Taking cardiac health to “heart”

February is a time when we think about matters of the heart, including heart health. Unofficially dubbed “Heart Month” by the Heart and Stroke Foundation it serves as a reminder that heart disease remains a real risk for Canadians, including many people living in the Central West region.

Between October and December 2016, Osler had the highest local volume of heart attacks requiring angioplasty for a single health care centre in Ontario. We preform around 2,000 Percutaneous Coronary Interventions (commonly known as coronary angioplasty) procedures in our cardiac catheterization lab each year, a significant increase from the 1,200 procedures we performed just three years ago.

These numbers are staggering but not altogether surprising. There are a number of reasons we’re seeing more heart attacks in our region. Osler serves a large South Asian community, which has a higher rate of heart disease and a greater risk of early death compared to the average Canadian.

Chronic diseases such as diabetes, high blood pressure and high cholesterol are also risk factors for heart attack. According to our partners at the Central West Local Health Integration Network (LHIN), our region has the third highest rate of diabetes in Ontario and the number of residents attending local diabetes education programs has increased.

To support the growing number of patients that depend on our cardiac programs and services, cardiac care is a major focus for Osler. Over the past five years we’ve steadily increased the number of programs and services for cardiac patients, such as introducing a 24-7 Code STEMI Program. As we continue to execute 2016-19 Clinical Priorities Plan, we’re continuing to enhance cardiac services by:

  • Opening key cardiac services at Peel Memorial including diagnostics, the Cardiac Health and Risk Management (CHARM), cardiac rehabilitation and heart function clinics.
  • Using Telemedicine to connect patients to an interdisciplinary team that will support self-management of their care and symptoms.
  • Partnering with the City of Brampton to deliver cardiac rehabilitation, ensuring patients receive care in the most appropriate setting.

These enhancements are just the tip of the iceberg when it comes to supporting cardiac care at Osler. We’re also participating in ground-breaking research that uses non-invasive therapy to minimize the damage caused by STEMI heart attacks when the patient is en route to hospital. This partnered study is the global-first and could ultimately result in this innovative technique being adopted by health care professionals across Canada and around the world.

Plus, our Live Well with Osler series takes cardiac care to heart this month by offering tips for leading a healthy life after a heart attack. These six heart-friendly tips can help patients lead a happier, healthier life after a cardiac event.

Osler’s incredible staff, physicians and volunteers that support Osler’s comprehensive Cardiac Program are truly putting patients at the “heart” of cardiac care.

Osler’s award-winning approach to high-quality patient care

It’s only the second full week of February and we already have a lot to celebrate! On January 31, at the Central West Local Health Integration Network’s inaugural Quality Awards, the spotlight was on Osler as we were recognized for excellence in our work to deliver exemplary care to the patients we serve.

The awards celebrate transformative initiatives that positively impact patient care and Osler received one of two 2017 Quality Awards for Physician Initial Assessment and Emergency Department Length of Stay in the Etobicoke General Hospital emergency department (ED). Lead by Dr. Sameer D’Souza and Helen Romas, this work has helped transform the ED at EGH into a top-performing ED in the Province.

We also received an honourable mention for the PoET (Prevention of Error-Based Transfers) Project, led by Dr. Paula Chidwick and Dr. Jill Oliver from Osler’s Ethics team. Designed to reduce error-based transfers between long-term care to hospital, PoET aligns the culture of decision-making with the wishes, values and beliefs of patients ultimately resulting in improved quality of care.

Congratulations to these teams on their well-deserved honours! This work is a testament to our commitment to innovative care delivered with compassion as Osler continues to be recognized as a quality organization that embraces innovative and effective approaches to providing safe, quality patient care.

In fact, we recently received word from Accreditation Canada that Osler has been awarded with two additional leading practice designations, which brings our total to SEVEN – a new record for us!

  • The Power of Diversity Change Champions for Safe, Equitable and Quality Health Care
  • Cleanliness and Fluorescent Marker Audit Practice

A leading practice is a national recognition that must meet at least two distinctions: we do something that no one else in the country does and we do something unique or better than anyone else in the country. The fact that we were recognized seven times is nothing short of remarkable.

As we move forward with our back to basics strategy around the consistent delivery of safe, quality care in the year ahead I’m confident that we will continue to shine.

Welcome to the new Peel Memorial

Just two and half years after breaking ground on the new Peel Memorial Centre for Integrated Health and Wellness, we’ve reached an incredible milestone in our redevelopment journey. Today is the day we can finally say “welcome to the new Peel Memorial.”

This morning we were so proud to officially switch on the lights, roll up the shades and open our doors to welcome patients to this innovative new facility.

