Healthy Living in the North

Northern Health MRI Improvements: Shyr Chui and Danita Braun

“Fifteen minutes later I got a call from the MRI booking office, and they told me they wanted me in the next day in the evening… and I was dumbfounded, because I was expecting it to be a 6 week wait for this appointment!”

In this video, we hear from patient Danita Braun, who was thrilled to hear the wait time of her MRI appointment was drastically cut down. Getting the MRI done sooner also meant a change in her care plan which she was thrilled to hear!

Also featured, Shyr Chui, Northern Health Radiologist, mentions how scanning hours have also changed, adding evening times and weekends!

Thanks to additional provincial investments in MRI services across the province, Northern Health is expected to increase the number of MRIs performed by 70% over last year, and an additional 102 MRI hours of operation have been added (between the Fort St. John, Prince George, and Terrace MRI locations).

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Northern Health MRI Improvements: Marina Downs and Margaret Kostyshyn

“This has increased patient happiness, and the morale of our technologists.”

In this video, Marina Downs, Northern Health Diagnostic Imaging Manager, speaks on how the addition of the MRI machine in Terrace has reduced patient wait times and travel, directly affecting the experience of both staff and patients.

Margeret Kostyshyn, a recent UHNBC patient, mentions how her MRI experience was “very positive,” and how the reassuring staff took away her initial fears of the process.

Thanks to additional provincial investments in MRI services across the province, Northern Health is expected to increase the number of MRIs performed by 70% over last year, and an additional 102 MRI hours of operation have been added (between the Fort St. John, Prince George, and Terrace MRI locations).

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Northern Health MRI Improvements: Ken Winnig and Karen Eldridge

“About a year ago, we were only able to do about 7,500 MRIs. Today, we’re on target to do over 13,000.”

There’s some pretty exciting MRI news circulating throughout the North! Since the installation of the two new machines in Terrace and Fort St. John, and a new replacement unit in Prince George, the northern region has seen some pretty incredible results.

In this video, Ken Winnig, Northern Health Regional Director of Diagnostic Services, explains the benefits of the new machines. Additionally, hear from Karen Eldridge, a recent patient, who’s been positively impacted!

Thanks to additional provincial investments in MRI services across the province, Northern Health is expected to increase the number of MRIs performed by 70% over last year, and an additional 102 MRI hours of operation have been added (between the Fort St. John, Prince George, and Terrace MRI locations).

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Thermometers help keep kids out of Dease Lake emergency room

Two staff holding thermometers.
L-R: Amy Bolton, Dease Lake Pregnancy Outreach Coordinator and Anna Fritch, Northern Health Nurse.

When someone goes to the emergency room with a cold or a mild fever, they often end up using some of the time and care needed for people with more urgent health concerns.

Anna Fritch, a nurse in Dease Lake, noticed this trend and decided to do something about it. Her goal was to cut down on the number of unnecessary emergency room visits.

She realized that many people who come to the emergency room don’t have basic health information on how to treat minor illnesses at home.

“I thought, ‘What do I know about taking care of a cold?’ I learned what to do from my mother as a child and how she self-treated us at home,” Anna says.

She realized one problem is that people don’t know where to get health information. Another problem is that people call emergency saying that their child has a fever, but when asked what their temperature is, parents respond that they don’t own a thermometer.

Anna works closely with the pregnancy outreach coordinator in Dease Lake, Amy Bolton. They meet a few times a month to collaborate and share information. When Anna mentioned the issues to Amy, Amy was immediately on board, offering to use some of her budget to buy thermometers.

Anna and Amy now wanted to work out how to give out the thermometers, but also educate people at the same time. They tried to do monthly pre-natal education sessions, but even though Dease Lake is a small town, the turnout wasn’t great.

The next step was to share the information with Dease Lake residents. At a community health fair, Anna provided thermometers, HealthLink BC info on how to take temperatures (children and adults), Northern Health info on treating a child’s fever at home, and a pamphlet from BC Children’s Hospital.

Now, Anna has the same information in her office, along with the thermometers. When a family or an elder comes to the emergency room, she takes the opportunity to educate them about fevers and gives them a thermometer. She teaches them what a fever represents, when to be worried about it, and what to do.

This education “makes a fever less frightening and puts a bit more agency into the hands of families,” says Anna. “People tend to think the moment they’re unwell, there’s nothing they can do.”

“It’s a willingness to partner and support people, but it’s also ‘here’s the tool you need and how to use it.’ These are the situations in which you can help yourself,” says Anna.

