong.
“It’s not so much what we’re giving
them,” explains Kiran Patel, Clinical
Services Manager, Cardiac Diagnostics
safe space where participants can can-
didly share their ideas, thoughts and
feelings.
Due to the nature of their work,
health care workers are experienced
and trained to be resilient, commit- and Cardiac Rehab at Osler. “It’s that health care professionals often carry
ted to their patients and dedicated special moment to just say, ‘I’m think- stress and emotional trauma, and the
to their profession, the COVID-19 ing about you. I know today’s a really pandemic has compounded this. Osler
pandemic has been challenging for busy day and you probably haven’t had team members who attend Schwartz
everyone. Thankfully, ‘health care a chance to get to the respite room, so Rounds gain greater insight into their
heroes’ continue to be there every we’re going to bring it to you.’ It’s just feelings, grow their capacity for com-
day to care for their patients, and it’s knowing that they can pause for that passionate care, and increase empathy
often the little things that keep them moment to think about themselves.” for individuals, patients, and their col-
going. That is why, in early 2021, leagues. Osler plans to hold Schwartz
William Osler Health System (Osler) SUPPORTING MENTAL Rounds four times a year.
implemented a Respite and Well-be- HEALTH WITH In line with its commitment to cre-
ing Program designed to offer a wide SCHWARTZ ROUNDS ate resilient, empathetic teams and
array of services and supports for Recently, Osler also implemented create a safe and healthy workplace
Osler teams, as they continue work- staff can go for beverages, treats, well- a new health and wellness initiative environment, Osler leverages these
ing around the clock to provide ex- ness resources, or for some quiet time. called Schwartz Rounds. One of the many resources to provide emotional,
ceptional care to the community. Managers can also sign out Compas- many ways Osler can put into practice physical and social support. Osler is
From outdoor yoga classes, mind- sion Carts packed with snacks and its Values of Compassion and Excel- proud to support its health care heroes
fulness moments, and Employee Fam- drinks for short shifts to bring around lence and help build healthy and re- always, to stay Osler Strong. ■H
ily Assistance Counselling, to Respite to their teams. It’s small actions, like
Rooms, ‘Compassion Carts’, virtual
choirs and seated relaxation chair
this, that have a big impact on teams.
Staff at all levels are appreciative of Trans people accessing acute
massages, Osler provides time and
space for staff to momentarily escape
the offerings but, Compassion Carts
are the most popular element of Os- mental health care more likely to
some of the pressures.
There is a dedicated Respite Room
ler’s Respite and Well-being Program.
Staying hydrated and healthy isn’t experience marginalization
at each of Osler’s three sites where always easy during busy shifts. The con- ransgender individuals disorders and suicidality, not because
Continued from page 4 T who access acute mental
health care are more likely
to experience marginal-
of their identity, but rather as a result
of their experiences with discrimina-
tion, oppression and marginalization,”
The trouble with ‘resiliency’ ization, present with mood disorders
and are twice more likely to be diag-
said lead author Dr. June Lam, a Staff
Psychiatrist at CAMH. “This study
If we don’t treat our healthcare contrary, we have barely begun the nosed with personality disorders than provides further data to support this
workers as a precious commodity we diagnostic process. the general population accessing these theory by looking at the experienc-
need to vigorously protect, we will be Healthcare workers need and deserve services. es of trans individuals who required
in trouble. much more than we are doing. We owe This according to a Centre for a mental health-related Emergency
We have weathered this pandemic them a true commitment to protect Addiction and Mental health – Department visit or hospitalization.
in relatively good shape. If we contin- their health and welfare, just as they (CAMH-) led study, “Characteristics Ultimately, the findings show an as-
ue along the path we are on, we may have committed themselves to ours. of Transgender Individuals Accessing sociation between trans people who
not fare as well in the face of the next We have an obligation to address Emergency Department Visits and accessed acute mental health care and
health emergency. And, we will have the systemic issues eroding the morale, Hospitalizations for Mental Health,” their experience with socioeconomic
no one to blame but ourselves. physical and mental health, and spirit newly published in the journal Psychi- marginalization.”
