HHR June 30 2015 - The Heartland Health Region

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June 30, 2015
In my recent discussions with Family and Resident Councils around the region there has been lots of talk about the
issues facing long term care facilities. These issues have garnered media attention, the attention of the Provincial
Ombudsman, and the Provincial Auditor. Heartland has been the subject of some of this attention. We had a
medication management audit within the last year that resulted in a number of recommendations from the
Provincial Auditor. One of the items that we were directed to address is the use of anti-psychotic medications in long term care. This
is an issue that is being discussed across the country.
This week I read an article from "Healthy Debates" about the use of anti-psychotic medications in Ontario's nursing homes that I
thought was interesting. Physicians, nurses, administrators, advocates, residents, caregivers, and others all have opinions about how
medications are prescribed and managed in long term care facilities. This is a complex issue that all of us in the long term care
business have a responsibility to increase our understanding of.
This week, I offer these excerpts from this article on Ontario's experience. Read it over and consider improvements that we need to
make in our long term care facilities in order to be able to say that we are following best practice here.
"The problem of inappropriate and over prescribing of antipsychotics has recently been put back in the spotlight by a Health Quality
Ontario report that demonstrates a wide variance in prescription rates across LTCHs in Ontario.
The modest decrease over the last few years may be due in part to Ministry of Health and Long-Term Care funded initiatives such as
Putting the PIECES together and Behavioural Support Ontario, which aim to provide LTCH staff with better training to serve patients
with dementia.
Aggression is not unique to people with dementia, and most people with dementia will never behave aggressively. However, nearly
one third of people with dementia (especially in the advanced stages), will at times behave aggressively. Frequently, aggressive
behaviors are triggered by social and environmental factors such as social isolation, changes in routine, or feeling ignored, as well as
psychological factors such as depression or stress due to not being able to complete tasks. Often, these factors are amplified when a
person is admitted to a hospital or long term care facility, where antipsychotics are used to reduce aggression, even when social,
environmental or psychological interventions would be more appropriate.
Another root of the problem is lack of knowledge about the alternatives. A 2008 study, by Paula Rochon, vice president of research at
Women’s College Hospital and her colleagues found that regulatory warnings from Health Canada and pharmaceutical companies
about the adverse effects of antipsychotics on patients with dementia had a limited impact on prescription practices. “When you have a
warning and it tells you not to do something, it doesn’t necessarily tell you what to do. And in the case of being told not to prescribe
one drug, we don’t have another drug to go to that’s safe and works, that’s a clear option,” she explains.
The AUA provided resources to assist facilities in developing individualized care plans through family consultations and team problem
solving. Sites were expected to implement a 12-step sequential action plan and were supported with a toolkit of resources.
This approach also stresses non-pharmacological management as first-line treatment for behavioral symptoms of dementia. These
social and environmental interventions include providing more structure to a patient’s day, scheduling events to adjust to a patient’s
needs, and shifting an agitated patient into an activity he or she enjoys such as going for a walk or listening to music. It also
recommends verbal and non-verbal communication techniques such as speaking at eye level, approaching from the front and
communicating in a clear, empathetic, adult tone of voice. All of these techniques are evidence-based, and aim at adjusting the
physical, environmental and psychosocial stressors that may lead to aggression.
The preliminary results of this initiative have been quite encouraging. Like Ontario, Alberta has experienced a modest decline in the
percentage of LTC residents on antipsychotics, from and average 26% in 2012 to 22% in 2014. However, the 11 AUA early adopter
sites were able to reduce their use of antipsychotics by half within 9 months, without changing staffing ratios. Additional benefits have
included an increase in staff workplace satisfaction, improvement in the quality of life for residents and greater attention to the
underlying causes of behavior including pain, side effects from other medications and actual psychotic illnesses. It became “less of a
project aiming to reduce inappropriate antipsychotic use and more a project to support LTCHs in their dementia care,” notes Dennis
Cleaver, executive director of the Seniors Health Strategic Clinical Network.
Another strategy that has been utilized in other jurisdictions including the United States has been requiring public reporting on
antipsychotic use in LTCH. Starting in June 2015, the Canadian Institute for Health Information (CIHI) will expand its web-based tool
Your Health System to provide individual and regional LTCH indicators including the inappropriate use of antipsychotics and restraint
use in LTCH. This nation-wide public reporting of individual LTCH indicators will be the first of its kind in Canada and it may
provide increased incentive to reduce this problem."
http://healthydebate.ca/2015/06/topic/community‐long‐term‐care/antipsychotics HEARTLAND LINK…..
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To the new hires in
Heartland Health
Region
Welcome to the new hires in Heartland Health Region who took Regional Orientation in
June. Please welcome your new colleagues to the region and your facilities.
