Read the 2014-15 Leadership in Mission Report

Contents
P. 3 Report on Governance and Leadership
P. 11 Report on Heath Care Ethics
P. 16 Report on Spiritual Care
The Report on Mission, Spiritual Care and Health Care Ethics is produced annually by St. Joseph’s Health
Care London for the St. Joseph’s Health Care Society. Our thanks to Marleen Van Laethem, Clinical Ethicist
and the Ethics Committees, and to Spiritual Care Coordinator, Ciaran McKenna and the spiritual care team.
St. Joseph’s Health Care London is a proud member of the Catholic Health Alliance of Canada and the
Catholic Health Association of Ontario.
On the cover: Sharing the Circle of Light
Looking back over her shoulder one evening as she was leaving Parkwood Institute’s Mental Health Care
Building, freelance photographer Sue Bradnam captured a beautiful scene of the moon shining over the
Chapel of Hope and multi-faith prayer room area of the building.
“What I love about the image is the three distinct elements and how they interconnect,” explains Sue. “The tree
in the foreground is like the tree of life, constantly changing through the seasons. Behind it is the glow from the
illuminated chapel, like a hopeful light in the night that celebrates the connection between our ever-changing
lives and the belief in something much greater than ourselves. That awareness… helps us keep life in
perspective. Behind the building, in the dark night sky is a glow that appears to be coming from the full moon.
But it is an illusion; the moon does not make its own light. In fact, it reflects the light from the sun…scientists
say that it is our moon and its closeness to earth that is responsible for life on our planet. And so goes the
circle of light.”
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Report on Governance
and Leadership
The Report on Mission, Spiritual Care and
Health Care Ethics is presented annually to the
St. Joseph’s Health Care Society, owners and
sponsors of St. Joseph’s Health Care London.
It is also available on the web with our Annual
Report to the Community.
As a Canadian Catholic health care
organization, St. Joseph’s Health Care London
is called to a mission of care in the example of
Jesus Christ, upholding values and principles in
a spirit of collaboration and compassion. This inherent part of who we are is sustained in many ways, thanks
to many people.
As we reflect on this past year it was a time of long-awaited beginnings and poignant endings. From the
closure of the Regional Mental Health Care London facility in November, to the opening of the bright, new
welcoming Mental Health Care Building at Parkwood Institute, the end of our restructuring journey that began
18 years ago is now in sight.
In this report you will find highlights of the initiatives and accomplishments achieved through the efforts and
support of so many, that are examples of St. Joseph’s living its mission in 2014/15.
Dr. Gillian Kernaghan
President and CEO
Margaret McLaughlin
Chair, Board of Directors
Learning and development
This year, our board members were involved in a wide range of development and education activities.
Representatives from St. Joseph’s board attended the Catholic Health Alliance of Canada (CHAC) governance
forum to strengthen the collective leadership of Catholic health care in Canada. This forum engaged the
Bishops of Canada in the work of the hospitals, and increased the liaison with the boards and CEOs across the
country.
Through a variety of initiatives, the board is continuing to strengthen its relationship with physicians through the
Medical Advisory Committee (MAC), London Health Sciences Centre (LHSC) and the South West Local Health
Integration Network. Dr. Sarah Jarmain, Chair of MAC, provides the Board with regular updates regarding
issues and concerns raised by physicians. To share information and further enhance communication, the
St. Joseph’s and LHSC Board Chairs presented at the November Joint MAC meeting.
Leadership development is continuing with the Studer Group through quarterly leadership development
institutes. In January, a special Physician Partnership Institute was held to engage a broader group of
physicians and physician leaders in the areas of performance improvement and hard-wiring behaviours.
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Sharing knowledge
Board Chair Margaret McLaughlin attended this year’s Catholic Health
Association of Ontario conference, together with Kathy Burrill, Vice President
Communication, Patient and Public Relations, and Brett Batton (pictured)
mental health care advocate and recipient of the 2014 Champion of Mental
Health Award presented by the Canadian Alliance on Mental Illness and
Mental Health. Kathy and Brett gave a well-received presentation on
meaningful ways to ‘give voice’ to those we serve through the use of selfexpression and storytelling.
Dr. Gillian Kernaghan, St. Joseph’s President and CEO, and Michelle
Campbell, President and CEO of St. Joseph’s Health Care Foundation,
presented a workshop at a national fundraiser’s conference talking about the
strong relationship between the hospital and the Foundation, which included
an overview of our memorandum of understanding between the two
organizations.
Mission Committee of the Board
Chaired by John Callaghan with senior support from Kathy Burrill, St. Joseph’s mission leader, the Mission
Committee continued its focus over this past year on the integration and reflection of St. Joseph’s mission in its
everyday work.
One example of this ongoing mission-centred practice
is the key role the committee played in further
enhancing and developing the Mission Leadership
program over the past year, which included consulting
on the content for the online Our Catholic Mission
modules.
In keeping with our desire to maintain ties to our roots,
in partnership with the Sisters of St. Joseph and
St. Joseph’s Health Care Society we sponsored the
visit of Deb Miller, Director of Organizational
Development and Learning Services, to Le Puy-enVelay in France where the Sisters of St. Joseph were
founded in 1650. In recounting her experience to the
Committee upon her return, Deb expressed how
inspired she was by the visit and the words of Sister
Delores Clerico, facilitator of mission effectiveness:
Statue of Jesus from a cemetery where the Sisters of
St. Joseph are buried in Le Puy-en-Velay, France.