The situation we find ourselves in of our healthcare workforce. atric Services. The study is the first to The data collected for this study
is curable; it does not require a pal- Our goal must go beyond helping use administrative health data to ex- came from 728 transgender individuals
liative approach. We have not ex- healthcare workers to survive. They plore how transgender patients access who visited the Emergency Depart-
hausted all of our options. Quite the deserve to thrive. ■
H mental healthcare services. ment and 454 transgender individuals
“It’s been theorized that trans people hospitalized for mental health-related
Irving Gold is the Chief Executive Officer of the Canadian Association of experience a disproportionately higher reasons, and who were aged 16 and
Medical Radiation Technologists. rate of mental illnesses, substance use above. The data originated from four
6 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.com
IN BRIEF
New guideline:
Equitable COVID-19 pandemic recovery in Canada
rom income to housing direct harms of COVID-19 abate, but
F to addressing racism and
more, a new guideline pro-
poses 13 ways to address
their recommendations may need to
be in place for months, years or as per-
manent solutions.
inequities exposed and worsened by Thirteen recommendations to ad-
COVID-19 in the pandemic recovery dress health inequities:
period. The guidance is published in
CMAJ (Canadian Medical Association INCOME
Journal). • Ensure a living income
If not addressed, these inequities • Universal unemployment insurance,
will continue to threaten the health of parental leave and paid sick leave
many Canadians. • Affordable loans
“Coordinated pandemic responses
include efforts to return life to ‘nor- HOUSING
mal’ after the immediate threat, but • Expand permanent supportive hous-
the COVID-19 pandemic has under- ing programs
scored the need to address inequities • Expand access to eviction prevention,
rather than resume the unfair status legal services and financial advice
quo,” writes Dr. Nav Persaud, a fam-
ily physician at St. Michael’s Hospital, INTIMATE PARTNER
Unity Health Toronto, scientist and VIOLENCE
Canada Research Chair in Health Jus- • Legal advocacy and supportive in-
tice at MAP Centre for Urban Health terventions for victims
Solutions, and associate professor,
University of Toronto, with coauthors. CHILDHOOD
The authors define the pandemic • Expand publicly funded childcare
recovery period as the stage when the • Healthy food distribution to children
outpatient health clinics in three cities gender people virtually invisible in
(Thunder Bay, Ottawa and Toronto) the healthcare system. We were only
across Ontario. All four clinics have able to identify transgender individ-
expertise in working with transgender uals through looking at data where
individuals and regularly collect data physicians or a health clinic asked
on self-defined gender identity. Re- their patients how they identify. This ACCESS TO HEALTH CARE “The pandemic recovery period
• Expand access to opioid substitution represents an opportunity to address
searchers used Health administrative research makes a strong case for the
therapy and supervised injection sites health inequities that have led to an
data held at ICES, an independent, need to identify transgender people
• Expand HIV and HCV screening for unfair distribution of the burden and
non-profit research institute, to conduct in the healthcare system. By creating
people at high risk harms of COVID-19. Policy changes at
this study. For each transgender sample, more transgender-inclusive systems
• Include prescription medicines in the federal, provincial and municipal
the researchers created two comparison and data collection practices, we can
Canada’s publicly funded health levels that promote health equity had
groups to understand the ways in which integrate inclusive response options to
care system been studied before this pandemic, and
the transgender population differs from better understand the experience and
• Improve health care for people who they should be implemented before the
the general population of those who ac- health of transgender individuals.”
are incarcerated next one,” the authors conclude.
cess acute care in Ontario. This study concludes that care pro-
“It is the societal and structural prob-
One limitation to the study, accord- viders can greatly improve the health-
ing to the authors, was that transgen- care services that transgender people RACISM lems that abetted the spread of SARS-
• Action on previous recommenda- CoV-2 – not the pandemic’s economic
der individuals identified were from receive through examining the unique
tions to address anti-Indigenous dis- effects – that have made COVID-19
clinics in larger cities in Ontario, needs and challenges of this popula-
crimination and anti-Black racism such a devastating crisis. COVID-19
which may not be representative of tion, ensuring the representation of
Addressing racism is particularly has taught us about the dangers of weak-
the experiences of individuals living in trans people through inclusive intake
important, as racialized people were nesses in the fabric of society. Canada’s
smaller cities and rural areas. response options, and closing the gaps
disproportionately affected during the policy-makers would do well to follow
Study co-author Dr. Alex Abramov- that exist for trans people who access
pandemic, with higher rates of SARS- Persaud and colleagues’ suggestion that
ich, an Independent Scientist with the care. It also calls for additional re-
CoV-2 infections and deaths. postpandemic policy-making centre
Institute for Mental Health Policy search into experiences of transgender
With heightened awareness of in- equity to ensure that all Canadians can
Research (IMHPR), said: “Typically, individuals presenting for acute men-
equities and a commitment from the benefit, and to protect against looming
when viewing administrative health tal healthcare, particularly around the
federal government to reduce pover- future threats,” writes Dr. Kirsten Pat-
data, patients are only classified as role that marginalization and discrimi-
ty by 50% by 2030, the time to act is rick, interim editor-in-chief, CMAJ, in
male or female. This makes trans- nation may play. ■ H
now. a related editorial. ■ H
www.hospitalnews.com JANUARY 2022 HOSPITAL NEWS 7
COVER
Enough already:
Workplace violence
By Henrietta Van hulle conducted by the Canadian Union of
Public Employees (CUPE) and SEIU
he risk of violence is Healthcare found that 66 per cent of
T nothing new to Canada’s
healthcare workers.
