For this special series, Inspiring Impact, HIROC is partnering with AdvantAge Ontario to highlight the work of several of the presenters at their online education and networking event in May.

Today we’re talking with one of the session presenters, reporter Moira Welsh, author of the recent book Happily Ever Older. For close to two decades Moira had been investigating the negative aspects of long term care homes. On a tip from someone at AdvantAge Ontario, she started exploring one progressive model of care in Peel Region. The outpouring of excitement around that story made Moira start thinking, maybe there are other stories out there of seniors living with purpose and energy and love.

Quotables

“It was simply leaders of individual homes who saw what was possible and saw that people could live in a way that eliminated the anxiety and aggression that people experience, especially those with cognitive decline.”

“In these homes they’re really focussed on removing loneliness as a consistent part of people’s lives.”

“For me what it comes down to is great leadership. People who are not afraid to innovate, who are bold and don’t mind taking risks – that can change everything.”

“What I learned from this is the concept of potential. No matter our age or our vulnerabilities, we can actually live up to our potential at any stage in life.”

“It matters immensely that homes can attract good staff and keep them. That’s what these programs are finding – people want to work there because they feel value in their work.”

Mentioned in this Episode:

Happily Ever Older

The Butterfly Home

Sherbrooke Community Centre

Dr. Bill Thomas

AdvantAge Ontario

AdvantAge Ontario Annual Convention

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For this special series, Inspiring Impact, HIROC is partnering with AdvantAge Ontario to highlight the work of several of the presenters at their online education and networking event in May.

Today we’re talking with one of the session presenters, Paige Fernandes, Planning and Community Engagement Coordinator at Belmont House, a long-term care facility in downtown Toronto. With staff struggling with stress and burnout during the pandemic, Paige and her physiotherapist colleague Gordana Perunicic-Stankovic, created an evidence-based program called Workday Wellness.

Those were difficult days at Belmont House and they thought, let’s create a program that incorporates mindfulness and exercise and see how it goes. Workday Wellness is still in its early days, but Paige and Gordana are encouraged by staff interest in the program and want to keep doing everything they can to foster a positive work environment.

Quotables

“In conversations with Gordana and my colleagues, we noticed that staff were struggling. We wanted to fuse our practices together – physiotherapy and my personal interest in fitness and wellness – to develop a wellness program.”

“It’s all about sharing and learning and continuously growing.”

“It doesn’t have to be this big encompassing program. I encourage other homes to really start small – look at what you have in place and build off that.”

“The seeds were already planted and we’re just growing this movement into something very positive.”

“All of us have been going through similar things in long-term care and we would be happy to share the knowledge and experience we’ve gained so we can get through some of these challenging times together.”

Mentioned in this Episode:

Belmont House

AdvantAge Ontario

AdvantAge Ontario Annual Convention

The Circle of Health, US Department of Veterans Affairs

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Our guest today, Jennifer Zelmer, is the newly appointed CEO of the organization formed through the amalgamation of the Canadian Foundation for Healthcare Improvement and the Canadian Patient Safety Institute. It’s called Healthcare Excellence Canada and we were fortunate to speak with Jennifer on the exact day the organization officially opened its doors, March 3.

Jennifer did her undergraduate degree in health information science at the University of Victoria and did several work terms in India, Australia, Denmark, and Canada. Those experiences awoke her interest her healthcare transformation – and since then she’s been dedicated to finding ways of making care not just better and safer, but how to scale those improvements so everyone can benefit.

Jennifer joined the Canadian Foundation for Healthcare Improvement as President and CEO in 2018 and was previously president of the Azimuth Health Group where she was a strategic advisor to leaders who sought to advance health and healthcare at local, national, and international levels.

Although they didn’t plan to bring the two organizations together in the midst of a pandemic, Jennifer is excited by the possibilities. “Amalgamation is a process, not a journey,” she says and knows change won’t happen in a day. But she’s dedicated to leading the organization in helping shift the conversation in healthcare in some simple and profound ways. It starts with asking not “what's the matter with you” but “what matters to you”.

Quotables

“Looking for opportunities for where were some of those levers of change and how could you put them together to make transformation happen.”

“We need to learn from some of those preparedness pieces as well as from the response during the pandemic.”

“This was an amalgamation that we chose as organizations to embark on, so quite a different context from amalgamations where that choice isn’t yours. Coming together as organizations just made sense.”

“It’s not just about individual innovations, but also about building our capacity for fostering excellence in the health system.”

