Young patient volunteers in stroke rehab clinic - HHS Share
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Young patient volunteers in stroke rehab clinic Andrew Mathieson’s heart defect had to be monitored each year. He was born with a bicuspid aortic valve instead of a tricuspid valve, which means there are two leaflets of the aortic valve instead of three. This reduces blood flow from the heart to the rest of the body. Doctor’s noticed Andrew’s aorta started to enlarge to the point of danger. In December 2017 at 22 years old, Andrew underwent open heart surgery with Dr. Richard Whitlock at Hamilton General Hospital to repair the valve and the enlarged blood vessel. Following the surgery, Andrew experienced a stroke which left him with loss of vision when looking to his right side and difficulty with concentration and memory.
Andrew left the hospital near the end of January. Just six months after discharge, he wanted to give back. Through our Volunteer Resources program, Andrew began volunteering as a recreational therapist assistant in the Regional Rehabilitation Centre’s stroke rehab clinic where he received treatment. “I’m helping out with the same nurses that helped me out. They all know me by name. They find it amazing I’m helping out at the same spot where I met them for rehab,” he says. Andrew’s neurologist, Dr. Wes Oczkowski, says Andrew is taking his experience in stride. “The biggest difference compared to most people with a stroke is that he’s only 22. That means his potential improvement – either with further recovery (healing), remediation (working on things to make them better) and the ability to compensate, all have the ability to be better than someone who is 72,” he says. Part of Andrew’s weekly volunteer visit involves sharing his story with patients over hot chocolate. “Seeing what I went through really makes them motivated. Every time I go out with them, they really light up,” he says. They enjoy activities like playing Nintendo Wii bowling, abstract painting together, and even decorating pumpkins in time for Halloween. Besides volunteering, Andrew runs six to seven kilometers daily to strengthen his heart and support his mental health. He is looking at different career options for his future. “I hope my story can help connect with those who are going through a hard time and give them a little bit of support in the worst part of their life.”
HHS ranks in the top three research hospitals in Canada Hamilton Health Sciences (HHS) has been ranked among the top three research hospitals in Canada, as announced today by Research Infosource Inc.. Research Infosource Inc. is an independent, leading source of
ranking information on research universities, corporations, hospitals and colleges in Canada. Each year, it releases results on the top 40 research hospitals in the country, based on total research revenue. In 2017, Hamilton Health Sciences generated $207 million in research revenue, a 20 per cent increase over the previous year. “As an academic teaching hospital with a mandate to improve patient care and our healthcare system through research, we take great pride in our achievement of this high ranking among some of Canada’s most accomplished health research communities,” says Ted Scott, vice president of research at HHS. More than one million participants from across the six inhabited continents have enrolled in research led by HHS. In partnership with McMaster University, Hamilton Health Sciences conducts research through five research institutes and centres, with expertise across the spectrum of care. To date, more than one million participants from across the six inhabited continents have enrolled in research led by HHS, and its experts have made discoveries around some of the world’s biggest health challenges. Click here for more information on research at HHS.
High tech hand makes vet unstoppable Craig Tourangeau can still feel his hand. The last moment he had it, his fist was closed. Closed tightly around a grenade, about the size of a toilet paper tube. His hand feels exactly as it did in those last seconds—gripped so forcefully that it feels wrapped in layers of duct tape. Except it’s not there. Craig was part of Joint Task Force 2, which was enlisted to protect the 1994 Commonweath Games from potential terrorism threats. The veteran had completed extensive training. He and his team were running a simulation drill in advance of the games. The scenario: a hostage rescue. Craig was armed with a stun grenade to distract the “terrorist.” It was just a drill, but it got very real, very quickly. The stun grenade was faulty. When Craig pulled the pin, it exploded in his hand.
