Colorectal cancer screening by primary care physicians: a prospective chart audit
A publication for Staff and Physicians of IH · colorectal cancer. As part of the program, family...
Transcript of A publication for Staff and Physicians of IH · colorectal cancer. As part of the program, family...
A publication for Staff and Physicians of IH
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InsideNet > Employee Health & Safety > Occupational Health > Influenza Protection Program
The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: [email protected] Deadline for submissions to the December 2013 @InteriorHealth magazine is November 15. Editors: Amanda Fisher, Breanna Pickett Designers: Breanna Pickett, Kara Visinski, Tracy Watson IH Communications Contributors: Lisa Braman, Lesley Coates, Susan Duncan, Karl Hardt, Megan Kavanagh, Erin Toews, Tracy Watson
Snapshots of our staff in action over the last month.
Learn more about the people and places that help protect our
communities from the flu.
Dr. Halpenny talks about our organization as he sees it from his
day-to-day perspective.
Rosanna McGregor’s Aboriginal background enriches IH Board.
Shining a spotlight on the many communities that make up where we
live, work, and play.
Get an overview of B.C.’s new colon cancer screening program.
Penticton resident benefits from cancer screening.
Making engagement part of our every day, we pose a new question.
Service to Interior Health became a second career for Board member
David Gillespie.
Public Health Nurses, Jane Luk-Tran and Roberto Barcelona, and
Health Centre Aide Karolyn Kleinharr, are among the thousands of people behind the annual public influenza campaign (see p. 8).
New doctors mean stable care in rural communities.
At Interior Health, we want to set
new standards of excellence in the delivery of health services in B.C.
and to also promote healthy lifestyles and provide needed health
services in a timely, caring, and
efficient manner.
To achieve this, we are guided by the following strategic goals:
Goal 1 Improve Health and
Wellness
Goal 2 Deliver High Quality Care Goal 3 Ensure Sustainable
Health Care by Improving Innovation, Productivity,
and Efficiency
Goal 4 Cultivate an Engaged Workforce and Healthy
Workplace
The articles featured in the @IH newsletter are great examples of
how we’re achieving our goals …
and realizing our vision and mission.
L-R: John Kettle, from the Regional Health District, joins Dr. Halpenny, Erica Phillips, Acute Health Service Administrator for East Kootenay, and Bill Bennett, MLA for Kootenay East, to look at the site for the new ICU at EKRH. (Photo Credit: The Cranbrook Daily Townsman)
F all is in the air and, like many of you, I am missing those extra hours of daylight. I started to notice the change on my recent
tour of the East Kootenays with Board Chair Norman Embree. At the beginning of October we visited sites in Cranbrook, Elkford, Sparwood, Fernie, Kimberley, Invermere, Golden, and Revelstoke. I appreciate these opportunities to see our sites; meet with staff, physicians, and leaders; connect with local elected officials and other community stakeholders; and thank our foundations, auxiliaries, and volunteers for their contributions. On this particular tour, we heard common themes about the challenges of providing health care in our rural areas – patient transport issues, recruitment and retention of staff and physicians, and helipads were hot topics. I was back in Kelowna for the IH Board meeting on Oct. 8. It included a presentation on fraud risks, sponsored by our Internal Audit team, which highlighted key fraud concepts, potential red flags, and recent examples of B.C. government fraud cases. It was timely given that IH has been doing some work on our own Fraud Prevention Program and is now rolling out a new Safe Reporting Line for staff and the public. In addition, Karen Bloemink, Executive Director Residential Care, provided an excellent presentation on residential care and the new beds we’ve opened across IH over the last five years. It was great to see an overview of the investments that have been made to improve care for our seniors. Following that, on Oct. 9, our Senior
Executive Team (SET) had a strategic planning session. It was a good day
with robust discussion. SET is working through a process to develop a
framework that will clearly articulate IH’s strategic direction with a focus on
identifying fewer priorities. I will keep
you updated on this as we move through