“Culture is fundamental to patient safety.”

“The need for that connection has never been more clear. There’s absolutely no substitute for just spending that time to be able to connect, even if we’re connecting in different ways.”

“There has never been more focus on healthcare than now (in my lifetime at least), so where are those opportunities, to say ok, here now we can move this mountain together. It’s going to take all of us, going to take some heavy lifting, there will some twists and turns in the road we didn’t expect, but we’re committed to getting there together.”

Mentioned in this Episode:

Healthcare Excellence Canada

Myer Horowitz

Azimuth Health Group

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Dr. Daniel Pepe did his medical training at the Schulich School of Medicine and Dentistry at Western University. He did a surgery residency before moving into family medicine. His wife is also a family physician and together they run the London Lambeth Medical Clinic.

Dr. Pepe is truly a different kind of family physician - he loves the give and take of social media, he questions the status quo, and admits he’s often working on the fringe. Long before the pandemic Dr. Pepe was using an array of digital tools to improve his interactions with patients. The beauty of these tools he says is that they create more options for patients and they give care providers a fuller and more accurate picture of what’s happening with patients over time.

Digital tools are just one way of approaching patient care. Dr. Pepe says he’s constantly learning from his patients and listening their stories – those stories are his inspiration for tackling the bigger challenges in our healthcare system.

Dr. Pepe has no interest in labelling patients as non-compliant. It merely means that the physician hasn’t taken the time to explain in plain language the details of what the patient needs to know. It requires a bit of quick thinking on his part, but the resourceful physician uses analogies – stories that connect a patient’s health with their real life – as a way of building trust.

Quotables

“It’s Dr. Mike Ryan from the WHO who says you have to move fast, you don’t have to be perfect, but you need to move fast. And that was really the mentality that we took early on.” – DP

“I’m not sure I’ve ever going to see something that moves at that pace and speed again. I actually saw what was possible when people put aside that organizational lens and say, ‘What is the right thing for the patients right now?’ It was pretty cool.” – DP

“Fundamentally if you think about the special sauce of primary care, it’s a relationship.” – DP

“The risk of technology is that sometimes we say, everything is going to be virtual and the answer to that is no. Things that should be virtual can be virtual, but it should also create capacity for us to care for the most vulnerable in-person and look at how it frees up our time and energy to do a good job for those patients.” – DP

“If you take the time to explain something as an analogy, it makes you really understand the concepts. You can no longer just hide behind medical jargon and lingo.” – DP

“By allowing the patient to tell their story and not defining the patient’s narrative, it allows us to really understand that story at a depth that we don’t traditionally do.” – DP

“I do think patients should actually own their own record and be the steward of it, and that’s one of the things I’m trying to push forward with some of the leadership work I’m doing.” - DP

“What you see when you look at the healthcare space, it’s a much more level playing field. It’s more real because it’s what people are saying and feeling in the moment. It’s more visceral and that visceral sharing allows us to drive more change and helps us scale.” – DP

“That knowledge sharing and scaling is critical and what we at HIROC value – to make change, you have to get it out there.” – PDS

“The technologies to dramatically change how we deliver care exist. It’s just the will and leadership to say, ‘Ok, let’s go make it happen’. And if we fail, fine – learn from it and go on to the next thing.” - DP

Mentioned in this Episode:

Drs. Puneet Seth and Damon Ramsey (InputHealth Systems)

Dr. Mike Ryan, WHO Health Emergencies Programme

The Innovator’s Dilemma by Clayton M. Christensen

London Middlesex Primary Care Alliance

Janet Dang, Primary Care Transformation Lead, London Middlesex

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In this episode we’re speaking with Dr. Lisa Calder, CEO of the Canadian Medical Protective Association, known as the CMPA. She stepped into the role in August last year and is the CMPA’s first female CEO.

Dr. Calder studied medicine at the University of Western Ontario and did an Emergency Medicine residency at the University of Ottawa. She has a Master of Science degree in Epidemiology and was an Associate Professor at the University of Ottawa in the Department of Emergency Medicine.

Dr. Calder pursued her passion for patient safety by completing two additional fellowships: the Patient Safety Fellowship in Emergency Medicine from the Society for Academic Emergency Medicine and the Emergency Medicine Patient Safety Foundation, and the American Hospital Association’s Fellowship in Patient Safety Leadership.

She spent more than a decade practising as an emergency physician before joining the CMPA in 2015 as the Director of Medical Care Analytics.