“It felt like my hand was slammed in a car door,” he recalls. Craig didn’t let the loss of his hand hold him back. If anything, it has pushed him to work even harder on his goals. There isn’t much he can’t do thanks to his motivation, the team in Hamilton Health Sciences’ Prosthetics and Orthotics Department, and some very cool technology. “he was showing us things he could do with it that we didn’t even know existed” “Craig’s success in the use of the prosthesis is a team effort,” says Ken Roczniak, a prosthetist at HHS who has been treating Craig for a number of years. “The patient is very much a part of that team.”
The power of a myoelectric hand
Technology has kept pace with Craig’s
desire to tackle new challenges with his
prosthetic hand. He currently uses a
myoelectric system that picks up on
electrical signals from his muscles. They
voluntarily open and close the hand. It
allows him impressive control. He can move
his hand into a range of grips by motioning
in different directions, or using an app on
his phone.
“It requires a fair bit of training to operate,” says Ken.
“Craig picked it up so quickly. Before we knew it, he was
showing us things he could do with it that we didn’t even know
existed.”
Determination is key
Craig regularly sees a team of specialists including a doctor,
prosthetist, prosthetic technician, and occupational
therapist. They ensure his prosthetic is well fitted, and able
to accomplish what he wants it to. He works as a canine police
officer, and is an avid motorcycle rider so he needs it to
perform at a high level.
“I’m always on the go,” says Craig. “I have different devices
for different activities, which allows me to do pretty much
everything.”
Ken says that while technology has enabled Craig to take on a
range of challenges, his success would not have been possible
without his attitude.
“I have the utmost respect for our veterans both past and
present,” he says. “I am inspired by Craig’s positive attitude
about the challenges that he faces with the loss of his hand. His determination to integrate this technology into his everyday life is a major factor in his success.”
Veteran no longer must ‘push through the pain’ Chris Teer was in the military for 18 years, first as a combat engineer, then as part of a Special Forces unit that focused on chemical, biological and radiological threats. He spent time in Afghanistan, Eritrea, and Ukraine. He endured gruelling training and saw many things he cannot unsee. He also developed severe chronic pain in his feet, knees, and lower back. “The training involved in military service takes its toll on the body,” says Chris. “It was a gradual accumulation.”
Just when all hope was lost… He sought help for his pain, but lost hope when treatment after treatment failed to give him the relief he needed. When he was enrolled as a patient with the Michael G. Degroote Pain Clinic at Hamilton Health Sciences, he doubted it would be any different. He is very happy to admit that he was wrong. “The team is fantastic,” he says. “Positive, transparent, open. I had lost faith in the system, and they changed that.” Chris came to Hamilton from Trenton for a month of treatment. The Pain Clinic’s care model includes daily sessions with a whole team of experts including psychologists, occupational therapists and social workers. They don’t just treat the symptoms of pain, they treat the causes behind it. Unlearning ‘push through the pain’ One of the specialists he worked with was physiotherapist, Adria Fransson. She helped suppress the urge to push through the pain. “In patients with a military background, we commonly see this mentality of ‘push through the pain,’” Adria says. “It may feel okay while you’re at it, but when the endorphins wear off, you are left depleted and in significant pain. People sometimes then become fearful of exercise because they don’t want to experience the pain that comes afterward.” It’s important for people with chronic pain to move their bodies. But too much intense movement can also trigger pain. Adria teaches patients how to reach a happy medium, and listen to their bodies’ signals. Chris was introduced to tai chi and yoga, as well as pool exercises, and swimming lengths. He learned how to exercise moderately, and manage his breathing. He also learned how to use simple equipment at home to relieve muscle tension.
“Learning how to feel the tension in my body, and relax it was an ‘aha moment’ for me,” Chris says. Life after the Pain Clinic Since returning home from his time at the Pain Clinic, Chris says his mood has improved, he’s spending more quality time with his family, walking his dog more, and sleeping better. “I can’t stress how grateful I am for the treatment I received,” he says. For Adria, seeing all aspects of a patient’s life improve is proof that the team’s model is working. “Chronic pain is not just a physical ailment” she say. “It affects our whole life. Having a whole team involved ensures we’re helping people to make lasting changes.” Did Chris’ story inspire you? Click here to read about another veteran, Glen, who regained control of his life with help from the Pain Clinic, and watch his video below.
