General Express October 2018

The push for enhancing our patients' experience comes straight from the heart
President and CEO Marianne Walker shares why it's so important to her

When President and CEO, Marianne Walker’s mother was diagnosed with breast cancer, it gave Marianne a clear perspective of what care providers and patients can sometimes experience in a complex healthcare system. Those experiences still resonate with her today and are some of the reasons why she is such a strong advocate for enhancing the Patient Experience at Guelph General Hospital.

 marianne with her mother cropped

For Marianne, one of the most profound learnings during that time was how often good-intentioned care providers made assumptions about her mother’s needs and those around her who were providing support. There were times when just asking a few questions would have made a big difference.

“No one wanted to hear her story. No one asked her what she wanted,” said Marianne. It was the same when it came to family members. “We knew her best. We knew her beliefs and how she wanted to be cared for especially at the end of her active life, but no one asked.”

She said she believes health care really needs to listen to family members. “There needs to be a dialogue which in part helps the family understand the journey of their loved one.”

She also saw how more communication would at times help make the care provided seem more personal. With her background as a paediatric nurse, Marianne knew how easy it was to get into the habit of providing healthcare as a list of tasks to be completed. Witnessing a task approach at times with her mother’s care, she said it was easy to see how it could be perceived as insensitive. Much of it could be softened with a simple solution – communication.

Better communication would have also helped with another aspect of her mother’s care – the fragmentation of information among providers. She gave a stark example. “During the final 12 days of my mother’s life, she was asked five times if she was DNR which she was. Each time she was asked it was upsetting for her and rightfully so.”

Some of the challenge came from numerous agencies providing homecare. Regardless of the cause, it was that experience which made her champion a different care model when asked to lead the restructuring of stroke care in the WWLHIN. For that, she insisted that patients who experienced a stroke have their care provided by a clearly identified “care team” which would minimize information fragmentation. She credits the integrated stroke model with playing a significant part in transforming local stroke care outcomes from being the lowest in the province to the best.

PE logo webEnhancing the “Patient Experience” at GGH is still in its early stages. One way is to actively include loved ones in a patient’s journey. For the hospital and all our exceptional staff, it requires a continued shift in the organization’s culture. Marianne knows it can be done because she’s seen it at GGH many times and has witnessed it elsewhere in her role as an Accreditation Surveyor. One of the hospitals she visited has taken the extra step to actually identify those family members who want to actively assist the efforts of its staff. “I’m a Care Provider” name tags are given out to family members to help staff be more comfortable about reaching out and including them in taking care of their patients.

The passing of Marianne’s mother continues to resonate in Marianne’s leadership. Her experiences from that time will have a positive impact on the care provided at Guelph General Hospital now and for the times to come. “I believe the future for healthcare is bright as we create exciting new opportunities for patients and their families to participate in their care, improvement activities and organizational strategy.”

Introducing our first ever Patient and Family Advisory Council This year's Volunteer of the Year named 
PFAC web Judy Steele Volunteer of the Year web
Our first ever PFAC is now up an running. Deciding to continue with their monthly meetings through the summer, the group is determined to have an immediate effect on decisions at the Hospital. Members of the group are: front row (l-r) Jodie Brown Bedford (GGH Patient Relations Co-ordinator), Bonnie Milliner, Suzanne Holder, Fran Hood, (Admin. Assistant)  Gwen Sharp, Marion Baldwin - back row (l-r) Melissa Skinner, (Director Quality and Professional Practice) Paul Clarkson, Geoff Holloway, Sue Honeyman, Shannon Pharoah, Carolyn Cattran and Michelle Lindsay. Judy Steele (centre) is this year's Volunteer of the Year. Presenting her award was Laura Hutchings, Director of Volunteer Resources, Student Registration & Spiritual Care (left) and Theresa Dennique, Manager of the Courtyard Boutique. Judy has been a volunteer at GGH since 2002 and to date has over 3,600 recorded volunteer hours.

Currently, there are over 300 volunteers who provide support throughout the hospital. GGH volunteers contribute in excess of 15,500 hours of service each year.

Healthy Hospital Employee Survey coming soon!

HHLogo people with sloganIt’s Healthy Hospital Employee Survey (HHES) time again. Every two years staff and professional staff are asked for feedback about their satisfaction of working at GGH. Our last survey was completed in 2016 and since then departments and teams have been working hard to make recommended improvements. During October 15 – 26 staff will be asked to complete the latest HHES online survey to share thoughts and ideas for improvement. What’s new this year? To encourage participation the survey has been shortened this time around. There are 18 key questions in total – about roles, departments and satisfaction.