In my 17 years as a
frontline nurse, I was hit, pinched,
the more than 2,600 respondents said
violence toward them or their cowork-
ers from patients or patients’ family
members has increased in the last 18
scratched and verbally abused. Thank- months. Hostility stemming from the
fully these incidents never resulted in pandemic is making an already stress-
serious injury. But I know I was one of ful job that much more difficult. In the
the lucky ones. same poll, 87 per cent of RPNs said
Throughout Canada’s health care they have considered leaving their jobs.
sector, violent incidents and acts of If these behaviours are allowed to
aggression continue to escalate in continue or worsen, the work environ-
both frequency and severity. Health- ment and quality of care is certain to
care workers describe violent events suffer. As feelings of anxiety and vul-
as daily occurrences, some so serious nerability deepen, workers may disen-
that they result in a range of physical gage, become less productive and feel
or psychological issues, from chronic less committed to their work, regard-
mental stress to anxiety, depression or less of whether they are the target of
post-traumatic stress disorder. the abuse. Failure to address inappro-
According to Ontario’s Workplace priate and unacceptable behaviours
Safety and Insurance Board, assaults, has financial consequences, too.
violent acts and harassment in the Workplaces can experience increases
province’s healthcare sector have in lost-time from work, workers com-
steadily increased over the past sev- pensation costs or health and medical
eral years, nearly doubling from 2012 expenses. Employers may also face
to 2019. Workplace violence was the charges, lawsuits or other legal action
cause of 14 per cent of all lost-time in- as a result of inaction and failure to
juries in 2019 in the healthcare sector protect workers.
– more than the injury claims allowed Every worker should expect a safe
for exposures to harmful substanc- and healthy work environment; vi-
es or environments. In 2020, while olence should never be tolerated as
COVID-19 exposures accounted for part of the job. Hospital employers
the majority of lost-time injuries in
Ontario’s healthcare sector, workplace
SURGE IN WORKPLACE VIOLENCE THE LAST and management have a duty to pro-
tect employee health and safety and
violence remained among the top five STRAW FOR CANADA’S PANDEMIC-WEARY address unsafe working conditions,
injury types, with 993 cases. HEALTHCARE WORKERS including includes taking action to
As alarming as these figures are, it’s prevent violent acts and threats of vio-
only the tip of the iceberg. The reali- lence. Ontario’s Occupational Health
ty is likely more shocking as incidents mental health resources, overcrowding the inability to say goodbye or carry and Safety Act (OHSA) requires em-
of violence and aggression have been and wait times, and staffing shortages, out funerals or other rituals as they’d ployers to assess the risks of workplace
found to be severely underreported. just to name a few. Now, we add pan- like. Hospital workers are dealing with violence and implement a policy and
Research indicates that this is most of- demic-related tensions to the list. confrontations related to the enforce- prevention program. Here are just a
ten associated with the normalization Perhaps unsurprisingly, COVID-19 ment of public health measures. Out few examples of recommended pro-
of violence among healthcare workers, has exacerbated the situation. The in the community, healthcare work- gram elements.
and is attributed to the belief that vi- pandemic has created an emotion- ers have been stigmatized, harassed,
olence is simply “part of the job”. Red ally-charged environment ripe for threatened or assaulted for fear of CONDUCT REGULAR
tape, blame, lack of response from aggression and violence, both in the spreading the virus. WORKPLACE VIOLENCE
management and fear of reprisal are hospital setting and out in the com- Recent polling shows verbal, phys- RISK ASSESSMENTS
among other reasons. munity. Some patients are prompted ical, sexual and racially directed vio- In Ontario, the OHSA states that
The rise in incidents can be attribut- to commit aggressive acts out of fear lence against healthcare staff surging employers must assess and control
ed to an aging population, increasing for their health. Family members are during the pandemic. A large provin- risks of workplace violence arising
rates of dementia, a lack of access to responding to the loss of relatives, cial survey of hospital-based RPNs from the nature of the workplace,
8 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.com
COVER
type of work and conditions of work. spond to workplace violence. Health-
Workplace violence risk assessments care organizations are also encouraged
enable the healthcare organization to establish effective Personal Safety
to identify risks and prioritize action. Response Systems that can effectively
This needs to be done as often as nec- summon immediate assistance for im-
essary to ensure that organizational pending workplace violence situations
policies and programs continue to or incidents in progress. Recent protests
protect workers. For these reasons, a at healthcare settings would indicate a
workplace violence risk assessment review of current security practices.
