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General Express August 2016

Multipurpose x-ray room opens

The large machine came with 100s of boxes filled with parts to assemble. The machine is finally ready to see its first patient. The room walls are freshly painted and a new laminate floor installed to help improve the patient's experience.

August 10 marked the first day of operation of our new multi-purpose x-ray machine.

It took four weeks to assemble on site after arriving in 100’s of boxes. Even before then, the old x-ray room received a fresh coat of paint and new inviting flooring to offer patients a more pleasant experience. 

The new machine replaces a much older x-ray unit and has a long list of improvements resulting from more advanced technology.

“Improved patient comfort and improved image quality top the list of enhancements as well as versatility,” says Jennifer Meher, Manager Diagnostic Imaging. “Before, multiple pieces of equipment across multiple rooms would be needed to carry out all the procedures this one piece of equipment can do.”

There’s also a productivity benefit too. The machine has the ability to perform both standard x-rays of bone and image soft tissue. Images may be taken with the patient standing or laying down which enables x-rays of the upper and lower digestive system too. Before, patients would have to go outside Guelph for those images. Now, patients residing in the communities of Guelph and Wellington can have these images done in the convenience of their own community hospital.

According to Meher, when purchasing new equipment, there are many considerations that go into the decision, but ultimately these investments need to meet patient needs today and for many years ahead.

Living our Strategic Directions - Sustain Our Financial Health

Every issue there'll be an article about one of the initiatives either underway or completed that are supporting our four new Strategic Directions. As a reminder, they are:

 

Members of the linen initiative team include (l-r): Sharon Hood, Sue MacNeil, Jackie Baker, Connie Reeves-Bolger, Sheryl Hutchison and Dayna Tippe, Booth Centennial representative.

Sue MacNeil, Director Food Services and Environmental Support, says these staff have been fabulous in bringing their creativity and enthusiasm to make positive changes without negatively impacting patient care.

Linen costs at GGH have been running over-budget by around $70,000 for a number of years. Annual reviews by our linen supplier, Booth Centennial, suggested there were opportunities for improvement in both inventory management and usage compared to our LIHN partners. 

A team of staff in Environmental Services initiated a number of changes early in the year to improve ordering, inventory and delivery processes resulting in a same-day delivery service. Although this lead to some early cost-savings, an additional goal of $50,000 savings per year was targeted to meet budget. 

The team expanded their work to identify additional opportunities by engaging staff throughout the organization. This included focus sessions, educational displays and walk-throughs on the units. Eleven key strategies were identified and are being implemented in coordination with unit staff. These strategies include;

  • introducing lower cost alternative items (hand towels instead of bath towels in outpatient areas, use of rags instead of towels or sheets for cleaning spills, use of stretcher sheets instead of fitted sheets in some outpatient areas)
  • standardizing bed making practices including usage of soaker pads and flannels
  • evaluating disposables vs reusables
  • minimizing overstocking in patient rooms
  • maximizing credits such as reject linen rebates. 

To date, costs have been reduced by $21,650 compared to this time last year. The team is well on track to achieve the targeted savings but will require the support of all staff in continuing to implement the changes as we move into our higher volume and colder seasons.

New program designed to improve a patient's experience by reducing time spent wondering if...

Last month the Hospital introduced a new program, the Breast Assessment Clinic. It is designed to significantly reduce the amount of time a woman spends waiting to know whether or not she has breast cancer. 

The patient’s journey usually begins when a lump is found or a shadow appears on a screening mammogram. Then, it can take up to three visits to the Hospital over a four to six week period before a diagnosis can be made. Usually, a second mammogram is needed which may be followed by an ultrasound. Then, some will need a needle biopsy with the sample sent to the lab. Now with the new clinic, all that is done in one day. 

It can result in quickly getting good news too. Some women will have a false alarm because something abnormal is found on mammogram but after more tests, no cancer is found. 

“This is about improving our patient’s experience by significantly reducing their time spent wondering whether or not they have cancer,” explains Dr. Samir Patel, Chief of Diagnostic Imaging. “It’s also about providing the best care possible should cancer be found. By taking advantage of our modern, fully digitized and integrated diagnostic equipment including our mammography machine, patients can get their diagnosis as quickly as possible which means treatment can be started sooner.”

Held every Wednesday, an appointment at the clinic requires a referral from a physician. So far, it’s been very well received. 

Old beds given new life and purpose President and CEO to be featured
In June, we received 30 new Hill-Rom Versa Care beds (above). At the same time we removed 30+ beds from the hospital and donated them to an organization out of Toronto who donated the beds to Jamaica. They arrived at their new hospital home August 21 and we're hoping to get some pictures.

"Staff did an amazing job in coordinating the bed purchases and nice to know the old ones were being donated to a worthwhile cause," says Joyce Rolph, Senior Director Patient Services.