When Covid 19 hit, Dr. Calder and her leadership team moved quickly, using a variety of tools to support their physician members during this tumultuous year. She credits her own experience as an emergency physician for teaching her disaster training and how to live with unpredictability.

Today Dr. Calder says the mission of the CMPA has never been more important - to protect the professional integrity of physicians and promote the safety of medical care.

Quotables

“There are things that we can see that are right in front of us, and are being reported in terms of numbers, but there are impacts that are more subtle – on our well-being, on the way we work together, and those are the ones that I find tricky to put my finger on and understand.” – LC

“We have a phone line which is available to our membership and we receive up to 200 calls a day from our physicians asking for advice.” – LC

“We’re always, when we look at medico-legal data looking back in time. We’re limited by what’s actually documented and that’s a significant limitation because we know that a lot happens in the moment when physicians are making critical decisions that does not get documented.” – LC

“I’ve seen a real shift, which I think is hugely positive to a more of a personal tone to the communication, more of a ‘sharing struggles’ and a willingness to be humble and authentic on the part of leaders.” – LC

“I want to know from employees, what does it mean when we say ‘We are here for you? What does that translate for you in tangible terms in your day-to-day work?’” – LC

“I’m fiercely protective of my lunch break every day. I need time away from my computer and I use that time to go for a quick walk around the block and then to meditate.” – LC

“At HIROC we introduced the Collision Chats, where we pair up staff randomly and they meet up for 5-10 minutes and that’s a way of having those hallways conversations online if possible.” – PAD

“The challenges ahead for the healthcare system are huge and so we will need more collaborative approaches to address these. I don’t think siloing organizations – everyone doing their own thing –is going to advance us where we need to be.” – LC

Mentioned in this Episode:

CMPA

University of Ottawa – Faculty of Medicine

Dr. Mamta Gautam

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For this special series HIROC is partnering with the Association of Family Health Teams of Ontario (AFHTO) to highlight the work of several amazing primary healthcare teams.

Family health teams provide comprehensive primary care and are based on a collaborative model where physicians, nurse practitioners, nurses, dieticians, social workers and many more disciplines work together.

In this episode we speak with Dr. Cleo Mavriplis, a family physician and professor. In 2017, Dr. Mavriplis started working with an interdisciplinary team of family physicians, nurse practitioners, and students from the University of Ottawa, Faculty of Engineering on an app called icanbewell. The programming team was comprised of engineering and computer science students led by Professor Liam Peyton. The students are funded by CREATE-BEST, an NSERC grant that brings programming students and health care providers together to create the best health smartphone apps.

The app launched this year and is the only Canadian, evidence-based, bilingual, mobile application for preventive care.

What’s unique about the app is that it has a patient interface and a healthcare provider interface and both are visible to each group. Healthcare providers can search by age and gender for options on applicable preventive measures for a particular patient, and they can also access teaching materials for patients. Patients can use the tool in a similar way to learn about self-assessment and general prevention guidelines.

To see the app go to: icanbewell.ca.

Quotables

“We’re working with the computer science people to make an interface that would be acceptable to transgender and non-binary people.” – CM

“Fifty to 70% of all illness and disease in Canada and in the world are really due to preventive causes…studies show that if you advise people and do some intensive training that you can get 30% of people you’re talking to quit smoking for example or change their lifestyle.” – CM

“When we did the study, people said, “Oh, I didn’t know Canadian health information is different,” and that’s why the app is important and it’s trusted.” – CM

“We understand now that prevention and all these measures do work if we do them. Also, the emphasis is on helping marginalized or vulnerable populations. We’ve seen that we’re only as healthy as our most vulnerable.” – CM

“We’re working with the computer science people to make an interface that would be acceptable to transgender and non-binary people.” – CM

“It’s been a gut feeling for me that I wanted to be very democratic and transparent...I’m kind of glad that we’ve stuck with the two interfaces on the same app.” – CM

Mentioned in this Episode:

The Bruyere Academic Family Health Team

University of Ottawa – Faculty of Computer Science

McGill University Satellite Faculty of Medicine

Canadian Family Physician

Helen Monkman

Ontario 211

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For this special series HIROC is partnering with the Association of Family Health Teams of Ontario (AFHTO) to highlight the work of several amazing primary healthcare teams.

In this episode we speak with Robin Mackie, Executive Director, Delhi Family Health Team; Roxanne Pierssens-Silva, Clinical Services Manager/RPN, Delhi Family Health Team; and Rebecca Spencer-Knight, Nurse Practitioner, Delhi Family Health Team.