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Partnering with LHSC
The strong partnership continues with London Health Sciences Centre. A joint retreat for board members,
senior leaders, and medical leaders in February featured guest speaker Janice Gross Stein who spoke on
Finding Space to Lead…Enduring Strategies for Change in a Complex, Constrained System. The retreat was
an opportunity to educate, collaborate and inspire. The respective hospitals’ Presidents and CEOs, Dr. Gillian
Kernaghan and Murray Glendining, presented on the current state of St. Joseph’s and LHSC, and provided an
overview of the Ministry’s Plan, “Patients First: Action Plan for Health Care.”
Catholic Mission Leadership program
An exciting new focus is underway to enhance the 16-hour Catholic Mission Leadership course with a tool to
help this information reach staff in a timely and effective way. Under the guidance of Deb Miller, Director of
Organizational Development and Learning Services, and the sponsorship of Kathy Burrill, Vice President
Communication, Patient and Public Relations, a five module online Our Catholic Mission program is being
developed.
A wide variety of stakeholders, including the mission committee of the board and the health care ethics
committee of the board, consulted on the modules' content. This program will highlight our founding legacies
and rich history of health care ministry, the principles of Catholic health care and Catholic Church teachings,
and what it means to work in a Catholic-sponsored health care organization. It will also explain ways to apply
these principles to our mandate for care, research and teaching, and explore the ethical principles that guide
our care and service.
Parkwood Institute
In June we let our community know we would be bringing
together the physical health care provided at Parkwood
Hospital with the specialized mental health care we provide
on the same site—signaling the start of an exciting new era
in care, recovery and rehabilitation. An era that is erasing the
line between physical and mental health care, and
recognizing that the care of the mind and body go hand in
hand.
To herald the start of this new era, when the new Mental
Health Care Building opened in November, it came together
with Parkwood Hospital under one new name for both
facilities: Parkwood Institute. Here, the vibrant academic
health care community is collaborating on physical and
mental health care, teaching and research.
The new name combines the well-known name “Parkwood”, with “Institute” which reflects excellence in care
and teaching, and the hope research holds for future discoveries in mental and physical health care.
Watch the Parkwood Institute video, www.sjhc.london.on.ca/parkwood-institute-video
The Honourable Deb Matthews, Deputy Premier with Board Chair Margaret McLaughlin and President and CEO
Dr. Gillian Kernaghan at the opening of Parkwood Institute’s Mental Health Care Building.
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Mental Health Care Building opens
“This building is designed with the belief that recovery is possible and, just as importantly, that even people who do not
achieve the level of hoped-for recovery, are worthy of the best care possible.
These two elements, recovery-focused care and worthiness go a long way to addressing stigma.”
Those meaningful words, spoken by Cathie Gauthier, mother and mental health family council member, struck
a chord with those who attended the grand opening ceremony of St. Joseph’s new Mental Health Care Building
on November 7. Cathie spoke of her family’s personal journey in supporting a child with a mental illness, and
what this new facility will mean to all those who receive care within its walls. “Any person who has loved
another who has fallen ill knows that natural light, fresh air, privacy, a place to walk and a place to pray, staff
that believe in their patients and value family as a strong component of recovery, has the best chance of
reclaiming wellness.”
The opening of this special building, dedicated to
the treatment, recovery and rehabilitation of
adolescents and adults experiencing severe and
persistent mental illness, was a major milestone
in a bolder vision for the future of Parkwood
Institute. Patients and staff moved into the new
building on November 16, 2014.
At the ceremony Dr. Gillian Kernaghan spoke to
the importance of a community network of care,
working together to take action, particularly
regarding affordable and supportive housing, in
order to truly embrace individuals with mental
illness and make a lasting difference. “We want
the doors of mental health care to be open, as
we, our partners and community continue to give
voice and hope where for much too long, myth
and stigma have resided.”
Bishop Ronald Fabbro with Chaplain Chris Baron, blessing spaces in the new Mental Health Care Building.
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“This is a beautiful building. This is a respectful building,” remarked Deputy Premier Deb Matthews, who also
spoke at the grand opening event. “All of us are part of history today because this building represents a new
way of caring for people who have challenges when it comes to mental health and
addictions.”
Understanding first-hand the need to care for people body and mind, Bill Wilkerson, cofounder of the Global Business Economic Roundtable on Addiction and Mental Health
stated, “this building is a statement and a philosophy as much as a facility of care.” He
added, “I heard someone say that there was as much love poured into this building as
there was cement…and like all great places that is the thing that will keep it alive and
keep it strong.”
The healing spaces of the new building combined with the importance of compassionate
care provided within its walls was beautifully summed up by Cathie, “St. Joseph’s commitment to care for the
body, mind and spirit is evident here. I am confident families will feel reassured that their loved one is safe and
cared about.”
Strategic Plan
The new 2015-2018 Strategic Plan is the first in 18 years not dominated by restructuring and renewal.
Throughout these years of change we honoured and held fast to our roots while undergoing transformational
change.
The strategic priorities woven throughout our new 2015-2018 Strategic Plan reflect our vision:
The Strategic Plan calls for us not only to listen and respond to the people at the heart of our mission, but to
be guided by their voices, deepening the philosophy of “nothing about me without me.”
The three areas of strategic focus will strengthen our performance when it comes to our patients, residents and
families; clinical education and research excellence; and our people.
