Well Aware – Winter 2015

The North Bay Regional Health Centre is pleased to provide you with our quarterly e-newsletter update! NBRHC Well Aware is designed to keep you up to date on changes to our services, new initiatives and news that impacts our communities

Changing what we do at NBRHC

We have been making changes at NBRHC in response to the province’s decision to move toward increasing community based health care funding and reducing funding for hospitals.

Because of this new approach to healthcare NBRHC has been working to change the services it provides to meet the needs of the community.  To provide an easy understanding of a rather complex issue we created a short video entitled Reshaping Care which literally draws the picture of service realignment at NBRHC.

We do need to reduce some aspects of our operation to respond to the reduced need created by among other things, new technology. For example we have introduced the green light laser that reduces how long a person needs to stay in hospital following surgery. We are looking to create new services that are responsive to community needs. Our breathing clinic for people with lung disease has reduced hospital stays significantly.

As partners in care, we should be doing what is right for our patients – providing them with the quality care they need, where they want it – at home, in the community or in their setting of choice. Patients want to receive care in the community and at home, and only access the hospital when truly required. Because of improved coordination and transitions of care, we no longer require the same numbers of beds as we did in the past and demand on inpatient services is also decreasing.

With respect to mental health services we are moving from a custodial based care model to a recovery based care model. Today there is a cohort of patients at NBRHC who are being over-served in the hospital setting. These in-patients with complex needs could be served in the community if appropriate housing, services and supports were made available. To do this effectively NBRHC in partnership with HSN (Health Sciences North) is conducting a joint mental health and addictions review. The outcome of the review is expected by this summer.

In the meantime a number of community supports for mental health have been established and we will not close mental health beds until the required supports are in place.

Examples of community supports in place:

• Partnership  with Canadian Mental Health Association in Sudbury where we have an 8 bed recovery home
• Partnership with the Nipissing Housing and Mental Health Support Services in North Bay…we have an 8 bed recovery/transitional home and the LHIN just announced funding for the Acquired Brain injury home where 3 patients will get 24/7 supports
• NBRHC recently signed a proposal for a 5 bed recovery home in Muskoka Parry Sound
• NBRHC has an 8 bed forensics transition house in North Bay

The changes at NBRHC are a microcosm of health system change occurring across the province. We are faced with rising expenses, growing health care needs and an outdated health care system that was designed based on episodic care only. In order to maintain high quality health care into the future, we must be responsible, courageous and creative about designing a new system that is patient-centred and designed as a continuous interconnected system of care.

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Patient Flow Navigator Role introduced

NBRHC has recognized the need to establish smooth and timely transitions between sectors in the Health Care System.  Improved patient flow begins in Acute care. Patient Flow Navigators (PFN) are now an essential part of the patient experience in the Inpatient Medicine and Surgery units.  The “problem statement” that brought about this initiative was that there was no clear leadership for moving the care plan for every patient forward. Every patient should have a consistent approach to the plan of care journey through to discharge/transfer.

“Staff representatives from various disciplines and roles were very helpful in the development of the Patient Flow Navigator role. I am very pleased to see this role launch,” said Nancy Jacko, VP Planning, Partnership, and Professional Practice and Chief Nursing Executive (retired). “The patients we are now seeing in hospital are very complex due to the changes in medical treatments and also the aging population with many chronic conditions. To ensure patients and their families understand their care journey and are participants in a safe discharge plan, this role is crucial.  By ensuring patients are discharged in a timely manner, access to the beds for others in need is made possible.”

Angela Gagne is one of the new PFNs. “The most exciting aspect of the job is the integral support we provide to patients and families, along with our existing multidisciplinary teams to ensure more efficient, patient-centered care at NBRHC,” said Angela after her first few days on the job. “We will focus on safe and sustainable discharges while applying the ‘Hospital to Home’ philosophy. PFNs will ensure patients receive the care they need by the right person, in the right bed, for the right amount of time, allowing for a smoother transition to home.”

• The PFN will address barriers and delays to patient progress throughout the care journey.

• The PFN will communicate, coordinate and collaborate to develop a care plan for every patient, every day including weekends.

