Healthcare Change Makers

For this special series, Voices Lifting the Community, HIROC is partnering with the Alliance for Healthier Communities to highlight the work of several of the presenters at their online primary healthcare conference in June.

Today we're talking with Celeste Turner, the LGBTQ2+ Support Coordinator at the Niagara Falls Community Health Centre and a member of the Alliance's Rainbow Communities Advisory Group. Celeste uses the 'they/them' pronouns. At the Alliance Conference, they will be presenting the session, "Making the Invisible visible: How can we get support if no one thinks we are there."

Celeste's early dreams were to work with animals but they found their calling in the field of fitness and health promotion. They remember feeling lost for so many years as a young person and feel privileged to now be in a position of advocating for others in the LGBTQ2+ community.

When it comes to giving trans folks access, inclusion and visibility, Celeste says the building is on fire. Their personal mission is to get their voices at the table and make sure their stories are told.

Quotables

"The building is on fire and I'm putting out fires on the ground, dealing with the smaller, more local things but this is a huge systemic issue that we need to come together on." - CT

"If we want to look at who makes the decisions about trans healthcare from a very high up level, it's probably not trans folks. We need to get those voices at the table." - CT

"If I do my job right, no one will replace me when I retire." - CT

"Understanding that it's absolutely not a choice. Someone's gender identity is a strong internal sense of being, sense of knowing and sense of self." - CT

"It all could be boiled down to education." – CT

"We make today Day One and start that journey of learning." – PDS

"I don't think virtual groups, services, having that virtual option, I don't think it will ever go away because it's proven to be very beneficial." – CT

Mentioned in this Episode:

Alliance for Healthier Communities

Alliance for Healthier Communities Conference 2021

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For this special series, Voices Lifting the Community, HIROC is partnering with the Alliance for Healthier Communities to highlight the work of several of the presenters at their online primary healthcare conference in June.

Today we're talking with Sarah Hobbs, CEO of the Alliance, a role she assumed in the fall of 2020. Sarah has worked in community health for over twenty years, most recently as Executive Director of Planned Parenthood Toronto. Being an advocate for health equity for underserved populations is difficult work but Sarah draws inspiration from the Alliance's 110 member centres who actively support marginalized people across Ontario.

She's also uplifted by the new ways she's seeing partners collaborating across the system during the pandemic – and the possibilities that now exist to build back a stronger healthcare system that works for everyone.

Quotables

"We can take the things we talk about and the things we learn and shift them into election strategies, and into conversations we're all having in different ways across the province around how do we build back better."

"People are recognizing that health equity needs to be a core component of our health system planning and beyond."

"I feel like I've sort of come home in this role to a certain extent."

"Being able to engage with member centres, our system partners, and decision-makers to influence what our vision, our strategic directions, what we need to be accountable to as a sector and as an organization, I'm really excited to begin those conversations and develop the plan."

"When I think about problems, I think about what haven't we thought about before and what have we tried in the past that might actually be the right solution now. I'm not afraid to do something new."

Mentioned in this Episode:

Community Health Equity Builders Program

Alliance for Healthier Communities

Alliance for Healthier Communities Conference 2021

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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 keynote speakers, Trish Tutton. Trish is a yoga instructor and mindfulness expert. Trish suffered a devastating loss early in her life and it confirmed that she was on the right path with her career choice. Her mission is to create calmer and happier workplaces and employees.

The words mindful and mindfulness get tossed around a lot, but in these unusual and stressful times, Trish says makes sense to take a moment to pause and notice what we're feeling.

Quotables

"Every time I got on a yoga mat, every time I heard some of these teachings, it was like there was something inside of me saying YES."

"A lot of us are just moving through every day, dwelling on our stresses, dwelling on our challenges, missing out on so many beautiful moments."

"This is not going to be the last difficult thing we're going to navigate in our lives. This is life. In mindfulness teachings, they sometimes call it the 10,000 joys, the 10,000 sorrows."

"Look to your challenges. These are your greatest teachers."

"The risk comes when we're in a chronic state of stress, when we don't get an opportunity to return back to our baseline level of homeostasis."

"We can have this feeling that rest is something we need to earn, all the 'to do' items need to be checked off until we're able to rest. But the real key is acknowledging there will never be a time when everything is done."

"This last year has really brought to light the focus that we all need to put on our mental health. Hopefully mental health will stay at the top of people's minds long after we come out of this."

Mentioned in this Episode:

Armchair Expert podcast

Will Ferrell

Banff National Park

AdvantAge Ontario

AdvantAge Ontario Annual Convention

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Paul is living proof that behind every healthcare leader is a nurse – in his case his mother and his wife. Their compassionate dedication to their craft has helped Paul develop a caring and thoughtful approach to leadership that's helped him in posts he's held in Calgary, Inuvik, Georgian Bay, and for the past 8 years in North Bay.

Paul is a true lifelong learner. He has the equivalent of more than 14 years of post-secondary education that includes two Masters Degrees, a Chartered Accountant designation, and he's a certified health executive.

We first spoke with Paul early in 2020 just before the pandemic hit, and we were lucky to catch up with him again this past March. He reflected on how the north has traditionally been humble about its innovations, talents, and capabilities. But with the pandemic, he says there's been a paradigm shift and people have started to appreciate the talents and resourcefulness of the north in a new way.

At one point in the pandemic, when the numbers of COVID positive critical care patients in southern Ontario was rising to dangerous levels, North Bay was officially added as a load sharing site. When we talked to Paul, they had not received any critical care patients, but since then, several have arrived and they expect to receive more until we're through this current crisis period.

Quotables:

"I always reflect that I've been fortunate to have the insight and wise counsel of my wife and my mother. It's helped me become a really considerate person who is thoughtful about the impact that the decisions I make have on our patients and staff."

"All of our leaders at every level of management and even beyond, are trained in continuous quality improvement tools, creative problem-solving tools, and other leadership skills. That goes for not only our administrative leadership, but for our physician leadership group as well."

"We've been working our team in overdrive going back even before the pandemic and I'm just so proud of how our teams responded."

"It's incredibly important that you don't ask your staff to do something that you wouldn't be willing to do yourself or follow some protocol that you wouldn't use yourself."

"I started scheduling in meetings while I was on the trail and realized I could actually conduct business and get exercise. I discovered a fun thing – it's hard to get stressed no matter what the conversation is when you're in the middle of the forest."

"Your team needs you to be well in order to make the right decisions."

"There is so much capacity and leadership in the north. Our challenge is the connectivity and the large geography. I think the virtual care options, virtual communication we developed is going to build a stronger voice for the north."

Mentioned in this Episode:

North Bay Regional Health Centre

ONE Initiative (Meditech Expanse)

West Parry Sound Health Centre

Sault Area Hospital

Duchesnay Falls

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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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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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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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