Migrant workers constitute a large portion of the workforce in rural Haldimand, Norfolk and Brant Counties. In Haldimand-Norfolk, there are 204 farms that hire and house over 3,300 Seasonal Agricultural Workers (SAW). The Delhi Family Health Team has traditionally provided primary care services to the workers and were the first people called when a case of COVID was reported. Within hours they transitioned to a fully-functional mobile care team. And they never looked back.

Using their cars, cell phones, and as much equipment and supplies as they could carry, Robin, Roxanne and Rebecca attended to the physical, mental and emotional needs of the workers who were isolated, spoke a different language, and were far from home.

The experience of providing low-tech care in an unpredictable environment reminded the team of why they became nurses in the first place and the importance of looking out for each other.

Quotables

“There were a lot of barriers this year for the agricultural workers being able to access primary care.” – RPS

“Within 20 minutes, I was on the phone calling my team and saying, ‘Can we start going out to these farms in the next couple of hours?’ I had no doubt that the team was going to respond in a positive way.” – RM

“My role as the Executive Director was to make sure that this team felt safe and that they were well before anything else so they could provide the great service they did to these workers.” – RM

“We were out there knowing that at any point in time if I needed supplies, if I needed support, if I needed just a phone call, I had people available to me at any time of day.” – RSK

“It’s amazing when you’re in something as big as this, how things just seem to fall into place.” – RPS

“By offering accurate information, by reassuring them about their care, and being there for them on an emotional basis as well, we were really able to enhance their ability to heal, their ability to cope with the isolation they were going through at that time.” – RSK

“The admin side we have to do now is taking away from that emotional, hands-on nursing that most of us got into healthcare for.” – RPS

“We put safety first, we put our workers first, we put our patients first and then we moved forward.” – RM

Mentioned in this Episode:

AFHTO Association of Family Health Teams of Ontario

Delhi Family Health Team

Migrant workers from Trinidad and Tobago stuck in Haldimand-Norfolk

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For this special series HIROC is partnering with the Association of Family Health Teams of Ontario (AFHTO) to highlight the work of several amazing primary healthcare teams.

In this episode we speak with representatives from the Youth Advisory Council, part of the St. Michael’s Hospital Academic Family Health Team. Katie Sussman is a Social Worker on the Family Health Team; Muzammil Syed is a member of the Youth Council and a graduate student at the University of Toronto; and Ermias Nagatu is also a member of the Youth Council and a student in the Occupational Health and Safety Program at Ryerson University.

The St. Michael’s Academic Family Health Team has a focus on serving vulnerable and unattached patients – and youth are an important part of that population. The creation of the Youth Advisory Council came from a desire to have youth patients inform the Family Health Team about what youth services were needed and where improvements could be made.

It’s only been a year – and the council has smoothly transitioned to virtual collaboration. The students are having an impact on decision-making as planned, but the council has also transformed into a place where the youth are playing a true leadership role.

Quotables

“We really consider patients to have the most essential insights when it comes to healthcare development and delivery.” – KS

“The initial intention of the youth council was to focus on healthcare services. What’s really amazing is that’s it’s transitioned into a place where youth really have a leadership role.” – KS

“We transitioned from meeting at the Bond St. Family Health team location to fully virtual on Zoom and attendance actually increased and engagement increased. From there, we were able to move forward with our next steps.” – EN

“When youth told us the service they needed the most but were not currently accessing was a psychologist or counselling, that gave us a target, something we could improve awareness of.” – MS

“One of the things that’s really important with any advisory committee is recognizing the importance of power-sharing and that the health practitioners aren’t actually the experts here. It’s the patients who are.” – KS

“There’s a strong emphasis on diversity within the team – a diversity of people with different backgrounds, with different life experiences, and diversity of thought as well.” – MS

“You need to give youth time. Youth provide energy, they provide new ideas, provide lots of momentum and a fresh new perspective. But it often requires time.” – MS

“We are so lucky to have youth patients who are so motivated, have such a desire to create, to change, to do and to also teach us.” – KS

Mentioned in this Episode:

Association of Family Health Teams of Ontario

St. Michael’s Hospital Academic Family Health Team

Ryerson University

University of Toronto

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Today, Ellen Gardner and Philip De Souza, Communications and Marketing at HIROC, speak with Dr. Ronald Cohn, President and CEO of the Hospital for Sick Children.

