OUR SHAREDPURPOSE

October 2019

Learning never stops St. Joe’s first-ever de Souza Nurse Associate (pg. 2)

Colour Days inspiring joyA new program at Providence uniting staff and residents.(pg. 7)

How resusTO is proudly different Another successful year for the St. Michael’s event (pg. 8)

Behind the scenes with Tim A look at the Hallway Talks video series (pg. 3)

What it takes toinnovate (pg. 4)

Making infectionprotection funHow the IPAC Olympics - and chocolate pudding - put a new twist on infection prevention learning. (pg. 4)

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Our Shared Purpose is a monthly newsletter highlighting our people and the ways they are improving care, patient experience and the health of our communities.

Learn more: www.unityhealth.to

The last few years in Mark Kocsis’ life have been busy, to say the

least. Kocsis graduated from Ryerson University’s nursing program in

June 2017, and by November of that year, had begun his career on the

Medicine, Oncology and Palliative Care (6M) unit at St. Joseph’s Health

Centre. All the while, Kocsis was fueling his desire to improve how he

cares for patients and taking the initiative to support

his professional development goals.

“I had a student placement in a hospice, which

was my first exposure to end-of-life care. I discovered

I really like nursing in palliative and oncology. I like

being present with patients and families and focusing

on psychosocial aspects of nursing,” said Kocsis.

His drive to develop his skills in end-of-life

care led him to the de Souza Institute continuing

education program.

The de Souza Institute, headquartered at

University Health Network, offers courses that empower clinicians

to handle every situation in cancer and palliative care. This includes

managing pain and symptoms as well as providing emotional support

to allay people’s anxiety and fear.

To date, more than 10,000 health-care professionals from across

Canada have enrolled in de Souza courses. In 2019, Kocsis became

the first nurse from St. Joseph’s – and one of only 45 nurses in all of

Ontario – to obtain the de Souza Nurse Associate Designation.

“I’ve always been a go-getter and life-long learner. The de Souza

courses have equipped me with the knowledge to provide more

competent and confident care,” said Kocsis.

Kocsis’ colleagues and supervisors rave about Kocsis and see a

bright future for him at St. Joseph’s.

The members of the 6M team describe Kocsis

as someone who is inquisitive, empathetic and

thoughtful, continually seeking out what is best for

the patient experience. They especially appreciate the

time he makes to sit with patients and learn about

their journey and how he takes a holistic approach to

care.

At a recent celebration to honour Kocsis’

achievements, his colleague Paula Larrondo, a social

worker in the Medicine and Seniors Care program,

spoke about watching Kocsis care for her father at St. Joseph’s.

“When my dad was in palliative care here, I had to step back and just

be present as a daughter, as a family member. It gave me a chance to

watch Mark in action from a different vantage point.

“I was so impressed with his nursing skills and his ability to

connect with my family. He’s really intuitive. He’s an absolute gem,”

said Larrondo.

Education program empowers clinicians

working in cancer and palliative care

by Emily Dawson

Mark Kocsis is St. Joe’s first-ever de Souza

Nurse Associate Dr. Rutledge met residents in Juniper and Sumac Houses as they gathered together for activation programming.

M E E T I N G R E S I D E N T S

The video showcases how our programs, like musical entertainment, are essential in building a sense of community for residents

S M I L E S A L L A R O U N D

Dr. Rutledge stopped by several Houses to say hello to staff to thank them for their dedication to creating a better resident experience in their day-to-day work.

M E E T I N G T H E T E A M“ “

BEHIND THE SCENES

Hallway Talks with Tim Last month, Dr. Tim Rutledge, CEO of

Unity Health Toronto, was in the Cardinal

Ambrozic Houses of Providence to film

a new episode in the ‘Hallway Talks with

Tim’ video series. The video, which will be

released in late October, takes a look at

what makes our Houses such a special

long-term care home.

STORY BY EMILY DAWSON

PHOTOS BY KATIE COOPER

The de Souza courses have

equipped me with the knowledge to provide more competent and confident care

MARK KOCSISDE SOUZA NURSE ASSOCIATE

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UV light — sprinkled on top. They rubbed their hands together to mimic

the friction of providing care and then had to remove the gloves without

contaminating themselves. Thomas then used a UV light to see if any

Glo Germ remained.

“When I took the gloves off, I could still see some spots on my arms,”

said Vina Magno, a registered nurse on the unit. “It’s so scary because

normally we can’t see what’s there.”

Many staff members also had Glo Germ on their fingers and hands

because of defects in the gloves.

“People have a mistaken idea that gloves are impermeable and

that’s why they don’t need to be as good about hand hygiene when

wearing them,” said Thomas. “Staff were surprised to see powder on

their hands and the reality is that Glo Germ powder is still bigger than

microorganisms that could get through, which is why it’s so important

that gloves be used in addition to really good hand hygiene.”

