Well Aware – Winter 2020

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.

Transforming Patient Care through a Shared Electronic Health Information System

In October the North Bay Regional Health Centre along with its partners, Sault Area Hospital and West Parry Sound Health Centre, launched a new electronic health information system (HIS).

Physicians and staff from the three hospitals worked together for two years to plan, build and provide training to implement a common system that will improve the way patients receive care. Known collectively as the ONE Initiative – one system for the northeast and one chart for each patient on the system – the regional partnership uses a common version of the Expanse system, created by US-based firm MEDITECH.

“The shared system improves patient safety and provides a better care experience for patients,” says Paul Heinrich, President and CEO, NBRHC, and Chair of the ONE Executive Steering Committee. “Clinicians also benefit through a more efficient workflow, real-time notifications, and complete and timely access to a patient’s story between the three hospitals.”

Thank you to everyone for working so hard both behind the scenes and on the front lines to help us reach this transformational milestone.

Thank you to Ed Regan for capturing what Go-Live looked like for our Health Centre.

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The Diabetes Education Centre Provides Comprehensive Care to Patients with Diabetes

At four years old Rachelle Gorecki was diagnosed with Type 1 Diabetes. With no history of diabetes or previous experience with the disease, Gorecki’s family turned to the Diabetes Education Centre (DEC) to learn how to manage her illness.

The DEC is an outpatient program of the North Bay Regional Health Centre (NBRHC), located in the community, offering comprehensive diabetes education and support by specialized staff. The North Bay location, and two part time satellite programs located in Sturgeon Falls and Mattawa, support clients in North Bay, Sturgeon Falls, Mattawa and other communities within Nipissing District.

Patients can self-refer, or be referred by their primary care provider and other allied health care professionals, to access many services including individual consultation, group education classes, pregnancy and diabetes counseling, the pediatric diabetes program, insulin pump training and support programs, and the endocrinology clinic.

Sandra Kilroy, Registered Dietitian – Certified Diabetes Educator says there can be a steep learning curve for someone newly diagnosed with diabetes. “There is a lot to learn,’ Kilroy says. “Fortunately our centre has a multidisciplinary team of specially trained care providers to provide our clients with comprehensive care.”

Diabetes Education Centre staff.

It is this multidisciplinary team—which includes registered nurses, registered dietitians, a social worker and admin support—who work together to deliver comprehensive, client centred diabetes education & support services. This team liaises with health care providers in the community (such as physicians, nurse practitioners, pharmacists, optometrists, and in-home care providers) to help clients meet their needs.Kilroy describes diabetes management education as a journey. “As with managing any chronic illness, there can be many challenges,” Kilroy explains. “Our goal is to provide people with the tools to become effective self-managers, and when there are bumps along the way, we are there to support them through those bumps.”

After her diagnosis as a young child, Gorecki learned how to test her blood sugars and even took over giving herself insulin injections. “My mom did the first needle and I did all the rest,” she remembers. “I hated having someone else do the needles.”

Managing a chronic illness 24/7 is never easy. Teenagers in particular often find it difficult to balance diabetes management in their life and can often resent feeling burdened by tests, injections and appointments.

Rachelle Gorecki and her daughter Julia meet with Sandra Kilroy, Registered Dietitian – Certified Diabetes Educator at the Diabetes Education Centre.

Gorecki admits she experienced these challenges with her diabetes management as a teenager and stopped using the services of the Centre. After a few years of what Gorecki describes as ‘neglecting her health’, as a young adult she made the decision to resume services at the Centre. “I was very nervous because it had been a while,” she says. “I was emotional about going back because I was embarrassed I had stopped going.” Gorecki was relieved when she arrived and said Kilroy was so supportive—and she has been regularly using the services ever since. Gorecki has recently entered a new stage in her journey with the birth of her daughter Julia earlier this year.

Kilroy has been with the Diabetes Education Centre since the program’s inception in 1995. In that time, she says she has been fortunate to see clients like Gorecki transition from the pediatrics education program to the adult diabetes education program. “Our goal as Diabetes Educators is to empower individuals to be self-managers of their chronic disease—it is with them 24/hours a day, 7 days a week.” She says that like Gorecki did, staff at the Centre hope that when clients have struggles, they will access the Centre for support and guidance when they need it.

