WRITING ON THE WALL
Sunnybrook's acute medical-surgical inpatient units are tackling occupancy challenges with electronic whiteboards, which provide a modern approach to care planning. "With this technology we're developing an excellent visual cue for the care team, which will help identify barriers to discharge earlier, and allow for better planning," says Bev Waite, manager of patient flow. "We think this new system will improve patient care and help the care team communicate."
Part of the hospital's Bed Management System (BMS), the boards replace the dry-erase whiteboards on each unit. Information is fed from the BMS and includes patient-specific information (such as allergies and risk of falls), nursing assignments and a memo board. The new boards also show upcoming events, including tests the patients must go to, and the unit's pending admissions. Milestones the patients must meet before discharge are also visible to the care team.
SMALL TOOL, BIG SENSITIVITY
Dr. Robert Nam is always thinking of the next best thing. "Men deserve better than the PSA test to predict prostate cancer," says Dr. Nam, a Sunnybrook Odette Cancer Centre urological oncologist and Sunnybrook Research Institute scientist. He has already developed the Sunnybrook Prostate Cancer Risk Calculator, a checklist to more accurately determine in minutes a man's risk for the aggressive disease. He is now applying his expertise of prostate cancer biomarkers to a microchip tool (developed by University of Toronto scientist Dr. Shana O. Kelley) that promises to detect very low levels of circulating tumour cells in the blood. The tool promises to help identify early stage and aggressive forms of the disease. Dr. Nam led studies showing several prostate-specific genes strongly associate with the disease, and the hybrid gene TMPRSS2:ERG is a strong predictor of disease relapse.
TIMELY ACCESS IN A TIME OF NEED
A Sunnybrook program is being praised for pairing newly diagnosed colorectal cancer patients with a friendly resource to ease them through a difficult time. "I have to tell you, your role is an absolute gift – the term 'navigator' is perfect," wrote one patient to Barbara-Anne Maier, a specialized oncology nurse with the Colorectal Diagnostic Assessment Program, who has more than 25 years of experience in colorectal cancer care. "Knowing there is someone there with a 'map' to help guide me through all of this makes me feel safe. I feel confident I can focus on other things and not get lost."
The Odette Cancer Centre program reduces anxiety by providing patients with access to a nurse right after diagnosis and before meeting with the oncologist. The nurse offers emotional support and symptom management, books appointments, orders the needed imaging and acts as a general navigator for patients who often feel overwhelmed.
"It really helped my father that things were streamlined and so patient friendly," Bill Panagopoulos says. Bill's father received the unfortunate diagnosis in early January, "but Barbara-Anne helped put us at ease and told us more about what to expect," says Bill.
The program is a collaboration with North York General Hospital.
A Sunnybrook project is making sure seniors "use it" and don't "lose it" during hospital stays – "it" being their precious mobility. "The ability of seniors to be mobile is tied to their independence, and that can greatly suffer during a hospital stay," says Dr. Barbara Liu, a Sunnybrook geriatrician and executive director of the Regional Geriatric Program of Toronto. "Resting in bed isn't the best medicine for these patients."
Move On (short for Mobilization of Vulnerable Elders in Ontario) aims to make sure seniors are urged, helped and allowed to get out of their hospital beds to stay as active as possible. Too often these patients have one condition treated in hospital, only to find lying in bed for days has severely hurt their mobility. With Move On, staff and family members become partners in getting the patients active. Patients are assessed daily, and expectations are adjusted as mobility increases. Dr. Liu is a lead investigator on a study assessing the program.
"Through the Move On project in Toronto, we have seen the positive impact simply being more active within the hospital can have on our patients. Being active keeps them functional and increases the chances they'll return to the community once the initial condition is treated."