ready or not, here we come! women & babies move set for...
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spotlight on women & babies
spotlight on WOMEN& BABIES
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Issue 8 – Fall 2009
Welcome to the eighth edition of Spotlight on Women & Babies, a newsletter for staff in Sunnybrook’s Women & Babies Program.
You’ll find updates on M-wing construction as well as news of interest to staff and patients in the program.
If you have any suggestions for future content, please drop a line to [email protected] or call 416.967.8554.
Ready or Not, Here We Come!
Women & Babies Move Set for Sunday, September 12, 2010
Jo Watson, Operations Director for the Women & Babies Program and
Dr. Andy Shennan, Program Chief for the Women & Babies Program
reveal the stork’s special message: the Program will move into its
new home at the Bayview campus on Sunday, September 12, 2009.
The team celebrates the announcement of the official move date for
the Women & Babies Program.
Photos by Doug Nicholson.
M-wing Construction is Over 85 Per Cent Complete
Construction of the new facilities for the Women & Babies
Program on M4 and M5 at the Bayview campus is over 85 per
cent complete. Ed Bush, Senior Project Manager in Corporate
Planning and Development provides a unit-by-unit rundown of the
construction at the Bayview campus:
Neonatal Intensive Care Unit (NICU): All partitions are in place
with the first coat of paint. Flooring is down, doors are being
installed and light fixtures are in place within the new ceiling grid.
Tile work is nearing completion behind the sinks in patient rooms.
Millwork is in progress for parents’ sleeping benches and lockers.
Installation of articulating arms is in progress throughout the area.
Work has started on the NICU Staff Lounge, in conjunction with
the installation of the last sections of the exterior glass, finally
possible with the removal of the construction hoist from the east
end of the building. In the NICU Pharmacy, casework is being
installed and new systems furniture are going in.
Continued on page 2
spotlight on women & babies2
Labour, Birth, Recovery and Postpartum (LBRP): The LBRPs
are proceeding quickly, with flooring installation underway, millwork
nearing completion and washroom fixtures being installed. All tiling
in the washrooms is complete, doors are being installed and work
has started on the last two LBRPs at the east end of the building.
Systems furniture for the nursing station is also under way.
Operating Rooms: Ceilings are installed, light fixtures and wall
finishes are completed and the construction crew is preparing to
start the epoxy flooring for the ORs. Flooring in the sterile area
corridor is complete.
A new room for Labour, Birth, Recovery and Postpartum (LBRP)
Look up!
M-wing Galleria Opens Up
As all of the work in the galleria between the 4th to 7th floors is
nearing completion, the contractor has removed the access
scaffolding located above the temporary galleria platform.
Removal of the galleria platform will begin in December. This
means that when staff, patients and visitors enter the M-wing,
they’ll be able to look all the way to the top and see the
impressive work done to date!
A new NICU room An exterior look at the M-wing construction project.
Continued from page 1 High Risk Antenatal Unit: All rooms in the unit are well under
construction, with flooring complete, headwalls installed and
finishes for washrooms nearing completion. Ceiling installation is
underway allowing the installation of lighting fixtures.
Combined Care Unit: Walls for all of the patient rooms are
completely installed, drywall is finished with the first coat of paint,
ceilings are underway, headwalls and flooring are installed and
millwork installation has started, including lockers for patients.
Ambulatory High Risk: All partitions have been built, flooring is
going down and ceilings are being installed.
M-wing Construction is Over 85 Per Cent Complete
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Transition committees have been busy planning for the move to
the Bayview campus in September 2010. Here is a snapshot of
the work of the various transition team sub-committees.
Equipment Committee – The Equipment Committee is preparing
evaluation forms for the items that will be trialed this fall. This
includes over-bed tables, bassinettes, case carts, gyne stretchers
and OB-TVs (fetal monitoring system). The IV Smart Pumps went
live on September 29, 2009 in the Birthing Unit and the NICU will
go live in the spring. New pain pumps (PCA/PCEA) are being
investigated and will hopefully be implemented by the spring.