Anna says that now, when people call the emergency room to say they’re coming in with a feverish child, they can attach a number to their concern because they’re using a thermometer.

“There’s a difference between hot to the touch and clinically having a fever,” Anna says. “When I did the teachings, I tried to emphasize that ‘I’m giving you the thermometer because when you call me, I want us to be talking about the same thing.’”

Anna and her nursing colleagues are still working on increasing people’s confidence to care for family members themselves. But now, they can objectively measure temperature, which gives Anna and the other nursing staff a talking point to use when they call or come into emergency.

This is a great example of how a simple tool and a little education can help reduce emergency room visits.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Team health care shines in Dawson Creek – because a patient spoke up

The outside of Dawson Creek and District Hospital.

When interprofessional health care teams, emergency rooms, and patients all work together, the result can be great health care. A case in point: a recent story from Dawson Creek.

While he was at the Dawson Creek emergency room for another concern, a patient — let’s call him “Fred”* — asked for a hepatitis B vaccine. Fred also made sure the nurse knew that the interprofessional health care team was involved in his care. This was a key step in ensuring he got the best care.

The emergency department then called the health care team to see if they could get the vaccine for Fred right away, so he wouldn’t have to book a separate appointment.

The answer from the interprofessional health care team was “Yes!” A public health resource nurse working with the team took the vaccine across the street to the emergency department, then helped the ER nurse give it to Fred.

Note: Given that Fred has unique health concerns, this approach made sense for his specific case – but normally, people who need immunizations should book them through their local health unit.

“This spoke to the client engaging in his own health care,” said Deanna Thomas, Manager of Community Services in Dawson Creek. “It shows the value of building relationships with clients so they feel empowered to speak up.”

Patients are a huge part of the solution in health care – high-fives to Fred for making sure the emergency department had all the facts, and to the emergency department and the health care team for their collaboration and quick response!

*Not his real name – identifying details have been changed.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Westbound with Northern Health Connections: A testimonial on riding the bus

A selfie of Fiona on the bus.

When I moved to the Communications department of Northern Health, I was very excited to take on the Northern Health Connections (NHC) program as part of my portfolio. If you’re not familiar with NHC, it’s Northern Health’s bus transportation service for medical appointments: if you have a medical appointment that requires you to travel to Vancouver but you live in Dawson Creek, you’re able to ride a NHC shuttle to and fro. It’s safe, comfy, and very affordable. I had heard all about this service, but what better way to find out what it’s all about than taking the bus myself! So, in the interest of discovery, I recently rode the bus for the first time: Prince George to Smithers, let’s go!

My trip began at a very convenient spot – the University Hospital of Northern BC entrance, where I was greeted by a cheerful driver named Arlene. Arlene was very helpful and extremely courteous. I took my seat in row 2, which I jokingly called “business class,” because trust me, that will be the closest I come to travelling business class! 

On this trip, there were around 18 people on the bus, two of which were seniors. Did you know that if you’re 60 or older, you are able to take the bus without a medical referral? If you’re planning a trip and unsure of who can ride, check out our passenger eligibility requirements.

We promptly left the hospital at 8:02 am heading west. It was pretty crazy to see a shuttle depart relatively on time, but I could tell it was important to the driver to stay on schedule, which is a great feeling as a passenger. If you do use NHC in the future, make sure you arrive at least 15-20 minutes early so the bus can leave at the scheduled time. We hate to see an unfilled seat!

Now, I’ve spent my fair share of time on buses. I have two boys that play hockey, so my husband and I take turns riding the bus with them. Let me tell you, this was nothing like riding the hockey bus! First of all, the noise level on a hockey bus is so loud you can barely hear yourself think. The only noise on this Connections bus was the adorable little seven-year-old that had us all watching Ella Enchanted. What a lovely change of pace, and more importantly, noise level, from the hockey trips I’m so used to!

We drove right through Vanderhoof; no pickups there! Next stop: Fraser Lake. A quick five minute stop here to drop off Red Cross Equipment, a great perk that NHC offers. I also loved the fact that the buses have tray tables and seatbelts. In this day and age, not too many buses have these extra features. It makes a big difference for comfort in the long run!

We then hit our first real stop – Burns Lake. Time to visit the convenience store for snacks, get a bathroom break, or grab a quick lunch. Within 10 minutes, everyone was back on the bus, happy and full, which proved to me this little break was just the right amount of time.