And Kilroy says Gorecki is an example of someone who has done just that. “I am always in awe of Rachelle’s diligence in the management of her diabetes,” Kilroy says. “She is very attentive to her diabetes and really is a good example of someone who has embraced knowledge and application. It’s wonderful to see her with her beautiful daughter, I feel very privileged, I really do.”

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Bed Pressures at NBRHC

NBRHC has been under constant and sustained bed pressures for more than two years. Some days we have up to 20 patients needing a bed that doesn’t exist.

At the same time, many of our 419 patients who no longer require, or want, the level of specialized care they receive at our hospital cannot access the care outside of our walls.

The launch of our new electronic health information system this fall and the learning curve as we switch to a new system adds to the strain these working conditions place on our staff and physicians as we work to provide the best possible care for our patients in any circumstance.

Our patients receive incredible care under challenging circumstances from our amazing staff, physicians, allied health and support services, but sometimes we have to provide care for our patients in non-traditional spaces, putting strain on every facet of our Health Centre.

Our Hospital Board and Senior Leaders have advocated with our provincial government to share how as an organization we have worked very hard to find every possible efficiency and that our Health Centre can no longer operate beyond the capacities for which we are designed and funded.

To help improve our patient flow, we are proud of our proactive measures like adapting our work and creating programs to support our people and programs. When possible we have made renovations to our space—changing bed configuration to maximize bed flexibility and maintain infection control, and creating a 15 bed transitional unit for patients awaiting long term care placement.

We know our health care system is evolving and the provincial government has stated that their priority is to build a sustainable, connected and modern health care system that puts patients in the centre. We are mobilized and ready to work with our government and communities in modernizing our system to improve care across the continuum of care.

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How does the Emergency Department Triage Patients?

Many of us have visited the Emergency Department and have been triaged by a Registered Nurse (RN), but few probably understand what goes into ‘triaging’ a patient.

“Triage is a sorting process for patients coming to the emergency department” explains Ashley Piekarski, Interim Clinical Nurse Educator/RN, Emergency Department. “Simply put, the triage system determines how quickly patients are seen depending on how severe their illness and symptoms are, their medical history and any other relevant information.”

Triage nurses are specially trained to assess patients using the Canadian Triage & Acuity Scale (CTAS).

CTAS is a five-level triage system:

Level 1 – RESUSCITATION
Condition threatens life or limb and requires immediate, aggressive intervention.

Level 2 – EMERGENT
There is a potential threat to life or limb that requires rapid intervention.

Level 3 – URGENT
There is a potential to progress to a serious problem requiring emergency intervention.

Level 4 – LESS URGENT
Factors of age and distress are considered. There is a potential for deterioration or complications.

Level 5 – NON URGENT
Conditions that may be acute but non-urgent as well as conditions which may be part of a chronic problem or without evidence of deterioration. Interventions for some of these can be delayed.

One way to avoid non-urgent visits to Emergency is to check out this link of the availability of walk in clinics for our area, and other options like Telehealth Ontario 1-866-797-0000. As always, in an emergency, don’t hesitate to call 911.

If you do need to come to the Emergency Department, here are some things you can do to have a more comfortable wait:

• Bring any medication you might need to take in the next few hours
• Have food and drinks available (there are vending machines located near Emergency and throughout the facility if needed)
• Come prepared with electronics and a charger (if required). Currently there is no access to wi-fi at NBRHC, so consider downloading content to have it accessible without wi-fi to avoid high data usages
• Remember there are sick people in the waiting room, so make sure to wash your hands and wear a mask if necessary.
• Please be patient! We know nobody likes to wait, but the sickest patients are being seen first.

If you haven’t already, it’s not too late to get a flu shot to protect yourself and family from the influenza virus. If you do feel sick, be mindful of visiting family/friends and consider staying home to prevent spreading illnesses to others.