Halloween spirit hits HHS Across the Hamilton Health Sciences (HHS) family of hospitals, the Halloween spirit was alive, yesterday. Hundreds of staff members dressed in costume and decorated their clinics to the delight of patients young and old. To see more photos of staff in costume, search #myHHS on Twitter and Instagram. Costume game strong The Child Life Department gave McMaster Children’s Hospital staff an extra incentive to step up their costume game. Teams were invited to enter a costume contest judged by patients and families. Some units went a step further, decorating their space to match the theme of their costumes. Congratulations to this year’s winners, the Tim Horton’s Drive Thru, 3C.
Their efforts were appreciated by patients and families who enjoyed seeing the creative costumes while they collected candy at the annual McMaster Children’s Hospital Halloween Parade. Hundreds of staff, volunteers and visitors lined the hallways of the hospital to hand out candy and toys to patients and their families. You can watch a Facebook Live video of the event below. Watch CHCH News’ coverage of the Halloween parade. Trick-or-treating for everyone This Halloween, for the first time ever, Hamilton Health Sciences’ Ron Joyce Children’s Health Centre (RJCHC) partnered with Eastgate Square to host an inclusive and accessible trick-or-treat event. “Our annual trick-or-treat event is always a hit with families,” says Barbara Miele, Marketing Director, Eastgate Square. “We were excited to be expand the event this year in partnership with Ron Joyce Children’s Health Centre.”
Halloween can be a difficult time for children with disabilities and their families. Barriers like steps, uneven footing, and unpredictable social interactions can make trick- or-treating difficult, or even impossible, for kids with physical and developmental disabilities. To ensure every child had a chance to participate, Eastgate Square offered an accessible hour of trick-or-treating inside the mall on October 31st. RJCHC staff collected donations of candy that were handed out to a group of eager trick-or-treaters. “We heard from families that they weren’t always able to fully participate in Halloween activities because of their child’s challenges,” says Lindsay Bray, Clinical Leader, Developmental Pediatrics and Rehabilitation, Ron Joyce Children’s Health Centre. “We are so glad we found a community partner to help us make this holiday one that everyone can enjoy.”
New ambulance decals will help create more stroke survivors When someone has a stroke, every second counts. The ability to recognize the “FAST” signs of stroke and call 9-1-1 can mean the difference between life and death, or the difference between a full recovery and lasting disability. To create more stroke survivors in our community, Hamilton Paramedic Service and Hamilton Health Sciences have partnered with the Heart and Stroke Foundation to help residents recognize the signs of stroke. To do this, Hamilton ambulances will display “FAST” decals to remind residents of the signs of stroke, and urge them to call 9-1-1 right away if stroke is suspected.
“FAST” stands for: Face – is it drooping? Arms – can you raise both? Speech – is it slurred or jumbled? Time – to call 9-1-1 right away! “We want Hamiltonians to understand that when it comes to stroke, timing is critical. By recognizing stroke symptoms early, Hamilton’s trained paramedics and our local stroke team can provide you with the treatment and care you need sooner, which greatly improves your chances at a full recovery,” says Hamilton Paramedic Deputy Chief Russell Crocker. “We want Hamiltonians to understand that when it comes to stroke, timing is critical.” Hamilton General Hospital is the regional stroke centre for Central South Ontario. There, a specialized stroke team sees some of the most severe cases of stroke in our region. They know firsthand the potentially devastating impacts that delaying stroke can have on individuals and their loved ones. “Knowing the signs of stroke could save your life, or the life of someone you love,” says Dr. Wes Oczkowski, stroke neurologist at HGH and medical director for the Central South Regional Stroke Network. “We hope this initiative will help create more stroke survivors in our community.” In Hamilton, more than 1,000 people suffer from stroke each year. In 2017 and 2018, Hamilton Paramedic Service has transported approximately 1,397 suspected stroke cases. Of those cases, half were men and half were female, with the majority aged over 40 years. “Knowing the signs of stroke could save your life, or the
life of someone you love.”