The NICU has chosen a vendor for their monitors and they will be
installed in the new nursery.
Staffing Committee – The Staffing Committee is in full swing
assessing the orientation and learning needs of all Women & Babies
Program staff. There will be a general orientation for all staff next
summer at the Bayview campus. As the program is changing the
model of care in the Birthing Unit and the NICU, staffing education
needs have changed. Cross-training of nursing staff is almost
complete, with all Birthing Unit nurses completing their Maternal
and Newborn Unit sessions. Four postpartum nurses who were
cross-trained in the Birthing Unit will continue in that unit. Work in
the NICU is focused on preparing for the move from an open bay
NICU to a single room model. The NICU has many new staff over
the past year and orientation is nearing completion.
Obstetrical nurses are continuing to enroll in the Critical Care
Program at George Brown College. To date, eight nurses have
completed the program, which included shifts in the CrCU, CVICU,
and soon the Emergency Department at the Bayview campus.
Seven nurses are enrolled this year. The program is proud to
be holding Journal Clubs which focus on applying critical care
knowledge to the field of obstetrical care.
Communications Committee – The committee has been
examining the communication needs of the Program with the goal of
eventually having a communication tool that will increase efficiency,
ensure safety and save time in our new home. Two members of
the committee are also creating a master list of all the contact
information for Women & Babies Program staff and updating it to
include new contact information after the move. The committee
is also implementing “huddles” twice daily between the NICU,
Birthing Unit and the High Risk Antenatal Unit to ensure timely and
accurate information-sharing is actively in place prior to the move.
Memories and Celebrations Committee – A fundraising walk
marking the move of the Women & Babies Program will be held
next August 22nd, 2010. The walk will coincide with the 30th
annual Preemie Picnic, a celebration for NICU graduates, their
families and staff. The plan is to walk from Queen’s Park (right
around the corner from 76 Grenville) to the Bayview campus
where we will join the Preemie Picnic and make it a huge
celebration. We want to make this a great fundraising success
while marking this memorable occasion. The committee will be
reaching out to families and staff to encourage them to join in
our journey.
Processes Committee – The committee continues to identify
processes that will change with the move and those that will
need modification as the model of care changes.
Family Practice Committee – Family Practice Departments from
Sunnybrook and Women’s College Hospital have been meeting
monthly to determine how they’ll work together in the new space
at Bayview Avenue.
Ambulatory Planning Update – Gynaecology, low-risk
obstetrics and urogynaecology will be located in B6 and B7.
Planning is underway with physicians and construction will start
shortly.
Maternal Fetal Medicine Medical Liaison Committee
(MFMMLC) – Meetings have taken place with representatives
of the medical subspecialties, including endocrine, renal and
other sub-specialties, to determine the logistics of consults
within the program.
Emergency Department Committee – Obstetrical and Neonatal
Guidelines are being drafted by the committee for Emergency
Department staff to use as a reference. Nurse educators Leigh
Andrews and Cheryl Philips have been holding educational
sessions with Emergency Department nursing staff, addressing
issues such as precipitous deliveries and neonatal resuscitation
that may occur in the Emergency Department.
Transition Committee Update
spotlight on women & babies4
Dr. Herbert Wong performed a laparoscopic hysterectomy on
November 18, 2009 that was broadcast live to the annual meeting
of the American Association of Gynecologic Laparoscopists
(AAGL) in Orlando, Florida. The procedure, assisted by Dr.
Romy Nitsch and Dr. Janet Bodley, demonstrated laparoscopic
hysterectomy using laparoscopic suturing techniques for all
major vascular pedicles. This operation is often done using
costly staplers, but using sutures, while more cost-effective,
requires a higher degree of surgical skill and can take a less
expert surgeon more time. Sunnybrook has the largest minimally
invasive gynaecology surgery group in the province, with a
focus on the removal of fibroids (myomectomies), treatment of
advanced endometriosis, incontinence procedures and pelvic
floor reconstruction. The AAGL has a membership extending
to 31 countries and is an internationally recognized authority in
minimally invasive gynecology. There were only five live tele-
surgery cases presented at the conference: three from American
centres, one from Taiwan, and one from Toronto. Congratulations
to Dr. Wong on this honour!