For patients, residents and families we will ensure they are full partners in their care, and in the design,
measurement and improvement of care; embrace the relentless pursuit of safety – everywhere; and optimize
transitions through the care system.
For clinical education and research excellence we will build on our research strengths and unique roles within
the academic health care system, with a particular focus on integrated complex, chronic disease management;
recovery and rehabilitation for the body, mind and spirit; and innovations in ambulatory surgery.
For our people we will achieve leadership excellence, enhance staff well-being and safety, become leaders in
staff and physician engagement and develop high performing teams.
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Here we highlight aspects of the Strategic Plan most closely linked to our Mission:
Optimize transitions through the care system with and for patients, residents and families.
We are uniquely poised to play a stronger role and achieve better results in both access to care and helping
patients to navigate through the care system.
Recovery and rehabilitation – body, mind and spirit.
The care of the body, mind and spirit provided at Parkwood Institute
includes rehabilitation, specialized geriatrics, complex care, veterans
care, and specialized mental health care. By bringing these care teams
together we are leveraging our strengths and synergies to achieve new
breakthroughs in care, recovery and rehabilitation.
Enhance staff well-being and safety
Staff and physicians need to feel physically and emotionally safe at
work. This includes enhanced emphasis on creating an environment
where people feel safe and accountable reporting errors and safety
issues. We are also implementing the national standard for workplace
psychological wellness.
Culture
Supporting all we do at St. Joseph’s is our culture. From the first three
Sisters who opened the Mount Hope Orphanage to the founders of the
Women’s Christian Association of London who visited people in prison
and took care of frail elderly people, to the men and women who
spearheaded care at our region’s first mental health hospitals, we are
built on the convergence of roots of love for one another.
Occupational Therapist Sarah Trenker
teaching wheelchair safety to Mount
Hope resident, Marianne.
Despite decades of change, revolutionary advances in care, and seismic shifts in our roles, St. Joseph’s roots
in the calling and devotion to serve, remains. While propelled always by emerging needs, new ways to improve
care, and the boundless possibilities of science and technology, St. Joseph's is also committed to preserving
and enriching its culture, which has anchored the organization through times of tremendous change.
It is a culture whose core values of respect, excellence and compassion align with the principles of Canadian
Catholic health care and a can-do attitude where ideas are solicited and explored, learning is embraced and
feedback is continually sought and shared.
“Culture outperforms strategy every time…and culture with strategy is unbeatable.” Quint Studer
Advocacy
Many strategic plan discussions centred around our mission as a Catholic health organization to raise our
voices to advocate for compassionate end of life care, care for the vulnerable members of society, sustain the
unique services provided by St. Joseph’s to the community and region and to effect system change.
Our staff do this work every day as they seek supports for patients ready to return to community living,
encounter people struggling to find affordable, supportive housing, and work to help people find meaningful
employment and social supports of many kinds.
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Leadership in Mission Award
The Leadership in Mission Award
recognizes St. Joseph’s leaders who
have made extraordinary efforts to
exemplify and advance St. Joseph’s
roles and values as a Catholic,
academic and community-oriented
health care provider. In 2014 there
were two recipients: Dr. Michael
Milo, psychiatrist with the London
ACT 3 team and Dr. Bill Payne,
Family Medicine Site Chief at
Parkwood Institute’s Main Building.
Dr. Michael Milo, centre holding award, leads with his heart and continuously
Described as “a truly servant leader”
advocates making a difference for the most vulnerable in our community.
Dr. Milo cares for people facing
severe and persistent mental illness,
addictions, poverty and often homelessness. “Dr. Milo sees the humanity in everyone and he has cultivated
this culture within his team,” says Jill Mustin-Powell, Director of the Assessment and Treatment and
Rehabilitation programs. “There is no place or person Dr. Milo considers beyond his reach.”
While growing up, Sister Mary Doyle was a close family friend. “From a very young age she instilled a humane
outlook in me,” recalls Dr. Milo. “Our clients are an invisible minority, disadvantaged yet surprisingly resilient.
We must lead with compassion and empathy no matter what; we will not be dismissed. These people deserve
to be treated; they deserve to be saved.”
Dr. Milo is nonjudgmental, respectful and compassionate; putting the needs of his clients before his own. On
one occasion he lent his own coat to a client who was found in the cold weather without one until such time
that she was able to get one of her own. Not afraid to speak out about his work and the challenges his clients
are sometimes forced to endure, he advocates for his clients and “looks for ways to bridge the divide between
the people he serves and the system he works in.”
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Known for his quiet demeanor, Dr. Payne consistently puts his patients’ needs in front of his own, often taking
on additional work because “it’s the right thing to do for the patient.” When accepting the role in Complex Care
over 25 years ago, Dr. Payne knew “I was taking on something very special.”
Dr. Payne was pivotal in implementing the Methicillin-resistant Staphylococcus aureas (MRSA) protocol at
Parkwood Institute. He has developed strong collaborative relationships with infectious disease physicians who
now provide onsite clinical consultation.
Not one to stand alone in the limelight, Dr. Payne acknowledges team effort. He conveys a sense that we are
all equal team members and colleagues, he listens to and values the opinions of all. “He has a passion for his
work that is contagious,” says Complex Care Resource Nurse Barb Sutherland. “He takes the time to be fully
present in conversations with patients, family members and staff. He stresses that even the smallest
successes of this vulnerable patient population should be celebrated. His care focuses far beyond basic
medical management to a holistic approach that consistently honours the dignity and value of each person he
interacts with.”
