SB News June 09 No.8.indd - Sunnybrook Health Sciences Centre

Sunnybrooknews
Volume 5 No. 8 July 8, 2009
Dr. Marvin Tile to Receive
the Order of Canada
Orthopaedic Surgeon a Founder of Sunnybrook’s Famous Trauma Program
Sunnybrook Health Sciences Centre
would like to congratulate Dr.
Marvin Tile on the recent announcement that he will be appointed as
a member of the Order of Canada
for his contributions as a clinical
orthopaedic surgeon, teacher and
groundbreaking researcher.
Dr. Tile is a world authority on the
treatment of pelvic and acetabular
trauma and has trained clinicians
from around the world in the care
of patients with critical orthopaedic
injuries. Dr. Tile has published two
books and fifty-nine manuscripts
that have shaped the practice of
orthopaedics across the globe.
“Many innovations in trauma care
and orthopaedics were brought to Dr. Marvin Tile
Canada and Sunnybrook through Dr.
Marvin Tile,” says Barry McLellan, President and CEO of
Sunnybrook. “Sunnybrook developed the first and largest
trauma unit in the country in 1976, a concept unknown
in Canada at that time, and much of this is thanks to Dr.
Tile’s expertise and dedication to treating patients with
traumatic injuries and musculoskeletal disabilities. He has
demonstrated outstanding passion for the Hospital and
for improving the lives of thousands of patients.”
Dr. Tile has been Chair of the Examining Board in
Orthopaedic Surgery for the Royal College of Surgeons
of Canada, was the Founding President of the Ontario
Orthopaedic Association, was President of the Canadian
Orthopaedic Association, President of the International
Society for Surgery of the Lumbar
Spine and President of the AO/
ASIF Foundation, an International
Foundation dedicated to research
and education in trauma and
fractures, with head quarters in
Switzerland. He is a renowned
lecturer who has made countless
presentations around the world and
brought honor to his Hospital and
University.
“Sunnybrook is proud of Dr. Tile and
his many breakthrough achievements
in helping people not only survive
traumatic injury but also in improving
their mobility and independence by
overcoming many serious orthopaedic issues,” says David Leslie, Chair of
Sunnybrook Health Sciences Centre’s
Board of Directors. “Sunnybrook is
fortunate to be home to leaders such
as Dr. Tile. His career has helped define the hospital’s vision
to invent the future of health care.”
Dr. Marvin Tile was born in Toronto where he attended
Harbord Collegiate and the University of Toronto, graduating with B.Sc. (Med.) and M.D. degrees. He received his
FRCSC in 1963 subsequent to which he visited major
orthopaedic centres in England and Europe as a Detweiler
Traveling Fellow. Dr. Tile was appointed to the surgical
staff of the Sunnybrook Hospital in 1966 and became
Chief of the Division of Orthopaedic Surgery in 1971.
From 1985 – 1996 Dr. Tile was Surgeon-in-Chief following
which he Chaired the Sunnybrook Foundation.
Dr. Andy Smith
Appointed Chair of
General Surgery at
University of Toronto
Dr. Andrew Smith,
Sunnybrook’s Head of the
Division of General Surgery
since 2003, has been appointed to the position of
Chair of General Surgery,
University of Toronto. A
talented clinical surgeon
who deals with complex
colorectal cancer, Dr. Smith
also runs an extensive
knowledge translation program in colon cancer.
Dr. Andy Smith
After completing medical
school at the University of Toronto, Dr. Smith completed
his General Surgery Residency as well as a Masters of
Science at the University of Toronto. He then completed a
Surgical Oncology fellowship at Memorial Sloan-Kettering
Cancer Centre in New York. Dr. Smith also works as a
Surgical Oncologist at the Odette Cancer Centre and an
Associate Professor in the Department of Surgery at the
University of Toronto.
Congratulations to Dr. Smith on this appointment.
Photos by: Doug Nicholson
A Distinction too Rare
New Approach Promises More Accurate
Diagnoses for Bipolar Patients
By Jim Oldfield
Dr. Brian Cuthbertson Appointed Chief of
the Department of Critical Care
After a comprehensive selection process that included
interviewing
several
very
capable candidates, Dr. Brian
Cuthbertson has been selected as Chief of the Department
of Critical Care at Sunnybrook
Health Sciences Centre.
Dr. Cuthbertson is currently the Professor of Critical
Care and the Consultant in
Intensive
Care
Medicine,
Dr. Brian Cuthbertson
Health Services Research
Unit, University of Aberdeen,
Scotland. He earned his Bachelor’s Degree in Medicine
in 1990, his Doctorate in 1997 and he became a Fellow
of the Royal College of Anesthetists in 1994. He has
extensive experience in intensive care, critical care and
anesthesia.
In Aberdeen, Dr. Cuthbertson is renowned as a clinical
teacher. He currently serves as the Coordinator for the
final year medical school program, similar to the clinical
clerkship at the University of Toronto. He co-developed a
course for care of the critically ill, the first of its kind,
that combines small group teaching with experienced
interprofessional tutors and teaches combined groups
of undergraduate medical students with critical care
nurses and physiotherapists.
Dr. Cuthbertson is an internationally recognized clinical researcher, studying multiple facets of critical care
including patient safety, improving outcomes from
critical illness and reducing the risk of major surgery.