Sunnybrook to Provide 765 New Staff Parking Spots
A new parking garage under construction at the Bayview campus
will provide 765 new parking spots reserved for Sunnybrook staff.
To be completed in June 2010, the garage is located near the
helipad in the east end of the hospital grounds and will bring the
total number of parking spaces for staff to 2515.
“We want to provide as many options for staff when it comes to
parking,” says Solomon Ayeneababa, Manager of Parking and
Transportation Services at Sunnybrook. “Women & Babies staff
will have the option of purchasing a monthly staff parking permit
or a pay-per-use pass which will allow them some flexibility.”
Details on the types of staff parking options can be found on
Sunnynet, under “Facility Services” and then “Parking and
Transportation Services”. Parking and Transportation Services
is also looking at other ways to meet the needs of the increased
staff at the Bayview campus next fall, including adding additional
shuttle buses, possibly to and from Union Station during peak
hours. Stay tuned for more details!
Excellence in Laparoscopic Surgery
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NICU Grad of ’57 Tours the Unit
Marion Deland, Patient Care Manager in the NICU, speaks with mother
Jean Bradley and daughter Cheryl Kallaste, an NICU graduate from
1957. The birth of Cheryl made front-page news when she was born at
30 ounces. Nicknamed “Pee Wee”, Cheryl spent three months in the
NICU and was eventually discharged at 5 pounds, 12 ounces. Mother
and daughter presented the unit with framed copies of news articles
from 1957, focused on Cheryl’s birth and discharge from hospital.
H1N1 Update
From a frequently-asked-question segment on the website, to
a webcast and links to local public health vaccination clinics,
Sunnybrook has been providing our patients and the public with
useful background on pregnancy and the H1N1 virus and H1N1
vaccine.
In early November, the Women & Babies Program began to
vaccinate its pregnant patients. A special thanks to Donna Brown
for helping to organize the vaccination program.
W&B Staff Give Back
Keep your eyes peeled for new ways to give back to the hospital…
the Women & Babies Program has launched several fun new giving
opportunities for staff, including:
• Miglio Designer Jewelry – Staff purchasing items from Miglio
designer jewelry from South Africa will be helping to purchase
equipment for the program’s new home at the Bayview
Campus. Ten per cent of each purchase will be donated to
the Women & Babies Program. Not only do you take home
gorgeous jewelry, but you’re doing it for a great cause!
To view some of the jewelry, please visit www.miglio.com. If
you’ve missed any of the scheduled sales, please contact
Lynnette Eisen at: 705-720-2811 or 705-627-9118 or email
• Change for Change – Don’t forget to drop your spare change
in one of the boxes in the NICU, High Risk Antenatal Unit,
Birthing Unit and Maternal and Newborn Unit. Every little bit
helps, so make sure you collect your change to support the
program.
• Goodies Baskets – Over the coming months, goodies baskets
will be raffled off by each unit and by various disciplines in
the Women & Babies Program. For just $5 for three tickets,
you can enter for a chance to win fun baskets. All proceeds
go directly back to the program.
• W&B Cookbook – Jean Chow and Davina Douglas will be
taking the lead on the Women & Babies cookbook, featuring
staff recipes. This cookbook will be sold to staff, patients and
the community to raise money for the program. Stay tuned
for more details!
• NICU Holiday Bazaar – There will also be a NICU Holiday
Bazaar on Monday, December 21, 2009 from 8 a.m. to 4 p.m.
in the main lobby at 76 Grenville Street. For more information
on how to donate, please email [email protected]
Farwell and Welcome…
Biz Westcott accepted the role of Patient Relations
Consultant in the Patient Relations Office at the Bayview
campus in September 2009. Biz was most recently Patient
Care Manager in the Maternal & Newborn Unit. In her new
role, Biz will be responsible for investigating and following
up on patient concerns. We wish her all the best.