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“Caring for the spirit is hard to measure,” says
Dr. Payne, “But on complex care we are able to
augment that spirit, so these people, who have
often endured an horrendous life-altering event,
can plan to move on with a new reality.”
Barb Sutherland, Dr. Payne, and Dr. Gillian
Kernaghan at the Leadership in Mission Award
ceremony.
The temporary chapel, located in the cafeteria space, was a place of worship for a number of years while the historical
chapel was refreshed. This space was well used for rituals, the celebration of Mass and for private meditation and
prayer and we are very grateful that we were able to use this space in the interim. The above chapel will be dismantled
this summer with the main elements returning to the St Joseph's Chapel and the space returned to the cafeteria.
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Report on Health Care Ethics
This past year saw many local, national and international news items with an ethics theme. Although the
sensational stories in the news are not what we routinely deal with at St. Joseph’s, they do heighten
awareness for physicians, staff, patients, residents and families which in turn can have a beneficial impact on
our clinical practice, leading to patients being treated more ethically. This contributes to earning complete
confidence from our patients and their families.
Some examples of ethics-related news items include: the Supreme Court of Canada decision on physicianassisted suicide; the British Columbia Court decision on feeding a patient with Alzheimer’s disease against the
wishes of family; and a forensic mental health patient in Belgium who requested assisted-suicide since there
were no treatment programs for him.
We are experiencing more consultations that overlap organizational ethics and business ethics; for example,
the mix of patient care services paid for through Ontario health care coverage, and revenue-generating patient
care opportunities. Ethics is often about asking questions—here are some questions that arise in this work:
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How do these services interact with the principles of universal access that are highly valued in our
Canadian society?
How will it impact (positively or negatively) our Catholic mission to give preferential attention to the poor
and marginalized in our society?
We are called to be careful stewards of resources – does this also call us to seek revenue-generating
opportunities in patient care areas?
Ethics committees
Committee members are drawn from a broad range of disciplines including vice president, physician, nurse,
occupational therapist, educator, spiritual care, ethicist, child youth worker, social worker, patient relations and
risk management, psychologist, physiotherapist, coordinator, director, patient rights advisor, our moral
theologian appointed by the Bishop, and volunteers.
When navigating ethical dilemmas, these committees constantly consult the
Health Ethics Guide from the Catholic Health Alliance of Canada.
Health care ethics committee (HCEC) of the board
The HCEC ensures Health Ethics Guide insights are integrated into all
areas of ethical discernment, and that all relevant decision-making
processes integrate ethical discernment. As well, the HCEC provides a
forum to discuss high-level clinical and organizational ethics issues; reflect
on ethical principles, policies and practices; and oversee priorities for
action. To determine the ethical consequences of developments in health
care ethics, the committee also monitors legislation and relevant legal
proceedings.
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Ethics Education and Consultation Committees
Three Ethics Education and Consultation Committees cover the main St. Joseph’s sites: Parkwood Institute
Mental Health Care Building and Southwest Centre for Forensic Mental Health Care; Parkwood Institute Main
Building and Mount Hope Centre for Long Term Care; and St. Joseph’s Hospital.
The Ethics Education and Consultation Committees help to plan and organize education events which this year
included a visit by Reverend Clint Moore, Clinical Ethicist at the Center for Clinical Ethics, Lutheran General
Hospital in Park Ridge, Illinois who spoke on Challenging Decisions in Health Care, webinar presentations on
tobacco-free policies and employer health and wellness initiatives. They also plan Ethics Awareness Week.
Ethics leadership council
This council is formed by the site ethics committee chairs.
While ethics consultations address a wide range of issues, the most common theme of our consultations
continues: finding the right balance between wanting to do what is right and best for our patients, helping them
strive towards optimal health outcomes, while also respecting their autonomy. Sometimes this autonomy
demonstrates itself as wanting to pursue risky behaviours such as smoking tobacco, drinking alcohol, or using
illicit substances. If a patient has capacity for making these decisions, then he/she can weigh the risks and
benefits and make the decision.
Ethics Awareness Week
St Joseph’s has a long history of ethical reflection woven into the fabric of
health care. We also have a strong history of celebrating Ethics Awareness
Week, held in conjunction with World Day of the Sick on Feb. 11.
Ethics Awareness Week serves as a reminder of the ethical undercurrents in
everyday health care, as well as ethics resources available to patients,
families, staff and physicians. Features of this year’s Ethics Awareness
Week included displays with ethics resources for patients and families, and
presentations for physicians and staff.
One presentation was by bioethicist Steve Abdool, on Privileged Healers
Safeguarding Integrity and Loyalty with the Sick and Marginalized. This
presentation focused on re-igniting the clinical encounter with the humanitarian art of health care delivery.
During this presentation Steve touched on many key points including that human dignity is inherent in each
patient – emphasizing dignity is not assigned or given to them; ways to empower patients in our day-to-day
work; and remembering compassion for patients, colleagues and ourselves.
Another presentation by Larry Lalone, Educational Consultant on addictions with Organizational Development
and Learning Services, on Substance Use Disorders explored the surgical challenges staff and physicians at
St. Joseph’s Hospital face because some patients do not disclose information about substance use. This is an
ethical issue as people with substance involvement or addictions often experience stigma and judgment, which
can be decreased by understanding their experience. It is also important to understand the cause of
addictions can be traced to brain disease, past trauma, or public health, social, cultural, psychological or
psychiatric origins. By having an open, non-judgmental attitude toward patients we can treat them more
ethically.