• The PFN will help decrease conservable days by providing a clear, consistent message and plan from admission to discharge, by increasing patient involvement and improved inter-professional collaboration.

Paul Heinrich, NBRHC President and CEO, pointed out that physicians helped design the model for this position and were actively involved. “This is a very big intervention that will make a difference, and I would like to commend the team that worked together to move this forward,” said Heinrich

The role of patient navigator was created from existing positions and funding, looking at ways to reduce duplication and to remedy gaps in roles. It will be evaluated to determine if it is feasible for other areas in the hospital.

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NBRHC Welcomes New Physicians

Ten new physicians were welcomed to the North Bay Regional Health Centre in 2014.

The new recruits include: three psychiatrists, two surgeons, a family physician, a paediatrician, a nephrologist, a radiologist and an emergency medicine physician.

Meet two Physicians who were welcomed to the North Bay Regional Health Centre in 2014:

Dr. Pawan Kumar
General Surgeon
Dr. Pawan Kumar, the North Bay Regional Health Centre’s newest General Surgeon, came to Canada from India in 2005 to pursue a fellowship and receive advanced training in cardiac surgery. After receiving recommendation from his mentors at the University of Toronto, he applied for the position, along with eight other potential recruits.

Dr. Kumar worked his locum at the health centre for three months before completing a panel interview in July. It was during this time he discovered all that North Bay and its medical community has to offer and knew this would be the place he would call home. “It is a safe place to raise a family, and a very well equipped hospital with healthcare workers eager to provide care,” says Dr. Kumar. “It is not just going above and beyond, but our duty as healthcare providers to give the best possible care to every patient, and a place with that mindset is where I want to be.”

Dr. Michael Creech
Orthopaedic Surgeon
Locally raised Dr. Michael Creech was welcomed to the health centre in the summer of 2014. “During my fourth year of residency in 2011 I completed an elective through the Northern Ontario School of Medicine at the North Bay Regional Health Centre, which provided me the ability to learn and grow within the orthopaedic sector while in North Bay,” says Dr. Creech.

His training has allowed for procedures such as arthroscopic surgery to diagnose and reconstruct pathology inside the shoulder and knee joints. Before Dr. Creech’s arrival, these surgeries would have required people to travel outside of the city to receive. Through a minimally invasive approach, the procedure allows for patients to return home the same day they receive treatment. “I grew up in North Bay, and knew it was a wonderful place to live, and the health centre is a great place to work. I am glad I can provide care for people closer to their home.”

“We are delighted that 10 exceptional physicians were successful in the recruitment process and are now representing health care in our community,” says Dr. Donald Fung, Chief of Staff at the North Bay Regional Health Centre. “We are now setting focus on recruiting family physicians, as primary care is our area of concern.”

With a growing recognition of the shortage of family physicians in north eastern Ontario, a Primary Care Advisory Committee pushing for a health human resource plan for the NE LHIN has been formed. The city of North Bay has also become engaged in physician recruitment, creating a task force to assist with attracting more family physicians to the community.

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Infection Control Spotlight		Community Events
Mumps Mumps is an acute infectious disease caused by the mumps (paramyxovirus) virus. The National Advisory Committee on Immunization (NACI) recommends immunization against mumps. About 40% of those infected develop unilateral or bilateral parotitis, 16-18 days after exposure. Subclinical infection is common. Nonspecific or primarily respiratory symptoms can occur in about half of those who acquire infection. Approximately 20% of infections are asymptomatic. Those infected with mumps are infectious from 7 days prior to 9 days after onset of parotitis, while maximum infectiousness occurs 1-2 days prior until 5 days after parotitis onset.Reference: Public Health Agency of Canada, 2013.		North Bay Blood Donor Clinic Clarion Resort Pinewood Park 201 Pinewood Park Dr. (Founders Room) Wednesday, March 04 12:00PM – 2:30PM & 4:00PM – 7:30PM Thursday, March 05 11:30AM – 2:30PM & 4:00PM – 6:00PM Visit www.blood.ca or call 1-888-2-DONATE to book an appointment!