During his career, he has been awarded about $8 million in research grants. He has also authored numerous
peer-reviewed contributions to the literature, contributed book chapters and is a sought-after speaker in the
many areas of this expertise.
Sunnybrook Health Sciences Centre is incredibly fortunate to have recruited an individual with the capabilities, experience, reputation and enthusiasm of Dr.
Cuthbertson.
Dr. Cuthbertson, along with his wife and two daughters, will be relocating to Toronto this summer and he
will join Sunnybrook in the fall.
Dr. Ayal Schaffer
In 2007, Dr. Ayal Schaffer, an associate scientist at
Sunnybrook Research Institute, uncovered a disturbing
treatment pattern in patients with bipolar disorder. He
found that Canadians with the disease—which his earlier
work suggested number 500,000—were more likely to be
on antidepressants than on any other medication.
The discovery was worrying because research shows
that antidepressants taken without a mood stabilizer can
make bipolar disorder worse by inducing mania (mood
elevation) and pushing patients toward the up-and-down
mood extremes that make the disease so debilitating.
continued on back page
EVENTS
Patient Safety Researcher Aims to Improve
Clinical Communication
Invitation to join the new Sunnybrook
Sustainability Committee
By Alisa Kim
Paging errors contribute to delays in responding to medical problems as nurses usually contact numerous people
before reaching the appropriate physician. Compounding
the problem is the difficulty in keeping physicians’ contact information up-to-date when pager numbers are
located in various places throughout a ward.
Are you passionate about the environment and
keen on making Sunnybrook a more sustainable
workplace? If yes, we want you to join the new
Sunnybrook Sustainability Committee! We are looking
to put together a team of 15 to 20 individuals who
can become Eco-Champions for various wings of the
facility. You will become the environmental voice of
your department and will have the opportunity to:
•Be an integral part of a committed team
•Be directly involved with initiatives that have helped
Sunnybrook to become one of the greenest health
facilities in Canada.
•Raise environmental concerns and issues regarding
your wing or department
•Participate in the discussion and decision-making
that takes place around such issues
•Enhance your overall knowledge of environmental
sustainability
•Bring fresh ideas and solutions to the table
•If you are interested in becoming a member of the
sustainability committee please respond to Beverley
Townsend, Manager of Environmental Sustainability
at [email protected] and let us
know your thoughts or ask us any questions you
may have. We can then email you an application
form. A preliminary meeting will be held in the
coming weeks. Thank you for being involved!
Shoppers Home Health Care RED DOT Sale
Shoppers Home Health Care in SCIL (Bayview campus,
UG01) has exciting news to announce. Starting June
10, 2009 all RED DOT items will be 60 per cent off
the regular price. We have a LARGE inventory of new
compression stockings, 8-15mmHg, 15-20mmHg and
20-30mmHg etc. Some are selling for just over $9.
Also we have added a stock of foot care accessories
i.e.. (Silicone gel toe separators, hammer toe crest,
etc.) Knee Braces and other supports, Electric Heating
Pads, canes, reachers, and assistive devices for daily
living.
For further information please feel free to visit or call
us at Shoppers Home Health Care at 416-480-5966.
www.shoppershomehealthcare.ca
10th Annual Sunnybrook Staff Golf Tournament
With all the beautiful weather, it is time to go
outside and play golf. Please join us for the 10th
Annual Sunnybrook Staff Golf Tournament on Friday,
September 11th, 2009. This year we are trying out
a new golf course and we would like to see lots of
Sunnybrook staff, physicians and volunteers having
fun together. Please see the details listed below, it is
never too early to get your teams organized, named
and submitted to Karen Fritz or Thomas Corse.
Date: Friday, September 11, 2009
Place: Station Creek Golf Club (12657 Woodbine
Avenue, Gormley)
Shotgun Start: 1:00pm
Dinner: 7:00pm
Cost for the day is $100.00 (includes green fees, power
cart, dinner) Can’t make the game? Come for dinner,
only $30.00
*Shower & Locker facilities are available*
Registration is now Open! To book your spot and
submit your payment, please contact:
Karen Fritz, Sunnybrook Room C-116b Ext. 5327
or Thomas Corse, Sunnybrook Room J-G22 Ext. 5991
Deadline for payment is on Friday, August 28th, 2009
Dr. Brian Wong
The “if it ain’t broke, don’t fix it” mentality that can mire
large organizations in stagnation and inefficiency doesn’t
sit well with Dr. Brian Wong.
Wong is a physician in the Division of General Internal
Medicine at Sunnybrook Health Sciences Centre and an
associate scientist at Sunnybrook Research Institute who
specializes in patient safety and quality. His research on
hospital paging errors has just been published in the
Archives of Internal Medicine.
For over a year, Wong studied the hospital’s system of
paging doctors, focusing on paging errors and ways of reducing them. Although hospital paging errors are not considered headline news, the importance of timely responses
to medical complications certainly is. “Paging error is a
serious problem, but one that is not widely reported,” says
Wong. “Long delays may lead to serious medical problems.”
In his analysis, Wong found that one in every seven pages
was sent to a doctor who was not on duty, which he defined as an error for the purposes of the study. Of these,
Wong found that one-third of the messages involved
medical issues that needed to be dealt with within one
hour, while 15 per cent of the pages involved situations
that required immediate action.