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Supreme Court ruling on assisted suicide
Assisting someone to commit suicide has long been a
criminal act in Canada. This will be changing because the
Supreme Court of Canada recently ruled on the right of
certain individuals to a doctor’s help in dying—also known
as physician-assisted suicide.
Many Canadians
support the Supreme
Court’s ruling, and
many do not. Many
religious and nonreligious individuals
consider this to be
immoral as it is a
form of killing, while
others view it as part
of compassionate care at the end of life. Catholic health
care does not support assisted suicide. St. Joseph's is a Catholic health care organization and remains
committed to the principles of Canadian Catholic Health Care, including the dignity of every person and the
sanctity of life.
In a recent article in the Catholic Health Association of Ontario (CHAO) newsletter The Quarterly, President
Ron Marr and Board Chair David Nash highlighted how the Supreme Court ruling heightens the need for
palliative care.
St Joseph’s has a long history of high-quality palliative care at Parkwood Institute’s Main Building. Three times
a year the ethics program dedicates time to this program offering topics like beneficence (physicians and staff
wanting to do the best for the patient’s symptoms) and the autonomous decision-making of either the patient (if
patient has capacity) or the appropriate substitute decision maker (SDM). For example, a patient’s daughter,
who is her SDM, does not want her mom to have pain medication because she does not think her mom is in
pain and fears the medication would only cloud her mom’s alertness. On the other hand, based on their
knowledge and experience, the care team does think the patient is in pain and wants to give her medication to
relieve the pain.
A palliative care approach is also employed in other areas of St. Joseph’s including the Veterans Care
Program, Geriatric Psychiatry, and Mount Hope Centre for Long Term Care. Palliative sedation therapy is one
of many tools available to palliative care. This therapy uses medication to sedate a person experiencing
symptoms such as shortness of breath, confusion or pain when all regular methods have failed or are not
possible. While some refer to this as stealth euthanasia, this is not true. Palliative sedation therapy is like any
therapy that is only used when relevant; it has long been deemed appropriate in Catholic settings. To dispel
the myths, the ethics program created information for patients and families on this topic.
Ethics often highlights the power of certain words when used to describe dilemmas. By using the term
physician-assisted suicide, the Supreme Court is highlighting the role of physicians and calling it a form of
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suicide or the desire to kill oneself. Religious groups, including Catholics, who do not support assisting a
person to kill themself, also use the term suicide. Supporters prefer to use the term assisted-dying, feeling it
softens the emotional implications of the topic.
Consider another wrinkle in the war of words: St Joseph’s is a regional leader in mental health care, with
expertise in addressing the terrible tragedy of suicide. People are not of sound mind when they attempt
suicide; however, the Supreme Court emphasizes their decision relates to adults with capacity for this
decision-making. In mental health circles, it is preferred to keep physician-assisted dying work separate from
suicide prevention work.
This is another example of how ethics demonstrates
the many shades of grey within complex issues—
even the choice of vocabulary is rarely black and
white.
Physician-assisted suicide will be a key topic at this
year’s networking meeting of ethicists working in
Catholic health care, which is supported by the
Catholic Health Alliance of Canada.
Parkwood Institute – creating synergies of
body, mind and spirit
The move of the mental health programs from
Regional Mental Health Care London to the new
Mental Health Care Building at Parkwood Institute in
November presented opportunities to explore
synergies with our patients and approaches to
physical and mental health care. The Ethics
Education and Consultation Committees for the two
Parkwood Institute facilities met to explore this at the
level of ethical discernment and challenges. Although
there are differences between the patients served,
there are also many similarities. The two committees
learned from each others’ experiences and also
collaborated on an Ethics Awareness Week event.
Glass work in the multifaith prayer room at St. Joseph’s Hospital.
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Substance use - making it safe to be honest
Substance involvement is a significant issue in our community and can affect patients and residents in all
programs and services across our organization.
Consider this situation: John is having shoulder surgery. When the nurse asks him about medications, he
thinks: “Should I tell them I get extra oxycontin from my dealer? Nah, it might get written down and I don’t want
to risk it.”
John is concerned about sharing this information, but he may not realize his surgery may be compromised
because he excluded important information. For example, he may
require more anesthesia, or it may be more difficult to keep him
comfortable during recovery. If the team knew about his substance
use in advance, they could better plan for his needs and optimize
surgical outcomes.
Consider John’s decision through an ethics lens, using the following
four principles:
Respect for autonomy: health care providers are ethically
responsible to provide John with full information about his decision,
including the risks and benefits of disclosing or not disclosing all
substance use information and how his substance use may impact the
surgical procedure. They are also ethically responsible to respect his
decision.
Beneficence (do good): health care providers use their knowledge
and expertise to strive for the best health outcomes for our patients,
so they may feel upset and frustrated knowing a better outcome
should have been achievable. Patients also expect the best
outcomes.
Non-maleficence (do no harm): not knowing John’s full history increases risk, which could be minimized by
providing an appropriate painkiller based upon full disclosure of all drugs (including alcohol, prescription and
non-prescription drugs) and providing nicotine replacement therapy to minimize withdrawal symptoms for those
who smoke.