should be completed at least annually,
though each organization should have COMMUNICATE
its own processes for determining how THE WORK REFUSAL
often to complete an assessment, and PROCESS
when to evaluate the effectiveness Workers in Ontario have the legal
of the process. In light of the recent right to refuse work or refuse to do
intimidation healthcare workers are particular work that they believe en-
facing just by going to work, this new dangers them, including situations of
risk should be assessed to ensure the workplace violence. This legal right
workplace measures and procedures ensures that workers have a voice in
address this new threat. situations of real or perceived dan-
ger. Employers, supervisors and Joint
ENABLE A RISK Health and Safety Committees (JHSC)
COMMUNICATION need to define and support their orga-
OR FLAGGING-ALERT nizational response to work refusals for
PROGRAM reasons of workplace violence. Work-
Employers in Ontario are required ers must also understand their right to
to provide all workers at risk with in- refuse unsafe work as well as any relat-
formation (including personal infor- ed processes.
mation) about a person with a histo- Of course, these are only a few of
ry or risk of violence. Workplaces, in the actions hospital management and
turn, must adopt effective prevention human resources departments can de-
strategies. One such strategy is a flag- velop, implement and manage to con-
ging-alert program to communicate trol the risk of violence and prevent
violence-related risks to healthcare violent incidents. When developing
teams. By taking this kind of proactive a fulsome workplace violence preven-
approach to managing violent, aggres- tion program, hospitals are encouraged
sive and responsive behaviours, hos- to build off established leading practic-
pitals can reduce the risk of harm to es for workplace violence prevention
workers while providing patients with in healthcare.
the best possible care. An example comes from Public
Services Health & Safety Association
ESTABLISH EMERGENCY (PSHSA), an Ontario-based non-prof-
RESPONSE PROCEDURES it organization funded by the Ministry
Ontario’s OHSA requires employ- of Labour, Training and Skills De-
ers to develop and implement mea- velopment to reduce workplace risks
sures and procedures for workers to and prevent occupational injury and
summon immediate assistance when illness across the province’s public
workplace violence occurs or is likely and broader public sector. PSHSA has
to occur. One important measure is a released eight workplace violence pre-
formal emergency response procedure vention toolkits specifically designed
to workplace violence, also known as for healthcare organizations to address
Code White. Code White is used in the largest gaps in workplace violence
many healthcare settings to alert work- prevention programs. Applicable to
ers to a real or perceived threat of vi- healthcare organizations of any size,
olence, which includes aggressive or the toolkits contain practical tools
responsive behaviours. Formal Code and resources for each of the afore-
White procedures also ensure there mentioned areas – risk assessment,
is standardization and consistency in flagging, emergency response, work
the response to workplace violence. refusals – and more to help healthcare
Everyone in the workplace needs to organizations control the risk of work-
be trained in the emergency response place violence and protect workers.
procedures and understand how to re- Continued on page 13
www.hospitalnews.com JANUARY 2022 HOSPITAL NEWS 9
NEWS
Keeping staff safe and
secure for years to come
By Paul Baratta IF THERE’S A NEED FOR MORE ADVANCED
which staff respond to patients. Some
mental health wards in the UK have
n recent years, there has SECURITY REQUIREMENTS, FACILITIES CAN experienced a 28 percent reduction in
I been an increase in the
workplace violence rate
in hospitals. Canada, the
United States, and Australia have said
CONSIDER A MORE ROBUST SOLUTION THAT
ENCOMPASSES AN ARRAY OF TECHNOLOGIES
NOT SOLELY SURVEILLANCE OR SECURITY
workplace violence due to implement-
ing body worn video solutions.
Nowadays, more people are brought
to emergency rooms by law enforce-
that workplace violence is a pandem- RELATED. ment. They are evaluated for mental
ic of itself in healthcare, where clini- health reasons, and hospital security
cians, security and nursing are dealing directors and clinical staff are report-
with physical and verbal attacks more reducing the number of shared access care centres better protect against ing incidents of hostile behavioural
than ever before. points. It can also be paired with a unauthorized access, drug diversion, events and an increase in physical and
It’s, of course, no surprise with the third-party system to automatically and protection of PPE and sensitive medical restraints. With body worn
current pandemic healthcare crisis, open and shut doors – further remov- patient files. solutions, staff have reported a de-
talent shortages, protesting and over- ing the need to touch any surface, Within hospitals and urgent care crease in events, restraints, and other
all, an environment of heightened such as a door handle. facilities, there are numerous locations intervention due to both security and
aggression. Hospitals and urgent care The type of access control solu- that need to be well-secured. For ex- clinical staff announcing they are re-
personnel are working around the tion required, depends on a hospital’s ample, restricted units with immune cording the event. The warning to
clock treating COVID-19, managing needs. For small, basic installations, compromised patients, surgical units, people that they are being recorded,
patient backlog and soon, we will be low touch access control that utilizes or quarantined areas. An access con- reduces the incidence of violence, and
amid that predicted autumn/winter a QR code could do the work. It cre- trol system helps by ensuring only au- provides for documentation in case of
surge with a looming flu season not ates a credential with validity date thorized personnel enter these zones. the need for persecution.