To address this issue, Wong devised a new centralized
paging system—a pilot program on one of the general medicine wards—wherein nurses would summon
residents from any computer terminal on the ward.
Pager numbers were removed from other locations
and could only be accessed using the hospital’s “Smart
Web” computerized paging program, which was linked
to physicians’ schedules and updated regularly. He then
ensured that each of the four physician teams had a resident responsible for fielding all pages during a particular
shift. When nurses sent pages to any of the four teams,
the messages were redirected to the resident scheduled
to respond to the pages during that time.
The impact of these reforms is being studied. One benefit
of this new system is that it does not require new investment in equipment or technology. “We weren’t taking
advantage of its capabilities,” says Wong of the “Smart
Web” software. “The beauty of the [new] system was that
no new purchases or upgrades needed to be made. It was
simply a matter of reorganizing the information that was
there and making sure it was up-to-date.”
Last July, all four wards of the division of general internal
medicine implemented the new paging system. While he
is hopeful that it will be adopted throughout the hospital,
Wong recognizes that an openness to change, particularly from the hospital’s leadership, will be required. “It’s
an important next step for all nursing wards, including
long-term care wards. It involves a shift in philosophy of
how paging is done.”
Qmentum Accreditation: A New Framework
for Supporting Quality Improvement
by Brigette Hales
Throughout April and May, several representatives from
across the hospital had the opportunity to participate
in the first step of the Qmentum Accreditation process
known as the ‘self-assessment’. This involved completing
a self-assessment questionnaire (SAQ) based on Canadian
standards. All accreditation teams have now received the
results of these SAQs and will be working to develop an
Action Plan to address any areas of concern that were
identified by their own feedback.
In past accreditation cycles, recommendations for improvement were given by external surveyors following an
on-site audit. With this new self-assessment being completed by frontline staff, the recommendations received
are based entirely on their own perceptions of how well
they meet the Canadian standards in their own area of
work. In essence, frontline staff members have become
the surveyors.
This change is seen as a significant improvement to several teams. Says Marion Deland, Patient Care Manager of
the Neonatal Intensive Care Unit: “I think the new process
is a great way to identify gaps because it is the team itself
that identifies them. It becomes personal, so there is a lot
of ownership over what the teams identify.” Linda JonesPaul, Patient Care Manager of the General Medicine Unit
on B4 agrees with the benefit of involving frontline staff
in the self-assessment: “I like [the new process] because
you’re asking the health care providers the issues, rather
than the managers”.
Recommendations lead to ongoing quality
improvement
Recommendations received through the accreditation
process, whether from surveyors or based on staff selfassessments, provide great momentum for local quality
improvement.
The NICU team was already actively examining opportunities to improve the identification processes for their tiny
patients when they received a similar recommendation
from Accreditation Canada in 2007.
In follow up to this recommendation, the NICU identified
a keen nurse among the team to champion a Quality
Improvement project to identifying a safer, more
reliable solution for identifying the neonates. Following
an extensive search process and evaluation of several
options, the final selection was the use of personalized
beaded necklaces – a solution that continues to provide
them with the safest possible method for identifying their
premature infant Population.
The General Medicine group also received a recommendation from the last accreditation cycle related to the
creation of an interdisciplinary tool for assessing elderly
patients and planning their care – a concept that had
already been previously identified and discussed at their
General Medicine Program Council. “We knew we needed
to do it to reflect best possible care for our patients at
Sunnybrook” says Jones-Paul.
The team has worked over the last few years to create
several iterations of an interdisciplinary screening tool
for the evaluation of the elderly, based on the acronym
SPPICES (Stability/Falls, Polypharmacy, Pain, Incontinence,
Confusion, Eating & Nutrition, Skin).
“The SPPICES tool is used as an early identification tool
indicating geriatric issues requiring prompt intervention
in order to plan care effectively and prevent further deterioration or complications” says Betty Matheson, Patient
Care Manager for Specialized Geriatric Services, who
co-led the group through this quality improvement initiative. The SPPICES tool has since been integrated into the
Kardex to become part of an Inter-Professional Care Plan
that is now used on all General Internal Medicine floors.
Accreditation Teams can expect equally meaningful
recommendations arising from this new process, where
self-assessment results come directly from their own
staff. Accreditation Team leaders will be looking to
frontline staff to provide input into the results of the selfassessment and share ideas on how recommendations
can be addressed.
For more information about the
Qmentum Accreditation program
and how you can get involved, visit
Sunnynet under ‘About Us’ or email
Brigette Hales at
[email protected]
Submission deadline for next issue: September 18, 2009
Issue date: September 24, 2009
Sunnybrook Staff Recognized for Clinical and Academic Excellence
The Seventh Annual Schulich Awards
by Laurie Legere
On the evening of June 4th, family, friends and
colleagues gathered for the seventh-annual Schulich
Awards for Nursing and Clinical Excellence and the
Schulich Awards for Academic Excellence.
The awards recognize ten regular employees who
work in the areas of diagnostic, therapeutic and direct
clinical patient care and three fourth-year graduating
medical students who demonstrate clinical and
academic excellence.