Social justice: highlights of this principle include considering addictions are serious illnesses; addiction is not
a moral failing or bad character trait; those with substance involvement issues must not be discriminated
against in their pursuit of, and access to, health care services; and that our health care mission and Catholic
health principles require us to treat all patients with dignity and respect.
We make it safe for patients to be truthful about their substance use by showing respect, having compassion,
and letting them know our primary concern is their safety and comfort. By doing so they are more likely to
share sensitive information with us.
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Report on Spiritual Care
It has been another year of endings and beginnings, celebrations and change—a
year in which Spiritual Care continued to make a difference.
Our Clinical Pastoral Education (CPE) program had a very successful unit through
the summer of 2014, one of which was the last one held at Regional Mental Health
Care London—46 years after the first unit was offered on that site. In the fall and
early winter our teaching supervisors and members of the Spiritual Care Advisory
Committee prepared for our re-accreditation as a teaching hospital for CPE.
Accreditation took place in January and we were successful in gaining the full fiveyear accreditation (see story in this section).
Chaplain Stephen Yeo, right, with Ciaran McKenna, accepted this certificate at the
national convention, where he was presented with his certificate as a full CPE
Teaching Supervisor. Congratulations to Steve, to his supervisors, and to the many
chaplain interns who helped shape him into the teacher he has become.
With the Mental Health Care Building opening, our mental health clinical chaplains switched portfolios, with
Stephen Yeo moving to this new facility, and Chris Baron moving to the Southwest Centre for Forensic Mental
Health Care. This move also led to a consolidation of our CPE program at Parkwood Institute. In September
we welcomed Chaplain Heather Vanderstelt back to our team at Parkwood Institute’s Main Building.
Across all our sites our team continues to inspire complete confidence in those in our care through one-on-one
and group work, collaborative work with care team members, and continuing to offer care and support to our
care givers. The team should be recognized for their great work, commitment and the quality of their presence.
Celebrating Spiritual Care Week
Spiritual well-being, the theme of this year’s Spiritual Care Week, was about our inner life and its relationship
with the wider world, including our relationship with the environment, with others and with ourselves. It
recognizes that our actions, intentions, and choices have a ripple effect on the journeys of others as well as
ourselves.
While the nature of our journeys may vary with the seasons of our lives, our spiritual well-being may include
transcendence, meaning and purpose, reconnecting and renewing, service, sacredness, strength, harmony,
hope, compassion, creativity, gratitude, forgiveness, and love.
To help foster spiritual well-being during Spiritual Care Week, spiritual care chaplains provided a variety of
activities across St. Joseph’s including displays, guided meditations, and labyrinth walks.
Grateful words
Recently I went for a biopsy at your diagnostic imaging department. I stopped first at the Spiritual Care office
because I was feeling nervous about the procedure and was warmly welcomed by spiritual care provider,
Ciaran McKenna. He has the ability to help you realize that you are not alone and no matter what we talk
about I leave feeling blessed.
During the procedure, I was very impressed by the care, compassion and sensitivity displayed by all the
nurses, techs and the doctor... All involved helped me feel respected and safe.
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Walking the Labyrinth
Research findings from the Walking the Labyrinth study at Southwest
Centre for Forensic Mental Health Care (Southwest Centre), conducted
by Chaplain Stephen Yeo and Occupational Therapists Clark Heard and
Jared Scott, are generating much interest.
A labyrinth is a solitary path that winds its way in a circuitous manner
toward a centre of destination and then follows the same pathway to
exit. Participants walk silently to engage their spirituality, meditate, or
quiet their mind. At Southwest Centre a labyrinth is laid with paving
stones into the floor of the chapel and the outdoor courtyard.
The study involved interviews with 12 patients from Southwest Centre
who participated in the Walking the Labyrinth program, with results
indicating the program markedly impacts participants and supports
feelings of spiritual connectedness, relaxation, peace, success, escape,
meaning making and stress reduction. At a practical level, this
therapeutic tool offers convenience, timely access, and ease of use for
patients and clinicians.
The study also makes recommendations related to potential health care
applications for labyrinths, including a focus on the link between mental
health care planning and labyrinth participation.
A chance to remember and say goodbye
Staff and patients said goodbye to Regional Mental Health Care London at a beautiful chapel ceremony on
October 20, 2014.
Inspiring words were spoken by many, including Sandy Whittall, then Vice President, Mental Health Services.
“So many of you know first-hand the hard work and dedication it has taken to get to this day; the day we say
farewell… we will hold on to our friends, our colleagues, our
expertise and superb care and hold the hands of our patients
as we move in the new mental health care facility.”
The St. Joseph’s choir sung beautiful hymns after a smudging
ceremony. The event concluded with a walk down the historical
avenue of trees. “I invite you to consider how we continue to
focus on hope in the face of suffering, how we are reminded by
the stories and memories that have brought us together where
we have shared our life, our tears, our laughter, our pain, our
resilience and ultimately our hope,” said Chaplain Chris Baron.
Chapel of Hope at the former Regional Mental Health Care London.
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New chapel
Comments at the
opening of the Chapel
of Hope in the Mental
Health Care Building
at Parkwood Institute
in November included,
“This is so calming, I could sit here for
hours. How delightful to have a chapel
and prayer space together.” In tears,
one former mental health patient said,
“I am so glad for the patients here who
have such a beautiful space.” As part
of the opening ritual, Bishop Fabbro
blessed the chapel space.