far off. and time. In this case, the employee If operations are looking to safeguard Other use cases for wearables in
As a result of this increased volatile receives the QR code, and from there, these quarters and mitigate the spread healthcare include documenting the
atmosphere, hospitals and urgent care the network door controller receives of infection, something like low touch movement of patients from hospital
centres have been looking into mod- their information and recognizes them. access control is ideal. beds to specialized departments, such
ern technologies and asking how such When they use the QR code, the sys- Outside of a hospital setting, you as for x-rays, and in behavioural health
can help provide quality care while tem grants them access. Facilities can can potentially have control over the wards to document staff interaction
minimizing in-person visits to decrease use a similar setup with RFID. system wherever you are with remote with patients and their guests. Clinical
the possibility of exposure. Further- If there’s a need for more advanced monitoring and communication. From staff may consider using these devices
more, there are questions on it that security requirements, facilities can any location, you can remotely open a to document surgeries, facilitate train-
can be used to help better protect PPE consider a more robust solution that door or speak to the person via your ing purposes, and in simulation rooms
equipment in temporary facilities, and encompasses an array of technologies smartphone. A forced or propped with student residence.
provide additional safety, health, and not solely surveillance or security re- open door can automatically trigger an
security protection for staff and even lated. Such a system, takes advantage alarm – this could improve business ef- PRIVACY SHOULD BE
patients. of the latest analytics and integrates
seamlessly with other systems, such as
ficiencies as it reduces false alarms and
makes managing staff easier.
AT THE FOREFRONT
As we are witnessing, the impact One common theme to consider,
of COVID-19 is not short-term. It’s intrusion detection, HVAC unit, HR and this applies to all surveillance
driving the need for facilities to put systems, etc. Depending on the sys- THE ROLE OF solutions in hospitals and urgent care
into place long-term practices and tem, the network intercom or video WEARABLE SOLUTIONS facilities, is around patient and visitor
adopt new technologies. Technologies door station, for example, could even Wearable solutions have demon- privacy.
that improve hospital and urgent care play a pre-recorded announcement for strated they can decrease violent Camera devices seem to be a con-
management today, but also address the visitor to wear a mask before enter- events in healthcare facilities. These cern regarding the expectation of
requirements for tomorrow. ing the building. devices have been employed in some privacy of patients, staff, and visitors
Hospitals can screen employees, vis- healthcare facilities with audio solu- given the sensitivities of the health-
ACCESS CONTROL itors, and vendors upon entry by using tions, by security and clinical staff to care environment and the legal and
ACTS AS A FORCE a cross-line detection application, net- document events and situations. regulatory circumstances they require.
MULTIPLIER AND PUTS work surveillance camera, and a net- If hospitals are looking to decrease A set of standards have been put
SECURITY IN FOCUS work horn speaker. When someone
enters a predefined area, the solution
violent instances, wearable solutions into place to protect certain health-
Preventing the transmission of are quite effective at doing this. Con- care information, and this type of vid-
coronavirus in high traffic healthcare automatically triggers an audio mes- sider a recent study by the National eo footage qualifies as such: this law in
settings is without question, critical. sage. Health Services of Great Britain. It Canada is instituted by the provinces
Hospitals can get a handle on the Along with helping to mitigate the showed a reduction of violence to- as a Personal Health Information Pri-
virus by utilizing an access control spread of viruses, access control solu- wards nurses, other clinical staff, and vacy Legislation for the Health Sector.
tions can help hospitals and urgent users. It’s also moderating the way in
system. This eliminates keypads thus Continued on page 13
10 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.comNEWS
Emergency department tackles workplace
violence with two new safety tools
By Robyn Cox
or physicians and staff in
F
the job.
the Emergency Depart-
ment (ED), physical and
verbal abuse is a reality of
A 2017 study of Ontario Council
of Hospital Union members found 68
per cent of frontline staff said they had
been physically assaulted in the past 12
months – with 86 per cent having ex-
perienced verbal violence in the same
period. And more anecdotal reports
and surveys suggest the pandemic has
exacerbated the problem.