With Biz’s departure, Monica Nicholson has accepted the
role of Patient Care Manager for the Maternal and Newborn
Unit, as well continuing with her role as PCM for the Birthing
Unit.
Aimee Santoro has accepted the administrative leadership
role for the Gynaecology Clinic and 6E until the program
relocates to Sunnybrook. Aimee’s office is in Room 619 and
her phone number is 323-6400 x4438. Aimee will continue
in the role of Nurse Practitioner for the program.
spotlight on women & babies6
Campaign for Sunnybrook:
Women & Babies Program Display Draws Staff, Donor and
Community Interest
Mother Kate Robson with daughter Maggie, who was born at
Sunnybrook in 2005 at 25 weeks and just 500 grams or one pound,
one ounce.
Kathryn Fowles and baby Sebastian, an NICU graduate, celebrate the
campaign launch.
The Women & Babies Program display.
Photos by Doug Nicholson.
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Campaign for Sunnybrook:
Women & Babies Program Display Draws Staff, Donor and
Community Interest
Laura Borges, NICU nurse, Marion Deland, Patient Care Manager in
the NICU and Monica Nicholson, Patient Care Manager for the Birthing
Unit, speak with members of the community at the Women & Babies
Program display.
HPV in the News
Aimee Santoro, Nurse Practitioner, administers the HPV vaccine.
Photo by Doug Nicholson.
Sunnybrook received several media requests regarding HPV and
the HPV vaccine during the fall. Dr. Jennifer Blake spoke with
Global-TV, CTV and CBC-TV The National on the importance of
vaccination and to promote Ontario’s Grade 9 vaccination program.
Media coverage sparked interest from Queen’s Park members,
where George Smitherman sponsored a media briefing for Cervical
Cancer Awareness Week at Queen’s Park featuring Dr. Blake.
The Sunnybrook Foundation announced the public phase of the
Campaign for Sunnybrook on Monday, November 2, 2009, in
M7, the future home of the Centre for Research in Image-Guided
Therapeutics. As part of the launch, programs hosted interactive
displays demonstrating how Sunnybrook saves lives with
innovation. The Campaign for Sunnybrook is a $470 million effort
to bring the space, technology, colleagues and flexible funding
that the hospital’s health care teams need to save lives and invent
the future of health care. To date, $265 million has been raised.
The Women & Babies Program display highlighted “A Woman’s
Journey to Motherhood”, including a gynaecology component,
an obstetrical mannequin with twins and neonatal isolette. Thank
you to the staff who graciously volunteered for the two-day
launch: Laura Borges, Deb Cull-Hollingsworth, Marion Deland,
Erin Limerick, Elizabeth MacMillan-York, Monica Nicholson and
Aimee Santoro.
Painting a True Picture of
Canada’s Maternal Mortality and
Morbidity RatesIt is commonly acknowledged that Canada has one of the lower
maternal mortality and morbidity rates in the world. But, digging
deeper, experts admit that accurate Canadian data on death and
severe illness during pregnancy, childbirth and postpartum is less
than optimal. Existing databases do not allow accurate collection
of maternal mortality or morbidity rates on a national basis. There
is an urgent need for a reliable mechanism to collect this form
of data in Canada, particularly in light of the nation’s increasing
Caesarean section rate which is very likely to be associated with
operative and other complications.
On Wednesday, December 2, 2009, a small working group with
international representation met with the goal of promoting
accurate data collection on maternal mortality and morbidity rates.
This group, led by Dr. Jon Barrett from Sunnybrook, an advisory
member to the World Health Organization (WHO), documented
the next steps for improving data collection. This includes pushing
for every hospital in Canada to use a simple, web-based software
program developed by the WHO that allows reliable data collection
on maternal mortality and “near miss” maternity mortality.
spotlight on women & babies8
Spotlight on Research
Another example currently in development is the Journey to
Home Discharge Checklist. This is a birth to transfer or discharge
communication tool that was designed by families and staff to
support the families’ transition to either home or transfer to a Level
2 peripheral unit. The goal of the checklist is to empower parents
and families in learning to how to care for their baby.