Catholic symbols
In the newly renovated Zone A at St Joseph’s Hospital the familiar statues are back again and staff are
delighted to see them incorporated into the new building.
The statue of St. Joseph (see following story) is among several meaningful symbols and artifacts preserved
during construction and incorporated into the new Zone A, infusing history, tradition and a touchstone for the
future into the addition.
“Each of the historic touches in Zone A represent a tremendous journey travelled, yet values that have not
changed,” says Ciaran McKenna. “They are reminders of the healing mission – where we have come from and
where we are headed, guided, as always, by the spirit of our founders.”
Crosses are installed in various places in the new zone as they are in the new Mental Health Care Building.
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Bringing together old and new, past and present
The St. Joseph statue stands tall again, a protective presence and poignant reminder of who we are and why
we are here.
In December, the statue was carefully removed
from the crate that had kept it safe for the past
two years of construction and was slowly
hoisted into place in front of the sleek, new
Zone A at St. Joseph’s Hospital. There, in
juxtaposition of old and new, of past and
present, St. Joseph took his rightful place, once
again a visible symbol of the values that have
guided St. Joseph’s Hospital for more than 126
years.
For St. Joseph’s Hospital, the presence of the
statue carries much meaning, connecting the
hospital of today with its enduring mission “to
help all those who come to us for care” in the
example of Jesus Christ.
The statue of St. Joseph being carefully
lowered onto its resting place.
See a video of the statue being put in place:
www.sjhc.london.on.ca/our-stories/watch-statue-go-st-josephs-hospital
The soul of St. Joseph’s
100 year-old chapel at St. Joseph’s Hospital reopening in June
In the 126 years since St. Joseph’s Hospital was founded, the chapel
has moved and grown in size and grandeur as the hospital evolved. But
it remains the cornerstone of all that is St. Joseph’s Health Care
London.
In 2012 the chapel was closed and carefully preserved while a new wing
at the corner of Richmond and Grosvenor streets was built. In June this
holy place will reopen and once again become the spiritual focal point of
the hospital.
“The chapel speaks to the importance of faith in the journey of healing
for patients and their families, and in the resilience needed by care
providers,” explains Dr. Gillian Kernaghan. “It speaks to the continuity of
the St. Joseph’s mission. One of our key values is compassion and the
faith embodied in the chapel is a faith grounded in grace, compassion
and a servant heart.”
A chandelier in the chapel, lowered and ready for cleaning and restoration.
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Father Michael Prieur, a renowned moral theologian and leader in ethical discernment who has long provided
guidance to St. Joseph’s care programs, describes the chapel as the “soul” of the organization and a bridge
spanning the past and future, connecting the care provided at St. Joseph’s with the deeper meaning of our
common humanity. “The chapel breathes faith in God and the healing compassion of Jesus Christ manifested
in so many of the people present in the hospital,” he says.
“The chapel has always been, and continues to be, about support for our community – a community of many
faith traditions,” says Ciaran McKenna. “At any hour of the day or night, one would find patients, families and
staff sitting quietly in this restful place, sharing their cares, hopes, fears and celebrations with their higher
power.”
Father Michael Prieur recently authored Panes of Consolation, a colourful book celebrating the stained glass
window in the chapel at St. Joseph’s Hospital. The book will be available soon.
Quest spans seven continents
Andrew Macpherson’s first introduction to Parkwood Institute was
when his Mom was in palliative care in 2000. Many years and
hundreds of thousands of kilometres later, he came back to view
Parkwood Institute from a much different perspective.
Andrew learned at an early age how people of various faiths can
grow and learn together. His great grandfather was a
Presbyterian minister, his grandfather a Methodist minister and his
father a United Church Minister. Andrew was born in India where
his father, serving there as a missionary, came to view Hinduism
as a complement to Christianity.
A series of sad events in Andrew’s life launched him on a 10 year
excursion travelling the world searching for the meaning of life and
death. “Eventually I discovered no matter where I looked – in
temples, mosques, synagogues, or with witch doctors—God is
everywhere, that Jesus Christ is closer to me than I ever realized.”
So he packed up his experiences and returned to Canada to take
the Masters of Divinity course at the University of Toronto. Next,
he enrolled in St. Joseph’s Clinical Pastoral Education (CPE)
course to add experience to his spiritual education.
“With hospital chaplaincy you can go from reading a verse from
the gospel of John, to reading an Ayat (verse) from the Qur’an,”
says Andrew. “The CPE program at St. Joseph’s gave me the
experience I needed to weave together the strands of my life.”
CPE intern Andrew Macpherson in the Chapel
of the Good Shepherd at Parkwood Institute.
Watch an interview with Andrew, and Chaplains Stephen Yeo
and Dawn Fania: www.sjhc.london.on.ca/our-stories/questspans-seven-continents
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The Creator’s sacrifice
A memorable Holy Thursday service at Parkwood Institute
featured 17 pieces of colourful First Nations art reprints by Ovide
Bighetty called Kisemanito Pakitinasuwin—meaning the Creator’s
Sacrifice in Woodland Cree—the Métis representation of the
stations of the cross.
To showcase the artwork veterans made red willow frames, and
Music Therapist David Vircillo provided special music and
conducted a drumming circle.
Veteran Maurice Smith participating in the drumming circle during on
Holy Thursday.
Celebrating Diwali
Hindu priest Pundit
Durgeshwar Tiwari, left,
discusses the display he
created at St. Joseph’s
Hospital to mark the
religious celebration of
Diwali with Elfriede
Schmidt, centre, and
chaplain Margaret
Vanderheyden.