the process. Next on the agenda was the bi-annual meeting with the regional hospital districts (RHDs) in IH’s region. These meetings give us an opportunity to provide updates on our key initiatives and also discuss possible solutions to the challenges we face in health care. The RHDs are important partners because they contribute 40 per cent of the total capital cost of hospital construction and new major equipment. IH representatives provided updates on infection prevention and control, the cardiac program, and capital planning and priorities. We also shared IH’s 10-year Capital Strategy with the group. This strategy will guide our investment decisions between 2013 and 2023 using three key drivers: projected demand for services, need for innovation and change, and sustainability of infrastructure and services. On Oct. 21, we held our monthly senior executive meeting. A focal point of our discussion was the budget status and go-forward plans to balance for fiscal year end. We are in the most difficult financial position we have seen since the inception of IH, so each one of us needs to do our part to ensure resources are being used in the most efficient and effective way possible, in every aspect of the work we do. I will close with a final plug for our employee and public flu immunization campaigns, which are well underway (details on the InsideNet and our public website). As employees, I encourage you to make a thoughtful decision about protecting yourself and the patients, residents, and clients you care for – the options of receiving a flu shot or wearing a mask during flu season are outlined in our Influenza Control Program Policy. Last year, I was pleased to see a vast improvement in immunization rates and hope to see more of the same this year!
opinions your
count @
What we heard in response to October’s topic …
What did you expect to see with our employee engagement survey results, compared to 2011?
“I thought the results would be worse than the previous survey’s. Because the work load has significantly increased &
with that the stress level has increased. High stress makes for little satisfaction in the job & unhappy employees.” “I think there was a better response this time round.”
Visit the Engagement web page on the InsideNet to view all the questions and answers posted since Your Opinions Count
started in January 2012.
With Dr. Halpenny’s words in mind, and the knowledge
that we face significant challenges in balancing our budget this year and beyond, we’d like to hear your
ideas and innovative approaches for finding efficiencies and savings across IH.
So here’s this month’s topic … and feel free to engage with your team and come up with ideas together!
What can we do to reduce What can we do to reduce costs and find savings while costs and find savings while still providing quality care?still providing quality care?
Send your ideas to [email protected]
and we’ll share excerpts in the next @IH, along with
a new topic for discussion.
“I often talk about how engagement and teamwork are closely linked, and how I see them as essential to success. Engagement with any team comes through appreciating the abilities of the collective. In IH, that is our collective intelligence as leaders, employees, and physicians. We have an astounding wealth of knowledge and commitment across the organization that I believe we can leverage, as a team, to help us succeed over the long term. To ensure a sustainable health system, we must continue to find innovative ways to provide care and deliver services. Listening to our staff and involving you in finding solutions is foundational to how we transform the system.” – CEO Dr. Robert Halpenny
P enticton resident Frank Griffiths has spent
most of his life travelling and working in the film industry. But last year he became familiar
with a different type of screen.
Looking back, Frank says he can’t recall exactly when
he had his FIT (fecal immunochemical test). The last year has been a blur.
Frank had displayed no symptoms but his doctor had
recommended the simple colon cancer screening test because, Frank explains in a cheery brogue, “I’m
bloody old.”
“In retrospect, it was an awesome idea,” he says.
The FIT was positive.
Both his doctor and Colon Check Patient Coordinator
Margot Heintz encouraged Frank to have a followup colonoscopy, but he had reservations. He immediately
turned to the internet, including a YouTube video about the procedure. He then spent time with Margot
reviewing information and weighing the pros and cons, before deciding to go forward with the procedure.
“It’s not at all uncommon for people to worry about having a colonoscopy. Ensuring patients understand
what is involved and addressing their concerns is an important aspect of our work within the colon
screening program,” says Margot.
“The patient coordinators initiate contact with the
patient upon receiving the referral, and we remain
Patient STORY
Patient Coordinator Margot Heinz with Penticton Resident Frank Griffiths. After a positive FIT screening test, Frank had three polyps removed from his colon.
involved in their care throughout their screening process
to ensure there is seamless communication and coordination with everyone on the team. Our patients
are well prepared for their colonoscopy as we educate them about the bowel prep and what to expect during
the colonoscopy. We also followup with everyone
post-colonoscopy via telephone and review their colonoscopist’s recommendations for future surveillance.”
