Enhancing Patient Safety in Obstetrical Care

The Obstetrical Units at MAHC’s hospital sites have joined the MORE^OB program as part of our ongoing commitment to deliver safe, high-quality care. From left are Dr. Sandi Adamson; Lori Steele, Midwife; Dr. Tina Kappos; Shelly McMurray, RN; Dr. Bill Hemens and Mary Boyer, Manager of Inpatient Services. Missing from photo is Anne Handley, RN.

I am excited to announce that Muskoka Algonquin Healthcare is now part of the MOREOB program. As part of our ongoing commitment to delivering safe, high-quality care, the Obstetrical Units at our two hospital sites have launched a three-year professional development program to enhance their obstetrical practice.
 
Managing Obstetrical Risk Efficiently, also known as the MOREOB program, is designed to create a culture of improved patient care within the obstetrical unit through emphasis on patient safety, quality improvement and professional development. MOREOB integrates evidence-based practice standards and guidelines in developing effective teamwork and communication amongst all obstetrical care providers. Many of the focuses of the MOREOB program are in perfect alignment with MAHC’s organizational values and strategic areas.

I am especially proud of the dedication and commitment already shown by our core teams, which include family physicians and midwives who care for obstetrical patients, nurses who work in the unit and administrators. They are all participating in this program that has been designed to improve clinical outcomes, decrease the risk of adverse events and to improve the quality of work life. They will be able to share knowledge and promote collaboration with trust and respect.


The Obstetrical Units at MAHC’s hospital sites have joined the MORE^OB program as part of our ongoing commitment to deliver safe, high-quality care. From left are Malcolm Eade from MORE^OB; Dr. Sheena Branigan; Katie Zammit, RN; Alicia Taylor, RN; Dianne Smith, Midwife; Kristen Bell, RN; Robert Alldred-Hughes, Chief Executive Human Resources & Support Services.

The program aims to improve patient safety and developing a team with shared knowledge that promotes a consistent level of care among all providers. It’s a way of making sure that everybody has the same degree of basic knowledge, so during deliveries or when looking after moms-to-be, the doctors and nurses and anybody else helping has the same understanding as to what’s going on, what to expect and how to expect and avoid complications.

So how do they accomplish these skills?

The program consists of three modules, with each module including theory chapters, skills drills for rehearsing scenarios and practicing the physical handling of different equipment, workshops, personal learning projects, and so on.

I am very excited to be joining the hundreds of hospitals that are part of the MOREOB program. With this initiative, we will continue to build a culture that puts patient safety at the forefront, ensures evidence-based practices are utilized at the bedside, and enhances the patient experience to be the best it can be.

Goals of Care: respecting patients' wishes for treatment

Each and every one of us has a very personal sense of who we are, what we like to do, and what brings the greatest meaning and value to our lives. Having control in our lives is very important to most of us. When we are faced with a significant illness and the possibility that we could die, we make choices for our treatment and care based on our diagnosis, prognosis, the potential benefits and risks associated with various treatments, as well as our personal priorities and values.

Our patients and their families have very personal hopes and goals for their lives. Respecting your wishes is very important to us at Muskoka Algonquin Healthcare (MAHC). As part of our commitment to patient focused care, we will discuss advance care planning with you upon admission, so our health care professionals have a clear understanding of your wishes.

Advance care planning is the process of thinking about, talking about, and documenting your wishes for health care should something happen and health interventions are required. Many of us think health care planning is what we do when we are near the end of our lives. However, life-changing events can happen in an instant. In order to be fully prepared, we are asking you to take the time to document your wishes.

Establishing your aims for care, which we refer to as Goals of Care, ensures you and your health care team are striving for the same outcomes in accordance your values and health aims. It also ensures the health care team is not providing unwanted treatment or therapies.

If you are admitted to the hospital, your Goals of Care will be determined in conjunction with your most responsible care provider. The Goals of Care include three categories that provide different amounts or levels of care for a patient while in hospital: resuscitative care, medical care and comfort care. These designations cover things like the “do not resuscitate” orders and/or the option to be admitted to our Intensive Care Unit, or make an informed decision about organ and tissue donation, for example.