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Dr. Barry McLellan, President and CEO joined coChairs of the Clinical & Nursing Excellence Awards
Marilyn Reddick, VP of Human Resources, Dr. Brian
Gilbert, chief of the Schulich Heart Centre and chair of
the Academic Awards, Dr. Leslie Nickell to honour the
award recipients and pay tribute to their exceptional
accomplishments.
“Tonight we honour a group of award winners who
truly contribute to the vision of Sunnybrook for they
are inventing the future of health care each and
every day,” said Dr. McLellen. “In their work, they
demonstrate a commitment to learning, exemplary
work with our patients and a talent for innovation.”
Dr. Brian Gilbert shared with the audience a brief
history of the award, adding, “This tremendous award
has been made possible by the generous donation from
Dr. Seymour Schulich, a wonderful supporter of our
hospital. Dr. Schulich’s support of this award is fueled
by a deep sense of commitment to the community and
a desire to reinforce the profound importance of using
our individual talents and resources to contribute to
society in whatever way we can. The Schulich award
winners are perfect examples of the tremendous
impact we can make when we strive for excellence in
everything we do.”
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Photos by: Doug Nicholson
Winners of the Seventh Annual
Schulich Awards for Nursing & Clinical
Excellence
Paul McMullin (1) - Technician, ECHO Lab,
Cardiology
Tracey Das Gupta (2) – Advance Practice Nurse,
Cancer Program
Lina Gagliardi (3) – Social Worker, C4
Susan Bates (4)– Clinical Resource Nurse, Cardiac
Cath Lab
Darrel Sparkes (5)– Charge Nurse, Operating
Room
Susan Robarts (6 left) - Advanced Practice
Physiotherapist, Holland Hip and Knee Program
Veronica Palinkas (6 middle) – Physical Therapist,
Holland Centre and Advanced Practice Physical
Therapist, Sunnybrook Fracture Clinic
Yvonne Ramlall (6 right)– Registered Practical
Nurse, 3 East, Holland Centre
Leslie Plauntz (7) – Registered Nurse, Division of
Plastic Surgery
Maureen Luther (8)– Physiotherapist, Newborn
& Developmental Paediatrics, Women & Babies
Program
Winners for the Seventh Annual
Schulich Awards for Academic
Excellence
Jennifer Boyd (1) – 4th Year Medical Student
Danielle Kain (2) – 4th Year Medical Student
Kristen Brown (3) – 4th Year Medical Student
Sunnybrook Nursing Leader Selected for
Distinguished Award
By Rosemary Irish
Mary Glavassevich, Patient Care Manager on C2 was
awarded the Prestigious Lawrence S. Bloomberg Faculty
of Nursing Award of Distinction.
The Award recognizes great achievements made by a
Lawrence S. Bloomberg Faculty of Nursing Graduate.
The recipient of this award has made significant lifetime
dedication and contributions to health care and the nursing profession according to the Alumni Awards Selection
Committee. The Committee acknowledged that Mary has
made contributions in the Community and established
herself as a mentor and advocate for the profession. To
sum up: “the recipient embodies a true nurse leader.”
The Selection Committee was very impressed with
Mary’s ongoing commitment to Oncology Nursing. She
was also honoured for being a role model for her peers,
students, faculty, and for the difference she has made
to health care and the profession. Anyone who knows
Mary is well aware of her dedication and commitment
and the role she has played in mentoring many nurses.
In her acceptance speech Mary said: “My education has
enabled me to not only support my own professional
development, but to support other nurses as mentor.
The role of mentoring is important to me and brings
me satisfaction.” Congratulations Mary for receiving this
well deserved Award of Distinction.
Mary Glavassevich Winner of the Lawrence S. Bloomberg
Faculty of Nursing Award of Distinction
Winners of the 2009 Feldman Patient Safety Leadership Award
BY LAuRA BRISToW
On Thursday May 21st three Sunnybrook teams were
awarded the 2009 Feldman Patient Safety Leadership
Award following Patient Safety Rounds in the McLaughlin
Auditorium.
The K2C/K2E Interprofessional Team, including
Lawrence Jackson BScPhm, Suzanne Plowman PCM,
Patricia Williams RN, Imelda Tablizo RN, Michael Matthews
MD, Evelyn Williams MD, and the nursing staff of K2C/E.
The annual award is given to teams who demonstrate
a commitment to the improvement and promotion of
patient safety.
• The safe use of medications by residents of the
Veterans Centre is being enhanced by the implementation of a new procedure that allows nurses to more
effectively communicate the effects of medications to
all members of the health care team. The K2C/K2E interprofessional health care team designed a method to
improve communication among nurses and to support
nurses in the selection of medication-related monitoring parameters. As a result of this interprofessional
collaboration, nurses, physicians and pharmacists are
able to evaluate therapeutic outcomes more accurately
and make timely dosage or medication adjustments
as needed. In addition, other care providers are able
to assess the impact that medications may have on
their plan of care. This care process improvement is
being incorporated into the electronic documentation system. Nurses routinely monitor the effects of
medication to ensure optimal care. Nurses document
their observations in the medical chart in order to communicate medication effectiveness or side effects to
other members of the health care team.
