Home First – A Patient-Centered Approach to Continuous Care

Muskoka Algonquin Healthcare embraces the home first philosophy and the ability for patients to receive continuous care in the comfort of their home.

Home – it’s a familiar place of comfort, warmth and security filled with memories and personal belongings. Just thinking about it soothes the soul and makes us feel better when we are unwell. So creating a concept where patients continue to recover at home with support services in place, after they are well enough to leave the hospital, is a patient-centered approach to providing continuous care. It’s why we at Muskoka Algonquin Healthcare support the home first philosophy – a component of the government’s Aging at Home Strategy and a significant shift in health care thinking to transition patients from hospital to home more quickly.

Often times, seniors are waiting in hospitals no longer needing acute care services and potentially moving to long-term care homes with health care needs that could be safely met in the comfort of their own homes with proper support. Hospitals are a place to receive acute care and to support you through serious, complex health concerns. When you are ill or injured, MAHC is here to provide you with safe, excellent care as long as you need it. Our goal is to get you well enough, and make sure in partnership with the Community Care Access Centre you have the right supports, to help you get back home where you are more comfortable and will recover more quickly in familiar surroundings, with the support of family and friends and away from diseases and other risk factors. 

At MAHC, we are committed to ensuring that patients, and especially seniors, receive the right care in the right place at the right time. In partnership with physicians, nurses and community health agencies such as the North Simcoe Muskoka CCAC, we are supporting patients and their caregivers in making informed decisions about their care. We want to help them understand why choosing home first may be the best option.

Why Home First? It’s simple. When given a choice, most seniors prefer to be at home than in a hospital. Outcomes are better when patients recuperate at home with appropriate supports, away from the inherent risks of hospitals, including risk of infection, pressure ulcers, falls and isolation. Once a patient’s acute health needs have been met in hospital, home is the best place for them to recover.

There are many good reasons to go home to recover: the familiar surroundings and overall comfort of your own home, being able to set your own schedule and make your own meals, sleep in your own bed and maintain the independence of doing more things for yourself in a normalized routine. Our community also benefits from your decision to choose home first. Our hospitals need to have beds available for patients with serious health concerns and having beds available will mean shorter wait times in our emergency rooms.

If you are admitted to hospital, planning for discharge is discussed from the beginning. The health care team works with you and your family to discuss what services are needed to support a transition back to home. The services are coordinated and referrals to community health agencies are made. Once at home, patients and their families can discuss long-term options and make decisions about any ongoing care needs.

We recognize that home first is not for every patient depending on their individual medical needs and physical capabilities. Our priority is our patient’s acute care needs and we are excited to embrace the home first philosophy and provide our patients with continuous care in the comfort of their home.

Watch a patient testimonial from the North Simcoe Muskoka CCAC or find out more at www.mahc.ca.

Improving food service delivery at your hospitals

South Muskoka Hospital Foundation Executive Director Colin Miller hands over a new patient serving tray as Muskoka Algonquin Healthcare Food and Nutrition Services staff Sharon Weese, Jean Dempsey and Karen Fisher look on. The Foundation funded improvements in food service delivery at the SMMH Site.

Food service is a prominent part of the overall quality of patient care. We know that hospital food plays an important part in the patient experience because hospital food is one area where we tend to receive feedback and suggestions for improvement. When you talk to patients, you get a sense of just how important food is to them and how it contributes to their satisfaction or dissatisfaction with their care.

Despite so many competing demands for investments in direct patient care, we have been fortunate to upgrade the food service delivery at both of our hospital sites. It’s all thanks to the tremendous investment and support from our fundraising partners at the South Muskoka Hospital Foundation and the Huntsville Hospital Auxiliary.

We have replaced outdated food service equipment that no longer meets optimal performance standards with a new Heat on Demand system. With this new equipment we are ensuring that our patients receive a hot meal in a timely manner.

Meals are prepared just in time for bedside tray service, and the Heat on Demand system uses conduction heating to extend the hot temperature of the meal for up to 60 minutes. So if a patient is off getting a test done when their meal arrives, the food will stay hot! The system also uses less electricity, making it a greener option as we continue to work toward improving our energy efficiency.