Frank’s colonoscopy allowed clinicians to find three polyps
that were removed during the procedure. A polyp is a small growth that sometimes forms on the inside lining of the
colon. Most colon cancers develop from a polyp that has
been present for several years.
“I would definitely recommend that if you are within the age for recommended screening, 50 to 74, that you go out
and get the test,” says Frank.
Colon screening with the FIT has been available in the
Penticton area since 2009 as part of the Colon Check pilot program. FIT has been publicly funded in B.C. since April 1,
2013, and now the new Colon Screening Program has rolled out across the province.
The provincial Colon Screening Program
promotes early detection and
prevention of
colorectal cancer. As part of the program,
family physicians refer men and women
without symptoms between the ages of
50 and 74 for FIT
screening once every two years. Patients
with a significant family history of
colorectal cancer
are referred for a screening colonoscopy
without a FIT.
For more information about colon cancer and the colon screening program, visit www.screeningbc.ca.
Based on his personal experience, Frank encourages those between
50 and 74 years old to be screened for colon cancer.
Colon cancer is the second deadliest cancer in the province
– but it’s also one of the most preventable cancers. Removal of precancerous polyps reduces the chance of getting colon
cancer by 90 per cent.
That’s the biggest incentive for the Colon Screening Program
working group, which has been moving full steam towards implementation of BC’s Colon Screening Program this fall.
The Colon Screening Program promotes early detection and prevention of colorectal cancer for British Columbians.
“This has been a tremendous undertaking, involving our GPs,
colonoscopists, surgeons, pathologists, BC Cancer Agency, IH
staff, and of course our patients,” says Denise Dunton, IH Surgical Services Clinical Leader. “We now have a facilitated
pathway for patients with consistent quality standards and reporting systems; we’ve hired two dedicated regional patient
coordinators with a third to come; and a centralized BC Cancer
Agency colon screening registry is being developed for appropriate patient tracking.”
“Patients who are referred for a colonoscopy will now have
access to coordination and preparation support to help make the experience easier and ensure colonoscopy resources are
used most effectively,” says Nancy Serwo, Health Service
Administrator, North Okanagan.
“The three new regional patient coordinators, who are registered nurses, will provide support to patients who are referred for colonoscopy. Patient coordinators will be able to assess and prepare patients going for colonoscopy
and will help ensure access for priority cases and most efficient use of screening colonoscopy resources.”
Since April 1 this year, the fecal immunochemical test (FIT) has been publicly-funded, and the new Colon Screening
Program has now been rolled out across the province. The program builds on the experiences of the BC Cancer Agency’s pilot colon cancer screening program, which ran in a number of B.C. communities, including Penticton
from 2009 to 2013.
Quick Facts
Age is the greatest risk factor for colon cancer – over 94% of new cases diagnosed each year in B.C. are in men
and women age 50 or older.
Removal of precancerous polyps reduces the chance of getting colon cancer by 90%.
FIT screening is for average risk men and women between ages 50 and 74 without symptoms.
Colon cancer screening decisions for those between 75 and 85 years of age should be individualized and based
on overall health, life expectancy, and personal preferences. These individuals should discuss their situation
with their primary care provider and willingness to undergo a colonoscopy if needed before being referred for
a FIT.
Regardless of age, if a patient is not medically fit to undergo colonoscopy, then a FIT is not appropriate.
Those with symptoms should talk to their doctor about a referral to a specialist; FIT is not appropriate.
Patients with a significant family history of colon cancer should be referred directly for a screening colonoscopy;
FIT is not necessary.
Nancy Serwo, North Okanagan Health Service Administrator; Denise Dunton, IH Surgical Services Clinical Leader; and Dr. Carla Nash, KGH Physician.