The winning teams and their projects are as follows in no
particular order:
The PAGER Team (PAGing Error Reduction), including Brian M. Wong (Team Lead - see profile
on pagetwo), C. Mark Cheung, Cecily Cheung,
Hasan Dharamshi, Sonia Dyal, Edward Etchells,
Carolyn Jardine, Andrea Reid and Khalil Sivjee.
• The team developed a New Paging Process on the
General Medicine service to prevent sending pages to
the wrong physician, which can result in unnecessary
delays and potentially threaten patient safety. The two
main contributing factors to this problem were: the
physician call schedule lacked sufficient information to
identify the most responsible physician for a given patient. Second, the existing paging process was random
and unsystematic, leading to pages sent to the wrong
physician. The team linked the physician call schedule
to the web-based SMART paging system and ensured
that there was always one resident who would respond
to pages at any given time for each General Medicine
team. The team then instructed nurses to use only the
web-based SMART paging system to page physicians,
creating a reliable, systematic process for sending
pages to physicians on the General Medicine service.
From left: Edward Etchells, Sonia Dyal, Hasan Dharamshi, Cecily Cheung, Brian Wong, Mark Cheung
From left: Dr. Evelyn Williams, Dr. Michael Matthews, Lawrence
Jackson, Imelda Tablizo, Patricia Williams, Suzanne Plowman
Members of the Neonatal Intensive Care unit (NICU)
Pharmacotherapeutics Committee, an interprofessional
team focused on medication use in the NICU. Its members
include: Dolores Iaboni, Chair and Clinical Pharmacist;
Carla Findlater, Clinical Pharmacist; Ali Estifaee and
Guia Cruz, Pharmacy Technicians; Dr. Eugene Ng, Staff
Neonatologist; Wendy Moulsdale and Esther Perkins,
Specialty Nurse Practitioners; Cheryl Philips, NICU Nurse
Educator; Stefanie Parashyniak, Respiratory Therapist;
Marion DeLand, NICU Coordinating Manager; and Joan
Ross, Corrie Scott, and Anne Cooke, NICU Staff nurses.
• A multidisciplinary group of NICU team members designed a preprinted physician order form to be used
upon admission to NICU to decrease prescribing errors caused by handwritten medication prescriptions.
During a one-month period prior to implementation,
an audit of all admission orders for NICU was performed using 25 criteria for prescribing errors. The
pre-printed standard form for NICU admissions was
implemented in May 2008. Members of the committee were available during the first week to provide
orientation to staff regarding the use of the new form.
A second audit was performed for a two-month period
following implementation using the same 25 criteria.
With the implementation of the preprinted form, the
rate of total prescribing errors decreased significantly
from 25 per cent to 5 per cent, with significant differences found in legibility, absence of recorded
gestational age, absence of documentation of mg/kg
dosing, and use of non-approved abbreviations. The
pre-printed form has become routine practice in the
NICU. A survey is planned to determine the satisfaction of the NICU staff in using this form.
From left: Carla Findlater, Stefanie Parashyniak, Esther
Perkins, Ali Estifaee, Dolores Iaboni and Guia Cruz
Sunnybrook Installs Elder-Friendly
Accessible Ramp
BY MARY ANDERSoN
Email a Patient
We understand how much support and kind
words from family and friends mean to our
patients during their hospital stay. We are
pleased to provide you with a free email service to send messages to your family, friends
and loved ones while they are patients here at
Sunnybrook Health Sciences Centre.
Rudy Amrein, Director of Plant Operations, Eileen Thompson and other W.P. Scott Geratric Day Hospital patients at the ribbon
cutting ceremony on June 17th.
After many years of planning, an elder friendly accessible
ramp was installed at the side of H Wing leading to the
W.P. Scott Geriatric Day Hospital. On June 17, Sunnybrook
held a celebration for the patients and staff to mark its official opening. The project also included automatic opening doors that patients can access with independence,
without fatigue, or risk of getting lost in the hospital.
The team who work with elderly patients are thrilled to
know that community driving services or family members
who drop off and pick up the seniors, will be able to
do this with dignity and safety, providing door-to-door
service.
The dedication and support of Rudy Amrein, Director of
Plant Operations, was acknowledged. Rudy became the
champion for this initiative, ensuring that the ramp became a reality for the patients who attend the outpatient
program. He, alongside Eileen Thompson, a patient of
the Day Hospital, cut the ribbon and the ramp was then
officially opened with applause and cheering. This event
was part of Seniors’ Month celebrations at Sunnybrook.
The W.P. Scott Geriatric Day Hospital is an outpatient
program that enhances independence and quality of life
for seniors living in the community. A dynamic team of
health care professionals design an individualized treatment program based on the patient’s goals and abilities.
Treatment sessions are provided in a friendly, supportive
environment, where the patient is empowered to attain
their goals. Links to a community program upon discharge is a focus of the program.
Mary Anderson is a recreation therapist at the W.P. Scott
Geriatric Day Hospital
Photos by: Dale Roddick
To send a message, visit www.sunnybrook.
ca to complete the form. Your message will
be received by a hospital representative and
forwarded to the patient in a sealed envelope
within 24 hours from the time the message
was received. Messages received after hours,
on weekends or holidays will be delivered the
following business day.
Although we will strive to maintain the
confidentiality of your message, all patient
emails are reviewed by Communications &
Stakeholder Relations before being delivered.