Heart & Stroke Director of Ontario Mission, Karen Trainoff, is
delighted to expand the reach of the FAST campaign through
this partnership with Hamilton Paramedic Service and Hamilton
Health Sciences.
“We know that public awareness increases in communities that
have FAST decals on their vehicles. We are pleased to know
that people will be reminded of the FAST signs of stroke every
time they see a Region X ambulance,” says Ms.Trainoff. “Our
objective is to ensure that all Canadians, no matter where
they live or how old they are, know and remember the FAST
signs of stroke.”
Stroke facts
A stroke is a sudden loss of brain function.
62,000 strokes occur in Canada each year – that is one
stroke every nine minutes.
83 per cent of those who have a stroke and make it to
hospital will now survive.
Brain cells die at a rate of 1.9 million per minute
during stroke.
Each year, more than 13,000 Canadians die from stroke.
Hundreds of thousands of Canadians are living with the
effects of stroke.
Stroke is a leading cause of acquired adult disability
Stroke can happen at any age. Stroke among people under
65 is increasing and stroke risk factors are increasing
for young adults.
Half of Canadians report having a close friend or family
member who survived a stroke.
For more information about the signs of stroke, visitwww.heartandstroke.ca/FAST. Inclusive cheer squad performs at Ticats game A group of very special kids took to the field during halftime at the Hamilton Tiger-cats game this Saturday. Some of them walked onto the field, some wheeled. They all cheered their hearts out. They are the Ron Joyce Children’s Health Centre (RJCHC) cheer squad.
The squad launched in September of 2018 with a goal of giving clients at RJCHC a chance to participate in an inclusive activity. Both children with physical and developmental disabilities, and typically developing children are encouraged to join so they can learn from each others’ experiences. Everyone can cheer RJCHC provides a range of services to children, youth, and adults in our region, many of whom are dealing with life-long health issues. The centre’s programs include Autism Spectrum Disorder Services, Developmental Pediatrics and Rehabilitation, Prosthetics and Orthotics, and Child and Youth Mental Health.
“We’ve noticed that children who use our services and their families often feel isolated because they can’t always take part in typical community programs,” says Lindsay Bray, clinical leader of Developmental Pediatrics and Rehabilitation at RJCHC. “This puts them at risk for developing secondary mental health issues which is why programs like the RJCHC cheer squad are so greatly needed.” “These kids see each other for who they are.” Lindsay and her team launched the cheer squad with support from parents of clients at RJCHC. One of those clients is Makayla Benner. She’s twelve years old and has been dancing for most of her life. Her mom, April, wanted to get her involved in cheerleading, but was unable to find a squad that would accommodate her needs. Makayla has Pitt-Hopkins Syndrome, a genetic disorder that affects her development, along with autism spectrum disorder.
“There are kids in wheelchairs, in braces, and everyone is helping everyone,” says April, of the scene she enjoys watching during practice. “These kids see each other for who they are.” Makayla’s typically developing friend and classmate has also joined the squad. April says it’s heartwarming to watch her daughter have fun with her peers. Learning to cheer from the pros There are already nearly 50 children enrolled in the squad. Former Hamilton Tiger-cats cheerleaders, Tanisha McDermott- Hansen and Dominique Krawchenko, coach them through weekly practices. Knowing they would be performing at the Tiger-cats game gave the squad great motivation to perfect their routine.