Now, back on the road, we were headed to Smithers! Everyone with full bellies, it was again fairly quiet on the bus. We made a quick stop in Telkwa to drop off two passengers. Then, 10 minutes out of Smithers, our patient, courteous driver offered to drop me off at my hotel instead of making me walk the 20 minute trek from the hospital. Wow, I was so impressed! I gave Arlene a huge thank you and wished her a Merry Christmas!

All in all, the trip went by very fast. There weren’t too many stops, it was very comfortable, and I was able to just sit back and relax. If you have to make a trip for a medical appointment, I’d recommend you try NHC! I would take the bus again in a heartbeat!

Fiona MacPherson

About Fiona MacPherson

Fiona MacPherson was born in Glasgow Scotland, but has spent most of her life in Prince George. She's spent the majority of her career at Northern Health in the IMIT department as a Project Manager, but most recently moved into the Communications department as the Lead for Northern Health Connections and Special Projects. Fiona loves to volunteer in her community and can be found at the local hockey arenas on the weekends watching both her boys play hockey.

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Terrace Health Unit: Better patient care through integrated practice even extends to how medical supplies are organized

Shelves of medical supplies at the Terrace Health Unit.
Newly organized storage shelves for medical supplies at the Terrace Health Unit.

Patient care is a priority, and little things matter. Kristen Gogag, a Primary Care Assistant at the Terrace Health Unit, and her colleague Hayley Lessard, Health Unit Aide, recently reorganized the storage room at the Terrace Health Unit, combining three storage rooms into one.

The reorganization reflects Northern Health’s new integrated approach. “We’re no longer Adult Mental Health, Home and Community Care, and Public Health. We’re all as one, integrated into one department called Community Health,” says Gogag. “So all the supplies we order are for everyone.”

The integrated practice that the storage room now reflects has also resulted in improved patient care. The extra space gives nurses room to fill baskets or bins with supplies needed for client visits ahead of time. “There’s no searching – it’s faster service for clients,” says Gogag.

As well, items that are used the most often, such as catheters and dressings, are stored where they’re easy to find, also resulting in faster service for clients. Additionally, everything is stored with the oldest items (closest to expiry) at the front of the shelves, to ensure supplies are used in time and not wasted.

“It’s been an absolutely amazing thing for our staff,” says Gogag. “Nurses love it – it’s easier for them to take a look at what we have in stock. It looks clean, it’s clutter-free, and it’s easier to maintain. It’s also so much easier to train people. I can tell them an item’s on the second A cart, 2nd shelf, and they can go right there and find it.”

One shelf of medical supplies.
Now everything is stored with the oldest items at the front, to ensure supplies are used in time and not wasted.

There have also been cost savings: Gogag notes that there has been a significant decrease in the amount of supplies they order.

“We used to have double orders and there would be massive overstock,” she says. “Some stock items would be stored in two different places, but now it’s all organized.”

One of the old storage rooms, which she describes as a former “dumping ground,” is now a large office for all the health care workers, and they love it, says Gogag. “They now have enough space. Now our staff room is for everyone — it makes us want to have coffee together,” she says.

The reorganization was facilitated by Marcia Bertschi, a Quality Improvement Advisor at Northern Health’s regional offices in Prince George. It was based on the “Kanban” system developed in Japanese industry, which features cards and other visual cues to organization and ordering.

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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Facility engagement removes silos, improves teamwork in the North

Article submitted by Doctors of BC.

A group of stakeholders at the Change Day event at UHNBC.
Change Day at UHNBC – a group of stakeholders.

Facility Engagement is a provincial initiative of the Specialist Services Committee that aims to strengthen relationships and engagement between health authorities and facility-based physicians, to improve the shared work environment and the delivery of patient care.

Dr. John Smith, Past President of Medical Staff at the University Hospital of Northern British Columbia (UHNBC) and an internal medicine specialist, has been a significant contributor to the work of Facility Engagement since its inception, both as a local physician leader and as a member of the provincial Specialist Services Committee (SSC) Facility Engagement Provincial Working Group.  

Dr. Smith says that the initiative is already fixing some challenges at UNHBC. He noted that administrators are responsible for making budgetary and policy decisions, while doctors are responsible for delivering the expenditure through patient care. “Yet none of the groups were talking to each other,” he says, “which quite obviously was not leading to useful results.”

He says that as a solution, facility engagement has created opportunities and incentives for increased teamwork between the doctors and administrators, who no longer work in isolation. Benefits are already showing in the areas of patient care, physician communication, and relationships with staff and administration.