President and CEO, Marianne Walker, was recently interviewed as a featured guest on a new Rogers TV show, "This is Guelph." According to its host, Martin Bosch (left), the half-hour show will feature individuals who have made Guelph what it is today. Those interviewed will include a broad spectrum from business people, to public administrators, politicians, City of Guelph employees and others. 

The episodes will be shown Wednesdays at 6 p.m. starting September 14. The broadcast order of featured guests hasn't been set but once it is that will be shared widely.

Improving Emergency mental health services at Guelph General Hospital and across Wellington County

Late July, the province announced more than $3 million to expand emergency mental health and addiction services at hospitals in Guelph and in Wellington County. This is great news for our patients, families, staff and community. 

The funding allocation was: 

  • Guelph General Hospital (GGH): $2,416,300
  • Groves Memorial Community Hospital: $326,100
  • North Wellington Health Care Corporation, including Louise Marshall Hospital and Palmerston and District Hospital: $326,100

GGH has seen an increase in acuity, volumes and escalating behaviours of patients experiencing mental health and addictions issues in our Emergency Departments (ED) across Guelph and Wellington County. As a result, an emergency mental health review was started in March of 2015. In January of 2016, the report identified a number of opportunities for improvements and provided recommendations for change. These proposed changes will support the creation of a safe environment for the provision of dignified integrated care for patients with mental health and substance abuse related conditions. 

Since receipt of that report, partners from the Canadian Mental Health Association Waterloo Wellington Dufferin, Groves Memorial Community Hospital (GMCH), Guelph General Hospital (GGH), Homewood Health Centre (HHC), North Wellington Health Care (NWHC), and the Waterloo Wellington Local Health Integration Network have implemented many changes and developed an action plan for improvement. The plan has been split into four different areas of focus (outlined below).

A new position of a dedicated program manager will be established to oversee all mental health services within Guelph Wellington. In addition, a project lead will be assigned to support each of the four working groups currently being established. 

The new funding will help us develop a system of care that will improve our emergency mental health services and patient outcomes. The key expected outcomes include: 

  • Reduced mental health Alternate Level of Care (ALC) in acute care settings 
  • Reduced ED Length of Stay (LOS) for patients needing mental health and addiction services 
  • Reduced admitted patient LOS in the ED
  • Reduced repeat visits for mental health and/or addictions 
  • Improved patient and staff satisfaction
  • Improved patient and staff safety 

Focus One: Improvements in the Rural setting – GMCH and NWHC
This team will focus on improving timely access to emergency mental health consultation for Groves Memorial, Palmerston and District, and Louise Marshall Hospital emergency departments. Staffing resources will be added to increase the hours which assessment is available on evenings, weekends and statutory holidays. 

In addition, a consult liaison service will be developed to improve access to psychiatric consultation for community referrals, hospital inpatients and ED referrals. Safe rooms are being created\renovated and will be completed by March 2017. Procedures and staff\physician training related to the use of safe rooms are being standardized across all ED sites. Security services will also be made available to assist in monitoring of patients at all three rural hospital sites.

Awaiting final inspection so the furniture can be moved in, the safe rooms are almost complete. Also in the secured area in the department is a specially designed "quiet room" to provide a comfortable yet safe area.

Foci Two and Three: Improvements at GGH and in Emergency Mental Health Unit (EMHU)
This team will focus on reducing time to consult and overall emergency department (ED) wait times for patients with mental health related visits. To accomplish this, we will be adding staffing resources to have a Mental Health (MH) nurse available for consult 24 hours per day in the ED. Addiction counsellors will be added to our team at GGH to support patients with substance addiction related conditions and those with concurrent disorders (both MH and substance addiction). Recruitment for these positions is in progress. These staff members will also provide therapeutic interventions for patients who are in the ED awaiting transfer to a psychiatric facility. The team will also work to develop and implement a MH “See and Treat” model of care in the ED. Safe rooms are being constructed and will be completed soon. Procedures and staff\physician training related to the use of safe rooms are being standardized. 

On the inpatient side, we will be enhancing our consult liaison (CL) service. Currently, we have a psychiatrist available for consultation. Enhancements to this service will see the psychiatrist available at GGH during the day and will also provide for a nurse to support the CL service and provide therapeutic treatment(s) to patients who are awaiting transfer to a psychiatric facility.

Focus Four: New program development – Mental health urgent care centre - Crisis Support
The goal of the urgent care centre will be to provide services into the evening hours and on weekends so patients have access to services outside of traditional business hours. Examples of services to be provided may include access to psychiatric consultation, therapeutic groups, and/or medication administration. Recruitment has begun and we are exploring space options. We anticipate this service will help to prevent repeat visits to the emergency department. In addition, the team will undertake an analysis of current service availability for treatment initiation and/ urgent assessments and crisis support. Using the knowledge created through this analysis, we will develop a new urgent care centre designed to address the identified service gaps. 

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