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Award Recipients 2009

 

Quality Awards

Laboratory Response Times and Access Improvements for Cancer Patients
Joseph Wasielewski, Thunder Bay Regional Health Sciences Centre, Northwest Regional Cancer Program 

Under the leadership of Dr. Wasielewski, laboratory services at Thunder Bay Regional Health Sciences Centre (TBRHSC) have undergone a significant transformation which has substantially elevated the quality of their laboratory services. Between 2007 and 2009, three important initiatives successfully culminated in:

  • Better, safer access to laboratory testing for cancer patients through satellite blood collection.
  • Timely and consistent pathology reporting as a result of the efforts of process improvement. Pathologists were able to reduce 90th percentile pathology turn-around times from 22 days to 7 days. They have been able to sustain 7 day turn-arounds for almost two years.
  • Standardized, evidence based pathology reporting for cancer patients using synoptic reports. Pathologists implement all 15 CAP checklist reporting templates including the 5 synoptic reports in lung, breast, colon, prostate, and endometrium that CCO is implementing and tracking. Synoptic reports, rather than reporting in narrative, has given clinicians faster access to complete evidence-based pathology reports in a standard format.

The Committee agreed that this transition has had an impact on the quality of diagnostic information that is being used to guide clinical decision making.

The review committee also noted that this was an excellent example of how data can be used to drive quality and foster a culture of quality improvement.

Implementation of a Corporate Vascular Access Program
The Ottawa Hospital
Jose Aquino, Paula Doering, Greg Doiron, Sheryl McDiarmid, and James Watters

Adequate vascular access, paramount to the delivery of systemic therapy becomes increasingly important as more regimens are administered through the chemotherapy home infusion pump program.

In order to improve the quality of care delivered, The Ottawa Hospital developed a corporate vascular access program. This quality initiative developed a team of health care experts who utilized evidence-based best practices to insert the right vascular access device in the right patient in a timely manner. As a result, this initiative help improve the quality of access, its effectiveness, efficiency, and safety. In addition, the hospital has been able to meet urgent insertion requests for patients to receive palliative pain management.

The review committee agreed that ensuring timely vascular access for chemotherapy patients is a growing issue among hospitals and commended the efforts of this initiative.

Hamilton Health Sciences Centre and The Juravinski Cancer Program at Hamilton Health Sciences
Tertiary Acute Palliative Care Unit (TAPCU) - Mary Ruth Crabb, Caroline Elliot, Beryl Fitzpatrick, Sylvia Fung, Nancy Henderson, Doreen Levett, Edward Mantle, Dawn Prevost-Zontanos, Carol Rand, Alysan Rouble, Bunny Ruiz, Sharon Russell, Marissa Slaven, Liliana Stefanczyk-Sapieha, Ann Vander Berg, and Laura VanKuren

The Oncology Response Coordinator | The Oncology Triage Tool
Michele Bertothy, David Bishop, Carol Burgess, William Evans, Nancy Henderson, Kristine Leach, Brenda Luscombe, Gabe Menjolian, Steve Metham, Elizabeth O’Sullivan, Carol Potvin, Carol Rand, Carol Robertson, Bunny Ruiz, Richard Tozer, Suganya Vadivelu, Laura VanKuren, and Jennifer Wiernikowski

For the first time, a Quality Award was presented jointly to three related projects. The review committee agreed that these three initiatives at the Hamilton Health Sciences Center represent how providing better end of life management and reducing the need for patients to use the ER for support can be done successfully within the Oncology program. The review committee also agreed that the three teams’ achievements clearly demonstrate how a broader patient care initiative can meet quality objectives.

Tertiary Acute Palliative Care Unit:
In January 2007 the TAPCU team created a center of palliative care expertise within the hospital to facilitate direct admission to the hospital from the cancer center bypassing the Emergency Department.

This is important because Canadians living with life threatening illnesses have consistently expressed a desire to have end of life care provided outside of the acute care setting (80 -90%). Despite this stated preference, more than half of Ontarians with cancer die in acute care hospitals. Forty percent have emergency department (ED) visits during the last phase of their lives, an environment poorly suited to maintaining the comfort and dignity of palliative patients.