Feedback on the IPAC Olympics was overwhelmingly positive

from staff on 4M, so much so that other units have requested a shot at

playing the games, which also included one related to cleaning shared

equipment and another that tracked bacteria growth in microlab plates

before and after practicing hand hygiene. The infection prevention team

is exploring ways to continue this work to engage all staff members who

interact with patients in a way that will hopefully stay with them.

“A lot of the time, we talk in health care about the moments when

you’re supposed to clean your hands but not really the why,” said

Thomas.

“But when you think about what you touched last and what you’re

touching next, it makes a lot more sense why you should stop and make

sure your hands are clean. Maybe next time someone on 4M is taking

their PPE off, they’ll think about the pudding and be aware that just

because they can’t see something that could potentially be harmful, it

doesn’t mean it’s not there.”

It’s not every day that Dianagris Balakrishnan finds herself covered

in pudding at work. But one day this summer, she had so much of it

on her personal protective equipment (PPE) gown and gloves that it

was dripping onto the floor. The pudding had been spread by Cameron

Thomas, an infection prevention practitioner, as part of an education

session at St. Joseph’s Health Centre called the IPAC Olympics.

Balakrishnan’s task was to remove the gown and gloves without getting

any pudding on her skin or clothes underneath.

“It was gross,” the registered practical nurse said, laughing. “But it

was a good reminder that there’s a lot of other stuff we could have on

us when we leave a patient’s room.”

The game was meant to mimic the potential for transmission of

all types of bacteria by nurses and other health care providers. Walking

in and out of different patients’ spaces means providers may be taking

more than they’d like when they leave, potentially spreading something

to other areas of the unit, other patients or themselves. This can be

especially dangerous for patients with a weakened immune system and

during high volume times – like flu season.

The PPE and pudding game was just one of four that was brought

to the hospital’s 4M unit to help engage staff and visually show the

significance of proper infection prevention practices.

“Working in health care means you get the same information over

and over again but the message gets lost because it’s always the same

– clean your hands, clean shared equipment,” said Rosalyn Espiritu, the

unit’s educator. “I heard that other hospitals had tried this interactive

way of providing education and thought it would be impactful here

because it’s new and exciting. People came over curious about why

there was pudding on the table.”

A common issue in health care is that people use gloves for

extended periods of time, often instead of regular hand hygiene. So in

another game, staff members put gloves on and had Glo Germ powder

— a visual tool used in cleaning education which shows up only under

Pudding and powder help staff learn about hand

hygiene and containing the spread of germs

by Amber Daugherty

Making infection protection fun

Dianagris and Elrica recently went through an education session called the IPAC Olympics to get a hands-on understanding of how bacteria can be transmitted on inpatient units. (Photo: Amber Daugherty)

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SHARING MEDICAL IMAGING DATA TO CUT RADIATION DOSESPatients might expect radiation doses for CT scans to be comparable from one hospital to the next, but a team at St. Michael’s Hospital says the dose variance can be startling. The team is collecting and analyzing data from eight hospitals for the Medical Imaging Metadata Repository of Ontario (MIMRO) to help reduce the province’s average radiation dose per scan. Using artificial intelligence to sort the hospitals’ data, the team generated comparative data by facility, scanner and exam to help determine best practices. MIMRO is funded primarily by St. Michael’s and was created by two of its radiologists, Drs. Timothy Dowdell and Bruce Gray.

Radiologist Dr. Bruce Gray and data analyst Lianne Concepcion review data submitted to MIMRO. (Photo: Katie Cooper)

FIRST PROTOCOL DEVELOPED TO MANAGE MASSIVE HEMORRHAGE

A study published in CMAJ Open outlines the design of Ontario’s first Massive Hemorrhage Protocol (MHP), a set of recommendations for hospitals that will enable rapid and coordinated delivery of blood products in a patient who is hemorrhaging. Until now, there hasn’t been one standard protocol for all hospitals to follow when treating massively bleeding patients, said Dr. Jeannie Callum, lead author and transfusion medicine specialist at Sunnybrook Health Sciences Centre. Co-lead author and transfusion medicine physician at St. Michael’s, Dr. Katerina Pavenski, said this new work will bring together the right care team to the right patient with the right resources.

Patients in Canada and the U.S. who underwent one of four low-risk surgical procedures filled opioid prescriptions within a week after discharge at a rate that was nearly seven times higher than patients in Sweden, suggests a new study. The research found that 76 per cent of the U.S. patients and nearly 79 per cent of the Canadian patients filled a prescription for opioids after their surgery versus just 11 per cent of Swedish patients. “Opioids are routinely prescribed for postoperative pain management in many countries; however, the findings suggest the potential to re-evaluate prescribing practices internationally,” says Dr. Karim Ladha, a scientist at the Li Ka Shing Knowledge Institute.

OPIOID PRESCRIPTIONS FILLED: HOW DOES CANADA COMPARE?