BC SENIORS’ FALL PREVENTION AWARENESS WEEK
E lkford, Sparwood, and Princeton each have
unique characteristics, but all three communities share a common health-care success story – new
physicians supporting local residents.
Lots of new physicians.
In the last six months, Interior Health and its physician and
community partners have recruited a total of seven new physicians for these three communities – three in
Princeton, two in Sparwood, and two in Elkford.
“This great news is a testament to the work our Interior
Health leaders and staff, local physicians and these communities have done in highlighting opportunities for
physicians. It demonstrates the importance of working in close partnership at all levels to generate interest when
we have physician positions to fill,” says Maja Karlsson,
IH Leader, Physician Initiatives.
Previous physician vacancies led to temporary service interruptions in Elkford and Sparwood and a temporary
service change in Princeton. Thanks to the success in finding new physicians, services in all three communities
are stable and patients once again have access to
consistent primary and emergency care.
Work in Princeton has also created a strong and ongoing bond between key stakeholders who will continue to focus
on health-care services and the overall health of the
community.
An “Action Framework” will serve as a blueprint for developing and sustaining an effective health-care model
for people living in and around Princeton. Membership
in the committee includes representation from Interior Health, the Regional District of Okanagan-Similkameen,
the Town of Princeton, physicians, the South Okanagan Similkameen Division of Family Practice, various
community agencies, and other community members.
“We know we still have work to do in other areas of IH, but these successes are something we can build on. Rural
living and rural medicine are worth celebrating and we need to continue spreading the word about the great
opportunities in Interior Health,” says Dr. Curtis Bell,
Community Medical Director.
All rural and remote communities in B.C. have significant incentive programs through the provincial government,
so it is important for Interior Health and its partners to
highlight the unique aspects of each community. That is being done through the IH physician recruitment
website, advertising, and by attending various physician conferences.
“We have some great communities in our region. It is important to make sure that physicians looking for new
opportunities know what our communities have to offer, both in terms of great quality of life and exciting and
challenging clinical practices,” says Dr. Bell.
Rural Recruitment Success
Dr. Eva Idanwekhai; Community Integrated Health Services Administrator Susan Brown; and Ed Staples, vice-president of Princeton’s Support Our Health Care, cut a cake celebrating three new physicians and stable services for the community.
I f any word defines Rosanna McGregor’s time on the Interior Health Board of Directors, it may be “perspective.”
She speaks of it often; the kind of perspective she brought when she was first appointed in 2006, and the kind she will take away when she retires in December. “How many things did I learn about? I was overwhelmed, at times,” says Rosanna, with a chuckle. “When you don’t work inside the system, you don’t understand how huge it is.” True, given that Interior Health spans a geographical footprint the size of the United Kingdom, with some 18,000 employees, the physicians they work alongside, and, most important, the patients they all serve. But what Rosanna did understand was her own background – an invaluable,
unique perspective that made her examine health care in a different light than many of her Board counterparts. She was, after all, one of the few women on the Board –and a relatively young Aboriginal female, at that.
Rosanna, a 47-year-old member of the Williams Lake Indian Band, is the lone Board representative from the Cariboo region. She is the Executive Director of the Cariboo Friendship Society, responsible for 26 urban Aboriginal service programs such as transition housing for women and children, pregnancy outreach, alcohol and drug programs, and a host of other social programs. “What I brought was diversity,” acknowledges Rosanna. “A healthy board of directors is a matrix of different skills and experiences. I always brought the perspective of being able to ask things like, ‘How do kids have access to mental health services in crisis situations?’ ” Rosanna’s experiences have allowed her to understand the world of those who need help accessing services and when their personal circumstances – language, culture, addictions or mental health – can become
a barrier to finding help. She says she hopes she provided insight to her fellow directors. Because of her perspective, Rosanna was also keenly aware of and interested in the direction IH has taken with Aboriginal Health programming. She became chair of the Aboriginal Health and Wellness Advisory Committee when she joined the IH Board, and she is pleased to see that IH has signed Letters of Understanding with several First Nations in the region. It has been a real team effort, she says, among a dedicated group of employees who believe in the cause of Aboriginal health. But even more than that, Rosanna’s own perspective has expanded because of her experience as a director. Her travels have taken her across IH, and she has seen that rural health care is different depending on the circumstances of each community. What she has learned will go with her. She hopes she is leaving something of value behind and that her contributions, particularly as an Aboriginal woman, have made a difference.