The HHES has already been used in over 30 Ontario hospitals which allows a comparison between our results and others. The results will be gathered and analyzed by Metrics@Work Inc. and be reported to the Senior Leadership Team in early December. The findings will be widely shared with all staff and professional staff as well as with our Board of Directors early in the new year.

Meeting the challenge of an ever-increasing demand for our services
It's only through the dedication and professionalism of all our staff and by continuing to look for ways to do better, says Marianne Walker

In 2006, the Province of Ontario released its Places to Grow Act. In it, Guelph was named as one of the areas where the rate of population growth would exceed the provincial average. According to Statistics Canada, the Guelph census area is one of seven Census Metropolitan Areas in Canada to experience accelerated growth between 2011 and 2016. During this time, the population in our area grew by 8.3 percent. Last year, Guelph was the 3rd highest growth area in the country and highest in Ontario.

That increase along with an aging population results in ever increasing demands for health care. At Guelph General Hospital, pressure was felt throughout the past year and continues to this day. There has been a sharp increase in our “Patient Days” which is a measure of how full we are. Compared to last year, our Patient Days increased by 8.4 per cent.

What does that look like at the Hospital? The pressures are felt across the organization. We’ve opened our “surge” beds normally set aside for flu season and we’ve had to keep them open. We’ve looked at converting non-traditional areas such as a Paediatric Day Surgery unit into ward room for six patients to reduce the number of times we have to practice “hallway” medicine with bedded patients.

Having no empty beds means longer waits for people coming to our Emergency Department who need to be admitted. It means our lab is doing more tests, diagnostic imaging more scans, pharmacy filling more prescriptions and nurses and physicians caring for more patients. It impacts our support services too from our cleaning staff to food service providers. There’s even a need for more equipment such as beds. Unlike other years when pressures come and go depending on the severity of the flu season etc., the pressure now is relentless because what is causing it is different. A fast growing and aging population is here to stay in Guelph.

Despite these pressures our GGH team has demonstrated their leadership time and again to rise to this challenge and to continue to provide the best possible care to every patient. In this regard, our Hospital is fortunate to have many leaders in patient care excellence. We’ve been able to do this through the dedication and professionalism of all our staff and by continuing to look for ways to do better. For example, this year we formed our first Patient and Family Advisory Council. It brings a different perspective to the table and will have a say in significant decisions being made at the hospital.

We will always do our best at Guelph General Hospital to meet the needs of the community we serve which continues to grow quickly. We are already the most cost efficient hospital in the area but will continue to explore ways do better.

Our Senior team would like to recognize our amazing leaders, staff and clinicians for their ongoing commitment to providing the best care possible during these challenging times.

Saying "goodbye" as only Joyce Rolph could

joyce send off web
As engaging as usual, Joyce (left) took time to chat with everyone who came to her send off. Sharing the moment was Michelle Bott, Senior Director, and Joyce's husband, Perry.
Recently, Senior Director Joyce Rolph left GGH for a VP position in eastern Ontario. She had been a foundational leader here at GGH for many years starting her career as a staff nurse and taking on many challenging roles including the Manager of the ICU/CCU, Special Projects, Director of OR/PACU and Senior Director. One of her last acts before heading out was to send out a hospital-wide email in her role as leader of our Patient Experience initiatives. She wanted to share a story she heard while interviewing candidates for our new Patient and Family Advisory Council. It was her unofficial way of saying goodbye. She will be missed.

“The Blue Gown”

On completing interviews for members of the Patient and Family Advisory Council I had the unique opportunity to hear many heart-warming stories from patient and family members about their experiences at our hospital. One story in particular provided a powerful message to me and really captured why our focus on Patient Experience means so much.

Several years ago “Mr. Smith” experienced a stroke which left him with several deficits including impaired speech and left sided weakness. His wife was his care partner and through the years was his advocate and spokesperson during his frequent hospital visits.

One time, he was admitted with an acute respiratory illness and after several days he was well enough to go home. On his discharge day his wife helped him get dressed and he sat by the side of the bed waiting for discharge instructions. His nurse cheerfully approached him and said, “Mr. Smith look at you all dressed. You look like a real person now!”  His wife was taken aback with this comment and said she wanted to say he was a “real person” when he was wearing a blue gown too!

For me, the reason this story hit home was it questioned my perceptions about patients. Do I see them as people like you and I who when healthy are high functioning individuals in the community? Or, does the blue gown change my perception of people?

Recently, I required some diagnostic tests even though I was perfectly healthy. What I realized is that donning the blue gown changes who you are. It turns you from a person to a patient. Suddenly, you feel more vulnerable and out of your element. You place immense trust that the health care provider is competent and caring in their role.