Huntsville Hospital Auxiliary members and Muskoka Algonquin Healthcare staff celebrate improvements in food service delivery at the Huntsville District Memorial Hospital Site. From left are Auxilian Sharon McNally, MAHC staff Kim Tatton, Robert Alldred-Hughes and Bev Leslie-Suddaby, Auxilian Helen Sparkes, Auxiliary President Joanne Matthews and Auxilian Gwen Todd.

The new meal delivery carts are ergonomically correct, lighter and easier to manoeuver by our staff. The new serving trays and thermal dishes that meals are presented on are also getting positive reviews from our patients.

At Muskoka Algonquin Healthcare, a team of cooks, food service supervisors, clerks, dietary aides and registered dietitians plan for, prepare and serve more than 120,000 meals per year for our inpatients and Meals on Wheels clients. Good nutrition is essential for recovery and good health and menus are based on Canada’s Food Guide and individual nutritional needs or restrictions.

For nearly a year now we have been serving meals as chosen by our patients. On a daily basis, they can select their preferred entree, dessert, soup or salad, and beverage for lunch and suppertime from a list of menu options. Our Dietary Aides use handheld technology at the bedside to record the patient’s meal choice, which is transmitted wirelessly to the kitchen using a paperless system. The desire for choice was something our patients highlighted in patient satisfaction surveys. Not only is this a way to provide better care through an improved service, but also reduces food waste and saves a few trees. Our Dietary staff will only prepare what the patient asks for. It means a more efficient and less labour intensive process thanks to technology like the tablet computer.

Although it may not be at the forefront of our thinking, food is one way we are providing comfort to our patients.

Is Quitting Smoking in Your Plans for 2014?

Quitting smoking takes more than willpower. It’s complicated, and for many people it’s the hardest thing they’ll ever do. Some people make it the focus of their New Year’s resolution; others fall ill and are triggered to stop smoking because of their health. No matter what the circumstance, we all know someone who may want to stop smoking. Supporting someone in their journey to be smoke-free can be just as rewarding as the ability to butt out. So we’re doing our part to support our patients who want to stop smoking, but need a little help.

We have partnered with the University of Ottawa Heart Institute and launched an inpatient smoking cessation program in support of efforts to decrease smoking rates locally. By following the Ottawa Model for Smoking Cessation, we have implemented a standardized protocol for smoking cessation interventions with our patients. It works like this: anyone admitted to the hospital will be asked about their smoking history; tobacco users will receive a smoking cessation consult by a Registered Respiratory Therapist; the RRT will provide education and support for cessation, such as free pharmacotherapy (i.e. nicotine replacement, Bupropion or Varenicline) and follow-up support upon discharge.

The potential results that could benefit from the program are really encouraging. The Ottawa Model has shown an 11% increase in long-term quit rates post-hospitalization. We also know there is a need for this type of program locally as the smoking rate in Simcoe-Muskoka is 22%, higher than the provincial rate of 17%. Smoking is a leading cause of hospitalization and is linked to so many conditions, so to reach just a few smokers and equip them with advice to make informed choices makes it all worthwhile and enables them to take action to meet their own cessation needs.

To date, since the launch of the program in October, we have been able to reach more than 50 patients. This work couldn’t be done without the support of all staff and physicians. I would particularly like to acknowledge MAHC’s Smoking Cessation Task Force, an interprofessional group of physicians, nurses, pharmacists and respiratory therapists, for successfully rolling out this program across our hospital sites.

If you or someone you know would like information or support to stop using tobacco, please contact the Smokers’ Helpline toll free at 1-877-513-5333 or visit www.smokershelpline.ca.

The Spirit of Giving

The Christmas season is a special time when family and friends come together and reminisce about times past, both good and bad. It is a time when we make sure we have reached out to one another and made time for each other. It is also a time when we think about all that we have and all that we are grateful for. It is also a time to reflect on the fact that not everyone is so blessed and to give back to those who are less fortunate.

People who work in health care are caring people who want to help others. Our hardworking staff, physicians and volunteers at Muskoka Algonquin Healthcare give of themselves each and every day they come to work. Many people will be working at the hospitals over the holiday season. At this time of year, I know that they give even more to comfort those in need and to lift the spirits of patients who cannot be with their families over the holiday season even though they themselves are away from their families.