CPE accreditation renewed
In alignment with St. Joseph’s mission to provide
excellence in care, teaching and research, the
Clinical Pastoral Education (CPE) program gives
chaplain interns experience in learning the art and
practice of spiritual care in a clinical setting, With
the renewed five-year CPE accreditation,
St. Joseph’s will continue to train the next
generation of spiritual care providers.
Chaplain Stephen Yeo, left, with CPE students.
Chaplains Dawn Fania and Stephen Yeo
supervise chaplain interns. Although St. Joseph’s
is a Roman Catholic organization, CPE interns
come from many faith backgrounds. They have
400 hours of training with half spent providing
direct care to patients, family members and staff,
and the other half in group learning opportunities.
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Wisdom of the heart
World Day of the Sick is a time to pray and reflect. Held in the chapel at
Mount Hope Centre for Long Term Care, residents and staff came
together for the service which was graced with the sweet voices of the
grade six students from St. Mary School Choir and Orchestra Program
singing hymns.
Father Peter Poel focused on Pope Francis’s World Day of the Sick
wisdom of the heart theme. “While it can be difficult at times to be a
caregiver, it can be very meaningful, especially on a spiritual level,”
Father Poel explained. “We can grow the wisdom of the heart through
caregiving—giving us a way of seeing things infused by the Holy Spirit.”
“To me, it is very important for people who are sick or elderly to not look
upon themselves as a burden to caregivers, but rather to remember the
meaning that it can give to those people in their lives; the way it can
actually transform their lives,” said Father Poel.
“The World Day of the Sick ceremony gives me the strength to get
through the ups and downs of life and live in peace,” said retired nurse
and Mount Hope resident Rita Mottram. “It also allows me to reach out
to others and let them know I understand what they are going through—
that there are others who care for them, not just the staff.”
Father Peter Poel and Mount Hope resident
Rita on World Day of the Sick.
See a video of Father Poel speaking about World Day of the Sick:
www.youtube.com/watch?v=5QPoNEbB4D8
World Day of Prayer
Spiritual care chaplains brought the warmth and beauty of
the Bahamas to Parkwood Institute’s Main Building in
celebration of World Day of Prayer.
This year’s service, prepared by the Women’s Inter-Church
Council of the Bahamas, was celebrated in 170 countries
around the world. Through video, displays, prayer, and
hymns knowledge was shared about the natural beauty of
the Bahamas, as well as the challenges of poverty and
abuse faced by Bahamians and Haitian migrant workers.
As we reflect on the compassion of Jesus washing the feet
of his disciples in John13:1-17 we are invited to follow in
His example in caring for others
Chaplains Kathy McLellan Lant, Heather Vanderstelt and
Dawn Fania at the World Day of Prayer exhibit.
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Sisters of St. Joseph Awards
The Sisters of St. Joseph Awards for Excellence honour staff, physicians and volunteers who share the
remarkable attributes of the Sisters - excellence, positive attitude, reliability, honesty, efficiency, creativity,
respect, caring, compassion, empathy and appreciation for the work of others. This year’s awards honoured
one team and four extraordinary individuals.
When urology residents Drs. Golnaz Naderkhami, Siobhan Telfer and Marie Dion were presented with the
Sisters of St. Joseph Awards as a team, they said, “We are surrounded by incredibly kind, compassionate,
skilled individuals we truly love to work with. There is a history and standard this hospital has maintained that is
unlike most other places, and that we are lucky to step into and experience briefly and to learn from. It is our
hope that where ever we end up we bring this passion with us and share it with those we work with and our
future patients.”
At the award ceremony Cindy
Pandke, eLearning Instructional
Designer with Organizational
Development and Learning
Services, said, “From the first
day I started at St. Joseph’s I
knew that here you become
family. Here you inspire others.
Here you help everyone go in
the direction they want to go.
Here is so much more than a
job.”
Award recipient Therapeutic Recreation Specialist, Tichelle Schram, works “on a hidden gem of a unit”
designed to meet the needs of veterans with a cognitive impairment. “I may be the captain of their ship, a
neighbour or relative. They rarely know my name but they always know that I’m their advocate, always their
friend.”
Registered Nurse and Unit Lead at Southwest Centre for Forensic Mental Health Care, Carol Schnarr said, “I
feel blessed to have a wonderful family both at home in the workplace.”
Therapeutic Recreation Specialist April Zehr dedicated her award to her acquired brain injury colleagues. “You
have inspired me to pursue my goals with hard work and dedication because that is what you bring to your
work. I truly appreciate and value everything I learned from you. It will forever remain a major contributor
behind my love and passion for my work.”
“The recipients have open minds, open hearts and open wills,” said Sister Valerie Van Cauwenberghe. “I thank
you for your courage insight, teamwork, innovation and, perhaps most important, your love of the people in you
care and those with whom you minister.”
The 2015 Sisters of St. Joseph Award for Excellence recipients, from left: Tichelle Schram, Carol Schnarr, April Zehr,
Cindy Pandke, Dr. Siobhan Telfer, Dr. Marie Dion, and Dr. Golnaz Naderkhami.
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“Saint Joseph was a
just man, a tireless
worker, the upright
guardian of those
entrusted to his care.
May he always guard,
protect and enlighten
families.”
Pope Saint John Paul II
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