“Violence has always been present
in our work, but I feel it has gotten
progressively worse,” says Kerri, who
works as a nurse in the ED at St. Mi-
chael’s Hospital of Unity Health To-
ronto and asked to be identified by her
Dr. Justin Logan and Kerri (first name), an ED nurse, stand outside the Emergency Department at St. Michael’s
first name. “COVID-19 has increased
Hospital (Photo by Yuri Markarov)
people’s stress level. What we’re see-
ing now is that stress becoming over- hospital’s safety event reporting system acknowledging that everyone who physicians. The campaign included
whelming – and a visit to the ED is and will identify if the patient was in- comes through those doors is not at a blitz of awareness-building on how
often the breaking point.” volved in violent incident in the past their best – and understanding that to use the new tools and an oppor-
A year ago, in the midst of wave six months. Current behavior is mea- we can do little things that can make tunity to facilitate honest conver-
two, the team in the St. Michael’s sured using the Acute Care Violence their day better.” sations about the ED team’s experi-
ED had reached a crossroads. “Be- Assessment Tool created by the Public Suggestions on the Agitation Road- ences with violence.
tween what we knew was statistically Services Health & Safety Association map include asking team members, “We’ve been having regular safety
true about workplace violence in the (PSHSA) – which takes into account such as such as a community support huddles – both morning and evening
ED and what we had anecdotally or behaviours like confusion, paranoia worker, mental health nurse or physi- to cover both shifts. We’re giving
personally experienced, there was a and verbal or physical threats to pro- cian, to check-in on a patient. The pa- staff an opportunity to ask questions.
sense that enough was enough and we vide an overall risk rating. tient may be feeling agitated because We’re explaining the Safety Dash-
needed to take control of this situa- “The Safety Dashboard can be they need food, water, warm clothing board and the Agitation Roadmap to
tion and act on it,” says Justin Logan, launched on the desktop of any ED or pain management. A patient may encourage uptake,” says Logan. “It’s
a physician in the ED. team member to give them situational also receive warnings from nursing or going to take a period of sustained
Logan and Kerri are members of the awareness of what’s happening in the security to ensure they know that ver- communication and support to really
St. Michael’s ED Safety Committee, department,” says Logan. “It’s updated bal abuse and violence won’t be tol- engrain these initiatives into our reg-
which brings together nurses, physi- every 15 minutes. If a patient’s vio- erated. If agitation continues despite ular protocols in the ED.”
cians, security personnel and other lence assessment tool rating goes up or warnings, a physician will be notified Logan and Kerri are quick to note
members of the ED team to improve down during their time in the ED, it’s to support timely decision-making on that improving safety in the ED is
safety in the department. Over the reflected on the dashboard.” the patient’s care plan. about long-term change and will take
past year they and their colleagues on While the Safety Dashboard sup- “These initiatives are about our peo- long-term strategies.
the committee have developed two ports awareness on the team, the Ag- ple being safe so they can provide the “This is only a starting point. It’s
safety initiatives: the Safety Dash- itation Roadmap empowers ED team best possible care,” says Kerri. “Our not a one-and-done situation,” says
board and the Agitation Roadmap. members to take action based on that patients are the reason we are working Kerri. “This is a culture change –
The Safety Dashboard is a digital awareness. It provides specific steps to – and that includes patients who are and that takes time. Over the last
tool that looks at the history of a pa- help manage difficult situations and agitated. These tools help us to think year, I’ve witnessed my colleagues
tient and their real-time behavior to suggestions to support patients who are about how we can approach the situa- have a voice and make their con-
give healthcare providers an under- agitated during their stay in the ED. tion safely and compassionately.” cerns known. It’s extremely import-
standing of whether the patient has “I don’t think anyone who comes Both tools launched in Novem- ant because change can only hap-
a mild-moderate or high risk of vio- into the ED is having a good day,” ber as part of the ED’s ‘No Violence pen through open communication
lence. The dashboard pulls from the says Kerri. “Sometimes it’s about November’ campaign for staff and and continual improvement.” ■ H
Robyn Cox is a Senior Communications Advisor at Unity Health Toronto
12 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.comNEWS
Continued from page 10 Continued from page 9
Keeping staff Workplace violence
The validated, consensus-based long. And now, as violent incidents
toolkits were built in partnership with continue to rise amid a growing fourth
safe and secure stakeholders across Ontario’s health-
care sector and are available free of
charge at www.workplace-violence.ca.
wave, where healthcare workers are al-
ready overwhelmed, burnt out and ex-
hausted, they’ve hit a breaking point.
However, under law enforcement centres should not be a short-term
laws, hospitals will only disclose fix unless it’s for a temporary fa- An evaluation of the initial five tools By building meaningful, cohesive
health information if required by law, cility. They should be adopted was completed to better understand and multi-faceted workplace violence
under court order, warrant or sub- with the intention of them being their awareness, use and effectiveness prevention programs, Canadian hospi-
poena to identify or locate a suspect, a long-term answer that can help among Ontario hospitals. Overall, 67 tals can deliver results and sustainabili-
fugitive, witness, or missing person. improve safety and quality of care per cent of public hospitals in Ontario ty in the prevention of violent incidents
In response to law enforcement, today, as well as in many situa- reported using at least one of the tool- and protection of their employees. In
officials will request information tions that could potentially occur kits and, of these, 89 per cent reported turn, this will create a climate where
about a victim or suspected victim of in the future. improving their processes, programs and workers feel comfortable coming for-
a crime to alert law enforcement of a Security and operations teams, systems to prevent and manage work- ward with concerns and improves the
death. Hospitals are obliged by fed- need to ask themselves “Where place violence. Hospitals used the tool- ability to recruit and retain employees.