One example involves solving the difficulties of getting adequate physician coverage for hospitalized patients, because GPs need to return to their individual family practices after morning hospital rounds and may be unable to return later in the day if needed. This is a common challenge at hospitals where GPs see inpatients.

“If the physician is only at the hospital between 8 am and 10 am,” says Dr. Smith, “it’s very hard for teamwork, planning and multidisciplinary rounds to occur. As a solution, we consulted with physicians and Northern Health to establish a general internal medicine unit. It’s a completely new structure developed to foster internal medical care, co-led by a doctor and an administrator.”

Under this unit, internists were recruited to look after the needs of hospitalized patients, and take pressures off of other GPs. The internist is able to make multiple rounds of patient visits, and address urgent concerns when needed in the middle of the day. With clear benefits for patient care, Northern Health was more than happy to collaborate on the project, and fund and sustain the new unit. “It’s simply a better system. The patients who are sick are looked after in a better way,” says Dr. Smith.

Another area of change he emphasized as a result of facility engagement has been improvements in physician communication. For example, internists and family doctors felt that each did not understand the other group’s pressures and needs. “With the help of Facility Engagement, they came together, expressed their concerns and agreed on a set of rules. They have found they have greatly improved communication and collaboration.”

A third area of improved collaboration is within the general hospital community, including staff and administration. Last fall, the entire hospital community convened a “Change Day” in which physicians came together with staff and pledged to change something in the hospital for the better.

“For the first time, something like this happened in Prince George and it was very successful,” says Dr. Smith. A total of 296 pledges were collected, placing Prince George fifth in the province. The main outcome of the event was broad collaboration.

Now that internal collaboration is becoming more firmly established in UNHBC, plans are under way to broaden collaborative efforts through a planning session for all hospitals in the region. “At the moment, Prince George has a lot of effect on Fort St. John, for example,” says Dr. Smith, “but the latter has no real say in Prince George.”

Dr. Smith says that facility engagement is a “very sensible initiative. It has increased the number of physicians who are active in hospital improvements and activities. If you told me three years ago that we’d have 40 per cent of physicians involved, I’d say ’no way’, but it is happening.”

And even though he’s retiring soon, Dr. Smith says that with the exciting opportunities that this initiative has created, “I would love to be starting again!”

Sanja Knezevic

About Sanja Knezevic

Sanja is a communications advisor with Northern Health’s medical affairs department and is based in Prince George. She moved to Canada in 1995 from former Yugoslavia to Fort Nelson where she lived for a few years before moving to Prince George in 2000. Sanja enjoys photography, curling up with a good book, cooking and spending time with her friends and family.

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Creative new approaches help people in Prince Rupert get occupational therapy

Emily Bennett posing with a spectacular mountain landscape view.Northern Health has a strong vision for creating teams of health care professionals that centre on the person and their family, but making big changes can be challenging. This article is my story of bringing better care to people in Prince Rupert.

I’m an occupational therapist (OT). This means I help people solve problems to make it easier and safer to do everyday things:

  • Self-care: getting dressed, eating, or moving around the house
  • Being productive: going to work or school, or participating in the community
  • Leisure activities: sports, gardening, or social activities[i]

The problem

In 2017, I started working as an OT on the community health care team in Prince Rupert. When I started, there was a large backlog of referrals for me, some from as much as three years ago. It was impossible for me to see everyone quickly enough.

This meant a lot of clients were getting by at home without much support. Some of them suffered falls. Others couldn’t leave their homes because they had pain or problems with mobility. Others weren’t using equipment, like walkers, that could have made them safer.

I wanted to set things up so that people could get therapy earlier, before things got serious. This way, we could head off problems before they happened, and we could help keep people independent and out of the hospital.

But, using the normal channels, I didn’t have time to see all the clients. To solve this problem, I had to think creatively and try new things. I’m passionate about quality improvement, so I enjoyed this process. Here are some of the solutions I came up with.

One-time sessions with clients

The community health care team helped me set up sessions with clients. With their support, I was able to set up one-time face-to-face visits with people who needed help. During the visits, I offered education and gave people advice, such as how to use equipment, and also gave them referrals to community resources and programs.

A couple of months later, I checked in with the clients. They reported that they’d made changes based on my advice, and that they now felt safer at home and more confident. Some of them had started using walkers regularly, some had adapted their home setups, and others had asked for more support from family.