Rosanna McGregor, representing Interior Health’s Board of Directors, joins with the chiefs of the Tsilhqot’in Nation to sign a health agreement during a ceremony outside of Williams Lake in August.
“ “
D avid Gillespie is not content to sit on the
sidelines and let the world unfold around him. Not when he is able to make a contribution that
just might make his own life and the lives of those around him a little bit better.
“When I retired from my law practice, I said to myself, now that I have lots of time, I wouldn’t mind making a
further contribution to public life,” says David, a 74-year-old retired Kamloops lawyer. “That’s when I went on the
Interior Health Board.”
That was in March 2008. In December, David will retire
once again, this time after serving two terms on the IH Board of Directors.
Add those six years to the 15 he served on the B.C.
Automobile Association Board, including a turn as Board
Chair, and the eight he has sat on the B.C. Lottery Corporation (BCLB) Board – yes, David truly believes
in giving back in his own backyard.
When he can do so and, at the same time, find the service both intriguing and stimulating, that’s a winning
combination, he says. It’s exactly what he found at
Interior Health.
“It is a very complex business. Right off the bat, I found that very interesting,” says David, who specialized in
real estate development and business law. “Interior Health is the most important organization in the Interior dealing
with people’s health. Everybody has a stake in how health care is provided.”
David says he has found those who work at IH to be conscious of their role in that provision of quality health
care, from staff right up to senior management. He gave extra kudos to Dr. Robert Halpenny, IH’s CEO and
President, for his leadership, in particular for steering
the ship through the complicated and sometimes challenging reorganization to “One IH.”
“I have to laud him. He’s the main person who made
that go,” says David.
Retirement from the IH Board will not take David away from public service entirely. He plans to remain on the
BCLC Board.
The self-described history buff will also continue to devour
new books and spend some time golfing. That is when he’s not travelling with his wife of 51 years, Donna, on their
annual treks to Hawaii and Palm Springs, Calif., and to their
cabin on Shuswap Lake, or spending time with their two children and their families, including four grandchildren.
But David says he also plans to keep in touch with his
fellow IH Board members, a diverse and co-operative
group who have become his friends. He wants to see how the future of health care evolves, now that he knows
a little more about it.
He’s proud of what has been accomplished in the past six years. Having been born in Royal Inland Hospital and
raised in Kamloops, he is eager to see completion of the
new Clinical Services Building.
“I feel really good about the fact that during the time I’ve been there, we’ve been able to see considerable
improvements, first of all in our facilities,” says David.
“A lot of money has been spent in improving (existing)
facilities and building new ones. Hospitals, and also residential and assisted care, have seen major
improvements and additions. It speaks volumes about what IH is doing.”
No Rest for the Retired
Everybody has a stake in how health care is provided
David Gillespie and his wife, Donna, will spend more time with the neighbours, now that he’s retiring as an IH Board member. If you look closely, you can see a few of them in the background. Bighorn Sheep are regular visitors to their Sun Rivers home in Kamloops.
Population: Approx. 7,000
Health Services: Castlegar &
District Community Health Centre, Laboratory, and Mental Health.
There are also community and
residential programs and services.
Economy: Retail trade, forestry,
manufacturing, educational services, and tourism.
Castlegar Lifestyle Located in the Selkirk Mountain range, Castlegar has become known as one of the most desirable places to live in the region. A vibrant mix of commerce,
recreation, and community makes Castlegar an easy choice for a comfortable
and active way of life.