You may notice that not all services will be available on day one. We’re taking a phased approach to opening services at Peel Memorial. Our administrative teams were the first to move into the building last fall along with Addictions Counselling, Child and Adolescent Mental Health Counselling and the Eating Disorders Clinic. Today, seven new services are available to patients:

  • Urgent Care Centre (UCC) – A convenient alternative for non-life threatening injuries and illnesses
  • Cardiac Diagnostics – Expertise and equipment to diagnose a wide range of heart conditions
  • Mental Health Services – Central Intake Service and Transitional Aged Youth Services will support a growing need for mental health and addictions services
  • Mental Health & Addictions Rapid Response Clinic – Patients are quickly connected with the services they need to meet their unique needs
  • Diagnostic Imaging and Laboratories – High-tech diagnostic services including radiography, mammography, ultrasound, CT scans, bone mineral density tests, and laboratory services
  • Urgent Medical Clinic – Urgent medical consults for patients that are referred from the UCC at Peel and patients referred from Osler-affiliated family physicians
  • Pharmacy – Support the medication needs of patients receiving care at Peel Memorial

In addition to these services, the cafeteria and Tim Hortons is also open and ready to serve everyone at Peel Memorial.

As we start to welcome patients to our new facility, we are continuing to prepare for the final move-in phase in March and April. With all services open to the public by the end of April, Peel Memorial will be fully open for business.

To celebrate this final milestone, we’re planning a special ribbon cutting ceremony for the spring. More details will be shared closer to the event.

Until then, I’m pleased to say “welcome to the new Peel Memorial.”

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What you need to know about the Urgent Care Centre at Peel Memorial

It’s been quite the journey, but I can’t believe we’re just days away from opening the Urgent Care Centre (UCC) at the new Peel Memorial Centre for Integrated Health and Wellness!

More than 3,000 people visited Peel Memorial during our many community tours over the past two months and among the services generating a lot of buzz was the Urgent Care Centre. (If you missed the in-person tours you can still see what our new space looks like by taking a virtual tour.

As we get closer to opening our doors we wanted to answer some of the most common questions we’ve received about the UCC.

What is the UCC?

Care at Peel Memorial’s UCC will be provided by Osler’s emergency-trained physicians and staff. These talented teams will be equipped with high-tech diagnostic imaging and lab services, and are ready to handle most non-life-threatening illnesses and injuries.

Do I need an appointment?

As with Osler’s emergency departments, no referral or appointment is needed to access the UCC’s services.

What are the hours of operation?

The UCC at Peel Memorial will be open 365 days a year from 8 a.m. to 10 p.m.

When should I go to the UCC?

When it’s not an emergency but treatment can’t wait, go to the UCC. Some examples of non-life threatening illnesses or injuries treated at the UCC include:

  • Sprains and broken bones
  • Cuts that might need stitches
  • Allergic reactions, skin rashes
  • Asthma attacks
  • Minor burns
  • Fevers, coughs and colds
  • Infections
  • Nose and throat complaints

If you have severe chest pain, stroke symptoms, or you are uncertain of where to go always CALL 9-1-1 or go to your nearest Emergency Department.

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We’ve seen unprecedented patient volumes over the holiday season and beyond, which has placed considerable pressure on our emergency departments. The UCC will help to improve patient access to care by providing a convenient option to the ED for non-life threatening conditions.

Starting the conversation about mental health

This week’s guest blogger is Kiki Ferrari, Interim Executive Vice President, Clinical Services

Pull up a chair. Let’s talk.

It’s a simple invitation, but for millions of Canadians living with mental health challenges, it’s one that’s not always easy to accept. January 25 is Bell Let’s Talk Day. This is an excellent opportunity for many of us at Osler to start the conversation about mental health, but we also need to continue the conversation in the days, weeks and months ahead.

Mental health issues touch all of us. Whether we’re living with mental health challenges ourselves, or supporting a colleague or loved one in the best way we can, the growing incidence is real. Here at Osler, the demand for mental health services is one of the fastest growing needs facing our community. In 2015-16, we had more than 65,000 visits to our Adult Mental Health Clinic and over 7,000 Child & Adolescent Mental Health Clinic visits. And in our Mental Health Emergency Services Unit (MHESU), the 1,500 patients we saw last year clearly shows the acute need for urgent mental health support in the community. These numbers have increased substantially over the past four years and we expect this trend to continue.

This shift has made mental health a central focus for our teams. A number of initiatives at Osler are helping us to support patients with these specialized needs:

  • The Geriatric Mental Health Team at Brampton Civic has created a “Silver Surfers” iPad program that introduces patients to cognitive stimulation games, provides social stimulation through Facebook and Skype, and helps create more comfort with technology so they can grocery shop, bank and fill prescriptions online. These skills can be used post-discharge in their daily lives.
  • Our Addiction Services team is working with the Centre for Addiction and Mental Health to pilot an Integrated Care Pathway for people living with depression and alcoholism, which has had a positive impact on reducing depressive symptoms and improving drinking patterns.
  • Osler received a Leading Practice designation during our most recent Accreditation review for our use of the Osler Suicide Interview Checklist (OSIC), a 25-item suicide risk assessment designed for use by experienced clinicians during initial contact with a patient who may be at risk of suicide.

In addition to starting the conversation about mental health, the Bell Let’s Talk Community Fund provides grants to organizations across Canada to improve access to mental health care, supports and services for people living with mental illness.