This was a great example of how health care teams can work together to improve their practice and build partnerships with other team members.

Really understanding where people needed help

In collaboration with other OTs across Canada, I created a questionnaire called Occupational Therapy Outcome Indicators to measure people’s overall functioning and quality of life. This made it easier to figure out exactly what areas people needed help with so that we could set goals and make recommendations. It also helped clients understand what I, as an OT, could and couldn’t do.

Working with other health care professionals

I also started three other partnerships with health care professionals with the idea of making services more efficient, enhancing collaboration, and making clients more able to cope on their own:

  • Together with a physiotherapist and rehab assistant, I set up a walker clinic.
  • I presented as a guest speaker to the Adult Addictions Day Program.
  • I presented to a falls prevention group at the Prince Rupert assisted living facility.

These programs let me see more clients at once and provide education and treatment in groups.

It was so beneficial to work with the physiotherapist and rehab assistants on the walker clinic. We completed assessments together and this model offered an opportunity for students that were on clinical placements at the time to learn to work collaboratively with other healthcare providers.

Making changes and trying new things can be difficult, but a preventive approach can help people stay safe, independent, and out of hospital. This also helps reduce the demand on the health care system and, most importantly, gives people improved quality of life and better health.

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[i] From https://caot.ca/site/rfs/res_for_students?nav=sidebar

Emily Bennett

About Emily Bennett

Emily is an occupational therapist from Northern British Columbia. She returned to work for Northern Health after completing her Master’s degree in Occupational Therapy in Hamilton, Ontario. She is invested in the well-being of our northern communities and is passionate about quality improvement and health promotion. When she is not immersed in her clinical practice, she enjoys spending time outdoors with her friends, her family, and her dog, appreciating the beautiful nature throughout

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Telehealth bridges the kilometers between patients and doctors: NH Board updated on 5-year plan

Healthcare professionals in a telehealth meeting.Imagine being able to see a specialist without having to travel away from your community. Picture your doctor being able to monitor your condition while you’re in the comfort of your own home. How would it feel to ask for a prescription refill without having to go to a clinic? Telehealth is making these possibilities a reality.

The Northern Health Board of Directors received an update on NH’s 2017-2021 telehealth plan for expanding the clinical use of telehealth to reach more people in more places. Telehealth uses different kinds of technology to provide healthcare right in people’s own communities, with no need for travel. Examples include talking to a specialist by videoconference, sharing tests electronically to another hospital, getting physiotherapy by digital monitoring, and sending data from a monitor (such as a heart monitor) directly to your doctor. Telehealth allows for prevention, screening, diagnosis, determining a course of treatment, and clinical advice – in a way that’s very similar to an in-person experience.

“Telehealth is a virtualization of new and existing services that allows for a more intimate experience than a simple phone call can provide,” said Frank Flood, regional manager of Northern Health’s telehealth department. “By using video and peripheral equipment to extend the reach of clinics and specialists, we reduce the physical and financial burden to our patients.”

A telehealth cart.Many different kinds of health care can be provided by telehealth, including:

  • Mental health and addictions
  • Chronic disease
  • Kidney health
  • Child and youth health
  • Pharmacy services
  • Emergency services
  • Specialist consultations

These services and more will be available to Northern Health patients, depending on where they live (note that not all kinds of telehealth will be available in all communities).

Telehealth will improve care in rural and remote communities, and Northern Health will be partnering with the First Nations Health Authority to use telehealth to benefit Indigenous communities. Telehealth will also strengthen healthcare for the elderly and for people who need services around pregnancy, birth, or childcare. Likewise, it can help people living with chronic disease, mental illness, or addiction.

For the first two years of the plan, financial support for expanding telehealth capacity, including continued investment in staffing, tools, and capital equipment (such as refreshing videoconference suites) will come from NH’s existing operational budget. Funding for increasing the capacity of telehealth will also be sought from outside sources, including the Joint Standing Committee on Rural Issues.

Overall, telehealth will reduce the impact of distance and time in bringing health services to people and their families – Northern Health is excited to provide this new level of health care support to Northerners!

Sanja Knezevic

About Sanja Knezevic

Sanja is a communications advisor with Northern Health’s medical affairs department and is based in Prince George. She moved to Canada in 1995 from former Yugoslavia to Fort Nelson where she lived for a few years before moving to Prince George in 2000. Sanja enjoys photography, curling up with a good book, cooking and spending time with her friends and family.

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