Central Health celebrates successes in annual report
Rosemarie Goodyear says Central Health has had several success over the past year.
© Andrea Gunn photo
Central Health interim CEO Rosemarie Goodyear poses with a copy of the health authority's annual performance report for 2012-2013. The report was released on Thursday night at Central Health's AGM, held in Grand Falls-Windsor.
At the healthy authority’s annual general meeting on Thursday night, the interim CEO for Central Health, cited improved vaccine safety, better access to telepharmacy services, and continuing efforts in diabetes education as some of those success.
Central Health is comprised of 34 facilities, and provides health care for 94,000 residents in central Newfoundland.
Goodyear said the three key areas of progress for the authority over the past year were: access to service, quality and safety, and healthy aging.
The organization has just completed its second and is embarking on its third year of action for tackling these issues.
Endoscopy wait times
Under the access to service initiative, one major area of accomplishment cited was improvements in wait times for endoscopy services across Central Health.
Dr. Richard Lush, VP of medical services, and wait time manager Tracey MacDonald provided an overview.
“I myself in about 2008 had about 1,400 people waiting for colonoscopies just by me alone. I’m just one of seven endoscopists,” Dr. Lush said, adding it was about that time the provincial government started looking at ways to improve wait times. “We took a look at our own list and realized the demand was far outstripping our capacity.”
Dr. Lush said Central Health took a ‘full team’ approach to cut down on wait times. He said the first step was moving all referrals to one booking clerk to sort and prioritize.
They also implemented a provincial standardized referral form for all incoming referrals, enabling those responsible for booking to determine whether the patient was urgent with a target to be seen within 14 days, non urgent with a target of 60 days, and so on.
MacDonald also highlighted how implementing a no show policy and two-room model have decreased wait times.
One of the most important initiatives within the endoscopy wait time initiatives was the implementation of the colorectal screening program. Patients that fit the criteria can now order a home test kit to enable them to play a role in screening themselves for precancerous and cancerous cells.
This allows Central Health to remove certain people from the colonoscopy waitlist and in some cases, classify their cases as urgent and prioritize them.
“Since June we’ve had 408 patients that came off our list, 82 per cent of them were negative, and that means they didn’t require colonoscopies…so we took over 200 patients off our list. 45 patients from that were positive,” Dr. Lush said. “Outside of identifying numerous patients with precancerous polyps, we identified five cases of colon cancer here in central that would have been otherwise waiting on the screening wait list.
In March, 2012, MacDonald said a patient waiting for an urgent colonoscopy would usually have to wait 211 days before they were seen, and the target is 14 days. Thorough implementing changes, by May of that year, the wait time was reduced to 33 days.
Long term care
With one of the fastest aging populations in Newfoundland and Labrador, it’s no wonder why healthy aging is one of the main areas of attention for Central Health in their three-prong improvement strategy.
Heather Brown presented Central Health’s work in that area over the last year.
“We started in May 2011 really looking at ‘how can we get a picture of what’s happening in long term care and how can we improve,’” she said.
Brown said Central Health consulted with staff in the 11 long term care facilities in the region as well as patients, families and partners to get an idea about the present state of long term care and the feelings of those that deal with the long term care system.
She said the main message that came out of that consultation was, whatever is done, it needs to be done with a resident centered approach where residents and their families come first.
Brown said some of the aim of the health care authority are to improve communication, and increase the profile of long term care so that it is seen as an area of specialty within health care.
“Also really important to our residents is creating a home-like atmosphere so they can feel as comfortable and as close to home as possible,” Brown said.
From these areas of improvement, Brown said Central Health created a long-term care council in the past year to oversee initiatives and to help meet the goals they’ve set.
The council includes staff and support workers, as well as families and partners of patients.
“One of our first orders of business was our development of our philosophy of care,” Brown said. “Our overarching statement is that ‘Central Health believes that the residents that live in our long term care homes and their families must be cared for with compassion and dignity and respect to ensure that their needs are met and optimum quality of life is achieved.”
She said the philosophy was developed through research, as well as from what staff, patients and families told them during consultations.
“We hope to see this not just as a statement on the way but with living breathing people who recognize (this) as guiding principals,” Brown said.
Other initiatives in long term care is trying to increase community involvement for residents by bringing community groups and activities to the residents so that they can continue to be active and engaged citizens. Brown said they’ve also recently finalized a long term care education program that will teach staff members core competencies for working in long term care.
“That’s really important because it says to out staff it’s not just a place to come and work but is a specialty and no matter if you’re a RN, dietitian, a domestic staff, someone who works in the kitchen, we all understand this is a special environment and there are core competencies,” Brown said.
“We’re really excited about our philosophy, I think we’re creating a sense among our long term care homes about the importance of the work that they do and the importance of how that impacts on the day to day care of our residents.
Goodyear also talked about the importance of two surveys conducted over the last year.
A client safety culture survey measured employee’s attitudes and activities associated with client safety, while a client care experience survey measured clients’ experiences post-care.
Patient safety has been one of the organization’s key focus areas for improvement.
“The patient safety work really started with some research back a few years ago, what (we) found was that there were some unanticipated outcomes happening in terms of in-health care,” Goodyear told the Advertiser. She said outcomes could range anywhere from a misidentification for medication to something as serious as surgical errors.
“The way the culture was in health care prior to the patient safety work starting was when those things were discovered, the focus was on individuals,” she said.
Since putting a major focus on patient safety practices, Goodyear said Central Health has made great strides in patient safety culture.
She said they’ve standardized the error reporting process, and research has shown that focus should be on tweaking the systems as a whole to make sure errors don’t occur again instead of just educating one individual.
Other business that arose from Thursday’s meeting included the adoption of minutes from the 2010-11 general meeting, appointment of auditors, and reports from the planning and finance committees, board performance improvement, community advisory committee, and board governance committee.
The full annual report is available through Central Health’s website, www.centralhealth.nl.ca.