The initiatives are paying off. In the 2008 Transfer Survey, 75 per
cent ‘strongly agreed’ to the statement “Overall I was satisfi ed
with the care my baby received while in the NICU” and 25 per
cent ‘agreed’. In the 2008 Discharge Survey 82 per cent ‘strongly
agreed’ to the statement “Overall I was satisfi ed with the care my
baby received while in the NICU” and 18 per cent agreed.
Survey questions are reviewed annually for clarification and
accuracy, with changes made based on input from families.
Comparisons are made within similar questions over time and
revised questions are introduced as new themes emerge, so
that an ongoing evaluation of the survey truly refl ects families’
perceptions in “real time”. Current survey questions address
issues related to our new NICU.
“These initiatives are a team effort between families and the unit’s
multidisciplinary staff, and result from always trying to fi nd ways
to increase effective communication between parents and families
and the NICU health care team. By giving families many ways to
communicate with us and provide feedback, like the survey, we
can achieve a much higher level of family satisfaction and patient
safety,” adds Laura Borges.
Sunnybrook’s NICU won the Quality and Patient Safety Award at
the 2008 Annual Partners in Paediatric Patient Safety Symposium
hosted by The Hospital for Sick Children.
The NICU Post Transfer and Discharge Surveys reveal that families
are very satisfi ed with the care their babies received in the NICU
during the period from 2006 to 2008. The survey was designed
with a dual purpose: to help build a trusting relationship and to
enhance communication between families and the health care
team. Results show high levels of satisfaction with information
sharing between the NICU team and families; families’ involvement
in their baby’s care and family involvement in decisions regarding
their baby’s discharge and transfer.
Created in 2003, the survey is part of the NICU’s involvement in
“Family Matters”, a Vermont Oxford Network Quality Improvement
Collaborative on Family Centred Care. Designed specifi cally for the
NICU environment, the results are used as a catalyst for evaluation
and improvement. Comprised of 30 questions, the telephone
survey is conducted by the unit’s Registered Nurses and includes
the opportunity for qualitative feedback from families. In 2008,
76 per cent of families completed the transfer survey and 78 per
cent completed the discharge survey.
“What makes this survey so powerful is that families’ responses
actually lead to change and improvement,” says Laura Borges, an
R.N. in the NICU and member of the Quality Assurance Committee
in the NICU. “We were hearing from families that they weren’t feeling
fully prepared for their baby’s transfer to another hospital. One of
the many ways we have improved families’ preparedness with the
transfer process was the creation of the Readiness for Transfer
Checklist. This was developed as a visual cue to give families a good
sense of when their baby is medically ready for transfer to a level 2
nursery closer to the family home. We hope to utilize this checklist
further, by adding a ‘Red, Yellow, Green, Go’ feature when we move
to new unit at the Bayview campus in 2010. This has the potential
to improve families’ knowledge and their level of preparedness
regarding their infant’s medical readiness for transfer or discharge.”
1. H1N1 and Pregnancy Registry: The Women & Babies
Program is collecting data on the outcome of pregnancies
after vaccination for the H1N1 virus. Led by Dr. Jennifer
Blake, the H1N1 registry for the fall and winter of 2009 is
open to all obstetrical patients at Sunnybrook.
2. “Comparison of Abdominal Musculature Thickness
in Postpartum and Nulliparous Women”: This study,
led by Dr. Jon Barrett, will look at the abdominal muscles
after pregnancy in Sunnybrook’s obstetrical patients
between the ages of 20 and 40 years. Abdominal muscles
alternately thicken or thin during pregnancy and this study
will determine the impact on back pain.
NICU Family Survey Leads to Change and Improvement
Family Satisfaction High in the NICU