Sunnybrook Health Sciences Centre reserves
the right to refuse delivery of any message
deemed inappropriate.
http://sunnybrook.ca/contact/patient/
Bone and Joint Health Network:
Improved Care for Patients Across Ontario
Sunnybrook Celebrates
Environment Week
By Jason Legge
BY Tyler Bradt
By improving access to care and maximizing system efficiency for hip and knee replacement and hip fracture patients across Ontario, the Bone and Joint Health Network
has been helping to set new standards in clinical practice
for patients needing joint replacement surgery and hip
fracture care. The network is located at Sunnybrook’s
Holland Orthopaedic and Arthritic Centre.
help prevent, screen and manage delirium and dementia;
and provides new and earlier access to inpatient rehabilitation for all patients that are medically stable regardless
of cognitive impairment. This ensures patients have the
opportunity to receive access to rehabilitation that they
have previously been denied. For most patients this
means new opportunities to return home faster.
The Bone and Joint Health Network was established in
April 2008 to work under the direction of the Orthopaedic
Expert Panel. The mandate from the Ontario Wait Times
Strategy is to improve orthopaedic care across the province beginning with the achievement of wait times for hip
and knee replacement of 182 days from surgeon’s office
to surgery and two days from emergency department to
the operating room for hip fracture patients. Benefits for
patients in Ontario include earlier access to assessments,
shorter waits for surgery, improved clinical practices
across the health care continuum and the development of
regional plans within the Local Health Integration Network
(LHIN) to meet the needs of patients and their families.
“These efforts are truly enabling improvement in clinical
practices through knowledge translation and sharing and
are resulting in improved access to orthopaedic care for
people across Ontario,” says Dr. James Waddell, Chair of
the Orthopaedic Expert Panel.
New models of care for hip and knee replacement and
hip fracture care were developed by bringing together
knowledge and experience from across the province. The
new central intake and assessment system for patients
requiring joint replacement uses an advanced practice
roles for the triage and management of patients.
The hip fracture model of care focuses on reducing surgery wait times to two days or less; offers interventions to
Over the next year, the Orthopaedic Expert Panel will be
increasing its mandate to include foot and ankle care.
Working with surgeons from across Ontario, a provincial
plan of care to manage foot and ankle conditions has been
developed that focuses on shortening surgical wait lists
and increasing access to services in local communities.
Additional priorities for the next year include continuing
to facilitate knowledge translation and spread of the initiatives throughout Ontario LHINs and hospitals through
continued local engagement, access to experts, an interactive website with a tool kit, and the availability of an
education initiative to engage all health professionals. To
learn more visit www.boneandjointhealthnetwork.ca
Jason Legge is a Communications Specialist at the Bone
and Joint Health Network at The Holland Centre
Sunnybrook Remembers Dr. John Kemp Morrison
The Water Awareness Event held on May 27 and May 28 in
T-Wing for Environment Week (June 1-5) was a huge success. Hundreds of staff and volunteers participated and
learned about water conservation techniques. The first
500 attendees also received a free stainless steel reusable water bottle. Through this event the environmental
sustainability department received some great feedback
on how Sunnybrook can become a more sustainable
place.
Below are some of the most common responses received
as well as some more specific responses that we feel are
unique ideas. Sixty seven of the respondents said that
promoting tap water vs. bottled water would be the most
beneficial. Another 66 cited turning off the lights when
they are not in use. Improving recycling initiatives came
in as the third most popular answer with 42 requests.
Twenty six respondents who requested to add more solar
panels and other forms of renewable energy. Some other
ideas included starting a green roof initiative, collecting and using storm water, and planting trees for each
patient cared for at Sunnybrook. Thank you again to all
participants.
Also, congratulations to our prizewinners from the Water
Awareness Event. Each will receive a brand new Brita water
pitcher with filter as well as a BPA-free reusable water
bottle to go along with it. With these handy products in
the home, our winners will be able to drink clean, cold,
and refreshing water without having to purchase cases of
bottled water, thus saving money and the environment.
Our Winners are:
•Kathy Hochman, Radiation Therapist
November 22, 1918 to June 6, 2009
•Shiang Yee Yang, Radiation Therapist
By Marian Lorenz
•Joe Medeiros, PSP
Governor General Roland Michener and
Dr. John Kemp Morrison at Sunnybrook in the 1960s
On June 6th, the 65th anniversary of D-Day, Sunnybrook
lost one of its icons when Dr. John Kemp Morrison passed
away in Ottawa, at the age of 91. He had lived in Ottawa
for several years in a retirement home following the death
of his wife, Melba, to whom he was married for 65 years.
Dr. Morrison, “Kemp” as he was known, was Sunnybrook’s
longest-serving CEO (he worked from 1962-1984). He
made an incredible contribution to Sunnybrook’s evolution during the era when the hospital moved forward
from being strictly a Veterans hospital to a general hospital in 1966. I worked with him during every one of those
years - a privilege I will always cherish.
Dr. Morrison served overseas in the Royal Canadian Army
Medical Corps during the Second World War. He practised
medicine as a general practitioner in rural Cape Breton for
ten years before coming to Sunnybrook. He was widely
respected and loved by his staff from the basement to
the Board Room and his office was always open to anyone
who wished to meet with him. The care of Sunnybrook’s
patients, especially its Veterans, was at the forefront of
all his decision making and guided the hospital both
before and after 1966.