Your Goals of Care designation clarifies treatment priorities and becomes a permanent part of your medical record so the information is readily available to all care providers at the bedside. Should your situation and/or wishes change, you can revise your Goals of Care at any time in conjunction with your most responsible care provider.

At MAHC, we are proud to support a culture that ensures patient centered decision-making and respects the wishes and values identified in these crucial conversations.

For more information about Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.   

New gynaecological surgery coming to Muskoka

For some time now, women have had to travel outside of Muskoka for different types of gynaecological surgery. But all of that is about to change this fall. Muskoka Algonquin Healthcare (MAHC) is enhancing services closer to home for residents of Muskoka.

Starting September 5, 2013, gynaecological surgery will be available at the South Muskoka Memorial Hospital Site in Bracebridge one day per week on an ongoing basis. The new service is being established by Dr. Khaled Abdel-Razek, Chief of Obstetrics at Orillia Soldiers’ Memorial Hospital (OSMH). Dr. Abdel-Razek has been practicing as an Obstetrician & Gynaecologist at OSMH since December 2004 and has served as the hospital’s Chief of Obstetrics for the past two years. He is a respected surgeon who has provided exemplary obstetrical and gynaecological care to his patients, and we are delighted that Dr. Abdel-Razek has decided to enhance our surgical team at MAHC so we can provide a much needed service in Muskoka.

Months of planning and collaboration have brought this partnership to fruition and we are proud to be partnering with OSMH to provide this important service closer to home. Arrangements are also underway to bring in a second gynaecologist/obstetrician from OSMH to support the surgical program and share the Operating Room duties on the gynaecology surgical day.

The addition of gynaecological surgery is just one example of how MAHC is trying to grow local health care services and use innovative ways to bring new services to the Muskoka region.

For more information about the services offered by MAHC, please visit our website at www.mahc.ca.

Planning for the future at MAHC

The health care needs of our population are always changing and so are the ways that we take care of them. Research and technology are improving the way that patients are treated, prolonging lives and improving the quality of life for many.

In order to prepare for changes, new technologies and equipment, Muskoka Algonquin Healthcare is currently working on a master program and a master plan. Both are required by the Ministry of Health and Long Term Care for any major decisions around programs, services and the use of the property. It is a lengthy process and one that is part of prudent planning for the future.

Our master program will outline the type and extent of health care services to be delivered by our facilities. It will include projected programs, staffing and departmental space requirements over a 25-year timeframe. The master plan supports and demonstrates potential for developing our sites and is a high level design view of how our sites could be developed to meet future requirements over the next 50 years.

We know that our facilities, due to their age, are not consistent with current standards and pose challenges in regards to space right now. We are also looking at long-range plans to best accommodate the services we should be providing as acute care hospitals to service our patient base.

The master planning exercise also allows us to consider development options as they relate to partnership opportunities with other health care services. This planning process will guide us in building and strengthening our services and may also show us that we need to make some adjustments so we are well positioned for the future.

In the meantime, MAHC is working to maintain our hospitals through renovations as funds are available. The emergency department at Huntsville District Memorial Hospital Site was recently renovated and renovations to the Dialysis unit are currently underway. These upgrades allow us to provide better care to our patients and improve workflow and infection control measures.
News about MAHC and improvements to our facilities can be found online at www.mahc.ca.

Investments in people drive better patient care

At Muskoka Algonquin Healthcare, we are always looking for ways to improve our patients’ care. Our people – the staff, physicians and volunteers at our hospitals in Huntsville and Bracebridge – are our greatest asset, and we strive to ensure they have all of the skills and tools they need to perform at their best.

Especially in a hospital setting, knowledge is power and the more knowledge our staff has, the better equipped they are to help our patients. That’s why we have substantially increased the number of education hours for our staff, from over 3,000 in 2011 to 11,000 in 2012. Education opportunities are available both inside and outside the two hospitals.

Last year, we brought in experts to teach our staff about neonatal resuscitation, trauma nursing and emergency paediatric nursing. We have also developed several in-house programs that were made available to our staff. For example, our Clinical Nurse Educator recently developed an emergency room nurse training program and critical care nurse training program. These programs gave our nurses the opportunity to expand their skills and knowledge and the flexibility to work in different units of the hospital.