Research from St. Michael’s has shed light on how a class of medications that help regulate blood sugar for patients with Type 2 diabetes can also protect against heart disease. The findings focus on the effect of a diabetes medication – empagliflozin – on cell repair in blood vessels and resulting risks of heart disease. This medication falls under a category of drugs called SGLT2 inhibitors. The research suggests it regulates circulating cells that play a role in heart health. “Clinical trials have shown that SGLT2 inhibitors may protect patients who have diabetes from heart disease,” says Dr. Subodh Verma, scientist at the Keenan Research Centre for Biomedical Science. “Before our study, it wasn’t clear why.”

DIABETES MEDICATION SHOWS POTENTIAL TO REDUCE HEART DISEASE

New study’s findings point to the differences in preference and culture of patients and providers says Dr. Karim Ladha, scientist at LKSKI. (Photo by Katie Cooper)

A multidisciplinary team at St. Michael’s, led by Dr. Subodh Verma, collaborated with Western University’s Robarts Research Institute on this work.

(Photo by Medical Media)Charmaine Coleman loves working with residents in Sumac House

in the Cardinal Ambrozic Houses of Providence. From their morning

smiles, to the stories and hugs they freely offer, working in one of the

Houses’ two dementia units brings her joy and satisfaction. Over the

years, she has dreamed of building something special to reciprocate

those feelings.

Coleman is a Resident Assistant (RA) who has worked in the

Houses of Providence for 16 years, with seven of them in Sumac

House. At a recent conference, she learned how colour has a positive

effect on residents living with dementia. Bright colours can invite

connection, instil a sense of welcoming, and promote happiness.

In June, Coleman introduced the idea of Colour Days for Juniper

and Sumac Houses. People living, working and visiting in the units are

encouraged to dress in the designated colour of the day, six days a

week.

“I wanted to do something for the residents, and also something that

could bring the staff together as a big team with laughter and fun,”

says Coleman.

The RAs will dress residents in that day’s colours if they have

something in their closet that has even a hint of the right shade.

For residents who are more communicative, RAs show them

possible options and encourage residents to make their own decisions

on what to wear.

“We get residents energized and smiling by dancing and singing

in our matching colours,” says Coleman. “It’s amazing how a little thing

can get people so excited.”

Coleman is equally pleased that family members, personal

caregivers, and volunteers are also getting into the spirit, as are staff

from other units.

“It makes me very emotional, to think that we can touch people

in this way. I’m privileged that after 16 years I was able to finally create

something special for my Houses family.”

“It makes me very emotional, to think that

we can touch people in this way.”

by Emily Dawson

Resident Assistant inspires joy through ‘Colour Days’ The Sumac and Juniper House staff are all smiles as they enthusiastically

embrace Colour Days.

OUR SHARED PURPOSE8

It’s clear that resusTO — a hybrid simulation-resuscitation

conference organized in partnership with St. Michael’s Hospital

— is different.

From branding inspired by a prolific southern California rapper, to

a program that included an escape room simulating being inside an air

ambulance, this year’s resusTO was boldly rejecting the conventions

of medical education conferences.

“ResusTO is different from other conferences in that it’s very

interactive,” said Dr. Christopher Hicks, an emergency physician and

trauma team leader at St. Michael’s and chair of the conference. Dr.

Hicks and Melissa McGowan, the research education co-ordinator for

the St. Michael’s emergency department, collaboratively organized the

conference, which took place on Sept. 10 and 11.

“Our plenary lectures delivered by the faculty are followed by

some sort of hands-on workshop. It gives participants an opportunity

to practice what they’ve learned so that it has more permanence

carrying forward into their practice,” Dr. Hicks said.

Participants from around the world travelled to Toronto for

this year’s conference, the follow up to last year’s highly successful

inaugural event. Dr. Hicks, McGowan and the entire organizing

committee feel gratified by the success and feedback they’ve received

so far, which they credit to the teamwork of St. Michael’s staff.

“They say it takes a village, and to execute an innovative event like

this, it really does,” she said. McGowan acknowledges the contributions

of Emma O’Neil, Andrea Meeson, the Emergency Department and the

team at the Allan Waters Family Simulation Centre – which is accredited

by the Royal College of Physicians and Surgeons of Canada.

The event was also made possible by staff from environmental

services, AV, catering, medical media, clinical equipment, procurement,

telecommunications, print shop, planning, and respiratory therapy and

finally all the volunteers – many of whom took vacation from their day-

to-day job at St. Michael’s to help make it a success.

At its core, resusTO is about challenging health care providers and

inspiring them to think beyond their current practice, said Dr. Hicks.

He believes the conference engages the medical community in a

novel way, which would not be possible without support from hospital

leadership.

“There is a true commitment to medical education and medical

innovation at St. Michael’s.”

“There is a true commitment to medical education

and medical innovation at St. Michael’s”

by Jennifer Stranges

resusTO: Not your typical medical conference

The follow up to last year’s highly successful inaugural event brought in participants from

around the world. (Photo: Yuri Markarov)