“As a mom who has a child with special needs, it’s always emotional to see her perform,” April says, of watching her daughter cheer at the half-time show. “It’s a different world for her, so when she gets to have these experiences, it’s meaningful.” “We want to make our kids and families feel that they truly “belong” in our community.” Lindsay says she and her colleagues have already seen a tremendous impact on the kids. “We provide services to support these kids physically, mentally and developmentally, but this social support is also greatly needed. We want to ensure our kids and families feel that they truly “belong” in our community.” The cheer squad is funded in part by a grant from the Hamilton District Society for Disabled Children.
Cancer-free and paddling to victory As of this month, Geri Schweinbenz has been officially cancer- free for a full year. It’s a major milestone for the X-ray technologist who works at Hamilton Health Sciences’ Main Street West Urgent Care Centre. Since her diagnosis with Stage 3 breast cancer six years ago, she has experienced painful lows and incredible highs. “I was in total shock by my diagnosis,” says Geri. “I hadn’t been feeling sick and I have no family history of breast cancer.” Her family was a great support, but Geri still struggled with anxiety during her treatment. Her oncologist and nurses helped reduce her stress, but treatments were still incredibly tough on Geri. One day during her chemotherapy treatment at
Juravinski Hospital & Cancer Centre (JHCC), Geri struck up a conversation with her nurse about support groups. She was receiving the physical treatment she needed, but knew emotional support was equally important in her cancer journey. “I was in total shock by my diagnosis.” “I had never used a support group before so I had no idea what to expect,” says Geri. “But, I knew I needed help with what I was going through.” Knowing Geri played recreational sports, her nurse suggested the “Knot A Breast” (KAB) dragon boat racing team. It’s comprised of breast cancer survivors from the Hamilton area. Her nurse referred to it as a “floating support group”. This piqued Geri’s interest, not just from an emotional perspective, but physical as well. She struggles with lymphedema, a build-up of fluid, in her right arm, which is a side-effect of cancer treatment. She learned that paddling helps manage lymphedema while building one’s strength back. Eight months after her last treatment, she decided it was time.
“I, like the majority of the ladies who join KAB, didn’t know anyone on the team. So, I was nervous heading to my first meeting,” says Geri. “But as soon as I was there, I knew I had found my support group.” “It gives us breast cancer survivors hope and a feeling of belonging.” This summer Geri and the team competed at the International Breast Cancer Paddlers’ Commission Dragon Boat Festival in Florence, Italy. While they started from behind, they managed to paddle past their competitors and cross the finish line in front with an astounding personal best time of 2 minutes and 20 seconds. This was their third consecutive first place finish at the international competition. Geri credits her survival to the incredible team at JHCC, and her recovery to her floating support group—KAB. “I wouldn’t have been here to join KAB without the team at Juravinski, and I wouldn’t be who I am today without KAB,” she says. “It brought back my confidence and taught me to push beyond my limits. It gives us breast cancer survivors hope and
a feeling of belonging.” Superheroes celebrate Halloween with MacKids Spider-Man and Batman rappelled down the exterior of McMaster Children’s Hospital (MCH) on October 17. Black Panther was also seen posing for photos as Mr. Incredible chatted with Captain America. The party at MCH was a hit with patients and families as the front lobby was transformed into the ultimate Halloween celebration.