In fact, Osler has directly benefitted from the Bell Let’s Talk Community Fund. In 2014, we received a one-time $25,000 grant to our Telephone Advice Psychiatry (TAP) program. TAP provides physicians throughout the region with expert advice and support that helps them better manage non-acute mental health issues of patients as they wait to be seen by a specialist. With this funding, the team was able to promote the program among 500 physicians in the Central West region. Osler Foundation is submitting new grant application for additional funding that will help us support more patients.

Mental health is important for us all. Let’s take a lead in starting the conversation, and let’s keep talking about it.

Roaring into 2017 with record patient volumes

Happy New Year! After spending some quality time with family and friends over the holidays, I’m ready to kick off another exciting year at Osler. I hope you had the opportunity to make some special memories with your loved ones this season, too.

It feels so strange to be typing “2017” but there will be great things happening in the coming year – and it roared in like a lion! We expect to see a higher than normal volume of patients during the holidays and this year was no exception – in fact – it was another record setting year.

In true Osler fashion, the busy festive season started with a Code Gridlock at Brampton Civic Hospital that was lifted just two days before Christmas. The pace hasn’t let up. In fact, there were so many visitors to our emergency departments, we have issued a number of Code Gridlocks at Brampton Civic and Etobicoke General to help us manage the steady stream of patients. Our teams across the organization are mobilized and focused on patient admissions and timely discharges, and on working with our partners to help keep patients moving to where they needed to be in the hospital as quickly as possible.

According to Kiki Ferrari, Osler’s Interim Executive Vice President of Clinical Services, “Our teams are, and continue to be, nothing short of spectacular during this year’s surge and beyond. The past few holiday seasons have shown us just how vital it is to work together to manage high patient volumes, especially when we need to react to demands that seem to change hour to hour.”

A number of factors contributed to the increase in patient volumes, including a surge of flu activity in the community. Many hospitals in the Greater Toronto Area have seen a significant increase in patients coming to the ED with the flu as the season is starting to peak, and Osler is no different. With more than half of flu season left to go it’s even more important to get vaccinated.

By the official end of the two week surge period, we had an unprecedented 25,734 patient visits. When we break it down, this adds up to:

  • 10,146 patients in our emergency departments
  • 2,216 patients admitted for inpatient care
  • 13,432 outpatient and day surgery visits

That averages out to our teams providing care for approximately 1,719 patients per day. These numbers tell an incredible story that begins and ends with the tremendous teamwork and dedication of Osler’s teams throughout this challenging time. While the ED is often the first place we feel the surge, impacts are felt throughout the hospital. Our inpatient, diagnostic imaging, laboratory and support service teams – in collaboration with many others – also worked tirelessly to provide an exceptional experience for patients during this busy time.

High patient volumes are nothing new for us but the way everyone – including staff, physicians and volunteers – rallied in response should be acknowledged and commended.

Thank you for going beyond to provide patient-inspired care without boundaries.

Weathering the surge and staying healthy this holiday season

High patient volumes are the new normal for us and each year we anticipate a 10 per cent increase in activity during the festive season during our annual holiday surge.

Last year, we set a record with 455 patients visiting the emergency department (ED) at Brampton Civic on Boxing Day. This was more than any other hospital in Ontario. Etobicoke General also saw significant volumes that peaked at 242 patient visits to the ED in a single day. By the end of the two week surge period we provided care to nearly 24,000 patients in our EDs, inpatient units and outpatient clinics.

Our amazing teams clearly have their work cut out for them at this time of year and we’re once again working hard to prepare for this annual increase in patient volumes.

What is Osler doing to help manage more patients?

In addition to creating waves in the ED, the surge has a ripple effect that quickly spreads to other parts of the hospital. We’ve put a number of measures in place to help get us ready, including:

  • Working with our partners at Central West CCAC and Headwaters, as well as EMS and Peel Public Health, to plan a united approach to care;
  • Using programs like Hospital to Home (H2H) to provide care in non-acute settings when possible;
  • Flexing our bed capacity to better align with demand and to respond to patient need;
  • Monitoring daily patient volumes and holding “command centre” meetings to strategize around the best way to move patients through the hospital;
  • Communicating with health care providers in the community to encourage the delivery of services without interruption; and,
  • Making sure our teams are staffed up and ready to act when we need them.

At the end of the day, our success during the surge comes down to the incredible teams of people who spend their holidays helping others. Thank you for your support and cooperation as we head into this busier than normal time!

How can patients prepare for the holiday season?

Patients and families also have a part to play in staying healthy over the holidays. A few simple ways include getting vaccinated against the flu to reduce the risk of catching or spreading the virus and knowing the health care options before coming to the ED to avoid the wait.

We’ve posted important information on Osler’s website, our Facebook page and Twitter feed to help educate patients about their health care options to receive the right care, in the right place this holiday season. This month’s Live Well with Osler topic also provides some helpful tips for how patients can stay healthy and happy during this most wonderful time of the year.

Happy holidays from Osler!

To cap off the year, we decided to have a little fun with our traditional holiday message. We asked teams at each site to take part in a festive Mannequin Challenge, a meme taking the Internet by storm, and boy did they deliver. Take a look – you may see some familiar faces!

This will be my last blog of 2016. On behalf of the entire Osler family, I wish you and your family a wonderful holiday season!