•Denise Winter, Staffing Coordinator
”Kemp was one of those people whose importance and
accomplishments were major factors contributing to the
survival of Sunnybrook and its becoming a major teaching hospital of the University of Toronto,” says Dr. Al
Harrison, Sunnybrook’s Chief of Surgery from 1964 to
1985. ”If one were to list his attributes they would include
great common sense and patience, an ability to delegate
well, transparency, honesty and being able to remain
calm in very trying times. He was a great leader and must
be remembered for the significant role he played in the
development of Sunnybrook into the great health care
institution it is today.”
•Melanee Eng-Chong, Infection Prevention & Control
Coordinator
“Dr Morrison gave Sunnybrook strong leadership at a
critical time in its evolution from a Veterans Hospital to
a fully integrated University Academic Health Science
Centre,” says Dr. Marvin Tile, Orthopaedic Surgeon.
•Janet Traverse, RN
•Mike Thompson, Research Assistant
•Richie Benedicto, Rad Tech
•Theresa de Borja, Data Collection Clerk
•Vlad Klimenko, Dispatcher
For those who didn’t win this time, don’t forget that
Toronto’s tap water meets more regulations than bottled
water. Did you know that filling a bottle by tap only costs
you 12 cents?
Tylor Bradt works with the Environmental Team at
Sunnybrook.
Dr. Morrison’s children (Maureen, Bill and Sandy) have honoured their father’s wishes in requesting that In Memoriam
donations be made to a local food bank. Donation acknowledgements may be sent to the family c/o The Kelly
Funeral Home, Kanata Chapel, Ottawa, Ontario.
Marian Lorenz worked at Sunnybrook in a number of different roles from 1954 to 2004
Sunnybrook’s Odette Cancer Centre Hosts MDS Conference
By NATALIE CHUNG-SAYERS
Sunnybrook’s Odette Cancer Centre in partnership
with University of Toronto hosted the Toronto
Myelodysplastic Syndromes (MDS) Conference. Local
and internationally-recognized opinion leaders
met to review and discuss the latest advances in
Myelodysplastic biology epidemiology, therapy and
supportive care to better meet the needs of MDS
patients. MDS is a disorder of the bone marrow that
results in insufficient production of blood cells.
There are an estimated 1,500 new cases of MDS per
year in Canada. Anemia, infection and catastrophic
bleeding are common with this disease which also
puts 25 to 30 percent of patients at risk of developing
acute leukemia.
At the conference, course directors, Drs. Rena Buckstein
and Richard Wells of Sunnybrook’s Odette Cancer
Centre Hematology Care Group, welcomed experts
from across Canada and the U.S., and Europe. Speakers
included Dr. Stephen Nimer from the Memorial Sloan
Kettering Cancer Center, New York, and Dr. Eva
Hellstrom-Lindberg from the Karolinska Institutet,
Sweden.
The Myelodysplasia program within the Odette
Cancer Centre’s Hematology Care Group, is recognized as an International Center of Excellence by the
Myelodysplastic Syndromes Foundation, a multidisciplinary, international organization dedicated to the
prevention, treatment and study of the disease
Left: Dr. Eva Hellstrom-Lindberg poses a question to the group.
Right: Drs. Wells and Buckstein welcome conference speaker
Dr. John Bennett, Professor of Medicine & Pathology, University
of Rochester
Photos courtesy of Alan Chan
How To Reach Us:
Room D100
Sunnybrook Campus
2075 Bayview Avenue
Toronto, ON M4N 3M5
P: 416.480.4040
F. 416.480.5556
E-mail: [email protected]
Sunnybrook News is published twice a month by the Communications & Stakeholder Relations Department (Public Affairs) at Sunnybrook Health Sciences Centre.
Submissions to Sunnybrook News are welcome, however, they are subject to space availability and editorial discretion.
Editor: Christine Henry
Visit us online at: www.sunnybrook.ca
About Sunnybrook:
Sunnybrook Health Sciences Centre is transforming healthcare through the dedication of its 10,000 staff members, physicians and volunteers. An internationally
recognized leader in research and education and full affiliation with the University of Toronto, distinguishes Sunnybrook as one of Canada’s premier health sciences
centres. Sunnybrook specializes in caring for critically-ill newborns, adults and the elderly, treating and preventing cancer, cardiovascular disease, orthopaedic and
arthritic conditions and traumatic injuries.
Sunnybrook Implants MRI
Compatible Pacemaker
By lAURie leGeRe
Fundraising for
Wellspring Sunnybrook
A Distinction too Rare
By CAiTlin mAHAR
Today, while some psychiatrists have limited antidepressant prescriptions for bipolar patients in favour
of alternatives like mood stabilizers, many family doctors—the physicians from whom most bipolar patients
receive initial treatment—are still prescribing them
commonly.
Sunnybrook’s Schulich Heart Centre is one of the first
sites in North America to surgically implant a new type
of pacemaker designed for safe use in magnetic resonance imaging (MRI) machines.
Why? Bipolar patients are often misdiagnosed with
depression, and treatment of depression calls for
antidepressants.