High-spirited fun Spirit Halloween generously donated new costumes for patients and their siblings, who enjoyed dressing up as ghoulish ghosts, beautiful princesses and fearless superheroes. More than 100 patients and siblings from MCH and Ron Joyce Children’s Health Centre signed up for the celebrations, which included face painting, pumpkin decorating and many other fun activities. The big surprise of the evening came when participants were invited outside to watch members of the Hamilton Police Service Emergency Response Unit rappel down the front of the building dressed as comic-book crimefighters. The crowd went wild to the sight of these real heroes in action. “We are extremely grateful to Spirit Halloween and the Hamilton Police for making this special evening possible,” says Parker Neale, the senior business and community
engagement development officer at McMaster Children’s Hospital Foundation. “This is an inspiring way to bring the community together and put smiles on the faces of patients during their journey.” Supporting Child Life Spirit Halloween’s Spirit of Children campaign supports the Child Life program at MCH by collecting donations at store locations throughout south-central Ontario. Nearly $170,000 has been raised since the Foundation began participating in the program two years ago. “Supporting the amazing work done by the Child Life team at MCH is a matter of pride for us.” “The communities we serve are extremely generous and we are very thankful,” says Tracy Akitt, the clinical leader of Child Life at MCH. “The support of Spirit Halloween and their
customers helps to supplement the programs and activities we offer, which makes a real difference for children and families.” Caring for Communities Staff at Spirit Halloween stores across the region eagerly await the Spirit of Children campaign each year and are excited to begin their fundraising for such a worthwhile cause. “Supporting the amazing work done by the Child Life team at MCH is a matter of pride for us,” says Dave Kerr, the operations manager at Spirit Halloween. “Children are our future and we are committed to caring for our communities.”
Stopping a stroke before it happens Too young for a stroke? Sheila Price works as a program secretary at Ron Joyce Children’s Health Centre (RJCHC). Every day, she walks past Hamilton General Hospital (HGH), home to the Stroke Prevention Clinic (SPC). The possibility of having a stroke never really crossed her mind—she was just 50, too young to be at risk, she thought. Then she started to experience numbness and weakness. Her family encouraged her to visit her family doctor who immediately connected the dots between her symptoms. She suspected Sheila was experiencing transient ischemic attacks, also known as TIAs, or warning strokes. They are often
followed by a full-blown stroke, especially if left untreated. Sheila’s family doctor referred her to the SPC. “I’m really lucky she knew exactly what to do,” says Sheila. “Sending me to the Stroke Prevention Clinic was the right choice.” The right team at the right time A few years ago, the SPC completed an improvement process to significantly reduce its wait times for new patients. The average wait time went from 35 days to just three. Sheila was seen the very next day after her referral. At that appointment, her family doctor’s suspicions were confirmed. Sheila had experienced two TIAs. “Her carotid artery, the tube that sends blood to the brain, was blocked,” says Dr. Kelvin Ng, who treated Sheila in the SPC. “Clots from the carotid artery in her neck were travelling to her brain and eye and causing the TIAs.” “She was fortunate she recognized the symptoms” Dr. Ng says Sheila was lucky she, her family, and her family doctor took quick action. “She was fortunate she recognized the symptoms of a TIA and got appropriate medical attention before she had a life changing stroke,” he says. Sheila immediately underwent a series of tests, and was admitted to the inpatient stroke unit at HGH. HGH is the regional stroke centre for central south Ontario, and provides complete stroke care from prevention to rehabilitation. Dr. David Szalay performed surgery to clear the blockage in her artery June 8th—just four days after she visited her family doctor.
“It was amazing how fast it all happened,” Sheila says. Making changes to prevent stroke in the future Her surgery was a success, but her journey was far from over. Sheila continued to meet with the team at the SPC to reduce her risk of future TIAs and strokes. “There are a number of factors that can affect risk of stroke, and we work with patients to manage them,” says Lisa Fronzi, clinical nurse specialist in the SPC. Sheila was a smoker when she first visited the SPC. The team worked with her to create a plan for quitting, since smoking is the second leading risk factor for stroke. Sheila also started taking medication to manage her cholesterol and blood pressure, and the SPC team worked with her family doctor on ongoing diabetes management. Sheila has been smoke-free since her stroke, her cholesterol is within normal range, and her blood sugar levels have gone down considerably. She was discharged from the SPC last month as a result of her progress. “She has done remarkably well,” says Lisa. “She made numerous lifestyle changes which will significantly reduce her risk of future stroke.” Both Sheila and her care team know that things could have gone very differently if she didn’t recognize her TIA symptoms. She says the experience was a wakeup call. “I’m lucky to be here,” she says. “I’ve made some big changes in my life, and I’m looking forward to living a long and healthy life.”