eral and local laws to inform police do we start”? They should look kits most often to identify safety risks, We know that healthcare workers
of any serious crime, the location to partner with a provider that consider safety proactively in planning play an integral role in our communities
of the victims, and perpetrator of a will work with them by under- and validate or improve existing efforts. and are our healthcare system’s great-
crime if they have the information. standing their facility’s unique While the risk of workplace violence est asset. Ensuring a healthy healthcare
requirements. Network surveil- is nothing new to Ontario’s healthcare workforce free from violence will help
SURVEILLANCE lance solutions should be inte- workers, it’s been tolerated for too sustain quality care for all Canadians. ■H
SOLUTIONS grated with other systems, and
Henrietta Van hulle is Vice President, Client Outreach at Public Services
Surveillance solutions installed they should be adaptable, flexible
and scalable. ■ Health & Safety Association. Henrietta began her career as a Registered
today by hospitals and urgent care H
Nurse where she cared for patients for 17 years before transitioning to
Paul Baratta is the Segment Development Manager for healthcare occupational health and safety.
for Axis Communications.
PCR Testing Standardized Molecular Testing
Diagnose with Confidence for Acute Care Settings
Scalable Design: 2-, 4-, 8- and 16-module
options available for customized throughput needs
Random Access: True, on-demand
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Easy Integration: No specialized training
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2 Transfer sample to cartridge
GO 3 Insert cartridge and start test
For more information visit www.cepheid.com/En_CA
For In Vitro Diagnostic Use.FROM THE CEO’S DESK
Test kits for staff
result in ‘multiple saves’
David Musyj is President and CEO,
Windsor Regional Hospital.
By David Musyj
Some are personal responsibilities like and doing the same to colleagues and in spread of COVID-19 between staff.
ince the start of COVID-19 wearing appropriate PPE, washing patients. As a result, in August before We looked at limiting the number of
S Windsor Regional Hos-
pital (WRH) has learned
that we need to review
the science and research and be able
hands and staying home if sick. Others
are shared responsibilities like vacci-
nation, quarantine and isolation and
border controls or stay at home orders.
school started we purchased rapid an-
tigen test kits and provided them to
staff for surveillance use at home. The
fast testing referred to by Dr. Mackay.
persons in each room at any given
time as well as tried various dividers
between staff with social distancing.
However, air ventilation and filtration
to make changes quickly and safely for Two shared responsibilities that are This has resulted in multiple “saves” to was not fully known. The addition of
the protection of patients, staff and also very important that sometimes that has possibly avoided spread in our C02 monitors in staff rooms allows for
our communities. From adapting to are not focused on is fast and sensitive community, schools or hospital. WRH an objective measure of air ventilation
changes involving the appropriate per- testing and appropriate air filtration team members have shared their sto- that has been used by multiple coun-
sonal protective equipment to clinical and ventilation. ries thanking the hospital team for tries across the world. The WRH staff
treatment of patients adapting to what At WRH we have implemented a making these rapid antigen test kits are provided with written materials on
we have learned over the last two years vaccine mandate for both staff and available to their family and avoiding the level of C02 to be aware of that is
has saved lives of both patients and visitors with limited exceptions for even spread within their own house- safe versus the level that indicates air
staff. In addition to adapting to chang- visitors as a result of being an acute hold due to fast testing and “acting circulation and ventilation is not ade-
es we learned not one item in and care facility with a trauma program. on the results”. Staff now use these quate and objectively determines that
of itself would protect our staff and However, we have also recognized test kits before they visit elderly loved the conditions are more favourable for
community. We had to use a layered that vaccines do not have 100 per ones or before they go to dinner with COVID-19 to be spread. At the end
approach to protection from acquiring cent efficacy. Also, many of our staff friends and family. Again, by itself the of the day you still need a positive
and/or spreading COVID-19. are parents or guardians to children antigen test kits are not perfect at pre- COVID-19 person in the room how-
Dr. Ian M. Mackay, a virologist that were not or still not eligible for venting spread. But added with other ever this objective measurement adds
at the University of Queensland, vaccinations. interventions it supports a defense to another layer to preventing the spread
in Brisbane, Australia, created the While at home, parents are not COVID-19. of COVID-19.