Looking back on 2013, I am overwhelmed with pride for everything our hospitals in Bracebridge and Huntsville have accomplished. Extensive work has gone into improving the people-focused care and the environment at Muskoka Algonquin Healthcare.

In April, we achieved full accreditation from Accreditation Canada after both hospital sites were evaluated on more than 1,600 standards. Our entire team across MAHC played a role in the success of this process which demonstrates our commitment to ongoing quality improvement.

We have recruited new physicians and have introduced a new gynaecological surgical service in Bracebridge. We have trained more staff from a variety of departments in the LEAN methodology, which is a process improvement tool that helps to eliminate non-value added steps and improve efficiency in our processes. We have developed partnerships with numerous providers, such as Family Youth Child Services of Muskoka and Muskoka-Parry Sound Mental Health Services, as well as Telehealth partnerships with Sick Kids Hospital and Orillia Soldiers’ Memorial Hospital. And these are just a few examples of the good work that is being done.

But what is most rewarding is hearing from our patients about their experiences with us here at MAHC. Through Patient Satisfaction Surveys and individual letters, we continue to receive positive feedback about the above-average quality of care we deliver.

The spirit of giving is core to the work that we do at Muskoka Algonquin Healthcare. And at this time of year, we give a little more to make sure everyone’s day is a little bit brighter. On behalf of the Board of Directors for Muskoka Algonquin Healthcare, I commend all of our dedicated staff, physicians and volunteers for the significant role you’ve played in making this a successful year. Please accept my sincere appreciation and thanks for the care you provide to our relatives, friends and neighbours each and every day of the year and best wishes for a very happy, healthy and safe holiday season and all the best in 2014.

Giving the Gift of Life

Today, 11 people in North Simcoe and Muskoka are waiting for a life-saving organ transplant. They are registered on a list with 1,500 others across the province who are also waiting for a miracle: the gift of life. These individuals may be our friends, our family, our colleagues or our neighbours, but more often than not, they are complete strangers to us. Every three days one of these people will die waiting because the call saying that a transplant match is available didn’t come in time.

If you knew you could save up to eight lives and transform as many as 75 others with one selfless act of kindness, would you?

Muskoka Algonquin Healthcare (MAHC) is very proud to join Trillium Gift of Life Network (TGLN) in working to save lives through organ and tissue donation. On November 19, 2013, we became a designated hospital under the Trillium Gift of Life Network Act legislation. By implementing policies and procedures around what they call “Routine Notification”, we are required to report impending patient death to TGLN so that their specially trained staff can identify potential donors and approach families to re-affirm consent.

By implementing this formal program, we hope that more lives will be saved through donation. This legislation has been implemented at other hospitals in Ontario and has been successful in increasing donations. Over the past five years, 11 people in the area serviced by our hospitals have received a life-saving organ transplant, and through this program, I’m confident that number will continue to grow.

We also hope that by participating in this program we can raise more awareness about the need for organ and tissue donors and inspire more people to register their donation decision in the donor registry. Across our region, the donor registration rate varies among communities. In Bracebridge, 41% of eligible health card holders have signed up to be an organ or tissue donor. In Gravenhurst, 36% have registered their consent, and in Huntsville the number is 40%.

MAHC supports a culture that enables every Ontarian to make an informed decision about organ and tissue donation and supports health care professionals in implementing those decisions.

Please help us lead by example. Just one more registered donor can mean everything for the family of someone on the waiting list, because when registered, 90% of the time families honoured their loved one’s donation decision. When not registered, only 60% of families consent to organ and tissue donation.
 
Have you registered your consent for organ and tissue donation? I encourage you to take the time to consider becoming a donor. It’s quite amazing when you think that one donor can mean the difference between life and death for someone on the waiting list.

Our organization is committed to doing our part and we're asking everyone at both of our hospital sites in Bracebridge and Huntsville to consider registering their consent for organ and tissue donation. We're also asking them to ask their friends and family to register as well. Please visit our Be A Donor campaign drive webpage at http://beadonor.ca/mahc and help give the gift of life by becoming an organ and tissue donor today!

You may also visit any ServiceOntario centre to register your consent, or fill out a Gift of Life consent form and mail it in. This ensures that your donation decision is accessible when needed. For more information, please visit www.giftoflife.on.ca.

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.