Signs of stroke If you suspect a TIA or stroke, call 9-1-1 immediately. Remember the signs of stroke: F – FACE – Is it drooping? A – ARMS – Can you raise them? S – SPEECH – Is it slurred or jumbled? T- TIME – Time to call 9-1-1 right away Code Blues become a rare
occurrence Originally published by Canadian Healthcare Technology Spring 2017 Code Blues used to sound every day at Hamilton Health Sciences (HHS), but an early warning system that measures six vital signs has been used to dramatically reduce their incidence. Now, it can be days before one hears a Code Blue at most of the hospital’s acute care sites. The Hamilton Early Warning System (HEWS) was developed in 2010 by a team of clinicians at Hamilton General Hospital (HGH) led by Dr. Alison Fox-Robichaud, a critical care physician. By monitoring vital signs such as oxygen saturation, pulse and respiratory rate, the system can quickly determine if a patient is deteriorating to the point that the response team should be called for help. In most cases, a cardiac or respiratory arrest can be prevented with appropriate intervention. HEWS is the system that triggers that early response from care teams and, so far, the impact has been significant. By not alerting the team in a timely manner, patient lives can be lost. The situation has been dubbed “failure to rescue”, and can also become a source of costly litigation between hospitals and patient families. Now, it can be days before one hears a Code Blue. With HEWS, the vital signs are manually collected and entered and the electronic medical record calculates a score. Based on the number, the nurse is given an alert to call the physician and/or the response team. While the province of Ontario started funding resuscitation teams in 2006, the concept of a response team was foreign to
staff and physicians. Rigorous education and training was implemented at HHS to foster uptake of this new change of practice. Today, the resuscitation – also known as “RACE” – teams are a vital resource. Dr. Fox-Robichaud observed that with the use of HEWS, the volume of calls to the response team has risen, but the number of transfers to the intensive care unit (ICU) has dropped considerably. “You do increase the workload, but at the same time, you decrease the transfers to the ICU,” she says. The original HEWS pilot project in 2010 showed an increased call volume to the critical care response team, but only a minor increase in the number of ICU admissions and a 50 per cent reduction in cardiac arrests on the pilot unit compared to the previous year. In addition to vital signs, HEWS also scores delirium, which is monitored by nurses. “It’s a unique factor at Hamilton Health Sciences, and it helps recognize the evolution of sepsis,” said Dr. Fox- Robichaud. Sepsis is also a major cost for hospitals; in the United States alone, said Dr. Fox-Robichaud, the cost reaches $23 billion per year. She noted that HEWS scoring may be superior to traditional forms of monitoring for sepsis development. Using the collected data, a score is tallied and the appropriate action can be taken. With a score of three, the charge nurse is informed; with a score of four, a call is made to the patient’s most-responsible physician; with a score of five, the response team is called for an assessment; and for six, a very important intervention must be made. A score of seven will trigger a Code Blue alert.