Kindersley Primary Health Services Area
Facility
Kayla Olson – Laundry/Dietary Services
Kindersley Health Centre
Courtney Ady – Admin Assistant
Kindersley Health Centre
Outlook Primary Health Services Area
Facility
Christine Doyle – CCA
Davidson Health Centre
Renee Manz – Dietary Services
Davidson Health Centre
Dean Bencharski – EMR
Dinsmore Health Centre
Rosetown Primary Health Services Area
Facility
Sara Taylor - GPN
Biggar Health Centre
Kendra Wisse – CCA
Rosetown Health Centre
Mary Karbo – RN
Biggar Health Centre
Carrie Littlebear – RN
Biggar Health Centre
Candace Moon – CCA
Biggar Health Centre
Stephanie Park – Environmental/Dietary Services
Biggar Health Centre
Tina Park – Environmental Services
Biggar Health Centre
Natasha Taylor – Admin. Assistant
Biggar Health Centre
Tracy Ekman – Environmental Services
Biggar Health Centre
Susan McNeil – CCA
Biggar Health Centre
Dawn Rivard – Environmental/Dietary Services
Biggar Health Centre
Allison Ozog – Pharmacist
Rosetown Health Centre
Shauna Goulet - Environmental/Dietary Services
Biggar Health Centre
Unity Primary Health Services Area
Facility
Josie Bayliss – CCA
Macklin Health Centre
Lyann Bolton – RN
Macklin Health Centre
Kylie Walz – CCA
Unity Health Centre
Kelsie Klein – EMR
Unity Health Centre
Corinne Knox – Admin Assistant
Macklin Health Centre
Laura Schwab – Dietary Services
Wilkie Health Centre
Manoja Kikkaduawa – CCA
Wilkie Health Centre
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A U of S College of Medicine Student
Showing Leadership
Jillian Kerry, currently enrolled in the College of Medicine at
the University of Saskatchewan, joins a prestigious group of
16 colleagues as a winner of the Royal Bank of
Canada-Canadian Federation of Medical Students
(RBC-CFMS) leadership award.
The national awards are handed out in the spring of each
year to medical students studying across the country who
go above and beyond their studies and show a commitment to their schools and communities.
Winning one of these awards is no small feat.
Each nomination consists of four parts: a personal statement that outlines not only why each applicant goes into
medicine, but how they contribute to the college and community; a letter of good standing from the College in
which each person is enrolled; a resume; and, at least two more letters of reference from individuals who are
familiar with the applicant’s leadership accomplishments.
Jillian has saskdocs’ very own CEO, Dr. Dennis Kendel as reference and mentor. She felt having a mentor to learn
from definitely helped her with the award application.
“I thought Dr. Kendel would be a really good fit for me to have as a mentor. He provided me with so much
guidance, advice and tips on leadership that I can’t say enough how much his mentorship helped me win this
award. He also left me this spring with a list of many, many books on leadership that I have to read over the
summer.”
Although Jillian is definitely an up-and-coming leader in Saskatchewan’s medical community, being a doctor
wasn’t her first career choice. It was a profession she thought long and hard about before applying to medical
school.
“Prior to medicine I completed my graduate and undergraduate degrees at the Edwards School of Business at the
University of Saskatchewan (U of S). But, while I was completing those degrees I always made sure my electives
were in the sciences like organic chemistry and physics. So when I pursued my first job with a Master’s in
Accounting, it didn’t take me long to realize that I wanted more. So on a trip home from Nova Scotia one summer
I started thinking more and more about what I wanted and when I got home I phoned my boss to say we needed
to have a meeting. Once I made that decision to quit accounting and go into medicine, I knew it was the right fit.”
Dr. Kendel and saskdocs are pleased to have Jillian as a student ambassador at the U of S College of Medicine, as
our relationship with the College is instrumental in finding the right doctors for the right practices. Mentoring
future doctors throughout their medical education in this province is just one more way to help us keep as many
Saskatchewan leaders here at home.
Reprinted from the SaskDocs summer newsletter, June 2015
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Kerrobert and District Health Centre phones have changed as
they upgraded to the new VOIP system when
they moved to the new building
Check out the new phone listings for Kerrobert below:
Exten‐
Phone Name 2800 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2815 2816 2817 2818 KERR ADMIN 1 KERR ADMIN 2 KERR STAFF RM KERR MTG RM KERR MTG RM 2 KERR MAINTENANCE KERR HOUSEKEEP J DUPUIS KERR DIETARY B MEYER K KISSICK KERR LTC 1 KERR LTC 2 D BODY KERR PUBLIC HLTH KERR PUB CLINIC T SIBLEY KERR HC NURSE 2819 2820 2821 2822 2823 2824 2825 2826 2827 2828 2829 2830 2831 2832 2833 2835 2847 2880 2881 2882 2883 KERR THERAPIES KERR VIS PROF 1 KERR VIS PROF 2 V MEIER KERR VIS PROF 3 KERR LAB T HEIDT KERR X RAY KERR CARE CONF KERR NURSING 1 KERR NURSING 2 KERR TRAUMA KERR PORTABLE 1 KERR PORTABLE 2 KERR PORTABLE 3 KERR PALLIATIVE K KEMBEL KERR CLINIC 1 KERR CLINIC 2 DR WENTZEL Y VERONELLY The new Kerrobert Clinic numbers in
red above will not be activated until the
clinic moves into the new facility later
this summer or early fall.