Recreation & Culture Natural beauty and rugged adventure is at your doorstep in Castlegar with
its biking and hiking trails and world-class skiing at nearby Red Mountain. Kayaking adventures are also very popular on the Slocan River. Castlegar
is hub-central for exploring life’s tickle trunk of outdoor activity in the West Kootenays. Camp, hike, shop, golf, fish, mountain bike, pursue arts and
culture, or wildlife watch.
In our own words... “Castlegar is a great place to live and work. It is a friendly city with many
opportunities to enjoy nature with rivers, nearby lakes, and camping. Many
recreation opportunities are here such as Millennium Park, golf and nearby skiing, and there is a strong Doukhobor heritage. There are great restaurants
and schools and it is a good place to raise kids, being not too big and not too small. Our city supports an earth-friendly model with initiatives such as
our new energy conscious City Hall and LED street light program. I feel very
fortunate and proud to still live in the area where I grew up and to be able to walk to work. Castlegar is a wonderful place to be!” – Shelley Lefurgey, RN
BSN, Talarico Place Lodge Castlegar
At a glance
Submit your photos of the beautiful places that make up IH: [email protected]
Our employees regularly share photos of the spectacular scenery that surrounds them wherever they are in the IH
region. Majestic mountain ranges, pristine pine-fringed lakes, blossom-filled orchards, abundant vineyards, and thick forests alive with wildlife are just some of the beautiful things that make up these places we call home.
Covering over 215,000 square kilometres, Interior Health is diverse in nature and composed of vibrant urban centres
and unique rural communities. This @IH feature shines a spotlight on many of these places … and perhaps will entice
you to add them to your travel wish list.
This month we feature photos near Kamloops, Kimberley, Enderby, and Nelson.
Castlegar
Where We Live & Work ... A Spotlight on Our Communities
Lower Hourglass Lake Submitted by: David Nikiforuk
Enderby Submitted by: Carole Pugle
Kamloops Lake Submitted by: Sean Adams
Nelson Submitted by: Kathy Montgomery
Several payroll staff participated in this year’s CIBC Run for the Cure on Oct. 6 in Kelowna to raise money for the Canadian Breast Cancer Foundation. Team “Bust a Move” consisted of the following staff: Lisa Jolley (Team Captain); Susan LeBlanc; Ashleigh Fry; Judy Newman; Susan Sebastianis; Crystal Tillotson; Rita Meade; Karen Dyson; Nadine Desson; Colleen Milne; Vicki Unrau; and Tracey Culling. Lisa, Susan, and Tracey’s daughters also joined. In total, the team raised $1,327 for the Foundation. Both Susan and Rita are breast cancer survivors, making the cause all the more important to the team.
snapshots from the region ...
Respiratory Therapist Lucy Lindros gets her flu shot at Royal Inland Hospital from infection control nurse Debbie Cosgrove-Swan. All health-care employees are encouraged to get immunized against influenza to help protect their most vulnerable clients and patients. Clinic information is posted on the InsideNet.
This fall the Recreation/Rehab team at Polson Place and Gateby invited residents to participate in a community art project with the Vernon Art Gallery. Recreation Therapist Allyson Thompson-Lambert picked up large canvases from the art gallery and residents from the two facilities created art projects which will be displayed on the side of the gallery. Pictured here are Polson Rehabilitation Assistant Trina Olsen and resident Norm working together on the painting.
Medical Device Reprocessing staff from around the region were recognized for their contributions to delivering high quality and safe patient care during MDR Week. Hip-hip-hooray!
East Kootenay Regional Hospital in Cranbrook
Royal Inland Hospital in Kamloops
Medicos en Accion (Doctors in Action) is a not-for-profit organization that began in Kamloops over a decade ago. They
provide surgical care, education, and support to underprivileged countries. Most recently they have travelled to Gambia,
Africa, where they run this surgical ward. This year’s mission departs on Nov. 29 for 2.5 weeks. Medicos en Accion are planning
a second mission this spring and are looking for interested surgical team members who may want to join this most rewarding
adventure. Visit www.medicos-en-accion.com for more information or contact President/RIH RN Anna Peron.
Kelowna General Hospital