The system integrates with the hospital’s electronic patient record, which is supplied by Meditech. Currently nurses manually input the data into the system, where the analytics engine calculates scores. A recent improvement has been the addition of smartphones, which make data collection easier and automates the alerting process. “We’re moving to mobile,” said Chris Probst, director of HITS Informatics at HHS, who noted the mobile app was created in just ten weeks. The Android phones, which also have integrated bar code scanners to check wristband codes for patient safety, are now being used in the HEWS project. The app prompts nurses to enter the necessary information about vital signs and delirium. Scoring is automatic, and notifications are sent immediately. Hamilton Health Sciences is working on analyzing the numbers to determine how many patients have been prevented from ICU transfers since the rollout of the system in 2014. It also has a grad student assessing the selection of vital signs that are used, to determine if they are the best mix. “This is a prime example of frontline-driven healthcare innovation that’s having a significant impact on patients’ lives.” What is known is that the system has made a noticeable difference at Hamilton Health Sciences. “Code Blue is now rare, at least during the day,” said Dr. Fox-Robichaud. “You can go for several days without hearing one, at least in the daytime. Now, we’re working on the night-time,” she said, noting there are fewer nurses and other professionals working the evening shifts. The team is also developing a set of indicators for pediatric
care. Dr. Fox-Robichaud said that other hospitals interested in starting an early warning system must put a premium on communication and training. “You have to engage your front-line staff,” she said. “Without that, you won’t have success.” She noted there is a cultural shift that goes along with the new system, as it flattens the hierarchy in the hospital. Nurses can’t be overridden by senior nurses, residents or physicians. “Nurses shouldn’t be prevented from contacting the team,” she said. “It’s not about saving face, it’s about saving lives.” Recently, HHS has involved IBM Canada through a collaborative innovation partnership to bring advanced analytics to the project, and to explore opportunities to deploy HEWS to other hospitals across the healthcare system. “This is a prime example of frontline-driven healthcare innovation that’s having a significant impact on patients’ lives,” said Ted Scott, chief innovation officer at HHS. “By infusing this unique, HHS-born innovation with the world- class technology and business insights of IBM, we’ll be able to develop an effective, invaluable product that will continue to transform healthcare delivery, beyond Hamilton and, perhaps, around the world.” This is just one of the many digital health projects that are part of our Digital Health Plan.
Three things an ER doctor wants you to know NOTE: ALWAYS call 9-1-1 if you think you’re having a medical emergency. Written by: Dr. Bill Krizmanich, emergency physician, Hamilton Health Sciences As an emergency doctor, a common concern I hear from my patients is that they’re not always sure where to turn for basic medical care. Often, the emergency department (ED) is seen as the best and quickest place to access a doctor’s expertise, but there’s usually a more convenient option. For health issues that aren’t emergencies, a family doctor or urgent care centre can offer the same level of expertise as an ED, and you’ll usually have a shorter wait. The next time you’re feeling unwell, consider your options.
There may be a better option for you than visiting the emergency department. Here are three things you should know: Family doctors offer more services than you might think. When it comes to managing your overall health, a family doctor is an excellent resource. From treatment for minor illnesses and injuries to support for mental health concerns, a family doctor can help you with a wide variety of issues. And, more and more, doctors’ offices are offering extended hours, after- hours clinics and 24-hour on-call services so that you can get the help you need, no matter the time of day. If you’re unsure about the types of services available through your family doctor, check with their office to learn more. If you don’t have a family doctor, click here to find one. Can’t wait to see your family doc? An urgent care centre can help. Except in the event of emergencies, urgent care centres (UCCs) are excellent options for medical issues that need quick attention, or when your family doctor is unavailable. Many people don’t know this, but Hamilton has two urgent care centres which are open 7 days a week, 365 days a year and are staffed by emergency-trained doctors. Our UCC teams are qualified to deal with minor fractures, sprained ankles, respiratory illnesses, and even minor cuts that need stitches. Aside from the high level of expertise you’ll receive at a UCC, you’ll probably also wait for less time than at an emergency department, where the sickest patients are always prioritized to be seen first. For information about Hamilton’s two urgent care centres,
click here. Sometimes, the best remedy is ‘home sweet home’. None of us like being sick. Illnesses like the cold or flu are uncomfortable and take us away from our daily activities like work, school and family time. And while it’s tough to wait out that pesky cough or runny nose, the best remedy is usually to stay home, get rest, and drink plenty of fluids. If you’re ever unsure about what you’re feeling or where to find care, call your family doctor for advice. As always, if you think you’re having an emergency, call 9-1-1 right away. For more information about your healthcare options in Hamilton, visit NeedADoc.ca. Preparing for flu season As flu season approaches, it’s even more important to protect yourself and those around you from infection. The first step is getting your flu shot. Learn more about the flu shot and other ways to prevent the spread of flu.
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