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Unity and District Health Centre phones to go live with
VOIP on July 7, 2015
Check out the new phone listings for Unity below:
Unity Phone List 306‐228‐2666 Extension Phone Name 2900 UNITY ADMIN 2901 M UZELMAN 2905 BIG BOARDROOM 2906 SMALL BOARDROOM 2930 D VANSEGGELEN 2976 UNITY NURSE PORTABLE1 2977 UNITY NURSE PORTABLE2 D BOSER 2978 UNITY BABY CLINIC 2959 C NODWELL 2979 UNITY LAUNDRY 2960 UNITY HEALTH RECORDS 2 2980 UNITY LTC NURSES 2961 N SPERLE 2981 A REINIGER 2962 S GEREIN 2982 UNITY LAB 2955 UNITY YELLOW LTC 2956 UNITY GREEN LTC 2957 UNITY PINK LTC 2958 2931 UNITY ULTRASOUND 2963 UNITY LTC PHARM 2983 UNITY XRAY 2933 S THURSTAN 2964 M SCHWAB 2984 C LEWIS 2941 W WALLACE L ARSENAULT T HEITT UNITY HEALTH RECORDS 2985 2942 2965 2966 K JOHNSON 2988 N WANGLER 2943 S WEBER 2968 T RESCHNY 2989 A CHAN 2944 L PRESCOTT 2969 C BOUCHER 2990 UNITY HCNURSE 2945 B BELSEY 2970 UNITY ACUTE 2991 C SPERLE 2946 B STEPHENSON 2971 NURSES ACUTE 2992 L MABBETT 2947 C GIENI 2972 K STABBLER 2994 UNITY KITCHEN 2948 UNITY D5 PORTABLE 2995 UNITY DINING 2996 UNITY MAINT 2949 2997 UNITY MAINT BASEMENT 2998 UNITY VISITING PRO 2973 UNITY N CORRIDOR UNITY D5L PORTABLE 2974 UNITY TROOM1 2950 J GROTH 2975 UNITY EMERGE 2951 C BRIDGEMAN 2953 J SCHURMAN 2954 C BRODY Remember these
numbers are not in
effect until they go
live on July 7th, 2015.
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Thank you to all those who helped to plan and setup Employee and Physician
appreciation events this past month. Also a special congratulations to all those
who have reached milestones in their career with Heartland Health Region this
year!
I now want to remind those who received letters inviting them to log into our
provider website to select your gift of choice, to do so on or before July 15,
2015.
If you have any questions, or have misplaced your log in information, please
feel free to contact me directly at 1 (306) 867-9701 or email me at
HHRappreciation@hrha.sk.ca.
Thank you, Leona Anderson—R&R Coordinator
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Rosetown Celebrates Canada Day
With an Ice Cream Break
On June 25th the Rosetown Activities
group organized a Canada Day Ice
Cream Break for the staff at the
Health Centre and Corporate Office.
There were 2 kinds of ice cream
available for staff to sample on their break! There were
also lots of Canada Day goodies
that were raffled off!
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Your Mental
Health
Mental health means striking a balance in all
aspects of your life: social, physical, spiritual,
economic and mental. Reaching a balance is a
learning process. At times, you may tip the
balance too much in one direction and have to
find your footing again. Your personal
balance will be unique, and your challenge will be to stay mentally healthy by keeping
that balance.
Mental Health for Life
Mental health is key to our well-being. We can’t be truly
healthy without it. It involves how we feel, think, act, and
interact with the world around us. Mental health is about
realizing our potential, coping with the normal stresses of
life, and making a contribution to our community. It may be
more helpful to think of good mental health as thriving.
Good mental health isn’t about avoiding problems or trying
to achieve a ‘perfect’ life. It’s about living well and feeling capable despite challenges.
Mental well-being is bigger than the presence or absence of a mental illness. People
who live with a mental illness can and do thrive, just as people without a mental
illness may experience poor mental health.
Brochure – Canadian Mental Health Association – click below
file:///C:/Users/lp2/Downloads/MH-for-Life-NTNL-brochure-2014-web%20(2).pdf
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Kindersley Employee Appreciation
Our "Hoedown" country themed staff apprecia on luncheon was held June 20th, 2015. Staff were donned in their best country ou its that day. We enjoyed a Pig Roast and smoked BBQ chicken with an assortments of salads and a Banana Split Bar for dessert. Awards were handed out and during our meal we were entertained by Dave and Debbie from the Cash Back Band. They were a two piece band who played us a variety of Johnny Cash tunes. HEARTLAND LINK…..
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