This year we revised and implemented a new performance management system. The management team and frontline staff got together to brainstorm ideas. In addition to providing safe, quality care, we really focus on individual productivity and how it impacts the team as a whole.

A new Leadership Development Program will start in May for both our formal and informal leaders at MAHC. We used the Ontario Health Association Leadership Development Model to put the program together. Managers will spend four hours a month working through 15 competencies. The program includes reading materials, videos, classes and workshops.  Throughout the session, our managers will be able to strengthen their leadership skills. The program will also be open to other staff members who would like to increase their leadership abilities.

Our doctors, nurses and support staff are tasked with providing a high standard of quality care, so it’s a priority for us that they are given the opportunity to learn and grow.

To learn more about Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.

Muskoka Algonquin Healthcare sets new quality goals for 2013-2014

Every year, Muskoka Algonquin Healthcare creates a new Quality Improvement Plan (QIP) that focuses on setting safety and quality targets for us to achieve. The provincial government mandates through the Excellent Care for All Act that this plan be created each year.

The 2013-2014 plan commenced on April 1st, and the full details of the plan are available on our website. Throughout the year, the progress and results will be reviewed by our Quality Council and the Quality and Safety Committee of the Board of Directors.

This year’s Quality Improvement Plan is important to all of us at Muskoka Algonquin Healthcare. We are committed to maintaining and improving a culture of quality and safety, and we continue to explore new ways to provide care as we know the importance of meeting our patients’ expectations and improving their hospital experience through the provision of safe, quality care.

In the year ahead, we will be working at strengthening different areas of our organization, including access, effectiveness, integration, being patient centered and safety. We have set specific objectives that we want to meet, including reducing emergency room wait times; unnecessary time spent in the hospitals and unnecessary readmissions, improving compliance in hand hygiene and medication reconciliation at admission/discharge, and our ongoing commitment to decrease hospital-acquired infections, like C. Difficile. The majority of our QIP indicators this year have focused the organization on improvements to the safety of the care we provide and will assist us to improve the quality of care our patients receive and deserve.

Last year’s QIP helped us reduce the number of hospital-acquired infections like C. Difficile to below the provincial rate, avoid patient falls, reduce the number of alternate level of care days and receive above average results in patient satisfaction.

You can follow our progress on our QIP indicators online with our Balanced Scorecard. Those interested can also view the 2012-2013 Quality Improvement Plan’s year end progress report.

For more information on Muskoka Algonquin Healthcare, please visit our website at www.mahc.ca.

Muskoka Algonquin Healthcare goes green

Two years ago the team at Muskoka Algonquin Healthcare (MAHC) began looking at how efficiently our hospitals in Bracebridge and Huntsville were running and where there were opportunities to do better.

MAHC joined Greening of Healthcare, a cooperative that works with partner hospitals to lower energy costs and raise environmental performance. This gave us the tools we needed to obtain, manage and assess data and compare it to other organizations. It is also a place to share best practices and learn ways to plan and implement improvements.

Experts were engaged and helped to identify significant savings through a number of different initiatives. This team of experts, including energy advisors, engineers, architects, and project managers, broke down the opportunities for savings and efficiencies into projects by looking at areas that had the biggest expenditure of energy.

Benchmarking the current practice has also helped us to identify the anticipated utility savings, which are estimated at 22 per cent at the Huntsville site and 25 per cent at the Bracebridge site. The total savings between both hospitals is estimated at $350,000 annually. The energy efficiency projects will focus on upgrading to more efficient ventilation systems, domestic hot water heating, lighting and automation and will cost $2.8 million.

In February, the MAHC Board of Directors approved these initiatives and the first phase is scheduled to begin in May 2013 using a staged approach, with the heating systems being upgraded during the summer and the cooling systems in the winter. The project is expected to take 18 months to complete, and the hospitals will start to achieve the full benefits by the end of summer 2014.

The project will be funded through a bank loan that will be repaid over seven and a half years using the savings the efficiencies will produce. Once the loans have been repaid, the savings will be reinvested into programs and services, providing greater care for patients.

We are excited for the project, as it will not only reduce our hospitals’ environmental footprint and save money, but will also increase the comfort level for both patients and staff.

For more information on other initiatives at MAHC, please visit our website at www.mahc.ca.