Early in his medical career, Dr. Ronald Cohn was on a tourist bus in Toronto and as it drove up University Avenue and by SickKids Hospital he told his wife, that’s one of the world’s leading children’s hospitals and I will probably never work there. Proving that life doesn’t go where you predict, in 2012 Dr. Cohn accepted a position as Chief of the Division of Clinical and Metabolic Genetics, Co-Director of the Centre for Genetic Medicine, and Senior Scientist at the SickKids Research Institute. 

Even as he leads the hospital, staying true to his identity as a physician and a scientist is essential for Dr. Cohn, who still sees patients and is very active in the lab that bears his name. Most recently, his laboratory started to investigate the application of a new genome editing technology, CRISPR/Cas9 that holds the promise of correcting genetic abnormalities that lead to muscular dystrophy.

Today he is guiding the hospital in a new strategic direction called Precision Child Health. The campaign is built around the concept of individualized care tailored to each patient’s unique characteristics, from their genetic code to their postal code.

Quotes

“There is an aura in our institution of the people who love working here. That is true for every single person who works here.” – RC

“Moving forward, under the concept of “SickKids care anytime, anywhere”, we will hopefully have monitoring opportunities of children at home that would help us reduce the time they have to actually stay in the hospital.” – RC

“I had a lab meeting and asked the small group assembled – look at this exciting research. I want us to drop everything we’re doing right now. Are you willing to go with me on a journey trying to use this technology as a way to identify new therapeutics for muscular dystrophy?” – RC

“(With Precision Child Health) we’re trying to look at the very broad data set and then leverage the technology in order to think about prediction as well as prevention.” – RC

“It’s a difficult journey, a journey that will never end. But I’m glad we made it (diversity, equity and inclusion) a pillar of our strategic plan and we have full support from literally everyone at the executive level and director level to bring some real change.”

“There are always opportunities for change. I think leaders need to see them, identify them and you need to help implement them.” – RC

“My wife said it best: you put on a suit, it fit you and you just ran with it.”

“I can tell you that one of the best decisions of my life was to move here, and it was a difficult one.” – RC

Mentioned in this Episode:

The Hospital for Sick Children

Johns Hopkins University

Precision Child Health

Dr. Indra Narang

CRISPR/Cas9

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For this special series we’re partnering with the Association of Family Health Teams of Ontario (AFHTO) to highlight the work of several amazing primary healthcare teams.

Family health teams provide comprehensive primary care and are based on a collaborative model where physicians, nurse practitioners, nurses, dieticians, social workers and many more disciplines work together.

In this episode we speak with Janet Dang, Transformation Lead for Primary Care at the Thames Valley Family Health Team, part of the London Middlesex Primary Care Alliance, and Asher Frydman, a 2nd year medical student at the Schulich School of Medicine & Dentistry at Western University. Asher was one of the early volunteers to join Janet’s Covid project.

In the early stages of Covid-19, Janet and her team realized the area was experiencing a severe shortage of PPE. With the help of student volunteers and donations from businesses and the community, this grassroots effort grew to become the primary PPE distribution hub for the provincial supply within the region.

Quotables

“I saw that there was a small project that was at its grassroots stage, collecting PPE from the community and I said this is absolutely I want to do.” – AF

“We started to call a couple of places and more PPE came in and things were being picked up, and it started to snowball. We thought, oh no, there’s only the three of us. We can’t really do this for the entire city!” – JA

“The actual cycle of making sure you’re tracking all of it, making sure they’re getting the exact amounts they need – no more no less – that really took a lot of cycles, discussing with each other and individuals who work higher up like Janet as well as some other doctors, to make sure we were working efficiently as well as ethically.” – AF

“The (AFHTO) conference gave us a chance to explain there are hub systems that can really work, and that can actually make a difference in your communities, that can maintain close relationships with physicians and other primary care providers to ensure they can continue their operations during a pandemic such as Covid.” – AF

“It was incredible to see how both the community can step up to help healthcare workers and how future healthcare workers are willing to step up as well to make sure we have that continuity of care.” – AF

“It just shows that when we communicate and work together in a way to provide support in a time of need, it just was truly grassroots and so organic, it was something very special to be a part of.” – JA

Mentioned in this Episode:

AFHTO Association of Family Health Teams of Ontario

Thames Valley Family Health Team

Schulich School of Medicine & Dentistry

SoleScience

Fanshawe College

Access More Interviews with Healthcare Leaders at HIROC.com/podcast

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Email us at [email protected].