It does beg the question. How do we perceive patients and do we allow ourselves to see beyond the diagnosis and the blue gown? Patients who are admitted to our hospital are out of their element, generally feeling unwell and are trusting of our expertise and caring approach. My question to you is, does the blue gown change your perspective?

More for GGH history buffs

A publication from 1975 was commissioned to celebrate the Hospital's 100th anniversary. In it are articles linking the past to what was then, the present. For those interested in the recent and distant history of the Hospital, it makes for some interesting reading.
In this issue of General Express is a scanned article about Purchasing. It highlights the progress made from the days of receiving jam in 20-pound pails to the modern efficiency of receiving all deliveries in one location except for "lumber and fuel oil and other power plant supplies."
Click on the image to the right to expand it for easier reading.
In the next issue, discover how our early physicians had to supply their own equipment.
100 year anniversary edition header web
Purchasing GGH 100 year anniversary edition
The movement of goods and supplies at GGH has changed a lot over the past 143 years!
GGH Snapshots
Blood donation winner web med carts web  Privacy Matters - Internal Emails email icon

How can I send an internal email about a patient?

Remove all patient identifiers, including patient name, date of birth, health card number and address when using internal emails. The G number (unit number) or patient account number can be used in the email as a reference. Let’s keep patient information confidential. For any privacy questions or concerns, you are welcome to contact Valerie Anderson, Chief Privacy officer at ext 2273. 

Guelph General Hospital (GGH) was recently recognized by Canadian Blood Services (CBS) as the winner of its annual Hospital Challenge. GGH was the top hospital in Ontario for the percentage of staff who donated blood.

Staff are reminded they can still donate blood at the CBS clinic in Guelph and have it added to the GGH total

After a collaborative and consultative effort between Emergency Department Staff, Materials Management Staff (Stores) and our vendor community, new medical Supply Carts are being introduced. It is hoped these new carts and reconfiguring will provide staff with better access, more efficiency, improved organization and assist with providing the best patient care possible.

Donors helping make family lounges more inviting and supportive

Caring donors, along with designer Karen Miller who donated many hours of her time, helped transform multiple family lounges into inviting, calming and highly functional spaces for patients, family and visitors 

Having a loved one in the Hospital can be overwhelming and stressful, especially when life is at risk and the outcome is not clear. Family members often spend long hours at the bedside of their loved one. There are also moments, or even longer stretches of time, when some quiet solitude is needed, or when a safe and private space is needed for a family meeting. In certain parts of the Hospital, such as our Intensive Care Unit, visitors in patient rooms are limited to one or two at a time, so if there are many visitors, a comfortable space is needed to accommodate them too.

icu before webIt was a happy coincidence Karen Miller from Modelo Interiors was referred to the Hospital to lead the redesign. Her mother was an ICU nurse at Guelph General, but of greater influence to her design was her own experience as a visiting family member.

Karen vividly recalls how she felt when her husband was admitted into the ICU following a cardiac arrest. “It was traumatic. I felt overwhelmed. I often needed to retreat to a quiet space to get a handle of my own emotions.”

Karen described what it was like walking into the old ICU family lounge. “It was just a big room with a bunch of old couches and chairs along the perimeter, it felt like a therapy circle,” she said.” When I entered I felt everyone looking up at me. It was uncomfortable and it added to the trauma I was already experiencing.”

Plenty of careful thought, research and planning went into the redesign, including interviews with family and visitors who were using the spaces.

Karen also spoke with nurses and staff in each of the units that had a family lounge in need of redesign. What she discovered was the rooms were each used in slightly different ways in different units of the Hospital. With this knowledge, Karen designed each family lounge to reflect how it is used.

icu after webThe ICU waiting room is often occupied by individual family members experiencing high levels of stress and highly charged with emotion, often spending long hours over multiple days at the Hospital. Privacy and solitude is most important to these individual visitors. To meet this need, the new design includes spaces where individuals can “cocoon” themselves into a chair or work station.

Marlene DaGraca, Director of Critical Care & Cardio-Respiratory Services, has an office located across from the ICU family lounge. She has seen a noticeable increase in visitors using the space.

“It’s much more welcoming to enter into the room and nursing staff also feel more confident and comfortable suggesting the space to visitors. Before the redesign, they would often suggest the Hospital’s more public cafeteria area.”

The ICU waiting room was the first to be completed and there are three others that will be complete next month.

Many caring donors helped to fund the transformation of these family lounges. More importantly, they will transform the experience of those that have loved ones at the Hospital. With thanks to these donors, family and other visitors will feel cared for too.