This initiative resulted in reductions in the use of the ED, reductions in admissions through the ED, and improved cost efficiency for a variety of services. In effect, it improved the overall quality of care of their palliative patients, as well as to facilitated early discharge to more appropriate care settings.

The Oncology Response Coordinator
The Oncology Response Coordinator is a unique care provider role being piloted to help reduce the movement of admitted patients to the emergency department (ED). There are often situations where very sick individuals arrive in the out-patient clinic whose immediate care needs exceed what can reasonably be provided by the oncology team in that clinical area.

The Oncology Response Coordinator worked to allow patients avoid admission by taking the time to arrange appropriate resources.

The Oncology Triage Tool
The Oncology Triage Tool marries two established assessment tools: the Cancer Care Ontario Telephone Practice Guidelines and the Critical Care Response Team (CCRT) Guidelines.

The tool assists in identifying patients, who often present in an unstable condition, whose symptoms are too acute for the ambulatory setting but do not warrant the level of care provided in the emergency department (ED). It helps ensure that Juravinski Cancer Center patients find themselves in the right place at the right time interfacing with the appropriate care provider according to the level of care required.

The tool has improved communication, facilitated the flow of patients and has increased seamless transitions for patients moving from the Juravinski Cancer Center to the emergency department.

Innovation Awards

Telepathology
University Health Network - Sylvia Asa, Brad Davis, Andrew Evans, and Peter Rossos

Through the use of affordable and effective virtual slide technologies, telepathology systems allow pathologists to securely review slides from remote locations over the Internet.

Since 2004, the program has assisted in the intraoperative care of over 1000 University Health Network (UHN) patients. It is the first program of its kind in Canada and the first telepathology program in the world to use virtual slide technology for primary diagnosis. UHN pathologists now report frozen sections without the need to travel to other UHN sites, resulting in a timely, highly accurate manner with minimal disruption to regular workflow. They can rapidly consult colleagues on difficult cases, optimizing both diagnostic accuracy and overall patient care.

Combined Nurse Practitioner and RNFA Role for Patient Focused Care in Thoracic Surgery
St. Mary's General Hospital - Matt Dubuc, Sandra Hett, and Kim Siegel

St. Mary's set out to achieve designation as a Level I Thoracic Centre. Their objectives included providing innovative surgical care while meeting the indicators for a quality and reputable program. With the help of this innovative model of care, the St. Mary’s surgeons have greater flexibility in their work. The Nurse Practitioner – Registered Nurse First Assistant (NP-RNFA) manages the daily plan of care and facilitates patient focused discharge to the next phase of care in the healthcare system.

The NP-RNFA combined role has allowed St. Mary's to achieve a seamless transition for the patient throughout their cancer care journey – which is of enormous benefit to their patients.

Meeting the Challenge of Delivering Oncology Patient Centered Care in a Large Geographical Area: Successes with Telemedicine in Rural Health
Regional Cancer Program, Hôpital régional de Sudbury Regional Hospital - Terry MacKenzie, Mark Hartman, Carole Mayer, David Want, Nicole McDonald, Denise Gauthier-Frohlick, Kerri Loney, Sheila Damore-Petingola, Carolle Thibeault, Audrey Oliver, and the Outpatient Oncology Clinic Team

A funding opportunity provided the ability to support the use of telemedicine in the outpatient setting of the cancer program, resulting in the ability to provide access to care for oncology patients living in a large rural geographic area spread across 310,000 square kilometers.

From seeing one hundred patients in 2002 the program now projects a case load of 5,487 for 2009. This volume represents 23.66% of the total Ontario Telemedicine Network (OTN) activity in Northeastern Ontario and 7.2% of the Provincial OTN activity. No longer do some patients have to travel up to 5 hours for a brief visit with their oncologist. Patients who benefit from this technology are patients in treatment, patients followed post treatment, palliative patients and patients requiring a consultation for decision making about treatment.

The review committee noted that quite possibly, this innovation has had a positive impact on the patient experience for the greatest number of patients in Ontario.