“Swiss Cheese Respiratory Pandemic wearing PPE with their children in Another intervention WRH added Similar to the Swiss Cheese mod-
Defense”. Dr Mackay’s model made their homes and as a result susceptible for its team members is carbon dioxide el that will continue to expand as we
it clear not one single intervention to acquiring COVID-19 and have lim- monitors (C02). During earlier waves proceed through this pandemic WRH
is perfect at preventing spread of ited symptoms as a result. This could it became evident at many health- will continue to actively monitor the
COVID-19 it takes multiple layers to result in a child returning to school care institutions across the world that science and research and implement
improve the success of preventing the and spreading COVID-19 to their staff rooms and areas in which staff changes that protect our patients, staff
acquisition and spread of COVID-19. class or the employee coming to work took breaks to eat or drink resulted and community. ■ H
David Musyj is President and CEO, Windsor Regional Hospital.
14 HOSPITAL NEWS JANUARY 2022 www.hospitalnews.comSPONSORED CONTENT
Disability claims – A primer
By Judith Hull & Katharine Creighton
s health care professionals,
A you are aware of the risk of
becoming disabled at any
age.
Prior to the pandemic, Canadian
workers took an average of 8.5 days of
leave for illness and disability in 2019.
The pandemic has had a signifi-
cant impact on frontline health care
workers’ mental health. A Statistics
Canada survey, Mental health among
health care workers in Canada during the
COVID-19 pandemic, February 2021,
revealed that 7 in 10 health care work-
ers reported worsening mental health
due to the pandemic.
For those who find themselves un-
able to continue working due to im-
paired mental health, chronic stress,
or other health-related disabilities, it is
important to understand which bene-
fits may be available to you.
Workplace Safety and Insurance
Benefits (WSIB) are available to
many hospital workers, provided that
the illness or impairment is sustained
by accident, arising out of and in the
course of one’s employment. Critically,
amendments to the Workplace Safety
and Insurance Act in 2017 now per- If your employer does not offer a disability benefits are often available CPP contributors who are under age 65
mit chronic or traumatic mental stress short-term disability plan, or you do either through a group plan (such as with a severe and prolonged disability,
arising out of and within the course not qualify for the benefit, you can your employer or union, college or as defined in the Canada Pension Plan
of the worker’s employment to be in- apply for Employment Insurance (EI) professional affiliations) or can be pur- legislation. There are two eligibility cri-
surable. A diagnosis of post-traumatic sickness benefits. EI benefits can pro- chased privately. Often, group plans teria for the CPPD program:
stress can also qualify certain enumer- vide you with up to 15 weeks of finan- provide basic coverage. For high-in- Ý$SSOLFDQWVPXVWKDYHPDGHFRQWUL-
ated workers for benefits, provided cial assistance if you cannot work for come earners, it is wise to purchase ad- butions to the program in 4 of the
certain conditions are met. medical reasons. You could receive 55 ditional long-term disability coverage last 6 years, with minimum levels of
privately. If you pay the entire amount earnings in each of these years, or 3
THE PANDEMIC HAS HAD A SIGNIFICANT of the disability premium yourself (e.g. of the last 6 years for those with 25
IMPACT ON FRONTLINE HEALTH CARE by funding your own private insurance,
or as a source deduction from your
or more years of contributions; and
Ý7KH\ PXVW GHPRQVWUDWH WKDW WKHLU
WORKERS’ MENTAL HEALTH. paycheque), your disability benefits physical or mental disability pre-
will be tax-free. If your employer pays vents them from working regularly
all or part of the disability premium, at any job that is substantially gain-
Your employer may also offer a per cent of your earnings up to a max- your disability benefits will be subject ful, and that it is long-term and of
short-term disability plan. Short-term imum of $595 a week. to deductions for income tax. indefinite duration or is likely to
disability insurance, as the name sug- Long-term disability benefits are Again, each disability plan is differ- result in death.
gests, is intended to replace a portion of intended to provide coverage for a ent so you should review your policy Not all disabilities can be plainly
your income for a short period of time longer period of time, generally up to to see what you might be entitled to seen or are easily recognized. The bene-
due to disability requiring you to be off age of retirement for those who qualify should the need arise. fits outlined above are intended to safe-
work. While each plan may vary, typi- and typically begin when short-term Another source of benefits is the guard you from an unexpected disabil-
cally, short-term disability will provide disability or EI benefits end. These dis- Canada Pension Plan Disability (CPPD) ity, including impaired mental health
coverage ranging from 60 to 80 per ability benefits typically replace 60 to benefits. They are intended to provide and chronic stress, that effects your
cent of your income for up to 6 months. 70 percent of your income. Long-term partial income replacement to eligible ability to work and earn an income. Q H
Judith Hull and Katharine Creighton are lawyers with the Personal Injury Team at McKenzie Lake Lawyers LLP. mckenzielake.com
www.hospitalnews.com JANUARY 2022 HOSPITAL NEWS 15You can also read