The MRI machine uses magnets and radio waves to produce images that allow physicians to see what is going
on in the body and diagnose a problem. Until now, patients with implantable pacemakers have not been able
to have MRI scans because the machine can interfere
with the pacemaker causing serious and possibly lifethreatening complications for the patient.
“Many of the patients we see with pacemakers have
symptoms that would normally trigger us to recommend
an MRI scan, which is one of the best ways we have to
see what is going on in the body and diagnose everything from cancer to degenerative disease.” says Dr.
Eugene Crystal, head of Cardiac Arrhythmia Services at
Sunnybrook. “Unfortunately, because of the potential for
the MRI to interfere with the work of the device, we’ve
had to use alternative methods of diagnosis for people
who have implanted pacemakers - methods that might
not tell us as much as an MRI scan could.”
Now, a new pacing system developed by Metronic
and currently being used on a case-by-case basis at
Sunnybrook is changing that. The new device is making
it possible for people with implanted pacemakers to receive an MRI scan by protecting them from electromagnetic fields that could contribute to complications with
their device. Medtronic’s pacemaker has been designed
to minimize the energy transmitted through the lead/
device connection point and eliminate the impact of
electrical noise from the MRI, which can interfere with
the pacemaker.
“The development of this new technology means that
more people will have access to the superior diagnostic
benefits of the MRI scan,” says Dr. Crystal. “At a time
when the number of patients with implanted pacemakers continues to increase along with the number of MRI
recommendations, this is a very significant and welcome
breakthrough.”
Commercially released in Europe last fall, the EnRhythm
MRI SureScan system is the world’s first and only pacing system designed and approved for use with MRI.
Although not currently approved for wide-scale use in
Canada, the devices are available on a case-by-case basis
upon recommendations of a cardiologist and application
to Health Canada.
continued from front page
Left: 12-year-old Kody
Mitchell-Sulyok shaved
her head to raise
money for Wellspring
Sunnybrook
Photos by: Doug Nicholson
Inspired by a close family friend who has breast cancer,
twelve-year-old Kody Mitchell-Sulyok came to Wellspring
Sunnybrook with a fundraising idea of shaving her head
only a few short months ago. Although Kody has been
through a tough year, and has suffered many physical
disabilities, she still thinks about helping other people.
On June 15, in a room full of family and friends, Kody
demonstrated remarkable strength and compassion by
shaving her head. Her hair is to be made into a wig for
someone dealing with the effects of cancer. She and
her family have raised almost $4,000 to date in support
of Wellspring Sunnybrook’s Expansion of Children’s
Programming.
Kody has put a challenge out for everyone to make a
difference by matching what she has raised. To make
a donation in support of Kody’s incredible fundraising
event, please
Caitlin Mahar is a fundraising coordinator at Wellspring
Sunnybrook Foundation
“It’s tricky to differentiate between the two,” says
Schaffer, who is also an associate professor at the
University of Toronto. Many bipolar patients spend
considerable time in the depressed phase of the illness
without showing signs of mania. Moreover, he says,
establishing an accurate diagnosis is a time-intensive
process. Family physicians have multiple patients waiting and only a few minutes to spend with each; thus,
they tend to avoid the full psychiatric assessment that
might illuminate the disorder.
Although U.S. researchers have documented the misreading of depression and bipolar symptoms for two
decades, Schaffer’s study hinted at another problem.
More than one-half the bipolar patients he looked at,
and almost an equal percentage of those with depression, had anxiety. Doctors, he reasoned, were either
prioritizing anxiety or making it the primary diagnosis,
both of which can also lead to antidepressant therapy.
Anxiety, while concerning on its own, can also be a sign
of bipolar disorder; that’s why Schaffer is now working to incorporate anxiety and other risk factors into a
tool that will help physicians diagnose the illness better. In addition to anxiety and mania, disease onset in
childhood or adolescence, and suicidal thoughts or attempts can increase a person’s risk for bipolar disorder;
Schaffer plans to publish a complete set of predictors
later this year.
Once stratified, Schaffer says, these predictors “ideally
will be used to help family doctors or psychiatrists identify those people with depression who are more likely
to have an underlying bipolar disorder.” Schaffer points
to cardiac screening as an example: a person walks into
the emergency department with chest pain; the doctor
may spend a couple minutes asking about the pain, but
a lot of time investigating risk factors for heart disease.
If the patient is 65 years old, smokes, has diabetes and
cholesterol, then he will be viewed very differently than
someone with the same pain symptoms who is aged
21 years with no history of trouble. “It’s a probabilistic model that fits with other areas of medicine,” says
Schaffer. “In psychiatry, beyond family history, we’ve
rarely talked about other predictors of bipolar disorder.”
This oversight has inhibited progress in a disease that is
not only a grim experience for patients, but that brings
lasting psychosocial and medical consequences.
Still, Schaffer is optimistic. Better diagnoses will lead
to improved outcomes, and about two-thirds of bipolar
patients will eventually be symptom-free with only intermittent relapses, or will be fully stable. “Is it hard to see
people go through it? Absolutely,” says Schaffer. “But
because we have tools and an understanding of what to
do, it’s a very exciting and satisfying area to work in.”
The Canadian Institutes of Health Research and the
Ontario Mental Health Foundation funded Schaffer’s
work.